A risk falling outside normal underwriting standards. If written at all, it is usually with a substantial premium surcharge.by Congress in 1980. Under this law, parties found responsible for polluting a site must clean up the contamination or reimburse the EPA for doing so. Liability is strict, retroactive, joint and several.
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US: An individual, who, because of health history or physical limitations, does not measure up to the qualification of a standard risk.
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MEDICAL, US: See: modified risk .
Insurance Encyclopedia
Substandard Risk (Impaired Risk)
A risk with higher than average probability of loss, such as a person with a physical impairment who applies for health insurer or a person with a bad driving record who applies for auto insurance.
Substandard risk class
Insured classification of individuals whose physical conditions are less than standard or who have a dangerous occupation or hobby. An additional premium is required because of the likelihood of loss from an impairment.
Substantial comorbidity
Medical condition that coexists with the primary cause for hospitalization (principal diagnosis) and affects the patient’s treatment and length of stay by at least 1 day in approximately 75% of the cases.
Substantial complication
Condition that occurs during the hospitalization and prolongs the length of stay by at least 1 day in approximately 75% of the cases.
substantial financial risk (SFR)
Incentive arrangement that places the physician or physician group at risk for amounts beyond the risk threshold, if the risk is based on the use or costs of referral services. The risk threshold is 25%. However, if the patient panel is greater than 25,000 patients, then the physician group is not considered to be at substantial financial risk because the risk is spread over the large number of patients. Stop loss and beneficiary surveys would not be required.
Substitute agent
A person or body appointed in accordance with part K of the Underwriting Byelaw.
Substituted expenses
Expenses incurred to prevent or reduce a loss for which the marine insurer would have been liable. The expenses may not qualify as general average expenditure but they can substitute for expenses that do qualify. If the substitution shows a saving, the substituted expenses are allowed in general average.
Substitution
The replacement of one insurer by another, as where the first ceases to underwrite.
Subterms
1. In the ICD-9-CM diagnostic code book, words or phrases that appear under a main term and identify site, type, or etiology for diseases, conditions, or injuries. 2. See modifying terms.