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Claims & settlement

What happens after the loss: notification, loss adjustment, case reserving, settlement pace, recovery and subrogation.

129 terms
Actual cash valueAdapted housing and vehicle costsAdditional living expenses (rehousing costs)ALFA (French insurance fraud prevention agency)Anxiety damage (France)Application fraudAppraisal by a third expertAsbestos Victims Compensation Fund (France, FIVA)Attendant care (third-party assistance)Average clause for underinsuranceAZF plant explosion (Toulouse, 2001)Badinter law (road accident compensation)Business interruption after an administrative closure orderCancellation after a claimCapitalization table for future lossesCase reserveClaim reopeningClaims and Underwriting ExchangeClaims leakageClaims payment patternCondensation damage (ship's sweat and cargo sweat)Consequential and pure financial lossConsolidation (bodily injury)Contractual limit of indemnity (first loss limit)Court-ordered expertiseCrash for cashCriminal Injuries Compensation Commission (France, CIVI)Debris removal and demolition costsDefense costs within limitsDelegated claims handlingDemand surgeDenial of access and civil authority coverDepreciation for wear and tearDeterioration of a bodily injuryDiethylstilbestrol (DES) claimsDintilhac schedule of heads of damageDischarge receiptDocument tampering fraudDriver personal injury cover (motor insurance)Drone claims inspectionDuty to defendEcological damage (pure environmental harm)Economic total loss procedure (French VEI)Educational harmEuropean accident statementEx gratia paymentFixed allowance for incidental lossesForensic accounting in claimsForfeiture of coverFrench technological disaster schemeFrench write-off procedures for damaged vehicles (VEI and VGE)Future loss of earningsFuture medical expensesGhost brokingGrenfell Tower fire (2017)Hammer clauseHospital-acquired infection (nosocomial infection)Hurricane Katrina (2005)Hurricane Sandy (2012)Improper stowage and lashingIncreased cost of construction (code upgrade)Increased cost of workingIncurred but not enough reportedIndemnity periodIndirect victims (losses of relatives)Insurable gross profitInsurance Fraud Bureau (IFB)Internal fraud (insurer)IRSA agreement between French motor insurersIRSI agreement between French insurersLarge loss thresholdLiquefaction of bulk cargoes (nickel ore, bauxite, ore)Loss adjustmentLoss of amenity (loss of specific leisure activities)Loss of chanceLoss of family life prospectsLoss of rentLubrizol fire (Rouen, 2019)Mass claims handlingMediator (benfluorex) caseMedical duty to informMorandi Bridge collapse (2018)National Museum of Brazil fire (2018)Natural disaster order (French CatNat decree)Neighbors' and third parties' recourse (French property liability)Non-damage business interruption (pandemic)Notice of circumstancesNotice of claimNotre-Dame de Paris fire (2019)Occupational impact (career harm)Opportunistic fraudOrganized fraudOroville Dam spillway failure (2017)Pain and suffering (endured suffering)Panel counselPast loss of earningsPermanent disfigurementPermanent functional impairmentPIP breast implant caseProportional rule of premiumRecoveries receivableRecovery by collateral payers (social security subrogation)Remote claims assessmentRepair in kind and approved repairer networksReplacement cost coverReservation of rightsReserve run-off resultSalvage valueSecond loss assessmentSeries claimSettlement agreementSettlement deadlineSexual harmSilverstein case (World Trade Center, one or two occurrences)Special Investigation Unit (SIU)Suspension of cover for non-paymentTemporary functional deficitTen-year limitation period for bodily injuryTenant's liabilityThird party recoveryTwo year time bar in insuranceUnderinsurance tolerance clauseUnenforceability against the insurer of the insured's settlementValencia DANA floods (2024)Victim's direct action against the liability insurerWaiver of subrogationWater damage (escape of water)Windstorm Xynthia (2010)Windstorms Lothar and Martin (1999)
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