Medical underwriting is a process which is used by the insurance companies to determine the health status of an individual applying for health insurance policy. This health information collected is then evaluated by the insurers to determine whether to offer coverage, up to what limit and on what conditions and exclusions. Thus, medical underwriting can determine the acceptance of declining of a risk and also the terms of cover.
Insurance Encyclopedia
medical-legal (ML) evaluation
In workers’ compensation, the independent assessment of an employee that results in the preparation of a narrative medical report prepared and attested to in accordance with the state labor code. It must be performed by either a qualified medical evaluator, agreed medical evaluator, or the primary treating physician for the purpose of proving or disproving a contested workers’ compensation claim.
Medical-legal expense
Any costs and expenses incurred by or on behalf of any party, the administrative director, the board, or a referee for x-rays, laboratory fees, other diagnostic tests, medical reports, medical records, medical testimony, or interpreter’s fees, for the purpose of proving or disproving a contested workers’ compensation claim.
Medical-legal testimony
In workers’ compensation cases, expert testimony given by a physician at a deposition or appeals board hearing about the medical opinion submitted by the physician.
Medical-only claim
In workers’ compensation cases, a claim in which time lost from work does not exceed 7 calendar work days.
Medical-surgical nursing
Nursing care of adult patients whose conditions or disorders are treated pharmacologically or surgically.
Medical-surgical procedures
Phrase that refers to the services provided by a physician. Sometimes abbreviated as med-surg.
Medically (or psychologically) necessary services
Medical or psychological services that are considered appropriate care; that meet standards of good medical practice; that are generally accepted by qualified professionals to be reasonable and adequate for the diagnosis and treatment of illness, injury, pregnancy, and mental disorders; that are not provided mainly for the convenience of the patient or the physician; or that are reasonable and adequate for well-baby care.
medically dependent children’s program (MDCP)
Medicaid program that provides a variety of services (nursing and respite) to support families caring for medically dependent children in their homes to encourage deinstitutionalization of children in nursing homes.
Medically driven
In a workers’ compensation case, issues that require medical information for decision-making.