What is third party liability insurance? #third #party #damage #insurance

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What is third party liability insurance?

Find a clear definition of third party liability insurance, explained with practical examples.

For any business owner, third party liability insurance is an important consideration, as it covers you for claims made by a member of the public against your business. It’s another way of describing public liability insurance. which is a core cover for businesses that come into contact with clients, suppliers, and other third parties. Since insurance terms like ‘third party’ and ‘liability’ can be confusing, we’re going to provide a definition of third party liability insurance and delve a bit deeper into what it covers and whether it’s right for you.

Definition of third party liability insurance

When you take out an insurance policy, you’re forming a legal relationship with your insurance provider. In this relationship, you’re the ‘first party’ and the insurer is the ‘second party’. The ‘third party’ is someone who doesn’t have any involvement with creating this contract, but could be affected by it. This is usually a member of the public who can make a claim against you.

If you face a compensation claim from a third party, your liability insurance could pay out to cover your legal expenses as well as the compensation payment, up to the limit of your policy.

So, who exactly could the third party be?

In the case of business insurance, the third party could be a customer, a client, a supplier, or just someone who comes into contact with your business on your premises or in the street. If they’re injured or their property is damaged by your business, they could claim compensation from you.

Typical third party liability claims

Imagine you’re a builder working on scaffolding and you drop a brick that damages a car parked below, or you’re a restaurant owner whose supplier trips over a wet floor while delivering ingredients. In either case your business could be faced with a compensation claim.

This compensation payment can take into account medical costs, lost earnings, and the replacement or repair of damaged property. As you can imagine, this means that compensation payments can be huge, so it’s important that you’ve got the right level of third party liability insurance. You can usually choose £1 million up to around £10 million of cover, based on the risks that your business faces and the possible extent of compensation claims. You should also check your client contracts, as some clients will demand a particular level of public liability cover.

Getting covered

Simply Business offers third party liability insurance from some of the UK’s leading providers. You can compare public liability quotes. add any extra cover you need to your policy, and buy online in minutes. Hit the start your quote button below to begin.

Let us know if you have any more questions in the comments section, and we’ll do our best to answer them.

Ready to set up your cover?

As the UK’s biggest business insurance provider, we specialise in public liability insurance and protect more trades than anybody else. Why not take a look now and build a quick, tailored quote?





What is an EOB? #third #party #medical #billing #companies

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What is an EOB?

At least once a week, a professional medical biller gets a phone call from a patient. “I got a bill from my insurance company,” the patient says. This is despite the fact that the top of the paper they are holding says, “THIS IS NOT A BILL.” Patients think it is a bill because it looks like a medical bill. It says that they are responsible for a set sum of money, or, sometimes, it states that a service on their healthcare claim was not covered by their insurer.

Patients do not receive bills for medical services from their insurers. Only healthcare providers send out bills for services rendered. What the patient receives is commonly called an Explanation of Benefits (EOB). Alternative terms include Summary of Benefits, Remittance Advisory, Coverage Determination, or Beneficiary Notice. Medical billers commonly refer to these as EOBs, and they are the means by which commercial healthcare insurers and government healthcare programs notify their beneficiaries of how an individual healthcare claim was processed for payment.

What is an EOB?

An EOB does look like a bill. It contains the date of service, the code used to bill a particular service to an insurance company, the fee charged by the healthcare provider, the allowed amount under the third-party payers’s contractual fee schedule, the patient’s responsibility under the terms of their coverage, the payment made by the payer, and the contractual write-off. The final entry of each line item is usually the titled something along the lines of, “what you owe,” or, “your responsibility.” This is why some patients confuse an EOB with a medical bill.

Like most medical billing transactions, EOBs consist of medical code, not only the Healthcare Common Procedure Coding System (HCPCS Level I and Level II) codes, but also explanation codes that have been established by the Healthcare Portability and Accountability Act of 1996 (HIPAA). These explanation codes are easily understood by professional medical billers who are schooled in the language of healthcare reimbursement, but they are a mystery to laypeople who only encounter them in EOBs. While each EOB normally includes a definition of the adjustment and adjudication codes, they are often in fine print and their definitions are not always apparent to a person unfamiliar with reading them.

