A provision in most D&O insurance policies that applies the deductible under Insuring Agreement B (i.e., coverage for the company to the extent the company indemnifies directors and officers) to any loss for which the company is legally permitted and financially able to indemnify, regardless whether the company actually grants the indemnification. Absent this type of provision, the insured company could simply fail or refuse to indemnify directors and officers (even though the company is legally permitted and financially able to provide the indemnification), thereby causing the loss to be covered under Insuring Agreement A, which typically has a zero deductible. In order to prevent the insured company from avoiding payment of the much larger deductible applicable to Insuring Agreement B, this provision applies the larger deductible if the company can indemnify, whether or not it actually does indemnify. Thus, in order to avoid the directors and officers having to personally fund the large Insuring Agreement B deductible, the insured company must indemnify the directors and officers when it can. If an EPL, fiduciary, or similar policy has different deductibles for indemnifiable and nonindemnifiable loss, those policies may also have a presumptive indemnification provision.
Insurance Encyclopedia
Pretext interview
An interview wherein one party misrepresents his or her identity, the intent behind his or her questions, or the reason for the interview.
Pretreatment review provision
See: predetermination of benefits provision.
Prevailing charge
Fee that is most frequently charged in an area by a specialty group of physicians. The top of this range establishes an overall limitation on the charges that a carrier, which considers prevailing charges in reimbursement, will accept as reasonable for a given service without special justification. In the Medicare program, this factor was previously used in determining payment.
Prevailing charge (Health Insurance)
The standard charge for a service in the geographical area where the insured resides. This amount is used by Medicare to determine benefit amounts.
Prevalence
Number of existing cases of a disease or condition in a defined population at a specific time. Calculation: Divide the number of persons with the disease by the total population of the defined group to obtain the prevalence rate of a disease.
Prevention
Action taken to diminish the onset of disease or an injury such as hand washing, refrigeration of foods, no smoking, little or no alcohol intake, prenatal care, and exercise.
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Elimination of causes of loss.
Prevention of access
See: Denial Of Access.
Prevention of Money Laundering Act (PMLA) 2002
The Prevention of Money Laundering Act 2002 was brought into force from 1st July 2005 when rules thereunder were formulated. The PMLA rules empower finance industry regulators like RBI, SEBI, IRDA to issue sector specific guidelines on AML/CFT. The Objectives of PMLA are (a) Prevention, control and combating activities concerning money laundering, (b) Confiscation of property involved in money laundering and (c) Dealing with matters connected with or incidental to money laundering.
Preventive care
Health care that focuses on disease prevention and maintaining good health such as annual physical examinations, mammograms, Pap smears, prostate and colorectal cancer screenings, and influenza and pneumonia vaccinations. This includes early diagnosis of disease, identification of individuals who are prone to certain illnesses, counseling, immunizations, regular exercise, avoidance of smoking, prudent diet, correction of congenital anomalies, and screening programs. Also called disease prevention and health management.
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This type of care is best exemplified by routine physical examinations and immunizations. The emphasis is on preventing illnesses before they occur.