Glossary

Ostensible agency liability refers to certain powers granted to an agent that the public has come to expect the agent to possess even if a principal has not actually granted such powers. In a medical professional liability context, the ostensible agency liability doctrine is often used to hold hospitals liable for the acts of independent contractor physicians who work in emergency and operating rooms. There are two reasons for this approach. First, a hospital environment creates a likelihood that patients will look to the institution rather than the individual physicians for care. Second, in many situations, a hospital presents a physician as its employee.

An osteopath is a doctor who has graduated from an osteopathic medical school and received a doctor of osteopathy (DO), while a doctor of medicine (MD) has graduated from a conventional medical school. Individuals with a DO degree have the same rights, privileges, and responsibilities as physicians with an MD degree. Both MDs and DOs must complete residency training in their chosen specialties, and both must pass the same licensing examinations. Osteopathy shares many of the same goals as traditional medicine but places greater emphasis on the relationship between the organs and the musculoskeletal system as well as on treating the whole individual rather than just the disease.

Other-than-collision (OTC) coverage is available under the personal auto policy (PAP). OTC coverage provides a form of "all risks" protection for damage to a covered auto from perils other than collision. Losses include but are not limited to fire, theft or larceny, explosion or earthquake, windstorm, hail, water, flood, malicious mischief, vandalism, riot, contact with an animal, and glass breakage.

An other insurance clause is a provision found in both property and liability insurance policies establishing how loss is to be apportioned among insurers when more than one policy covers the same loss. These provisions vary: some policies provide no coverage when other insurance is in place, some pay a pro rata share, and others apply in excess. They are included to comply with the principle of indemnity, which states that an insured should not profit from an insured loss.

Other states coverage is workers compensation and employers liability insurance coverage for an insured's employees traveling through or temporarily working in states other than the insured's home state, as specifically listed in item 3.C of the information page of the policy. The endorsement expands the policy so that an injured employee can receive compensation benefits as prescribed by the other states listed on the endorsement. However, coverage only applies to states so listed, and coverage cannot be extended in this manner to monopolistic fund states.

Other structures coverage is found under standard homeowners policies. It covers structures on the residence premises separated from the dwelling by a clear space or connected to the dwelling by a fence, utility line, or related connection. Examples include a detached garage, tool shed, driveway, swimming pool, gazebo, or fence. The limit of insurance for all other structures combined is 10 percent of the dwelling limit. Due to increasing home prices and lack of land availability, home construction changed in the United States in the 1970s. Builders stopped building homes with detached garages and, instead, built the homes with the garages attached or built under the home. At this point, many consumers began to view the charge for other structures in the homeowners policy as a charge for unneeded—and unusable—coverage. Thus, some insurers started issuing homeowners policies without this coverage and giving the insured a rate credit. Others changed the wording in their policies to allow for the addition of the other structures limit into the dwelling limit, if the homeowner had no other structures.

Other underwriting income refers to ceding commissions or profit commissions earned from reinsurers.

Out-of-pocket costs under a health insurance plan refer to the expenses for medical care that are not reimbursed by the insurance. Examples of out-of-pocket expenses not covered by a health insurance plan include deductibles, coinsurance, and co-payments.

Under a health insurance plan, the out-of-pocket (OOP) limit is the maximum amount the covered individual will have to pay for covered health services during the policy year. Generally included within the OOP are the plan deductible, coinsurance, and co-payments.

Outcomes measurement is the process by which the ability of a physician to treat an injured worker competently, efficiently, and cost effectively is gauged. The evaluation of the doctor is based on the successful performance of the employee after returning to work and the financial costs associated with the treatment.