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Loss

UK: (1) event giving rise to a claim, (2) financial disadvantage incurred by the insured as a result of an adverse contingency; (3) cost of settlement of a claim (4) in the term underwriting loss, an excess of amounts payable over amounts receivable (in the usual accounting sense) referable to underwriting.
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US: (1) The basis of a claim for damages under the terms of a policy. (2) Loss of assets resulting from a pure risk. Broadly categorized, the types of losses of concern to risk managers include personnel loss, property loss, time element loss, and legal liability loss.
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MEDICAL,USA: 1. Reason for an insurance claim for recovery of indemnity or payment for damages. 2. Any reduction of the quantity, quality, or value of a property.
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UK: A claim under a policy. The financial loss caused to the insured by the occurrence of the event insured against. Certain ‘loss’ definitions such as constructive total loss are contained in the Marine Insurance Act 1906.
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A general term used to refer to the amount of a claim filed by the insured. This term can also mean the amount the insured’s property value decreased as a result of a loss. This term can also refer to the amount an insurer has paid on behalf of an insured.
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An unintentional decline or disappearance in value arising from an event.
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An unplanned decrease in a property (or other) value which can be measured in rupee terms. As regards insurance the term generally refer to (i) The amount of reduction in the value of an insured’s property caused by an insured peril. (ii) The amount sought through an insurance claim. (iii) The amount paid on behalf of an insured under an insurance contract. (02) What the Policyholder may suffer an what insurance is designed to cover.
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US: The happening of the event for which insurance pays.

Loss (or Claim) Reserve

(i) Reserve representing an Insurer’[s estimate of amounts payable for insured losses which have already occurred (including) losses which have occurred but not yet been reported to the Insurer). Loss reserves may be established through estimates for individual cases, as well as through various averaging and formula methods. (ii) Similar reserve established by an organization retaining its own losses.Reserve for Incurred But Not Reported Losses (or Claims) : Loss reserves established by an Insurer because it knows from past experience that, although it has not yet been informed of them, some events have already occurred that will give rise to insured losses or claims.Unearned Premium Reserve : Reserve, for the total of the unearned premiums on policies an Insurer has in force, representing the Insurer’s obligation to return unearned premiums on request, and enabling the Insurer to purchase portfolio Reinsurance, if needed.Res Ipsa Loquitur : Literally translated this expression means “facts speak for themselves.” Under this doctrine, an individual is presumed to be negligent if the circumstances of injury are under his complete and exclusive control and it can be shown that the injury or damage could only have occurred if the individual were negligent.

Loss Adjuster

A person who assesses the size or value of a loss on behalf of the Insurer.
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UK: an independent expert who negotiates claims settlements as an intermediary between the insurer and the insured.
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UK: Independent claims expert engaged by insurers to investigate claims and assess the true extent and value of any loss. Loss adjusters are not engaged for smaller, routine losses. The relevant professional body is the Chartered Institute of Loss Adjusters.

Loss Adjustment Expense

All expenditure of an insurer associated with its adjustment, recording and settlement of claims, other than claim payment itself. The term encompasses both allocated loss adjustment expenses (ALAE) which are loss adjustment expenses identified by a claim file in the insurer’s records, such as attorney’s fees and unallocated loss adjustment expenses (ULAE) which are operating expenses not identified by claim file, but functionally associated with settling losses, such as salaries of claims department.
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The total expenses associated with adjusting a claim. The actual amount of the loss is not included in this amount.

Loss adjustment expense (LAE)

US: The cost of investigating and adjusting losses. LAEs need not be allocated to a particular claim. If they are allocated to a particular claim, they are called “allocated loss adjustment expenses” (ALAE); otherwise, they are unallocated loss adjustment expenses (ULAE).
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UK: The expense incurred by a cedant in the defence and settlement of claims but not its overhead expenses. The definition of LAE depends on the terms of the reinsurance contract.
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REINSURANCE: The expense incurred by the ceding insurer in the defense, cost containment and settlement of claims under its policies. It is normally broken down into two categories: Allocated (ALAE) and Unallocated (ULAE). ALAE are those expenses that are directly related to (or “allocated” to) a specific claim such as the legal defense of a liability claim. These are typically covered by a reinsurance contract as a component of reinsured ‘loss”. The elements of loss adjustment expenses that are covered by the reinsurance as loss are specified in the terms of the reinsurance agreement and may be treated on a proportional basis (the ALAE is shared by the cedent and reinsurer in the same proportion as they share the indemnity loss) or it may simply be added to the indemnity loss for reinsurance recovery purposes. By contrast, ULAE are claim expenses that are not directly related to a specific claim and are considered part of the ceding insurer’s overhead and cost of doing business. They are not subject to reinsurance recovery as loss, but may be considered in determining a commission to be paid by the reinsurer to the ceding company (ceding commission) to help offset the ceding company’s expenses.

Loss adjustment expenses

All expenditures of an insurer associated with its adjustment, recording, and settlement of claims, other than the claim payment itself. The term encompasses both allocated loss adjustment expenses (ALAE) that are loss adjustment expenses identified by a claim file in the insurer’s records, such as attorney’s fees and unallocated loss adjustment expenses (ULAE), which are operating expenses not identified by claim file, but functionally associated with settling losses, such as salaries of claims department.
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Expenses incurred to investigate and settle losses.