MEDICAL,USA: Monetary payment awarded in court for actual loss or injury to a person or property sufficient in the amount to indemnify the injured person for the loss suffered. Also called compensatories.
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The award, usually monetary, that is intended to compensate the claimant for injury sustained. In addition to actual loss or injury, this term may include amounts for expenses, loss of time, bodily suffering and metal suffering but does not include punitive damages.
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The total of monetary loss experienced by the injured party are compensatory damages and can include special damages and general damages. The distinction between special damages and general damages is that the former can be calculated accurately from the records of actual expenses incurred or financial losses (e.g., loss of salary etc.) suffered whereas the letter are estimated by courts taking into account a number of factors relevant to individual cases.
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Compensatory damages (Legal Terminology)
Damages awarded to the insured for a loss or injury he or she has suffered. This may include damages given for mental or physical suffering, time lost, or expenses.
Competence (Legal Terminology)
The mental capacity to understand the consequences of entering a contract. This is required to enter a contract with an insurer.
Competency
This is one of the elements that must be present in order to have a legal contract. It relates to the fitness or ability of either of the parties to the contract. An example of incompetency would be an alcoholic or a mental incompetent.
Competent
Individual able to understand and act sanely and reasonably.
Competitive benchmarking
See: benchmarking.
Competitive bidding
A situation in which an insured requests premium quotations on its insurance program from a number of agents/brokers. In some instances, insureds provide agents/brokers with detailed specifications upon which to base their quotations. Under other circumstances, the agents/brokers present proposals for coverage reflecting their own ideas for structuring the insured’s program.
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A situation in which an insured requests premium quotations on its insurance program from a number of agents/brokers. In some instances, insureds provide agents/brokers with detailed specifications upon which to base their quotations. Under other circumstances, the agents/brokers present proposals for coverage reflecting their own ideas for structuring the insured’s program.
Competitive medical plan (CMP)
1. Established by the Tax Equity and Fiscal Responsibility Act (TEFRA). This is a state-licensed health plan similar to a health maintenance organization (HMO) that delivers comprehensive, coordinated services to voluntary enrolled members on a prepaid, capitated basis. 2. CMP status may be granted by the federal government for the enrollment of Medicare beneficiaries into managed care plans, without having to qualify as an HMO. CMPs with Medicare contracts offer Medicare beneficiaries all services covered by fee-for-service Medicare. Medicare pays these plans on a monthly basis for each Medicare beneficiary. Medicare beneficiaries get all Medicare-covered hospital and medical insurance benefits through the plan. The CMP may also collect a premium from each Medicare member enrolled in the plan.
Competitive pricing
Method that uses market information for establishing payment rates that reflect the costs of an efficient managed care plan or health care provider (e.g., competitive bidding that obtains information on costs through the process of bidding).
Competitive state fund
A facility established by a state to sell workers compensation in competition with private insurers.