Definition of "Claim report"
Report furnished by the adjuster to the, insurance company (insurer) that documents the amount of payment the insurer is legally obligated to pay to or on behalf of the insured under the terms of the policy. This report includes the following items:
- Is there an INSURABLE INTEREST did the person who submitted the claim have expectation of a monetary loss?
- Is there a coverable cause of loss was the source of the loss an insured peril ?
- Is the property covered was the damaged or destroyed property insured?
- What is the location of the loss was the occurrence of the insured peril within the geographical scope of the policy?
- What is the date of the loss did the loss occur while the policy was in effect?
- What are the applicable EXCLUSIONS was the loss caused by a peril specifically excluded by the policy?
- What are the applicable CONDITION (S) and WARRANTY (S) were the condition (s) and warranty (s) under the policy complied with by the insured?
- What is the SALVAGE value of the damaged property is there a portion of the damaged property that can be salvaged and how does the value of the salvageable property affect the total dollar amount of the loss?
- What is the status of any OTHER INSURANCE in force are there any other insurance policies in force carried by the CLAIMANT covering the loss?
- What is the status of SUBROGATION are there any third parties responsible for a covered loss against which the insurer can take legal action?
- Was there any MISREPRESENTATION (FALSE PRETENSE) and CONCEALMENT involved did the insured falsify or withhold material facts from the insurer?
- What is the status of the availability of documentation are there photographs available of the damaged or destroyed insured property? Does the insured have receipts or other pertinent records relating to the damaged or destroyed insured property?
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