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In insurance, an adjustment clause in a contract specifies how the amount of a claim (particularly a claim against an insurance company) will be determined for the purposes of a settlement, giving consideration to objections made by the debtor or insurance company, as well as the allegations of the claimant in support of his claim. For example:
a claim in respect of any one casualty where the aggregate claim against all insurers exceeds $500,000 or the equivalent in any other currency prior to adjustment for any franchise or deductible under the terms of the policy, shall, subject to the prior written consent of the Assignee, be paid to the Owner as and when [the vessel] (the "Vessel ...
For example, when a claim is first reported, a $100 payment might be made, and a $900 case reserve might be established, for a total initial reported amount of $1000. However, the claim may later settle for a larger amount, resulting in $2000 of payments from the insurer to the claimant before the claim is closed.
Here is an example template for a possible letter. Example template [Your Name] [Your Address] [Phone Number] [Email Address] ... such as filling out an online form or emailing your request.
A demand letter, letter of demand, [1] (of payment), or letter before claim, [2] is a letter stating a legal claim (usually drafted by a lawyer) which makes a demand for restitution or performance of some obligation, owing to the recipients' alleged breach of contract, or for a legal wrong.
Adjustment of claims is not confined to claims against insurance companies. An allowance made by a creditor, particularly a storekeeper, in response to a complaint by the debtor respecting the accuracy of the account or other claim, or a reduction in the claim or account made to induce a prompt payment, is in a proper sense an adjustment.
The rating is a method used by insurers to determine pricing of premiums for different groups or individuals based on the group or individual's history of claims. The experience rating approach uses an individual's or group’s historic data as a proxy for future risk , and insurers adjust and set insurance premiums and plans accordingly. [ 1 ]
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
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