Group of Reinsurers acting as a cooperative in offering Reinsurance and sharing among themselves, on specified terms, certain Reinsured business.
Insurance Encyclopedia
Reinsuring Clause
Language that describes the coverage agreed upon by the parties, i.e., what is covered and when. The key components are thee: The indemnity aspect of the agreement, the type of business covered, and the method of determining whether a loss falls within the scope of the agreement. Also known as Cover Clause, Business Reinsured Clause and Application of Agreement Clause.
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UK: The clause in a reinsurance contract that sets out the terms under which a claim can be made. It is the reinsurance equivalent of the operative clause.
Reject status
Insurance claim encounter data that did not pass the front-end edit process and the data need to be corrected and resubmitted.
Rejected claim
Insurance claim submitted to insurance carrier that is discarded by the system due to a technical error (omission of erroneous information) or because it does not follow Medicare instructions. It is returned to the provider for correction or change so that it may be processed properly for payment. It cannot be appealed. Also called soft denial .
Rejection
(i) Refusal by an insurer to underwrite a risk. (ii) Sometimes used to refer to the refusal or denial of a claim by an insurer.
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MEDICAL,USA: 1. Refusal by an insurance company to insure an applicant. 2. Refusal by an insurance company to pay an insurance claim. This can occur when a medical service is not a benefit of the health insurance plan.
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A term used for an insurer’s refusal to insure a given risk. This term can also be used to describe the insurer’s refusal to pay a submitted claim.
Rejection insurance
Covers loss due to goods being rejected or condemned by the governmental authorities of the importing state. Insurance is arranged by exporters of consumer goods, including food, that may be perceived to have a health risk. Cover is conditional upon high standards of quality control in the country of origin.
Rejection Risks
Rejection risk Insurance is a form of supplementary coverage offered by the Insurer only to selected clients. This Insurance is concerned with any rejection or condemnation by the government of the country importing edible foods.
Rekindle
To reignite after extinguishment.
Related cases
Clinical cases that have medical procedures with the same diagnosis, same operative area, and same indication.
Relation of earnings to insurance (Health Insurance)
A clause stating that if the insured’s disability income exceeds the income he or she earns, upon disability the benefits will be reduced to the appropriate amount and premiums that were paid toward excess coverage will be refunded to the insured.