Disputes regarding Insurance claims relating to the amount payable under the Policy are settled through the process of arbitration provided in the Arbitration Act, 1996, as amended up-to-date. The arbitration condition in the Policy gives effect to this position.
Tag: RAW
Amount subject
The maximum amount that underwriters estimate can possibly be lost under the most unfavorable circumstances in any given loss, such as a fire or tornado. Contrast with Probable Maximum Loss.
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Maximum value of property which underwriters estimate can possibly be lost under the most unfavorable circumstances in any given event, such as a Fire. Refer “Loss, Maximum probable.”
Amount-in-controversy (AIC) requirements
In the Medicare program, the dollar amount of a medical service that has been denied and then appealed by the provider and patient to the insurance carrier for redetermination.
Amount, duration, and scope
Medicaid parameters defining a state’s benefits. Because each state has different Medicaid plans, these benefits will vary from state to state.
Amounts made good
The sums contributed as general average contributions to make good general average sacrifices. The allowances or amounts to be made good are formula-based to ensure equity in the adjustment. With expenditure, the amount made good is the expenditure itself.
Amounts paid in error
Payment of a claim in error by an insurer is recoverable if the mistake is of a fact, but not if the payment is by mistake of law. Failure to deduct excesses or apply average are mistakes of fact and can be recovered.