Adjudication Codes

Certified medical coders are not usually familiar with the code sets that third-party payers use to communicate payment or denial information to medical billers who post payments and make financial adjustments to patient accounts. These codes fall fully within the professional domain of a medical practice’s business office rather than its compliance department. This code set is used exclusively by third-party payers, and certified medical coders do not assign these codes. They are assigned by insurance adjusters as they process healthcare claims.

CO-16 means that required information was not receive on a healthcare claim, preventing payment for an otherwise covered service. N257 means that a third-party payer does not recognize the provider of service. CO-45 means that the fee charged exceeds the contractually agreed upon fee schedule. CO-97 means that a procedure has been bundled into a previously provided and charged, related service.

Professional medical billers recognize these codes and adjust accounts accordingly. Some codes, such as N257, indicate that a patient’s healthcare claim was submitted with an inaccurate National Provider Number (NPI) to identify that a credentialed provider rendered covered services to a patient. The claim is then corrected by the biller and resubmitted. Other codes, such as CO-97 mean that a claim must be referred to a certified medical coder to determine if the documentation in the patient’s medical record supports modifying a charged code, or if an appeal of denied payment should be initiated by supplying appropriate documentation.

The Role of EOBs

Third-party payers try to keep their beneficiaries informed of what healthcare claims were submitted on their behalf by healthcare providers. They inform their patients of expected financial obligations for healthcare received, such as copays, co-insurance, and deductibles. They also inform patients that they may have received services that a payer considers medically unnecessary, experimental, or cosmetic in nature. EOBs are an important factor in identifying healthcare fraud and abuse.

Though most patients may not be able to discern the difference between the codes 99213 and 99214, an intermediate versus an extensive office visit as defined by Common Procedural Terminology (CPT), they can tell if they received an intramuscular injection (CPT 96372). By informing patients of what was charged on their behalf, third-party payers hope to identify fraudulent charges and patterns of abuse in the billing process.

The federal Medicare program has recognized that EOBs are a powerful fraud and abuse detection tool by actively enlisting beneficiaries to report suspected fraud and abuse. Medicare beneficiaries receive quarterly Medicare Summary Notices (MSNs) that detail all healthcare claims that have been submitted on their behalf in a three-month period. Recent changes in the format of MSNs are designed to make them more easily understood by people who are not fluent in the language of medical coding or HIPAA-standard adjudication codes. New MSNs contain plain language, and the Centers for Medicare and Medicaid Services (CMS) has undertaken an extensive public information campaign directing patients to compare their MSN to services actually received by healthcare providers.

Clean Claims

Professional medical billers and certified medical coders work together to ensure that accurate claims are submitted to third-party payers that clearly describe the services contained in the patient’s medical record. This includes accurate demographic information such as a patient’s date of birth, insurance identification number, or the provider’s NPI, and it also includes the correct procedural and diagnostic codes to describe services, with appropriate modifiers if applicable.

An EOB informs a patient of what is included in their healthcare claims, and how it was processed according to the terms of their coverage. In an efficient medical practice or inpatient facility, the information has already been applied to a patient’s account before the patient calls with a query. A medical biller applies the information contained in an EOB because he or she receives it in the form of a Remittance Advice (RA) that accompanies a check or formal denial from a third-party payer. When the patient calls, a professional medical biller can refer to a patient’s account and tell the patient what their financial responsibility is, if any, or if a denied claim has been corrected and resubmitted on their behalf.

The business side of medicine is conducted on a daily basis by professionals who are trained to negotiate the intricate transactions that govern healthcare reimbursement. Every medical code is associated with a charge and an agreed-upon fee. By applying the information contained in EOBs and RAs in an effective manner, medical billers ensure that no patient is responsible for more than is legally due for services, while medical coders ensure that no patient is responsible for more than is legally due for medically necessary services that were provided. EOBs ensure compliance with applicable statutes and contractual obligations, making patients an important component in the transparency of healthcare reimbursement. Educated and trained billers and coders strive to ensure that the only advisement code they see on an RA is CO-45.





