U

Uberrimae Fidei. A Latin phrase meaning "of the fullest confidence or absolute openness and honesty." See Utmost Good Faith.

ULAE. See Loss Adjustment Expense.

Ultimate. The value of claims or premiums when they have fully matured.

Umbrella Liability Policy. An insurance policy providing limits of liability in excess of primary and excess liability insurance and providing coverage for risks not covered by a primary policy. The term umbrella is derived from the fact that it is a separate policy of insurance and provides coverage above the insured's other liability policies.

Unallocated Claim Expense. See Loss Adjustment Expense.

Unauthorized Reinsurance. See Nonadmitted Reinsurance.

Unauthorized Reinsurer. See Nonadmitted Reinsurer.

Uncollected Premiums. See Agents' Balances.

Under-insurance. Failure to maintain adequate insurance coverage.

Underinsured Motorists Coverage. A provision in an automobile insurance policy that protects the insured from losses caused by a driver with inadequate insurance coverage.

Underwriter. A synonym for insurer or an employee of an insurance company whose responsibilities include reviewing applications submitted for insurance coverage, deciding whether to accept or reject all or part of the coverage requested and fixing the terms of coverage.

Underwriting. The process undertaken by an underwriter in reviewing applications submitted for insurance coverage, deciding whether to accept or reject all or part of the coverage requested and fixing the terms of coverage.

Underwriting Capacity. See Capacity.

Underwriting Cycle. The phenomenon within the property-casualty insurance industry in which prices, profits and availability fluctuate between shortage and abundance. See also Cycle Turn, Hard Insurance Market and Soft Insurance Market.

Underwriting Expense. Administrative, general and other expenses attributable to an insurer's underwriting operations.

Underwriting Manager. An individual, at the local or home office level, responsible for setting company underwriting criteria to assist underwriters in the risk selection process.

Underwriting Profit. Income earned by an insurer from its underwriting activities. This does not include income derived from the insurer's investment activities.

Underwriting Reserves. See Reserves.

Underwriting Year. The year in which a policy was issued.

Unearned Premiums. The portion of an insurer's premiums attributable to the unexpired period of policies.

Unearned Premium Reserve. A reserve account that contains the portion of an insurer's premium attributable to the unexpired period of a policy that has been collected but has not yet been recognized as earned premium and accounted for as revenues.

Uninsured Motorists Coverage. A provision in an automobile insurance policy that protects the insured from uninsured and hit-and-run drivers.

Unisex Rating. A rating formula required in certain jurisdictions that forbids the use of sex as a separate rating factor. For example, although women on average live longer than men, unisex rating charges both sexes the same for annuities and life insurance policies. Without unisex rating, for two individuals of equal age, a woman would pay more for an annuity and a man would pay more for a life insurance policy.

Universal Life Insurance. A flexible-premium life insurance policy that allows the policyholder to change the death benefit and vary the amount or timing of premium payments.

Unreported Claims. See IBNR.

Urban Property and Reinsurance Act of 1968. See FAIR Plans.

USPCC (United States Per Capita Cost). Medicare's payment amount, based on actual historical expenditures, including traditional Medicare program claims, risk HMO capitation payments and all other expenses, which is projected forward based on anticipated inflation rates, utilization trends and program changes.

Usual, Customary, and Reasonable Charges. See Reasonable and Customary Charges.

Utilization. The patterns of use of a service or type of service within a specified time. Utilization usually is expressed in rate per unit of population-at-risk for a given period (e.g., the number of hospital admissions per year per 1,000 persons enrolled in an HMO).

Utilization Management (UM). All activities directly or primarily related to the provision of efficient, cost-effective and appropriate use of health care resources. These managed care techniques and tools are used to manage costs through case-by-case assessments of the clinical necessity for proposed medical services before, during and after treatment. UM techniques include precertification, case management, concurrent review, discharge planning, retrospective review, utilization review and others.

Utilization Rate. The rate at which a covered group uses a particular health plan or program.

Utilization Review (UR). A cost-containment measure used by health care insurers, third-party administrators and others to evaluate the need for treatment and assess alternatives to expensive or complex procedures. Among the techniques used are preadmission certification, solicitation of second opinions and use of rehabilitation programs. Evaluation of the use of hospital services, including admission, length of stay, ancillary services and outpatient costs, using objective clinical criteria. The objective is to ensure that services are medically necessary and provided at the appropriate level of care.

Utmost Good Faith (Uberrimae Fidei). A contract is uberrimae fidei when the obligee is required to disclose to the obligor every fact or circumstance that may influence a decision concerning whether to enter into a contract. This duty exists whether such information is requested. Contracts of insurance are subject to the duty of utmost good faith, while ordinary commercial contracts are subject to the doctrine of caveat emptor.