Claims-made policy for research organisations, drug manufacturers, hospitals, universities, etc., involved in clinical trials. The insurer indemnifies the policyholder in the sums they have agreed to pay to trial participants for injuries regardless of fault. Claimants may prefer to make normal legal liability claims rather than use the agreed arbitration/ compensation processes. If so, the policyholder’s legal liability is covered under a second section of the policy.
Insurance Encyclopedia
Clinician
General term denoting a medical or dental practitioner who has hospital staff admission privileges and primary responsibility for care of inpatients.
Cloning
1. When each entry in a patient’s medical record is worded exactly alike or similar to the previous entries. 2. When medical documentation is worded exactly the same from patient to patient. Cloning is considered a misrepresentation of the medical necessity requirements for insurance coverage of medical services. If suspected or identified, the services will be denied and may result in recovery of any overpayments made.
Close
Conclusion of the sales presentation that leads to the signing of the insurance application.
Close links
A linkage between an FSAauthorised firm and another firm or entity falling into one of a number of defined categories, viz: a parent company; a subsidiary; a subsidiary of a parent company; entities or persons owning or controlling 20 per cent of the voting rights or capital; companies in respect of which the firm owns 20 per cent or more of the voting rights or capital. The FSA is concerned to satisfy itself that, taking account of close links, it can exercise its supervisory function effectively.
Close or closely held corporation
A corporation that is owned by a small number of individuals who are related. A close corporation fills its own vacancies.
Closed access
Managed care plan that requires enrollees to select a primary care physician (PCP) from the plan’s approved panel of providers. The PCP acts as a gatekeeper and may refer the patient to a specialist when required.
Closed Access, Health
A situation where covered insureds or the designated service provider must select one primary care physician. That physician is the only one allowed to refer the patient to other health care providers within the plan. Also called Closed Panel or Gatekeeper Model.
Closed adoption
To take into one’s own family by legal process and raise as one’s own child, but the identifying information about the adoptive and birth families is not shared. The adoptive and birth families do not establish or maintain contact.
Closed claim
Status of an insurance claim when all benefits have been paid.