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A reservation of rights by a liability insurance company is an expression of the insurer’s agreement to defend its policyholder with the limiting condition [3] that it does not waive any right to later deny coverage under the terms of insurance contract. A reservation of rights permits an insurer to fulfill its broad duty to defend [4] while ...
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [ 1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: the payee, the ...
In insurance, the insurance policy is a contract (generally a standard form contract) between the insurer and the policyholder, which determines the claims which the insurer is legally required to pay. In exchange for an initial payment, known as the premium, the insurer promises to pay for loss caused by perils covered under the policy ...
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A cause of action or right of action, in law, is a set of facts sufficient to justify suing to obtain money or property, or to justify the enforcement of a legal right against another party. The term also refers to the legal theory upon which a plaintiff brings suit (such as breach of contract, battery, or false imprisonment ).
The filing of a declaratory judgment lawsuit can follow the sending by one party of a cease-and-desist letter to another party. [6] A party contemplating sending such a letter risks that the recipient, or a party related to the recipient (i.e. such as a customer or supplier), may file for a declaratory judgment in their own jurisdiction, or sue for minor damages in the law of unjustified threats.
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Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any ...