Loss in excess of the working layer, usually of such magnitude as to be difficult to predict and therefore rarely self-insured or retained.
Insurance Encyclopedia
Catastrophic plan
See: catastrophic coverage.
Catchment area
1. Specific geographic area in which a managed care plan enrolls its members. 2. In the TRICARE program, a certain region defined by ZIP codes that is approximately 40 miles in radius surrounding each U.S. military treatment facility. Also called service area.
Catchment area management (CAM)
System in which medical services planning and resource budgeting are based on the population in a specific geographic area in which a managed care plan enrolls its members.
Categorical programs
Federal health programs created to benefit a certain group of people (e.g., Medicare for elderly and some disabled individuals and Medicaid for the indigent).
Categorically needy
Classification in the Medicaid program of aged, blind, or disabled individuals or families and children who meet financial eligibility requirements for Aid to Families with Dependent Children, Supplemental Security Income, or an optional state supplement.
Categories
One of the divisions of the Current Procedural Terminology (CPT) code book. The book is divided into seven code sections and appendices. Within each of the main sections are subsections and categories divided according to anatomical body system, organ, or site; procedure or service; condition; and specialty.
Category
1. Three-digit code that represents a single disease or a group of closely related conditions in the diagnostic code book titled International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) . 2. Letter with two digits that represents a single disease or a group of closely related conditions in the diagnostic code book titled International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Also referred to as three-character category.
Category III CPT codes
Procedure codes in the Current Procedural Terminology (CPT) code book that end with the letter “T.” They are temporary codes for emerging technology, services, and procedures and must be used instead of a Category I unlisted code.
Cattle Insurance
This Insurance provides cover against death of animals like bulls, buffaloes, cows etc., within the geographical area specified in the Policy arising from any disease (inclusive of Rinderpest, Black Quarter, Hemorrhagic Septicemia, foot and mouth disease subject to vaccination against these diseases), surgical operations, or accident including Fire, Flood, Cyclone, Famine or any other fortuitous circumstances contracted or occurring after the commencement of the Insurer’s liability under the Policy. The indemnity payable under the Policy is the loss which the insured suffered by the death of the animal but not exceeding the sum insured by the Policy. Cattle refers to (a) milch cows/buffaloes, (b) female calves/crossbred heifers, (c) stud bulls and (d) bullocks. Livestock refers to other animals like camels, work horses, ponies, mares, mules, yaks, donkeys, sheep, goats, pigs, rabbits etc. Death or loss due to malicious or willful act, negligence, overloading, unskilled treatment, use of the animal other than stated in the policy, intentional slaughter, transport by air or sea, transit beyond 80 kms by road or rail, theft or clandestine sale, missing of the insured animal, partial disablement whether permanent or temporary, permanent total disablement which in case of milch cattle results in permanent and total incapacity to conceive or yield milk, in case of stud bulls results in permanent and total incapacity for breeding and in case of bullocks results in permanent and total incapacity for the purpose of use mentioned in the proposal, war, nuclear and allied perils is excluded. Similarly, no tag no claim. Death of the animal due to disease within 15 days from the inception of the policy. Blanket policies can be issued subject to monthly declaration to be submitted by a client who maintains records of each animal, illness suffered, treatment provided and vaccination etc. in the normal course of his business.