See: Claims Cooperation Clause.
Tag: UK
Claims condition
A condition setting out what the insured has to do in the event of a claim. It covers notice of loss, assistance to the insurer and proofs of loss, and in the case of liability policies there is a control of proceedings clause and a non-admission of liability clause.
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A condition in many types of insurance policy setting out the insured’s duties in the event of a claim.
Claims equalisation reserve
An insurer’s reserve for smoothing out fluctuations in claims costs where the incidence is of an uneven nature. Produces a greater level of consistency in the revenue account.
Claims expenses/claims handling expenses
Direct costs of investigation and settlement as distinct from the payments of the claims themselves. Includes loss adjusters’ fees, court fees, etc. The indirect expenses, claims handling expenses, relate to the salaries and overheads associated with running a claims department.
Claims experience
The insured’s claims history with regard to the cost and frequency of previous claims. It is material for an insured to disclose his claims experience when proposing insurance. The term also describes the relationship between premium and claims experienced by an insurer for a particular class of business over a period of time.
Claims handling agreements
Agreements between insurers involved in the same incidents or losses to settle matters between them by way of a prescribed formula rather than resort to costly and regular litigation. The knock-for-knock agreement has been replaced by the memorandum of agreement.
Claims handling expenses
expenses incurred in negotiating and settling claims, including the direct expenses of the claims department (loss adjusters’ fees, court fees, etc.) and any part of general administration expenses associated with the claims function.
Claims made
a term referring to liability policies covering all claims notified in the policy period, regardless of the time of the occurrence (contrast losses occurring).
Claims series clause
A clause in a liability or reinsurance contract designed to treat a series of loss occurrences unified by a common cause as a single loss. This means that any deductible or retention will be applied only to the aggregate of individual claims arising from the common cause and not to the claims individually. For example, individual claims originating in the same product design fault would be aggregated and might breach the deductible while each one individually might fall below it. The clause also has a bearing on the application of limits of indemnity. See HOURS CLAUSE; ORIGINATING CAUSE.
Claims Underwriting and Exchange (CUE)
Database containing details of nearly all household and private motor claims over a six-year period. The purpose is to combat fraud such as multiple claims for the same loss or the staging of a series of incidents. Underwriters may search CUE at the underwriting stage and avoid ‘bad risks’. More usually they search CUE when checking the validity of claims.