Living near to, but not in actual contact with nearby property. Some Insurance policies cover adjoining but not adjacent property. Refer “Adjoining.”
Insurance Encyclopedia
Adjoining
In physical contact with, rather than next to, but not touching. One building is adjacent to another when it is so located that it touches the other building. Contrast with “Adjacent.”
Adjudicate
Processing of an insurance claim by an insurance company through a series of edits for determination of coverage (benefits) and issue of payment to the provider or patient.
Adjudication
A quasi-arbitration where a neutral adjudicator issues an award or decision, binding on the parties, unless unenforceable by the court or an arbitrator. The Housing, Grants, Construction and Regeneration Act 1996 provides a compulsory adjudication scheme in most construction contracts to resolve disputes on an interim basis, to minimise site delays. The adjudicator reaches a decision within 28 days of referral. The decision is binding unless the dispute is finally decided by agreement, or until, on occasions only, there is a fresh hearing by litigation or arbitration. Otherwise the court intervenes if the losing party refuses to honour the adjudicator’s decision. See ALTERNATIVE DISPUTE RESOLUTION.
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MEDICAL, US:
Process of the final determination of the issues involving settlement of an insurance claim as payable, partially payable, or denied; also known as claim settlement
Adjunct codes
CPT codes that are referred to in the Medicine Section as Special Services, Procedures and Reports and fall under the category of Miscellaneous Services. They are important to consider when billing because these codes provide the reporting physician with a means of identifying special services and reports that are provided in addition to the basic services provided such as handling of laboratory specimens, telephone calls, seeing patients after hours, office emergency services, supplies and materials, special reports, travel, and educational services rendered to patients.
Adjunctive dental care
This type of dental care includes dental and oral tissue examination and diagnosis at the request of a physician (MD). It is provided after the physician’s examination and is done to help improve the systemic condition of the whole body and not just one area.
Adjustable feature
A cost modification provision found in some reinsurance agreements. Parties agree to adjust final premium rate or final ceding commissions retrospectively, in accordance with the loss experience, by formulas set forth in the agreement.
Adjustable life insurance
A type of coverage wherein changes to the amount of policy, premium, period, or length are permitted.
Adjustable life insurance policy
Life insurance contract that allows the policy owner to change the policy’s plan by changing the amount of the coverage or premium. The insurance company calculates the plan of insurance based on the chosen death benefit and premium. An adjustable life insurance policy can use a plan that ranges from a term insurance policy of short duration to a limited-payment whole life insurance policy.
Adjustable policies
Policies where, at inception, the insured estimates the size of the risk in terms of a key variable such as turnover or wages as in employers’ liability insurance. The premium is based on this estimate but adjusted up or down at the end of the year when the actual figure is declared by the insured. Any return made to the insured is subject to a minimum premium.