1. Request process to reconsider a decision by an insurance plan after a first appeal. 2. In the Medicare program, the first step for an appeal is called redetermination (telephone, letter, or CMS-20027 Form) and the second step after a first appeal is called reconsideration.
Tag: RAW
Appeal rights
Right of an individual or provider to ask for a review of the case for a possible change in the decision.
Appeals board
In workers’ compensation cases, this phrase refers to the Workers’ Compensation Appeals Board (WCAB) of the Division of Workers’ Compensation in each state.
Appearance allowance (Vehicle Insurance)
Money given to the insured to keep a part of the vehicle that is barely damaged.
Appellant
Individual who appeals a claim decision.
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The person making an appeal to the higher court.
Appellate
Refers to courts which hear appeals for review of decisions rendered by a lower court.
Appellee
Also called the respondent. The person to whom the appellant is making his appeal.
Apple Plantation Insurance
Indemnifies the insured the plantation input cost for total loss of apple plant and/or damage to fruit, when loss occurs due to fire and allied perils. The indemnity is the amount arrived at after applying percentage of loss to sum insured, franchise, excess etc. Policy also covers loss of inputs cost incurred by way of damage to fruit which is assessed by applying percentage of loss to sum insured. Coverage is available for only trees between age of 1 to 30 years to regularly bearing orchards only. Intercropping involving rice, wheat, maize and potato not allowed. In the event adverse climate prevails at the time of blossoming the insured shall resort to hand pollination or any other suitable technique.
Appleton rule
A rule requiring every insurer in New York to comply with the New York Insurance Code. If the insurer does business in any other state, he or she must still comply with this code.
Applicant
1. Person applying for insurance coverage. 2. Practitioner, provider, or supplier that is applying for a Medicare national provider number.