1. Federal regulations require states to use an EQRO to review the care provided by capitated managed care entities. EQROs may be a quality improvement organization (QIO) program, another entity that meets peer review organization requirements, or a private accreditation body. 2. Organization with which a state contracts to evaluate the care provided to Medicaid-managed eligibles. Typically, the EQRO is a peer review organization. It may conduct focused medical record reviews targeted at a specific clinical condition or broader analyses on quality. Although most EQRO contractors rely on medical records as the primary source of information, they may also use eligibility data and claims/encounter data to conduct specific analyses.
Insurance Encyclopedia
External transfer
Occurs where a pension sharing order has been made and the former spouse is not able to make an internal transfer to the members scheme because dual membership is not permitted. Consequently an external transfer must be applied to the pension credit.
Extinguishment damage
Damage caused by water and other extinguishing agents used to extinguish and contain fires. Such damage is the natural and probable consequence of the fire and so is a part of the fire damage.
Extirpate
To surgically remove foreign body, organ, or unwanted tissue from the body.
Extortion
Surrender of property away from the premises as a result of a threat to do bodily harm to the named insured, relative, or invitee who is being held captive.
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Extortion is robbery if the offender, at the time of committing the extortion, is in the presence of the person put in fear, and commits the extortion by putting that person in fear of instant death, of instant hurt, or of instant wrongful restraint to that person, or to some other person, and, by so putting in fear, induces the person so put in fear then and there to deliver up the thing extorted. (The offender is said to be present if he is sufficiently near to put the other person in fear of instant death, of instant hurt, or of instant wrongful restraint. Refer also: “Robbery.” Refer also “Theft.”
Extortion coverage form (Criminal)
Commercial crime insurance that covers loss of cash, securities, and other goods as a result of extortion.
Extortion Insurance
Covers loss due to surrender of money or other property to someone threatening to do bodily harm to persons being held captive or to do damage to buildings. Also See Also: “Kidnap-Ransom Insurance.”
Extra charges
Marine insurance term referring to the expenses incurred by the insured in proving a loss, e.g. survey fees, auction or sale charges. The insurer pays them only if the claim is admitted. However, where a survey is carried out on the instructions of the insurer, e.g. by the Salvage Association, this will always be paid by the insurer.
Extra Charges for Loss
Those charges e.g., survey fee incurred in order to ascertain the extent of loss or damage. These are paid in the first instance, by the claimant. If the claim is admissible, these are reimbursed to him by the insurer.
Extra Contractual Obligations (ECO)
Damages awarded by a court against an insurer which are outside the provisions of the insurance policy, due to the insurer’s bad faith, fraud, or gross negligence in the handling of a claim. Examples are punitive damages and losses in excess of policy limits.
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A generic term that, when used in reinsurance agreements, refers to damages awarded by a court against an insurer that are outside the provisions of the insurance policy, due to the insurer’s bad faith, fraud, or gross negligence in the handling of a claim. Examples are punitive damages and losses in excess of policy limits.