Expenses that are insured as a part of the gross profit item under a business interruption insurance. They relate to expenses that will continue despite the interruption in the business, e.g. rent and interest payments. See SPECIFIED WORKING EXPENSES.
Insurance Encyclopedia
Untraced Drivers Agreement
Agreement between the Motor Insurers’ Bureau and the government under which the MIB compensates the personal injury victims of negligent motorists who remain untraced. The deliberate running down of victims is outside the scheme as compensation is available from the Criminal Injuries Board.
Unusual expenses
In life reinsurance, non-routine expenses of the cedant for claims investigation, legal defense or rescission actions. The reinsurer typically agrees to pay such expenses as distinct from punitive, exemplary or other non contractual expenses that it does not agree to pay.
Unusual procedural service
Procedure or service that is unique or an atypical finding that affects the patient’s treatment. When billing for an unusual procedural service, a -22 modifier is appended to the usual five-digit CPT procedure code when the service provided is greater than that usually required for the listed procedure.
Unvalued policy
Property insurance in regard to which the amount to be paid on a total loss has not been agreed. The parties fix a sum insured representing the insurer’s maximum liability otherwise claims are to be dealt with on an indemnity basis subject, often, to pro rata average. Marine Insurance Act, s.16, provides a basis of valuation for the insurance of hulls, cargoes and freight, etc., which, in the absence of any agreed value, must be used for the purpose of indemnifying the insured. Hulls and cargoes are invariably insured under valued policies but freight is generally insured under unvalued policies. See VALUATION CLAUSE.
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A property insurance policy where the sum insured has not been agreed by the insurer in advance as the actual value of the property. In the event of a loss, therefore, the value is open to discussions with a view to the insured being indemnified against his true loss up to the sum insured.
Unwitting CMR
Unknowing participation by a carrier in a CMR contract. Occurs when a road carrier accepts goods for part of a European road carriage between different countries when a single CMR contract governs the complete carriage. Each successive carrier, even if not crossing a national frontier, becomes a party to the contract and liable under CMR even if not aware of the contractual situation.
UP
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating three patients served.
Upcode
See: upcoding .
Upcoding
Deliberate manipulation of Current Procedural Terminology (CPT) codes for increased payment by using a code for a higher payment than the code for the service performed (e.g., a podiatrist who performs a simple nail clip service but bills for foot surgery). Under the False Claims Act, providers who are caught upcoding face a civil monetary penalty of $5,000 to $10,000 per service. In addition, the federal government can make an assessment against a provider of up to three times the service claim amount as repayment for a Medicare case. Also called code creep or overcoding .
Update
Annual adjustment of the Medicare fee schedule to raise or lower base payment amounts to allow for changes in cost of living by determining the relative values of new and revised procedure codes. See Medicare economic index (MEI) and Medicare Volume Performance Standard (MVPS) .