Health insurance plan in which the insured pays 100% of all medical bills until he or she reaches the annual deductible and then the insurance company pays a percentage of covered benefits up to a maximum amount. Most indemnity plans pay 80% of total charges, leaving policyholders with a 20% coinsurance. The insured may obtain care from any health care provider and the provider is paid each time a service is rendered on a fee-for-service basis. The insured pays a fixed monthly premium, but these plans are more expensive than a managed care plan. These plans often provide coverage only for medically necessary doctor visits and not preventive care. A “pure” indemnity plan has no controls on utilization or price; a “managed” indemnity plan incorporates some utilization review and case management. Schedule of allowances, table of allowances, and usual, customary, and reasonable (UCR) are examples of indemnity plan fee schedules. Also known as indemnity insurance, conventional group insurance , and traditional insurance .
Tag: RAW
Indemnity Principle
Of a general legal principle related to insurance which holds that the individual recovering under an insurance policy should be restored to the approximate financial position he was in prior to the loss.
Indemnity reinsurance
A form of reinsurance under which the risk but not the administration is passed to the reinsurer that indemnifies the cedant for losses covered by the reinsurance agreement or treaty. The cedant retains its liability to and its contractual relationship with the insured.
Indemnity schedule
See: schedule of allowances , fee schedule , and usual, customary, and reasonable (UCR) .
Indented codes
In ICD’9’CM, codes listed after stand-alone codes whose descriptions have a dependent status. To read the description, you must first read the description of the stand-alone code that comes before the semicolon (;) and then continue with the indented description listed by the subsequent code (indented code).
Indenture
A deed to which two or more persons are parties and under which they enter into obligation towards each other. It is an agreement in Writing Independent contractor:
Independent Action
A move by which a member of a shipping conference elect to depart from the specific service rates set forth by the conference, giving ten calendar days’ notice of such action. The conference member’s new schedule of rate or rates, officially takes effect no later than ten days after receipt of notice by the conference.
Independent adjuster
An adjuster who works for various insurers to scrutinize and settle claims. These adjusters are independent contractors, who may work for other types of companies.
***
An individual or member of a firm who contracts with insurers to investigate claims and suggest appropriate settlements. Contrast with Public adjuster.
***
One who is licensed by IRDA and adjusts losses on behalf of companies but it not employed by any one. He is paid by fee for each loss adjusted.
Independent Adjustor
Claims adjustor who offers his or her services to insurance companies and is compensated by a fee.
Independent agency system
A system for the distribution of insurance through independent contractors. The agents work on a commission basis for insurers they have contracted with to sell or provide service on insurance policies.