Terms Used In Tennessee Code > Title 33 > Chapter 2 > Part 1 - Community Service System

• Actuary: means a person who is a member in good standing of the American Academy of Actuaries. See Tennessee Code 56-6-502
• Actuary: means a person who is a member in good standing of the American Academy of Actuaries. See Tennessee Code 56-6-802
• Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Appraisal: A determination of property value.
• Arraignment: A proceeding in which an individual who is accused of committing a crime is brought into court, told of the charges, and asked to plead guilty or not guilty.
• Attorney: means the person designated and authorized by subscribers as the attorney-in-fact having authority to obligate them on reciprocal insurance contracts. See Tennessee Code 56-16-102
• Attorney-in-fact: A person who, acting as an agent, is given written authorization by another person to transact business for him (her) out of court.
• Catastrophic disaster: means an event that results in large numbers of deaths and injuries, causes extensive damage or destruction of facilities that provide and sustain human needs, produces an overwhelming demand on state and local response resources and mechanisms, causes a severe long-term effect on general economic activity, and severely affects state, local and private sector capabilities to begin and sustain response activities. See Tennessee Code 56-6-902
• Clinical criteria: means the written policies, screening procedures, decision rules, decision abstracts, clinical protocols, practice guidelines, and medical protocols used by the utilization review agent to determine the necessity and appropriateness of health care services. See Tennessee Code 56-6-703
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-703
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-1001
• Commissioner: means the commissioner of mental health and substance abuse services. See Tennessee Code 33-1-101
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-902
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Contract: A legal written agreement that becomes binding when signed.
• controlled: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a contract for goods or nonmanagement services, or otherwise. See Tennessee Code 56-6-602
• Controlling person: means any person, firm, association or corporation who directly or indirectly has the power to direct, or cause to be directed, the management, control or activities of the reinsurance intermediary. See Tennessee Code 56-6-802
• Conviction: A judgement of guilt against a criminal defendant.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Crop: means and includes any agricultural product, including livestock, nursery product, tree and product from a tree, as well as anything insured by the Federal Crop Insurance Corporation under a crop insurance program. See Tennessee Code 56-6-1001
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Department: means the department of commerce and insurance. See Tennessee Code 56-1-102
• Department: means the department of mental health and substance abuse services. See Tennessee Code 33-1-101
• Department: means the department of commerce and insurance. See Tennessee Code 56-6-1001
• Enrollee: means an individual who has contracted for or who participates in coverage under an insurance policy, a health maintenance organization contract, a health service corporation contract, an employee welfare benefit plan, a hospital or medical services plan, or any other benefit program providing payment, reimbursement, or indemnification for health care costs for the individual or the individual's eligible dependents. See Tennessee Code 56-6-703
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Escrow: Money given to a third party to be held for payment until certain conditions are met.
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Federal Reserve System: The central bank of the United States. The Fed, as it is commonly called, regulates the U.S. monetary and financial system. The Federal Reserve System is composed of a central governmental agency in Washington, D.C. (the Board of Governors) and twelve regional Federal Reserve Banks in major cities throughout the United States. ^{Source: OCC}
• Fiduciary: A trustee, executor, or administrator.
• Fingerprints: means an impression of the lines on the finger taken for purpose of identification. See Tennessee Code 56-6-902
• Foreign: when used without limitation, includes all companies formed by authority of any other state or government. See Tennessee Code 56-1-102
• Fraud: Intentional deception resulting in injury to another.
• Health care service: means health care procedures, treatments, or services provided by a facility licensed in this state or provided by a doctor of medicine, a doctor of osteopathy, or a health care professional licensed in this state. See Tennessee Code 56-6-703
• Healthcare facility: means an institution, place, or building providing healthcare services that is required to be licensed under title 68, chapter 11, or title 33. See Tennessee Code 56-6-703
• Home state: means the District of Columbia and any state or territory of the United States in which the public adjuster's principal place of residence or principal place of business is located. See Tennessee Code 56-6-902
• Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. ^{Source: FDIC}
• Independent casualty actuary: means a casualty actuary who is a member of the American Academy of Actuaries and who is not affiliated with, nor an employee, principal, nor the direct or indirect owner of, or in any way controlled by, the insurer or producer. See Tennessee Code 56-6-602
• Individual: means a natural person. See Tennessee Code 56-6-902
• Insurer: means any person, firm, association or corporation duly licensed in this state as an insurance company pursuant to §. See Tennessee Code 56-6-502
• insurer: means a person, firm, association or corporation duly licensed to transact a property/casualty insurance business in this state. See Tennessee Code 56-6-602
• Insurer: means any person, firm, association or corporation duly licensed in this state pursuant to the applicable provisions of this title as an insurer. See Tennessee Code 56-6-802
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Licensed producer: means an agent, broker or reinsurance intermediary licensed pursuant to the applicable provisions of this title. See Tennessee Code 56-6-802
• Livestock: means all equine as well as animals that are being raised primarily for use as food or fiber for human utilization or consumption including, but not limited to, cattle, sheep, swine, goats, and poultry. See Tennessee Code 1-3-105
• Mental illness: means a psychiatric disorder, alcohol dependence, or drug dependence, but does not include intellectual disability or other developmental disabilities as defined in title 52. See Tennessee Code 33-1-101
• MGA: means any person who:
  (i) Manages all or part of the insurance business of an insurer, including the management of a separate division, department, or underwriting office. See Tennessee Code 56-6-502
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• NAIC: means the National Association of Insurance Commissioners. See Tennessee Code 56-6-902
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
• Person: means a natural person. See Tennessee Code 56-6-1001
• Person: means an individual or a business entity. See Tennessee Code 56-6-902
• Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
• Personal property: All property that is not real property.
