Cost Containment Provision
Definition of "Cost containment provision"
In many health insurance and dental insurance policies, stipulation that, if the estimated cost of a recommended plan of treatment exceeds a specified sum, the insured must submit the plan of treatment to the insurance company for review and predetermination of benefits before service begins. Usually, however, predetermination of benefits is not necessary for emergency treatment.
Popular Insurance Terms
Present value computation of the accrued or projected benefits of a retirement plan. This computation is known as the actuarial valuation because it is based on probability (retirement ...
Principle of surplus distribution as the result of excess funds above the amount required to establish legal reserves. These excess funds are generated from three sources: mortality ...
Reinsurance broker for a primary company (the re-insured). This broker is paid commissions by the reinsurance company, just as an agent is paid commissions by an insurance company for ...
Provision by an employer for the economic and social welfare of employees. Generally include: pension plans for retirement; group life insurance for death; group health insurance for ...
Stipulations of the rights and obligations of an insured and an insurer under a policy. ...
Individual or other entity who owns an insurance policy. Synonymous with policyowner. ...
Failure to exercise proper care. Many property insurance policies exclude losses that result from negligence. Neglect is also the basis for many liability suits. If an injury can be ...
Coverage underwritten on members of a natural group, such as employees of a particular business, union, association, or employer group. Each employee is entitled to benefits for hospital ...
Total earned premiums minus total expenses and losses paid of the insurance company. ...
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