1. Pertaining to voluntary ending of an insurance agreement by the insured (policyholder). 2. Related to a provider withdrawing from treating a patient.
Insurance Encyclopedia
Withdrawal provision
Clause in a universal life insurance or annuity policy that allows the policy owner to reduce the amount in the policy’s cash value by taking that amount in cash. Also known as partial surrender provision .
Withdrawal reinsurance
See: REINSURANCE WITHDRAWAL.
Withhold
1. Portion of the monthly capitation payment to physicians retained by the health maintenance organization (HMO) until the end of the year to create an incentive for efficient care. If the physician exceeds utilization norms, he or she will not receive it. Also called withhold incentive . 2. Percentage of payment or set dollar amounts that are deducted from the payment to the physician group/physician that may or may not be returned depending on specific predetermined factors.
Withhold fund
Account established to cover use of medical services that exceed the managed care plan budget. The funds are given to participating providers when medical services do not exceed the budget.
Withhold incentive
See: withhold .
Withhold pool
Total amount that a health maintenance organization (HMO) retains from the providers’ payments until the end of the year. Cost of referrals and medical services that are considered excessive are held back by the HMO.
Without prejudice
Phrase used during the negotiations of third party claims settlements indicating that liability is not admitted. Statements and offers made ‘without prejudice’ cannot subsequently be used in evidence at court proceedings.
***
(i) An ex-gratia settlement made by an underwriter on condition that such action shall not be used as a basis for settling a similar loss in the future. (ii) In all correspondence with the insured relating to a claim, the Insurers incorporates the words “without prejudice” on the top. The effect of these words is that whatever action the Insurers may take in the processing of the claim, they reserve their right to deny liability ultimately if they are legally entitled to do so.
Without profits policies
Whole life or endowment policies that guarantee a fixed sum on death or, in the case of endowments, survival without any bonus addition. They are also called non-participating policies as they do not participate in the insurer’s profits.
Without proportion
Indicates that if an annuitant dies during the interval between two annuity payment dates, there will be no payment for the period between the payment preceding death and the date of death.