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The first reported judicial decision involving an effort of a health insurer to seek subrogation on a personal injury claim is the 1982 decision in Frost v. Porter Leasing Corp., 436 N.E.2d 387 (Mass. 1982) in which subrogation was denied. “ERISA reimbursement” claims began arising in the late 1980s and have been resisted by some federal ...
Subrogation is the assumption by a third party (such as a second creditor or an insurance company) of another party's legal right to collect debts or damages. [1] It is a legal doctrine whereby one person is entitled to enforce the subsisting or revived rights of another for their own benefit. [ 2 ]
Pre-existing condition exclusions prohibited in all health insurance plans; Prohibit treating acts of domestic violence as a pre-existing condition; Waiting period for enrollment in new health insurance plans limited to 90 days; Grandfathered existing health insurance plans must prohibit pre-existing condition exclusions by January 1, 2014
In addition to medical expense insurance, "health insurance" may also refer to insurance covering disability or long-term nursing or custodial care needs. Different health insurance provides different levels of financial protection and the scope of coverage can vary widely, with more than 40% of insured individuals reporting that their plans do ...
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
When a consumer purchases a health insurance policy, there is a moral hazard risk because the consumer may utilize too much medical care because the full cost of care is defrayed (i.e. he/she has a lower marginal cost for care than the open market). [17]
National health insurance (NHI), sometimes called statutory health insurance (SHI), is a system of health insurance that insures a national population against the costs of health care. It may be administered by the public sector, the private sector, or a combination of both. Funding mechanisms vary with the particular program and country.
The Pre-existing Condition Insurance Plan (PCIP) was a form of health insurance coverage offered to uninsured Americans who were unable to obtain coverage because of a pre-existing condition. These provided coverage to as many as 350,000 people to fill the gap until the Affordable Care Act went into effect in 2014. The plan was funded by ...