Definitions

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  • (a) “Commissioner” means the Commissioner of Insurance.

  • (b) “Health care provider” means a person, corporation, facility or institution who must be licensed by this territory to provide health care or professional medical services including but not limited to any physician, osteopath, hospital, dentist, registered or licensed practical nurse, optometrist, podiatrist, physical therapist, psychologist, chiropractor, par-medical personnel and emergency medical technician, pharmacist and laboratory technicians, or any health care facility, including but not limited to a medical center, hospital, clinic, health center and/or group practice that are licensed or certified under the Virgin Islands Code to provide treatment for injuries, diseases, pain or deformity of the human body.

  • (c) “Insurer” means a corporation or association which is engaged as a principal in the business of making contracts of insurance, but shall not include an insurance broker acting as a broker.

  • (d) “Recognized health insurer” means an insurer licensed to do business in the Virgin Islands that offers health insurance to the public.

  • (e) “Uncontested claim” means a claim from a health care provider for services that are covered under a health insurance plan, is adequately documented and medically appropriate, and which charges reasonable fees for services rendered.

  • (f) “Preferred Provider Organization” means a network of health care providers that has entered into a written agreement with an insurer to provide benefits under a health insurance plan issued under this chapter, and which shall provide reasonable access to such health care providers.


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