• Personal property: includes money, goods, chattels, things in action, and evidences of debt. See Tennessee Code 1-3-105
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. ^{Source: OCC}
• Preauthorization: means the process by which the utilization review agent determines the medical necessity of otherwise covered health care services prior to the rendering of such health care services including, but not limited to, preadmission review, pretreatment review, utilization, and case management. See Tennessee Code 56-6-703
• Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Producer: means an insurance broker or brokers or any other person, firm, association or corporation, when, for any compensation, commission or other thing of value, the person, firm, association or corporation acts or aids in any manner in soliciting, negotiating or procuring the making of any insurance contract on behalf of an insured other than the person, firm, association or corporation. See Tennessee Code 56-6-602
• Property: includes both personal and real property. See Tennessee Code 1-3-105
• Provider of record: means the physician or other licensed practitioner identified to the utilization review agent as having primary responsibility for the care, treatment, and services rendered to an individual. See Tennessee Code 56-6-703
• Public adjuster: means any person, other than someone who is employed by an insurance carrier, who, for compensation or any other thing of value, on behalf of the insured:
  (i) Acts or aids, solely in relation to first party claims arising under insurance contracts that insure the real or personal property of the insured on behalf of an insured, in investigating, verifying, substaining, estimating, appraising, determining, presenting, and discussing the value of the claim, and effectuating the resolution of a claim for loss or damage covered by an insurance contract. See Tennessee Code 56-6-902
• Reciprocal: means the aggregation of subscribers under a common name. See Tennessee Code 56-16-102
• Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
• Reinsurance intermediary: means a reinsurance intermediary broker, or a reinsurance intermediary manager. See Tennessee Code 56-6-802
• Reinsurer: means any person, firm, association or corporation duly licensed in this state pursuant to the applicable provisions of this title as an insurer with the authority to assume reinsurance. See Tennessee Code 56-6-802
• Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
• Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Serious emotional disturbance: means a condition in a child who currently or at any time during the past year has had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet psychiatric diagnostic criteria that results in functional impairment that substantially interferes with or limits the child's role or functioning in family, school, or community activities and includes any mental disorder, regardless of whether it is of biological etiology. See Tennessee Code 33-1-101
• Service of process: The service of writs or summonses to the appropriate party.
• Service recipient: means a person who is receiving service, has applied for service, or for whom someone has applied for or proposed service because the person has mental illness or serious emotional disturbance. See Tennessee Code 33-1-101
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• signed: includes a mark, the name being written near the mark and witnessed, or any other symbol or methodology executed or adopted by a party with intention to authenticate a writing or record, regardless of being witnessed. See Tennessee Code 1-3-105
• State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• Subpoena: A command to a witness to appear and give testimony.
• Support: means any activity or resource that enables a service recipient to participate in a service for mental illness or serious emotional disturbance or in community life. See Tennessee Code 33-1-101
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• To be in violation: means that the reinsurance intermediary, insurer, or reinsurer for whom the reinsurance intermediary was acting failed to substantially comply with this part. See Tennessee Code 56-6-802
• Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. ^{Source: OCC}
• Uniform business entity application: means the current version of the NAIC uniform business entity application for resident and nonresident business entities. See Tennessee Code 56-6-902
• Uniform individual application: means the current version of the NAIC uniform individual application for resident and nonresident individuals. See Tennessee Code 56-6-902
• United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• Utilization review: means a system for prospective and concurrent review of the necessity and appropriateness in the allocation of health care resources and services given or proposed to be given to an individual within this state. See Tennessee Code 56-6-703
• Utilization review agent: means any person or entity, including the state, performing utilization review, except:
  (A) An agency of the federal government. See Tennessee Code 56-6-703
• written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
• Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105