Article 2
IA-BOD-RES 9/2011 Effective from 4/12/2011The following words and expressions shall have the meanings ascribed thereto, unless the context otherwise requires:
| State/UAE: | The United Arab Emirates. |
| Law: | The Federal Law No. (6) of 2007 Concerning the Establishment of the Insurance Authority and the Regulation of Insurance Business. |
| Competent Authority: | The local competent authority in the concerned Emirate. |
| Authority (IA): | The Insurance Authority established under the provisions of Law. |
| Board: | The IA Board of Directors. |
| Chairman: | The Chairman of the IA Board of Directors. |
| Director General: | The IA Director General. |
| Register: | The Register of Health Insurance Third Party Administrators at the IA. |
| Insurance Company: | An insurance company licensed by the IA to practice health insurance business in the State. |
| Health Insurance Third Party Administrator (TPA): | A company licensed by the IA to perform health insurance third party administration in accordance with the provisions of these Instructions. |
| Medical Service Providers: | Individuals and entities licensed by the competent health authority to provide medical treatment services such as hospitals, physicians, clinics, rehabilitation centers, medical laboratories, pharmacies and other professions associated with medical treatment services. |
| Beneficiary: | A person insured by the Insurance Company. |
| Excess: | The amount borne by the insured from the value of payable compensation. |
| Fraud: | Deliberate deception by an individual or an entity for the purpose of unlawful exploitation of health care through intentionally fraudulent acts leading to receiving benefits, obtaining excluded advantages or exceeding the limits permitted to such individual or entity. |
| Abuse: | Carrying out actions that may lead to obtaining un-entitled benefits or advantages, but with no intention of fraud, deception, deliberate lie or falsification of facts for the purpose of obtaining the benefits. |
| Agent: | A natural person of UAE nationality or a juridical person incorporated in the UAE and fully-owned by natural UAE citizens. |