Arizona Personal Injury Attorneys #personal #injury #lawyer, #injury #lawyer, #accident #lawyer, #accident

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Zanes Law

Tucson Phoenix Personal Injury Lawyers

The Zanes Law injury lawyers have helped clients recover tens of millions of dollars on their personal injury claims. Over the years, we have helped thousands of clients on everything from normal everyday car accident claims to extremely complex wrongful death claims. We take an aggressive approach to how we represent our clients because we care deeply about them and understand that we are here to fight for them. Our personal injury lawyers are some of the best in Arizona and have helped clients on a variety of injury cases, which include car accidents, truck accidents, bicycle accidents, motorcycle accidents, wrongful death claims, and more. We are personal injury attorneys and car accident lawyers with years of experience.

SERVING TUCSON, PHOENIX MORE

We are an Arizona personal injury law firm with offices in Tucson and Phoenix, but we help clients nationally. So regardless of your location, we can help you on your personal injury or car accident case. Our Tucson and Phoenix personal injury lawyers are here to help you, regardless of where you live.

TUCSON PHOENIX CAR ACCIDENT LAWYERS

If you drive a car, unfortunately sooner or later you will be involved in a car accident. At least that is what the statistics show. If and when that happens, Please call a Zanes Law Phoenix car accident lawyer or Tucson personal injury attorney so that we can help you. This is important. It is important that you have a Phoenix personal injury attorney or a Tucson car accident lawyer who has the experience to get you the compensation that you deserve. Hiring the right personal injury lawyer will help to ensure that you get the highest compensation possible. Although there are many car accident law firms and personal injury lawyers to choose from, it is the Arizona car accident lawyers at Zanes Law who have a proven track record of success. Our personal injury lawyers strive to provide our clients with the best possible representation and our car accident lawyers have successfully helped thousands of clients.

4 WAYS WE CAN HELP YOU AFTER YOUR ACCIDENT

The attorneys at Zanes Law have helped thousands of injured people make smarter, more confident legal decisions so that they are made whole after an accident. Today it’s your turn.

Do you have questions or concerns about health insruance, providers, and covering medical costs?

Medical Bills

Medical bills caused by an auto accident are a cost that should be covered by your injury settlement. If you have health insurance, you should present your insurance card to all medical providers so they will bill your health insurance. If you do not have health insurance, you will need to find a medical provider that will treat you on a lien. This is something that Zanes Law can help you with.

*Treating on a lien: This means that you will not be charged any up-front costs for treatment and the provider will be compensated upon your settlement. This provider would require payment for their services before you receive your proceeds from the claim.

Property Damage Insurance

Car rentals: If you have rental car coverage through your insurance carrier, you should request your car rental through them. It’s usually an easy process and your insurance will be reimbursed if liability is accepted by the adverse party. When you do not have rental coverage, you will have to wait until liability is established with the other driver’s insurance.

Property damage: Open a property damage claim with your insurance company (even if the accident is not your fault). If you have collision coverage on your insurance, your insurance company will fix your car and will work with the other car’s insurance to ensure they cover the costs. Please note, you may be required to pay your deductible up-front if liability has not yet been established. Once it is, your insurance company will be able to get your deductible back and reimburse you. Click here for information about property damage after a car accident.

Bodily injury: Injury claims are completely different than property damage claims. If you are injured due to a car accident, we recommend you consult with a personal injury lawyer or accident lawyer to open your bodily injury claim for you. If you were injured in the accident, you need to seek medical care immediately and you need to speak with a personal injury attorney as soon as possible. If you are injured and choose to speak with the insurance adjuster on your own, you must make it clear to the adjuster that you are in fact injured. However, our advice is that you seek the assistance of a personal injury attorney and that you limit the conversations that you have with the insurance adjuster. Let your personal injury attorney handle all of these conversations on your behalf.

Lost Wages Compensation

Lost wages: If your accident has caused you to miss time from work, you are entitled to some type of compensation through your injury claim. You should document all time you took off and keep all doctor’s notes that justify your time off.

