Glossary

A claims-made coverage trigger requiring that a claim be both made against the insured and reported to the insurer during the policy period for coverage to apply is called a claims-made and reported provision.

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.