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Resource ValueSet/FHIR Server from package hl7.terminology#current (47 ms)

Package hl7.terminology
Type ValueSet
Id Id
FHIR Version R5
Source http://terminology.hl7.org/https://build.fhir.org/ig/HL7/UTG/ValueSet-v3-RoleClassClaimant.html
Url http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant
Version 3.0.0
Status active
Date 2014-03-26
Name RoleClassClaimant
Title RoleClassClaimant
Experimental False
Realm uv
Authority hl7
Description **Description:** A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible. **Discussion:** With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary. **Note:** A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants. In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a claim for a loss. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits. **Example:** A claimant under automobile policy that is not the named insured.
Copyright This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html

Resources that use this resource

No resources found


Resources that this resource uses

CodeSystem
v3-RoleClass RoleClass


Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ValueSet v3-RoleClassClaimant

Language: en


Source

{
  "resourceType" : "ValueSet",
  "id" : "v3-RoleClassClaimant",
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet v3-RoleClassClaimant</b></p><a name=\"v3-RoleClassClaimant\"> </a><a name=\"hcv3-RoleClassClaimant\"> </a><a name=\"v3-RoleClassClaimant-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><ul><li>Include codes from<a href=\"CodeSystem-v3-RoleClass.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleClass</code></a> where concept is-a <a href=\"CodeSystem-v3-RoleClass.html#v3-RoleClass-CLAIM\">CLAIM</a></li></ul></div>"
  },
  "url" : "http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.1.11.20120"
    }
  ],
  "version" : "3.0.0",
  "name" : "RoleClassClaimant",
  "title" : "RoleClassClaimant",
  "status" : "active",
  "experimental" : false,
  "date" : "2014-03-26",
  "publisher" : "Health Level Seven International",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org"
        },
        {
          "system" : "email",
          "value" : "hq@HL7.org"
        }
      ]
    }
  ],
  "description" : "**Description:** A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible.\r\n\r\n**Discussion:** With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary.\r\n\r\n**Note:** A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.\r\n\r\nIn the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a claim for a loss. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a \"claim\" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.\r\n\r\n**Example:** A claimant under automobile policy that is not the named insured.",
  "immutable" : true,
  "copyright" : "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html",
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleClass",
        "filter" : [
          {
            "property" : "concept",
            "op" : "is-a",
            "value" : "CLAIM"
          }
        ]
      }
    ]
  }
}

XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.