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Glossary of Insurance Terms

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Underwriter: The individual or team within a life insurance company who is trained to evaluate the insurability and determine the classification of applicants for insurance protection.

Underwriting: The process of evaluating applications for insurance based on an established set of guidelines. Underwriting determines the risk associated with an applicant and either assigns the appropriate rating class for the policy or declines to offer a policy.

Uninsurable Risk: An individual who is not acceptable for insurance due to excessive risk related to current health, medical history, occupation, avocations, etc.

Universal Life Insurance: A type of permanent life insurance that combines term life insurance and an investment feature into one contract. Universal Life insurance policies generally offer flexible premium payments.

Utilization Management (UM): A management tool used by managed care plans involving the systematic process of reviewing and controlling patients' use of medical services and providers' use of medical resources in order to optimize efficiency and appropriateness of care. UM includes an array of techniques, such as second surgical opinion, preadmission certification, concurrent review, case management, discharge planning, and retrospective chart review.

Utilization Review: The assessment of treatment in accordance with guidelines and standards that are established and accepted by health care professionals using medical necessity criteria. The assessment occurs before and during the delivery of health care. Its purpose is to enhance the cost effectiveness of health care through reviewing its appropriateness.

Usual, customary and Reasonable (VCR): Usual Fee: The fee usually charged for a given service by an individual provider to his or her private patient, that is, his or her own usual fee. Customary Fee, the range of usual fees charged by providers of similar training and experience in an area. Reasonable Fee, a fee that meets the two previous criteria or, in the opinion of the responsible medical or dental association's review committee, is justifiable considering the special circumstances of the particular case in question.

Urgent Care: Care for injury, illness, or another type of condition (usually not life threatening) which should be treated within 24 hours. This is also referred to as after-hours care.

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