BANKRUPTCY |
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Bankruptcy is a legally declared inability or impairment of ability of an individual or organization to pay their creditors. A declared state of bankruptcy can be requested by creditors in an effort to recoup a portion of what they are owed; however, in the overwhelming majority of cases, the bankruptcy is initiated by the bankrupt individual or organization.
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CLAIMS |
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A claim is a legal action to obtain money, property or the enforcement of a right protected by law against another party.
Individuals and businesses purchase insurance policies to protect against monetary losses. In the event of a loss, policyholders submit claims, or requests for payment, seeking compensation for their loss. Adjusters, appraisers, examiners, and investigators work primarily for property and casualty insurance companies, for whom they handle a wide variety of claims alleging property damage, liability, or bodily injury. Their main role is to investigate the claims, negotiate settlements, and authorize payments to claimants, all the while mindful not to violate the claimants rights under Federal and State privacy laws. They must determine whether the customers insurance policy covers the loss and how much of the loss should be paid to the claimant. Although many adjusters, appraisers, examiners, and investigators have overlapping functions and may even perform the same job, the insurance industry generally assigns specific roles to each of these claims workers.
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CONTRACT & MISC. SURETY |
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A surety is a person who agrees to be responsible for the debt or obligation of another. The situation in which a surety is most typically required is when the ability of the primary obligor or principal to perform its obligations under a contract is in question, or when there is some public or private interest which requires protection from the consequences of the principal's default or delinquency. In most common law jurisdictions, a contract of suretyship is subject to the statute of frauds (or its equivalent local laws) and is only enforceable if memorialized by a writing signed by the surety.
A surety bond is a contract between at least three parties: (i) the principal, (ii) the obligee, and (iii) the surety. Through this agreement, the surety agrees to make the obligee whole (usually by payment of money) if the principal defaults in its performance of its promise to the obligee. The contract is formed so as to induce the obligee to contract with the principal, i.e., to demonstrate the credibility of the principal.
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DEPOSITIONS |
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In law, a deposition is the act or fact of taking sworn testimony, outside of court, in certain well-defined circumstances. It is a part of the discovery process whereby litigants obtain information from each other in preparation for trial. Some jurisdictions recognize an affidavit as a form of deposition.
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ESCROW |
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Escrow is a legal arrangement in which an asset (often money, but sometimes other property such as art, a deed of title, website, or software source code) is delivered to a third party (called an escrow agent) to be held in trust pending a contingency or the fulfillment of a condition or conditions in a contract such as payment of a purchase price. Upon that event occurring, the escrow agent will deliver the asset to the proper recipient, otherwise the escrow agent is bound by his or her fiduciary duty to maintain the escrow account.
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HEALTHCARE FINANCE & REIMBURSEMENT |
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Find HEALTHCARE FINANCE & REIMBURSEMENT experts and consultants for HEALTHCARE FINANCE & REIMBURSEMENT litigation support. Available to be HEALTHCARE FINANCE & REIMBURSEMENT expert witnesses and provide HEALTHCARE FINANCE & REIMBURSEMENT forensic consulting in HEALTHCARE FINANCE & REIMBURSEMENT litigation, in addition prepare HEALTHCARE FINANCE & REIMBURSEMENT expert witness reports for use in deposition and/or in-court trial testimony.
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HEALTH CARE MANAGEMENT |
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Managed care is a synonym for PPO, HMO, MCO, and POS.
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Managed care is a concept in U.S. health care which rose to dominance during the presidency of Ronald Reagan as a means to control Medicare payouts. As a major Medicare claims administrator, the Blue Cross-Blue Shield insurance firm was a major architect of managed care. It spread fairly quickly to the health insurance industry in the private sector.
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INSURANCE - GENERAL |
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General insurance policies, including automobile and homeowners policies, provide payments depending on the loss from a particular financial event. General insurance typically comprises any insurance that is not determined to be life insurance, and is called property and casualty insurance in the U.S..
In the UK, General insurance is broadly divided into three areas; personal lines, commercial lines and London market.
The London market insures with large commercial risks, for example insuring supermarkets, football players and other very specific risks.
