Glossary

Claims-made basis is a form of reinsurance under which the date of the claim report is deemed to be the date of the loss event.

A claims-made coverage trigger obligates an insurer to defend and/or pay a claim on an insured's behalf if the claim is first made against the insured during the period in which the policy is in force.

A claims-made multiplier is a factor applied to rates used for a claims-made commercial general liability (CGL) policy, depending on how long an insured has been in a claims-made program.

A claims-made policy provides coverage that is triggered when a claim is made against the insured during the policy period, regardless of when the wrongful act that gave rise to the claim took place.

Claims-made reinsurance provides for reinsurance of claims-made policies on a claims-made basis.

A claims-paid policy is a liability insurance policy that is triggered at the time a claim is paid, rather than at the time a claim is first reported (claims-made policy) or at the time the injury or damage occurs (occurrence policy).

Claims administrator is a generic term used to refer either to an insurance company claims department or to a third-party claims administrator.

A claims audit is a systematic and detailed review of claims files and related records to evaluate the adjuster's performance.

A claims cooperation clause is a clause in a reinsurance contract that requires the sharing of information between the cedent and reinsurer.

Claims leakage (CL) concerns dollars lost through claims management inefficiencies that ultimately result from failures in existing processes (manual and automated).