If in the ordinary course of business or professional affairs a person seeks information or advice from another who is not under contractual or fiduciary obligation to give the information or advice, in circumstances in which a reasonable man so asked would know that he was being trusted, or that his skill or judgment was being relied on, and the person asked chooses to give the information or advices without clearly so qualifying his answer as to show that he does not accept responsibility, then the person replying accepts a legal duty of exercise such care as the circumstance require in making his reply; and for a failure to exercise that care an action for negligence will lie if damage results. With respect to Doctors, the law, as laid down by the Supreme Court of India in L.B.Joshi vs. T.R.Bodbole (1968) is: A person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties, namely, a duty of care in deciding what treatment to give or a duty of care in the administration of that treatment. A breach of any of these duties gives a right of action to the patient against doctor of negligence. Basis of liability is professional negligence which pre-supposes (i) The existence of a duty of care, (ii) A breach of that duty, and (iii) loss or damaged caused by the breach. Classification of Professional Risks : (i) Where professional negligence may result in bodily injuries (fatal or otherwise). Doctors, dentists etc. fall into this group. (ii) Where professional negligence may result in financial loss. Accountants, solicitors etc., fall into this group. And (iii) Where professional negligence may result into financial loss and/or bodily injury. Architect etc. fall into this group.
Insurance Encyclopedia
Modified life
Ordinary life insurance that has premiums during the first few years (usually 5) that are slightly larger than the rate for term insurance. After that time period, the annual premium is higher.
Modified life policy (Life Insurance)
A life insurance policy wherein the premiums are lower than normal to start and stay that way for a period of three to five years. After this time, premiums become higher than normal.
Modified net premiums
Net premiums, other than level, that are lower for the first year and higher in subsequent years.
Modified risk
In life and health insurance, individual whose physical condition is less than standard or who has a dangerous occupation or hobby (e.g., history of stroke or race driver). An additional premium is required because of the possibility of loss from an impairment. Also called substandard risk or impaired risk .
Modified Standard of Care
See: “Professional indemnities: Standard of care, modified.”
Modified work
In workers’ compensation cases, job that has been changed to allow an injured worker to perform (e.g., to alter a workstation so that the job can be done seated instead of standing or to adjust the content of the work to exclude tasks the worker is not able to perform). Also called modified job .
Modified-premium whole life insurance
Type of whole life insurance in which the policy owner pays a lower than normal premium for a certain initial period and then the premium increases to a specific amount that is higher than usual, which is then paid for the life of the policy.
Modifier
1. In Current Procedural Terminology (CPT) coding, a two-character (numeric or alphanumeric) add-on indicator placed after the usual procedure code number to indicate circumstances in which a procedure as performed differs in some way from that described by its usual five-digit code (see Box M-1 ). Also called code modifier . 2. In HCPCS Level II coding, a one- or two-digit alpha or alphanumeric number placed after the usual Level I or II code that helps further describe a procedure or service. Also see Healthcare Common Procedure Coding System (HCPCS) modifiers .Box M-1MODIFIER27372-51 (typed on one line)
Modifier-22
CPT modifier used for unusual procedural services. When the services provided are greater than those usually required for the listed procedure, they may be identified by adding modifier -22 to the usual procedure number. A report may also be appropriate. This modifier may affect reimbursement, depending on the payer.