Role Call!
This PI role communicates with clients, coordinates medical appointments, communicates with healthcare providers, and ensures the injured party receives treatment.
What is a Case Manager? (CM)
This first-party auto coverage provides payment when an at-fault driver does not have ANY insurance to cover the bodily injury they caused.
What is Uninsured Motorist coverage? (UM)
This is the maximum amount of money that an insurance policy will pay out for damages or injuries.
What are Policy Limits?
This is a legal document signed by a party to a lawsuit or dispute, relinquishing their rights to pursue any further legal action.
What is a Release?
This is a type of Health Insurance plan that allows the freedom of members to visit any medical provider or facility without a referral. Seeing medical providers inside the network's plan, offers lower out-of-pocket costs.
What is a PPO? (Preferred Provider Organization)
This PI role represents clients in legal disputes that may end up going to trial.
What is a Litigation Attorney?
This coverage provides payment for injuries of which I may be legally responsible for.
What is Bodily Injury coverage? (BI) Sometimes also broadly called "liability"
This is the amount of money a policyholder is responsible for paying, before the insurance coverage kicks in.
What is a Deductible?
This is a document signed by a medical provider, the client, and the attorney guaranteeing the medical provider will be paid for their services after the settlements funds are received.
What is a Letter of Protection? (LOP)
This is a fixed dollar amount that a patient must first pay for certain medical services. The fixed amount is pre-determined by their plan.
What is a Copay?
This PI role works with attorneys and case managers to provide administrative support.
What is a Legal Assistant? (LA)
This coverage pays for damages to my vehicle, no matter who is at fault.
What is Collision coverage?
This is a legal concept when an insurance company is not acting ethically, and their actions in handling claims are seen as unfair or deceptive.
What is Bad Faith?
This is a letter sent from your auto insurance company, when they have paid the full amount required under the PIP statute.
What is a PIP Exhaust letter?
Regarding medical billing, this is the timeframe within which a medical claim must be submitted to a payer.
What is Timely Filing?
This role works for the insurance company. They assess damages and aim to resolve the claim efficiently and cost-effectively.
What is an Adjuster?
This optional medical coverage covers me, or passengers in my vehicle, for medical expenses, regardless of fault.
What is MedPay coverage?
This is the general name for the specific protections and benefits an insurance policy provides.
What are Coverages?
This is a document detailing the distribution of funds received for the client's settlement. It documents the attorney fee, costs, and ultimately how much money the client will receive from their settlement.
What is a Settlement Sheet?
This is a requirement by a health insurance company for a patient to receive approval for certain medical services, before they are provided.
What is Prior Authorization?
This role is responsible for handling the subrogation for a health insurance company.
What is an Analyst? or, Subrogation Analyst
This medical insurance provides first-party coverage for medical expenses, lost wages, and other injury expenses related to the auto accident, regardless of fault.
What is PIP? (Personal Injury Protection, or No-Fault Insurance)
This is the time limit a case/claim must be settled, without filing a lawsuit.
What is the Statute of Limitations? (SOL)
This is a statement by an insurance company that saves their right to deny coverage for a claim, in the future.
What is a Reservation of Rights? (ROR)
This is a type of managed healthcare plan that typically requires members to select a Primary Care Physician (PCP) and obtain referrals for a specialist's services.
What is a HMO? (Health Maintenance Organization)