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Term
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Definition
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unallocated loss adjustment expense (ULAE)
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those claim-handling expenses of the insurer that are not easily attributed to any single claim; in retrospective rated plans, these expenses are part of the loss conversion factor
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unbundled services
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insurance arrangement where, at the request of the policyholder, an entity other than the insurer (often a TPA) handles claim administration or some portion of it; loss control services are also sometimes unbundled
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underwriting cycle
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theory that U.S. property and casualty insurers conduct business in a never-ending cycle of hard markets and soft markets
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underwriting department
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insurer’s unit responsible for determining whether to offer WC insurance to an employer and at what premium
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unit statistical report (unit stat report)
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calculation of premium and losses the insurer files with regulators; the calculation methods are governed by a statistical plan manual such as that of NCCI
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United States Longshore and Harbor Workers Compensation Act (USL&H)
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see Longshoremen's and Harbor Workers Compensation Act
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unity modification
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an experience modification factor of 1.0, resulting in no credit or debit to premium
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usual and customary employment
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the set of job duties that the injured worker typically performed prior to the work injury
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usual exertion doctrine
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for some injuries to be covered by WC, the physical exertion must be unusual (often considered in heart attack claims)
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utilization review
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for WC, prospective, concurrent, or retrospective review of the effectiveness of medical services
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