v3-RoleClassClaimant
type: ValueSet
node role: treeRoot
id:
  v: v3-RoleClassClaimant
language:
  v: en
text:
  status:
    v: generated
  div: Include codes fromhttp://terminology.hl7.org/CodeSystem/v3-RoleClass where concept is-a CLAIM
url:
  v: http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant
identifier:
  system:
    v: urn:ietf:rfc:3986
  value:
    v: urn:oid:2.16.840.1.113883.1.11.20120
version:
  v: 3.0.0
name:
  v: RoleClassClaimant
title:
  v: RoleClassClaimant
status:
  v: active
experimental:
  v: false
date:
  v: 2014-03-26
publisher:
  v: Health Level Seven International
contact:
  telecom:
    system:
      v: url
    value:
      v: http://hl7.org
  telecom:
    system:
      v: email
description:
  v: **Description:** A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible. **Discussion:** With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary. **Note:** A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants. In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a…
immutable:
  v: true
copyright:
  v: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license
compose:
  include:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-RoleClass
    filter:
      property:
        v: concept
      op:
        v: is-a
      value:
        v: CLAIM