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Estimated premium

A projected premium amount that is later adjusted.
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A provisional premium subject to final adjustment on ascertainment of the necessary facts. For example, in Workers Compensation Insurance an estimated premium is based on estimated payrolls for the coming year. At the end of the year, final payrolls are determined and the final premium is computed.
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See: Deposit premium.

Estoppel

The legal doctrine that a party may be precluded from denying that certain rights exist if, by behavior or implication that such rights did, in fact, exist, another party has acted upon this information to his or her detriment.
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The legal principle whereby a person loss the right to deny that a certain condition exists by virtue of his having acted in such a way as to persuade others that the condition does exist. For example, if an insurer allow an insured to violate one of the conditions of the policy, he cannot at a later date void the policy because the condition was violated. The insurer has acted in such a way as to lead the insured to believe that the violation did not void the coverage.
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UK: The rule of evidence or doctrine of law that precludes a person from denying the truth of some statement formerly made by him, or the existence of facts, which he has by words or conduct led others to believe. Where an insurer continues to deal with a claim despite knowing of a breach giving him the right of avoidance, he may be estopped from denying liability (Evans v. Employers Mutual (1936)).

Estoppel (Legal Terminology)

A legal term referring to an individual losing the ability to deny the existence of a condition by virtue of his or her behavior. For example, if a health insurer has paid out several claims to an individual with a certain disease in the past, he or she may be estopped from later claiming the disease is not covered, because the insured was reasonably led to believe it was covered.

Estoppels

Legal doctrines that prevent a person from denying the truth of a previous representation of fact, especially when such representation has been relied on by the one to whom the statement was made.

ET

HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating an emergency treatment.

Ethics

Standards of conduct generally accepted as a moral guide for behavior by which an insurance billing or coding specialist may determine the appropriateness of his or her conduct in a relationship with patients, the physician, coworkers, the government, and insurance companies.