4.2 Claims: Handling Flashcards Preview

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Flashcards in 4.2 Claims: Handling Deck (49)
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1

When will insurer be litigating against 3rd, usually

Subrogated claim in name of insured or for broker's BoD

2

Third figure in reserve table

Costs (Defendant)

3

What should go in status of claim

Current status of Ps, e.g. LoC received, proceedings commenced, notification received

4

When will insurer be litigating against insured, usually

Over policy wording, refusing to pay out, or trying to avoid

5

When will a Client Care Letter be required

If S is not on the panel for the insurer - one-off instruction

6

What are the defence costs covering in the reserve

For both insured and the other side - stage to show costs if settles early

7

After considering notification clause, consider what two things

Any avoidance issues and relevant exclusion clauses

8

What is an IBNR reserve

Claims incurred but not yet reported, e.g. extreme weather event

9

Two situations in which litigation can ensue

Against 3rd or against insured

10

If there is a breach of a general condition, remedy would be what

Damages, but negligible

11

What two columns of figures should there be in reserve table

To trial and to early settlement

12

What is a market report

Coverage report addressed to entire market

13

Always remember to take what off quantum table

Excess to be paid by insured

14

What does an SLA set out

Standard of service, how it will be measured, fees, DR and termination

15

Before responding to insured, what should S always do on behalf of insurer

Reserve rights

16

Why does S usually attend market meetings

To advise + keep discussions privileged

17

After avoidance issues + exclusion, what next in Coverage

Insurers should (not) provide cover bc

18

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

19

Two different options to include in Strategy part of report

Consequences if insurers decide to accept, and consequences if decide to deny, w/ recommendations

20

Why does insurer deal w/ claims instead of insured

Control costs and look from commercial perspective

21

After going through insuring clause + if within policy period, what next in Coverage

Go through Limit of indemnity, defence costs, and excess

22

What is the indemnity part of reserve covering

Exposure of insurer under the policy - losses recoverable under policy

23

Panel Ss usually have what C w/ insurers

Service Level Agreement

24

What are the two main ways of reporting to the market

Market meetings and market reports

25

If insurer is successful in subrogated claim, what happens with recovering from reinsurer

Will take account of subrogated recovery

26

First figure in reserve table

Liability

27

Three different kinds of reserves

Open claims, IBNR and IBNER

28

Timeline of claims handling

Notification by insured to broker/insurer; insurers contacts Ss; Ss acknowledge instructions; Ss build initial report

29

What is the potential consequence of failing to keep insurer updated

Negligence

30

What to contain in 'Liability' part

Discussion of claim against insured - potential defence? Concede liability?