Contractual benefits that are based on the actual amount of financial loss. In traditional medical expense insurance plans, insureds are reimbursed for the covered medical expenses they incur up to a maximum dollar amount. Also known as reimbursement benefits. TO TOP
Compensation paid to the workers' compensation claimants for non-medical loss resulting from an injury or illness. Six types of award are permitted by the WCL: â€¢ temporary total disability benefits (for periods of total wage loss); â€¢ temporary partial disability benefits (for periods of partial wage loss); â€¢ facial disfigurement awards (at judge's discretion but subject to a maximum, for cosmetic facial disfigurement resulting from the accident or exposure); â€¢ permanent partial disability benefits (for loss if physical function or for periods of partial wage loss after a claimant has been classified as having a permanent partial disability); â€¢ permanent total disability benefits (for loss of wage earning capacity after a claimant has been classified as having a permanent total disability); and â€¢ death benefits (compensation benefits awarded to spouse, children or under certain circumstances, other family members following a work-related death).
Established dollar allowances for covered services. Payments are made toward the charge, not necessarily as payment in full.