4.2 Claims: Handling Flashcards
When will insurer be litigating against 3rd, usually
Subrogated claim in name of insured or for broker’s BoD
Third figure in reserve table
Costs (Defendant)
What should go in status of claim
Current status of Ps, e.g. LoC received, proceedings commenced, notification received
When will insurer be litigating against insured, usually
Over policy wording, refusing to pay out, or trying to avoid
When will a Client Care Letter be required
If S is not on the panel for the insurer - one-off instruction
What are the defence costs covering in the reserve
For both insured and the other side - stage to show costs if settles early
After considering notification clause, consider what two things
Any avoidance issues and relevant exclusion clauses
What is an IBNR reserve
Claims incurred but not yet reported, e.g. extreme weather event
Two situations in which litigation can ensue
Against 3rd or against insured
If there is a breach of a general condition, remedy would be what
Damages, but negligible
What two columns of figures should there be in reserve table
To trial and to early settlement
What is a market report
Coverage report addressed to entire market
Always remember to take what off quantum table
Excess to be paid by insured
What does an SLA set out
Standard of service, how it will be measured, fees, DR and termination
Before responding to insured, what should S always do on behalf of insurer
Reserve rights
Why does S usually attend market meetings
To advise + keep discussions privileged
After avoidance issues + exclusion, what next in Coverage
Insurers should (not) provide cover bc
What 6 things to include at top of initial report
Insured, Claimant, Date of Claim, Date of Accident/event, Insurer’s reference, Recipient and address
Two different options to include in Strategy part of report
Consequences if insurers decide to accept, and consequences if decide to deny, w/ recommendations
Why does insurer deal w/ claims instead of insured
Control costs and look from commercial perspective
After going through insuring clause + if within policy period, what next in Coverage
Go through Limit of indemnity, defence costs, and excess
What is the indemnity part of reserve covering
Exposure of insurer under the policy - losses recoverable under policy
Panel Ss usually have what C w/ insurers
Service Level Agreement
What are the two main ways of reporting to the market
Market meetings and market reports
