A claims series clause term. The meaning has been interpreted in a number of ways but where a series of individual claims are unified by a common cause, that cause may be regarded as the originating cause. An insured may seek to rely on this provision to reduce the deductibles payable and reach the minimum level at which the insurers’ obligation to pay commences. A primary layer insurer may seek to aggregate multiple claims to limit its exposure to its retention level. A financial institution mis-sold pensions but was not allowed by the House of Lords to treat the poor training of their representatives as the common cause and could not therefore aggregate the losses to breach the £1m deductible. The poor training was background only; the real cause of the 22,000 losses (maximum was £35,000) was the failure of the representative to give best advice to each claimant individually.
Tag: UK
Orphan estate
any part of a life insurer’s assets which is not required for smoothing purposes or to pay terminal bonuses; sometimes referred to as ‘inherited estate’.
Orphan syndicate
a syndicate which is unable to find another syndicate to accept an RITC premium at the three year point, and goes into run-off.
Outstanding claims reserve
An amount reserved based on the estimated amount needed to meet incurred claims that have not yet been finally settled.
Outstanding losses or claims
The total of losses or claims that have been notified but at a given time are still outstanding and as such are only estimated amounts.
Outstandings
in Lloyd’s, claims which have been notified to an insurer syndicate by the end of the year, but not yet paid; in general insurance the provision for claims outstanding includes both claims notified but not yet settled, and IBNR. Outstanding claims portfolio
Over-age additional premium
Additional premium on an open cover applied to a cargo which is carried by a vessel over 15 years old or which is outside the scope of the classification clause. It may also be applied for breach of navigational warranties (Institute Warranties where the ship is over 15 years.
Over-insurance
Insuring property for more than its actual value. It can be inadvertent or fraudulent. The penalties for under-insurance can cause the insured to over insure but the use of declaration policies enables insureds with fluctuating sums insured to overcome the problem.
Over-the-counter (OTC) derivatives
A derivative, sold by a financial intermediary, tailored to particular risk financing needs rather than being exchangedtraded. I-Wex OTC Weather Risk Market allows ‘open access’ enabling a company to submit all details, barring price, of the weather risk they seek to hedge. Others search the database with a view to making offers.
Overall premium limit
Maximum amount of business a Lloyd’s member may write based on the member’s Funds at Lloyd’s (FAL). The limit is allocated to syndicates in proportions agreed between the member and the member’s agent.