Rating method in which premiums are based on the average health care costs within a specific geographical region as modified by rating factors such as age and sex that have been filed with the state insurance department.
Tag: RAW
Modified Competitive Bidding for Risk Management
A process under which the risk manager invites producers and Insurers to suggest Insurance coverage that will best meet the needs of his firm subject to some broad directives and cost considerations.
Modified contribution rate
See: RECOMMENDED CONTRIBUTION RATE.
Modified endowment contract (Life Insurance)
An endowment contract wherein the amount to be paid out after the endowment period is greater than the face value of the policy. The amount payable in the case of death is either the face value or the cash value, whichever is greater. This type of contract is taxable and subject to any penalties after tax.
Modified fee for service (Health Insurance)
A process wherein reimbursements for the actual cost of each procedure are made, up to a certain maximum.
Modified fee-for-service
Third-party payer system in which physicians are paid for a unit of service provided with a set maximum fee for each service.
Modified fire resistive construction (Property Insurance)
A building constructed of masonry materials or otherwise fire-resistant supplies on the outside walls, roof, and floor surfaces.
Modified job
See: modified work .
Modified Legal Position for Standard of Care
If in the ordinary course of business or professional affairs a person seeks information or advice from another who is not under contractual or fiduciary obligation to give the information or advice, in circumstances in which a reasonable man so asked would know that he was being trusted, or that his skill or judgment was being relied on, and the person asked chooses to give the information or advices without clearly so qualifying his answer as to show that he does not accept responsibility, then the person replying accepts a legal duty of exercise such care as the circumstance require in making his reply; and for a failure to exercise that care an action for negligence will lie if damage results. With respect to Doctors, the law, as laid down by the Supreme Court of India in L.B.Joshi vs. T.R.Bodbole (1968) is: A person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties, namely, a duty of care in deciding what treatment to give or a duty of care in the administration of that treatment. A breach of any of these duties gives a right of action to the patient against doctor of negligence. Basis of liability is professional negligence which pre-supposes (i) The existence of a duty of care, (ii) A breach of that duty, and (iii) loss or damaged caused by the breach. Classification of Professional Risks : (i) Where professional negligence may result in bodily injuries (fatal or otherwise). Doctors, dentists etc. fall into this group. (ii) Where professional negligence may result in financial loss. Accountants, solicitors etc., fall into this group. And (iii) Where professional negligence may result into financial loss and/or bodily injury. Architect etc. fall into this group.
Modified life
Ordinary life insurance that has premiums during the first few years (usually 5) that are slightly larger than the rate for term insurance. After that time period, the annual premium is higher.