Type of insurance protecting physicians, surgeons, nurses, and other medical practitioners against claims alleging failure to perform.
Insurance Encyclopedia
Medical malpractice insurance
US: Coverage for the acts, errors, and omissions of physicians and surgeons, encompassing physicians professional liability insurance, hospital professional liability (HPL) insurance, and allied healthcare (e.g., nurses) professional liability insurance. Although the majority of policies are written with a claims-made coverage trigger, such coverage is sometimes available on an occurrence basis. Typical exclusions are for are for intentional/criminal acts, punitive damages, sexual misconduct, and specialized procedures (e.g., radial keratotomy) for which coverage may be “bought back” in return for additional premium. In addition to commercial insurers, medical malpractice coverage is also available in most states through physician-owned insurance companies known as “bedpan mutuals.”
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MEDICAL,USA,REFERENCE: See: professional liability insurance (PLI) and malpractice insurance .
Medical management
System employed by health insurance and managed care plans that uses administration and policy and the individuals who make the decisions and supervise to achieve business objectives and reduce costs and use of health care services.
Medical meaningfulness
Phrase used in statistics that explains patients in the same diagnosis-related groups (DRGs) that are anticipated to have a set of clinical responses that result in a comparable pattern of use of medical services and supplies.
Medical model of health care delivery
Medical care given only when an individual is ill with emphasis on the diagnosis and treatment of disease instead of health promotion and prevention of disease.
Medical necessity
1. Performance of services and procedures required by the patient, indispensable, and consistent with the diagnosis in accordance with standards of good medical practice, performed at the proper level, and provided in the most appropriate setting. Medical necessity must be established (via diagnostic and/or other information presented on the individual claim under consideration) before the carrier may make payment. 2. Cal. Wel. & Inst. Code 14059.5 defines medical necessity when it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain. Also see medically necessary care .
medical nutrition therapy (MNT)
Specific nutritional procedures including assessment, counseling sessions, and interventions in the treatment of an acute or chronic illness, injury, or disease condition. MNT is provided by registered dietitians (RDs) and state-licensed dietitians.
Medical Payments
Will pay reasonable expenses incurred for necessary medical and /or funeral services because of bodily injury caused by accident and sustained by you or any other person while occupying a covered automobile.
Medical payments coverage
See: no-fault insurance .
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a Coverage found in auto and liability policies that Pays medical expenses to injured persons without regard to liability.
Medical Payments Insurance
US: A coverage, available in various liability insurance policies, in which their insurer agrees to reimburse the insured and others, without regard for the insured’s liability, for medical or funeral expenses incurred as the result of bodily injury or death by accident under specified conditions.
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A form of coverage, optional in Automobile and other Public Liability Policies that provides for the payment of medical and similar expenses without regard for liability.
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MEDICAL,USA: Liability insurance coverage in which the insurance company agrees to pay the insured and others, subject to a limit, for medical, surgical, hospital, and funeral expenses sustained because of bodily injury or death by accident regardless of whether the insured is liable or not. Usually this type of coverage is included in automobile and other public liability policies.