Pennsylvania Statutes Title 77 P.S. Workers' Compensation § 1039.1. Definitions

The following words and phrases when used in this article shall have the meanings given to them in this section unless the context clearly indicates otherwise:

“Attorney” means an individual admitted by the Pennsylvania Supreme Court to practice law in this Commonwealth.

“Health care provider” means a person licensed or certified pursuant to law to perform health care activities.

“Insurance claim” means a claim for payment or other benefits pursuant to an insurance policy for workers' compensation.

“Insurance policy” means a document setting forth the terms and conditions of a contract of insurance or agreement for workers' compensation.

“Insurer” means a company, association or exchange defined by section 101 of the Insurance Company Law of 1921  1 and the State Workmen's Insurance Fund, an unincorporated association of underwriting members, a hospital plan corporation, a professional health services plan corporation, a health maintenance organization, a fraternal benefit society and a self-insured health care entity under the act of October 15, 1975 (P.L. 390, No. 111), known as the “Health Care Services Malpractice Act.”  2

“Person” means an individual, corporation, partnership, association, joint-stock company, trust or unincorporated organization. The term includes any individual, corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society, beneficial association and any other legal entity engaged or proposing to become engaged, either directly or indirectly, in the business of insurance, including agents, brokers, adjusters and health care plans as defined in 40 Pa.C.S. Chs. 61 (relating to hospital plan corporations), 63 (relating to professional health services plan corporations), 65 (relating to fraternal benefit societies) and 67 (relating to beneficial societies) and the act of December 29, 1972 (P.L. 1701, No. 364), known as the “Health Maintenance Organization Act.”  3 For purposes of this article, health care plans, fraternal benefit societies and beneficial societies shall be deemed to be engaged in the business of insurance.

“Statement” means any oral or written presentation or other evidence of loss, injury or expense, including, but not limited to, any notice, statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of property damages, bill for services, diagnosis, prescription, hospital or doctor records, X-ray, test result or computer-generated documents.