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?
Popular Insurance Terms
Fund from which losses are paid for the insolvent members of Lloyd's of London. Each year, members of Lloyd's of London contribute a percentage of their premium volume to this fund to act ...
In insurance, fraudulent or unethical practice that is illegal under state law. States may fine or revoke the licenses of agents and brokers for unfair trade practices, including ...
System whereby the re insurer shares losses in the same proportion as it shares premium and policy amounts. Proportional reinsurance may be divided into the two basic forms: automatic ...
Clause in some current ASSUMPTION WHOLE LIFE INSURANCE policies Such as UNIVERSAL LIFE insurance that allows unscheduled premiums to be paid at any time prior to the policy's maturity date, ...
Monthly income payment from a disability income insurance policy made to the insured wage earner when income has been interrupted or terminated because of illness, sickness, or accident ...
Single limit insurance program remaining in force for several years as compared with traditional insurance programs where there is a series of annual limits. The LUMP insurance program is ...
Buildup of policy cash value, as distinguished from the death benefit. A policyholder has a choice between surrendering the policy for its cash surrender value or keeping it in force for ...
System established for checking claims to determine whether they should be paid immediately or checked further for validity. ...
In many health insurance and dental insurance policies, stipulation that, if the estimated cost of a recommended plan of treatment exceeds a specified sum, the insured must submit the plan ...
Have a question or comment?
We're here to help.