Franchise

1. Relieves insurer of each and every loss that does not exceed a specified amount or percentage. If the limit is exceeded the loss is paid in full. The term, is distinguished from an excess, the amount of which continues to be deducted for each and every loss above the specified amount. 2. The amount by which a Lloyd’s syndicate is permitted to exceed its syndicate allocated capacity. 3. See LLOYD’S FRANCHISE.

Fraudulent claims

Claim where the insured has: (a) made false statements of fact; or (b) made statements, knowing them to be false, or not believing them to be true, or without caring whether they were true or false. Good faith, implied in all insurance contracts, requires that any claim by the insured shall be honestly made. If the insured submits a fraudulent claim all benefit, including the premium, under the policy is forfeited. See CHEATLINE.
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Dishonest claims made by people who suffered no loss or who magnify a loss for their own gain.

Fraudulent misrepresentation

UK: Breach of the duty of utmost good faith occurring where the person knowingly makes a false statement relating to a material fact, does not believe it to be true or makes it recklessly without due regard to its accuracy. The Road Traffic Act 1988 makes it a statutory offence for a person to make a false statement or to withhold material information for the purpose of obtaining a certificate of motor insurance required by the Act.
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MEDICAL,USA: False statement to get an insurance company to provide insurance coverage for an applicant. Fraudulent misrepresentation gives an insurance company grounds to terminate a policy at any time.
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Misrepresentation made knowingly with intent to deceive, or recklessly without care whether it be true or false.

Fraudulent trading

Occurs when a company continues to trade and incur debts, when, to the knowledge of the director(s), there is no reasonable prospect of the creditors being paid. It includes a situation where there are no good grounds for believing that the company can pay its way even if the director(s) hold an opposite view. Any director guilty of fraudulent trading may be liable to contribute to the company’s assets. See DIRECTORS’ AND OFFICERS’ LIABILITY.

Free asset ratio

For UK life insurance companies only, a solvency measure calculated as available assets minus the required minimum margin/admissible assets. All other things equal, the higher the free asset ratio, the higher the level of surplus capital relative to the asset base. Reported free assets ratio are dependent on the assumptions made to value the liabilities.

Free assets

Life insurance company’s assets that exceed the sum of the company’s liabilities and the required minimum margin of solvency (RMM). It is a measure of surplus capital once the RMM has been covered.

Free cover

The maximum amount of death or disability cover which an insurer covering a group is prepared to insure for each individual without production of evidence of health.