Pain and Suffering: This is a term used in the legal industry that refers to emotional and physical stress, as well as the actual physical pain, caused by a car accident. Injury victims are entitled to compensation for pain and suffering.

Overall compensation: Settlement amounts are directly correlated to the facts of a particular case. Some factors that determine a settlement amount are: types of injuries sustained, how long the individual sought medical treatment, total amount of medical bills, future medical bills, and many other factors. We recommend that you contact the personal injury attorneys at Zanes Law in order to find out what the actual value of your claim is.

Everything

Bills, property damage, medical treatment, insurance, lost wages, and compensation.

If all of the above are concerning you right now, we recommend you speak to a personal injury attorney to answer your specific questions. Yes, a personal injury attorney. Not a general attorney who practices all case types. A personal injury attorney works on these cases all day, everyday and is more experienced when it comes to injury claims. An accident attorney can assist with motorcycle accidents, trucking accidents, construction accidents, premise accidents, bicycle accidents, mass torts, burn injury and class action lawsuits to name a few.

Arizona Law Offices

4222 E. Thomas Rd. #230
Phoenix, Arizona 85018
United States
Phone: 602.999.9999
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Social Host Liability #party #liability #insurance

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Social Host Liability

Whether you are hosting a Super Bowl party or greeting the New Year with friends in your home, if you are planning to serve alcohol at any type of party it is important to take steps to limit your liquor liability and make sure you have the proper insurance.

Social host liability, the legal term for the criminal and civil responsibility of a person who furnishes liquor to a guest, can have a serious impact on party throwers. Social host liability, also known as “Dram Shop Liability” laws vary widely from state to state, but 43 states have them on the books. Most of these laws also offer an injured person, such as the victim of a drunk driver, a method to sue the person who served the alcohol. There are circumstances under these laws where criminal charges may also apply.

While a social host is not liable for injuries sustained by a drunken guest (as they are also negligent), the host can be held liable for third parties, and may even be liable for passengers of the guest who have been injured in their car.

Before planning a party in your home, it is important to speak with your insurance agent or company representative about your homeowners coverage and any exclusions, conditions or limitations your policy might have for this kind of risk. Homeowners insurance usually provides some liquor liability coverage, but it is typically limited to $100,000 to $300,000, depending on the policy, which might not be enough.

Most importantly, whether you are hanging out with a small group of friends for cocktails or throwing a big family bash, remember that a good host is a responsible host, and takes steps to ensure guests get home safely if they have been drinking.

How to Protect Yourself and Your Guests

If you plan to serve alcohol at a party the I.I.I. offers the following tips to promote safe alcohol consumption and reduce your social host liability exposure:

  • Make sure you understand your state laws. Before sending out party invitations, familiarize yourself with your state’s social host liability laws. These laws vary widely from state to state. Some states do not impose any liability on social hosts. Others limit liability to injuries that occur on the host’s premises. Some extend the host’s liability to injuries that occur anywhere a guest who has consumed alcohol goes. Many states have laws that pertain specifically to furnishing alcohol to minors.
  • Consider venues other than your home for the party. Hosting your party at a restaurant or bar with a liquor license, rather than at your home, will help minimize liquor liability risks.
  • Hire a professional bartender. Most bartenders are trained to recognize signs of intoxication and are better able to limit consumption by partygoers.
  • Encourage guests to pick a designated driver who will refrain from drinking alcoholic beverages so that he or she can drive other guests home.
  • Be a responsible host/hostess. Limit your own alcohol intake so that you will be better able to judge your guests’ sobriety.
  • Offer non-alcoholic beverages and always serve food. Eating and drinking plenty of water, or other non-alcoholic beverages, can help counter the effects of alcohol.
  • Do not pressure guests to drink or rush to refill their glasses when empty. And never serve alcohol to guests who are visibly intoxicated.
  • Stop serving liquor toward the end of the evening. Switch to coffee, tea and soft drinks.
  • If guests drink too much or seem too tired to drive home, call a cab. arrange a ride with a sober guest or have them sleep at your home.
  • Encourage all your guests to wear seatbelts as they drive home. Studies show that seatbelts save lives.