Busy. Please wait.
Log in using Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Didn't know it?
click below
Knew it?
click below
Don't know
Remaining cards (0)
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

CPHRM Claims

CPHRM Claims and Litigation 2014

Claims process identification, investigation, analysis and classification, reporting, coverage determination, setting reserves, claims management strategies, resolution
IBNR Incurred But Not Reported
PCE occurrence for which a claim can be reasonably anticipated but for which no claim has yet been asserted; event for which there are grounds/contributing factors found after investigation, worthy of compensation (NO INJURY REQUIRED)
Claim Formal notification (generally in writing) that monetary damages are being sought for an alleged injury
Lawsuit formal legal action filed in court
Negligence Elements (4Ds) Duty to exercise reasonable care (Standard of Care); Duty breached; Direct or proximate causation (injury); and Damages resulted
Vicarious liability imputed liability for acts of another; employer for acts of negligence or omissions of it’s employees
Respondeat Superior Employer responsible for the acts of their employees if the alleged wrongful act is within the course and scope of their employment; Employee has to also have been found liable
Ostensible or apparent agency Patient looked to the facility rather than the individual physician for care; the institution held out the independent contractor as an employee (e.g., hospital based physician services)
Corporate negligence Facility responsible for own acts of negligence in failing to ensure that a proper standard of care is upheld; must have known of a defect in procedures and the defect was substantial factor in the patient injury
Timeframe to set initial reserves within 90 days of claim
Loss Ratio formula Losses (paid losses + expenses + reserves)/Paid Premiums
Alternative Dispute Resolution (ADR) a process designed to resolve disputes in a manner that avoids the cost, delay, and unpredictability of the traditional adjudicatory process (arbitration, mediation, negotiation)
Motion for Summary Judgment facts are not in dispute and legal principles suggest there’s going to be a ruling for the defendant
Motion in Limine managing what the jurors will see (may be for not allowing facts to come forward that have nothing to do with case)
Direct Verdict Plaintiff failed to meet their burden of proof
Created by: camellia



Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards