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S2 Claims (Tiers (Tier-2 CLAIM NUMBER (i.e. individual reference),, Tier…
S2 Claims
Tiers
Tier-2 CLAIM NUMBER (i.e. individual reference),
Tier-3 TRANSACTION (i.e. outstanding movement, and/or settlement and/or recovery); across 5 functional areas within the claims system:
Tier-1 CLAIM GROUP (i.e. market catastrophe or ‘event’),
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Reserve Maintenance of money set aside to pay policyholders as a fund to pay out incurred claims that have yet to be settled (aka 'balance sheet reserve')
Reserves can be entered against closed claims but it will re-open the claim that will not automatically re-open the claim).
Frozen brokers, business partners or original insureds on the treaty to which the claim is attached then no movements in reserve can be entered
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Claim Types (5)
Precautionary -
1 Reinsurers notified of a potential normal standard 'front claim(s)'
2 Bulk claims reported as accumulation of many front claims (processed in the same way as Normal Claims and effect both statistics and accounts).
- Bulk-Component for specific amounts of a front claim extracted from a bulk claim for reinsurance recovery purposes,
- Reserves and payments presented in Accounts and Statistics. History of payments and outstandings on spreadsheet attached to claim. Reinsurance reserves and recoveries included in Accounts and Statistics).
- Non-accounting processed transactions information only not bookable to accounts for an 'information only' treaty
Claim Statistics
25 calculations (including Claim FGU ( (From Ground Up of total costs involved) Total? PTD Loss? PTD LAE (LOss Adjusted Expenses) ? Company Share Reins (reinsurance) O/S Total?)
Reinstatement Reserve Premium for generating inward reinstatement reserve premium and the treaty to which the claim is attached has reinstatements,
Message will be displayed on Save asking the user whether they wish to generate reinstatement reserve premiums, if ‘Yes’, the amount of reinstatement reserve premium will be calculated
Worksheet Entry screen will be opened with the reinstatement reserve premium details defaulted in. The worksheet can then be saved without any changes, modified and saved, saved as incomplete or cancelled.
Settlement/Subrogation Maintenance of transactions in respect of claim payments in a number of ways (e.g. check, ‘in account’, etc.), and require authorisation before they can be released.; and the payment will be authorised manually.
Transactions may be entered against open or closed claims (then reset to ‘open’ claim. If a zero reserve is entered, the claim will remain closed).
Claim Ceded Contract Link Maintenance displays links created and list of non-proportional ceded contracts whose criteria match the inward treaty and claim for which links are being maintained. Note: Claims which are part of a Claim Group or CAT do not need to be linked to ceded contracts.
Recoveries are entered against the Group/Event instead of a specific Claim Reference. Initialisation 1st -‘Selected Ceded Contracts’ of any non-proportional ceded contracts that have previously been attached to the claim; if there are no previously attached contracts, the grid is blank. 2nd-‘Available Ceded Contracts’ implicit display of non-proportional contracts that could be attached to the inward treaty line of this claim that do not already appear in the ‘Selected Ceded Contracts’ frame. 3rd ‘Cancel’ Button returns to the calling program without any data being saved to the database. so that no outward treaties are attached to the claim
Precautionary Notice will be held by Claim Type, then possible to make this into a full claim at a later date by amending the Claim Type field
‘Reduce and Review’ of current outstanding amounts reduced/increased by the amount of the settlement/subrogation. (user may amend the system calculated amounts if necessary).
Claim Aggregation of claim totals (outstanding estimates and paid amounts) by various criteria to accumulate the current combined totals of a chosen set of claims e.g. total losses for a policy; event; Company name; vessel etc. or policy sub totals within a particular event, or individual claim totals within an assured e.g. event total split by policy and currency