A clause found in reinsurance contracts providing that, upon the happening of some specified condition or event, such as the insolvency, merger, loss in credit rating or decline in policyholder surplus of one party, the other party may fully terminate the contract earlier than would otherwise be required, had such condition or event not happened. The clause should state which party may initiate the termination, the notice requirements, the triggering conditions or events necessary, the effective date of termination, and the method of terminating existing business (i.e., whether on a cut-off or run-off basis). Termination by the reinsurer of a contract may be detrimental to the liquidation of a ceding company and may be rejected by regulators.
Insurance Encyclopedia
Special types
Generic term used by motor insurers to describe vehicles or mobile plant designed for special purposes, e.g. bulldozers, diggers, etc. They may be insured under motor (particularly for Road Traffic Act purposes), engineering or public liability policies. ‘Tool of trade’ risk is covered when they are used on site.
Special waiver clause
Professional indemnity clause whereby the insurer agrees not to exercise their right of avoidance where the insured shows that any non-disclosure or misrepresentation of facts or untrue statement at inception or any subsequent renewal was entirely innocent. Where the nondisclosure prejudices any claim, the insurer is able to reduce the amount payable to the sum that would have been payable in the absence of such prejudice.
Special Warranty Deed
A warranty only against the acts of the grantor himself and all persons claiming by, though, or under him.
Specialist physician
Medical doctor who has received training in a specific area of medicine and who treats only certain parts of the body, certain health problems, or certain age groups such as cardiovascular surgeon, dermatologist, and endocrinologist. These doctors are board certified by doing additional advanced residency training followed by several years of practice in the specialty and then passing a specialty board examination. Members of managed care plans usually need approval from their primary care physician to see a specialist.
Specialist referral authorization
See: referral authorization .
Specialty
A contract under seal.
Specialty capitation
System of payment used by a managed care plan in which a specialist provider is paid a fixed, capitated fee for giving medical services.
Specialty care
Health care services that a medical specialist provides (e.g., cardiologist, dermatologist, orthopedic surgeon).
Specialty case rate
Flat fee paid to a medical specialist for all medical services or procedures.