Commercial lines products are usually designed for relatively small legal entities. These would include workers comp (employers liability), public liability, product liability, commercial fleet and other general insurance products sold in a relatively standard fashion to many organisations.
Personal lines products are designed to be sold in large quantities. This would include autos (private car), homeowners (household), pet insurance, creditor insurance and others.
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INSURANCE - TITLE |
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Title insurance is insurance against defects in title to real property, available in most but not all countries. It is meant to protect an owner's or lender's financial interest in property against loss due to title defects, liens or other matter of public record. It will defend against a lawsuit attacking the title, or reimburse the insured for the actual monetary loss incurred, up to the dollar amount of insurance provided by the policy.
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LEGAL PRACTICES, FEES |
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Attorney's fees or attorneys' fees are the costs of legal representation that an attorney's client or a party to a lawsuit incurs. Attorney's fees are assessed in a number of ways, usually set by contract in advance of the representation, including by billable hours, flat fees, or contingent fees. Attorneys who voluntarily accept work on behalf of indigent clients often work pro bono.
An upfront fee paid to a lawyer is called a retainer. Money within the retainer is often used to "buy" a certain amount of work. Some contracts provide that when the money from the retainer is gone, the fee is renegotiated.
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MEDICAL LIENS |
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As all healthcare providers know, patients do not always have the present financial ability to cover the cost of their medical bills. In cases involving injury to a patient through the negligence of another, healthcare professionals can employ medical liens to secure payment for their services. Medical liens can be created in two different ways: 1) by contract and 2) by operation of law. This article will briefly touch on contractual liens while focusing on the express statutory language which create liens through the operation of law.
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MEDICARE |
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Medicare is a health insurance program administered by the United States government, covering people who are either age 65 and over, or who meet other special criteria. It was first passed on July 30, 1965 by President Lyndon B. Johnson as amendments to Social Security legislation.
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NURSING HOMES - GERIATRICS |
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A nursing home or skilled nursing facility (SNF) is a place of residence for people who require constant nursing care and have significant Activity of Daily Living (ADL) deficiencies. Residents include the elderly and younger adults with physical disabilities. Adults 18 or older can stay in a skilled nursing facility to receive physical, occupational, and other rehabilitative therapies following an accident or illness. In the US, nursing homes are required to have a licensed nurse on duty 24 hours a day, and during at least one shift each day, one of those nurses must be a Registered Nurse. In April, 2005 there were a total of 16,094 nursing homes in the United States, down from 16,516 in December, 2002. Some states have nursing homes that are considered NF or nursing facility......these homes do not have beds certified for Medicare patients, but can only treat patients whose payments source is Private Pay or Medicaid.
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ONCOLOGY |
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Oncology - The branch of medicine that deals with cancer and tumors, including study of their development, diagnosis, treatment, and prevention.
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PHYSICIAN ASSISTANT - PA |
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In the United States, Physician Assistants (PAs) are non-physician clinicians licensed to practice medicine with a physician's supervision. This supervision, in most cases, need not be direct or on site and many PAs practice in remote or underserved areas in satellite clinics. PAs can treat patients and, in most states, prescribe medicine, and in some states in the US they carry a DEA number that gives them authority to prescribe controlled medications like narcotics. PAs in surgical practices also serve as first assists in surgery. PAs provide medical services that are reimbursed under Medicare and third party insurances. Physician Assistants and Nurse Practitioners both provide similar services in most states, the major distinction being that nurse practitioners are registered nurses by trade. Both are also known as Advanced Practice Clinicians (APCs) or mid-level practitioners (MLPs).
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REINSURANCE |
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Reinsurance is a means by which an insurance company (called the reinsured, ceding company or cedant) shares the risk of loss with another insurance company (called the reinsurer).
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WORKERS COMPENSATION |
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Workers compensation systems (workers comp or compo) provide for financial compensation for work-related injuries of employees, in particular compensation of loss of wages, sometimes also for medical costs. These laws are usually a feature of highly developed industrial societies. Employees compensation laws are often only implemented after long and hard fought struggles by trade unions, particularly in early industrialisation. There are often benefits available to dependents of workers killed on the job as well.
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