Associate in Claims
Representational documents - ANSPhotographs, maps, diagrams, and video footage that are
useful as a means to document evidence for a file.
Bad Faith - ANSAn insurance company's unreasonable and unfounded (though not necessarily
fraudulent) refusal to provide coverage in violation of the duties of good faith and fair dealing
owed to an insured. Bad faith often involves an insurer's failure to pay the insured's claim or
claim brought by a third party.
Compensatory Damages - ANSA monetary compensation to a victim for harm actually suffered,
including lawyers' fees, court costs, and interest. Can include contractual damages,
consequential damages, a/or emotional damages.
Contractual Damages - ANSThe amount payable under the contract according to the contract's
terms.
Consequential Damages - ANSDamages awarded by a court to indemnify an injured party for
losses that result indirectly from a wrong such as a breach of contract or a tort.
Emotional Damages - ANSDamages for mental suffering without physical injury.
Punitive Damages - ANSDamages imposed in order to punish the wrongdoer. The standard for
awarding punitive damages varies by jurisdiction but generally requires proof of insurer behavior
that is worse than ordinary wrongdoing, such as malicious, fraudulent, or oppressive behavior.
Defenses to a bad-faith claim - ANSThe defenses include statutes of limitations, lack of right to
sue (lack of standing), reliance on lawyers' advice, insured's collusion with the claimant,
debatable reasonable basis, statutory defenses, fair dealing and good documentation,
comparative bad faith, and contributory negligence.
Statute of Limitations - ANSA statue that requires the plaintiff to file a lawsuit within a specific
time period after the cause of action has accrued, which is often when the injury occurred or
was discovered.
Summary Judgment - ANSA judgment granted by the court when it determines that no factual
issue exists.
Good Faith - ANSBroadly defined as consideration given to the insured's interests that is at
least equal to that given to the insurer's interests in handling the claim.
, Gramm-Leach-Bliley Act of 1999 (GLB) - ANSEnacted by Congress to protect the security and
confidentiality of customers of financial institutions such as banks, securities firms, insurers, etc.
Sarbanes-Oxley Act - ANSThis act requires publicly traded companies to meet and certify
certain financial disclosure requirements.
Fair Credit Reporting Act - ANSEnacted by Congress in 1970 to promote accuracy and privacy
of personal information assembled by credit reporting agencies. The act requires reporting
agencies to follow "reasonable procedures" to protect the confidentiality and privacy of personal
information.
Courts hold insurers to higher standard of conduct - ANSTo discourage them from abusing their
position of power. Insurers create the contract and are in a superior position of knowledge and
power.
Equitable Subrogation - ANSDescribes a situation in which an excess insurer has the same
rights as the insured to bring a suit against the primary insurer.
Elements of good faith claims management - ANSConsistent supervision, thorough training, and
manageable caseloads.
Bad Faith Claims - What do they arise from? - ANSClaim denial, excess liability claim, statutory
bad faith, and violations of unfair claims settlement practices act.
Regulation of insurers' claim settlement practices - ANSMany states base their unfair claims
settlement practices laws on Model Act, but not all of them.
Requirements to prove intentional misconduct by a claims representative - ANSA complainant
must show that the CE intended both the misconduct and the consequences.
Compensatory damages - ANSCompensation to claimsts for their bodily injury or property
damages resulting from a covered loss.
Includes contractual damages, consequential damages, and/or emotional distress damages.
What is a defense to bad-faith claim? - ANSStatutes of limitations that apply to a particular
lawsuit can vary by state.
What does the litigation process begin with? - ANSReceipt of the summons and complaint
Allegations - ANSSpecify what the plaintiff expects to prove to obtain a judgment against the
defendant. Cause of action is the set of facts that make up the grounds for the lawsuit.
Cross-claim - ANSWhen defendant files a lawsuit against other defendants in a claim.
Representational documents - ANSPhotographs, maps, diagrams, and video footage that are
useful as a means to document evidence for a file.
Bad Faith - ANSAn insurance company's unreasonable and unfounded (though not necessarily
fraudulent) refusal to provide coverage in violation of the duties of good faith and fair dealing
owed to an insured. Bad faith often involves an insurer's failure to pay the insured's claim or
claim brought by a third party.
Compensatory Damages - ANSA monetary compensation to a victim for harm actually suffered,
including lawyers' fees, court costs, and interest. Can include contractual damages,
consequential damages, a/or emotional damages.
Contractual Damages - ANSThe amount payable under the contract according to the contract's
terms.
Consequential Damages - ANSDamages awarded by a court to indemnify an injured party for
losses that result indirectly from a wrong such as a breach of contract or a tort.
Emotional Damages - ANSDamages for mental suffering without physical injury.
Punitive Damages - ANSDamages imposed in order to punish the wrongdoer. The standard for
awarding punitive damages varies by jurisdiction but generally requires proof of insurer behavior
that is worse than ordinary wrongdoing, such as malicious, fraudulent, or oppressive behavior.
Defenses to a bad-faith claim - ANSThe defenses include statutes of limitations, lack of right to
sue (lack of standing), reliance on lawyers' advice, insured's collusion with the claimant,
debatable reasonable basis, statutory defenses, fair dealing and good documentation,
comparative bad faith, and contributory negligence.
Statute of Limitations - ANSA statue that requires the plaintiff to file a lawsuit within a specific
time period after the cause of action has accrued, which is often when the injury occurred or
was discovered.
Summary Judgment - ANSA judgment granted by the court when it determines that no factual
issue exists.
Good Faith - ANSBroadly defined as consideration given to the insured's interests that is at
least equal to that given to the insurer's interests in handling the claim.
, Gramm-Leach-Bliley Act of 1999 (GLB) - ANSEnacted by Congress to protect the security and
confidentiality of customers of financial institutions such as banks, securities firms, insurers, etc.
Sarbanes-Oxley Act - ANSThis act requires publicly traded companies to meet and certify
certain financial disclosure requirements.
Fair Credit Reporting Act - ANSEnacted by Congress in 1970 to promote accuracy and privacy
of personal information assembled by credit reporting agencies. The act requires reporting
agencies to follow "reasonable procedures" to protect the confidentiality and privacy of personal
information.
Courts hold insurers to higher standard of conduct - ANSTo discourage them from abusing their
position of power. Insurers create the contract and are in a superior position of knowledge and
power.
Equitable Subrogation - ANSDescribes a situation in which an excess insurer has the same
rights as the insured to bring a suit against the primary insurer.
Elements of good faith claims management - ANSConsistent supervision, thorough training, and
manageable caseloads.
Bad Faith Claims - What do they arise from? - ANSClaim denial, excess liability claim, statutory
bad faith, and violations of unfair claims settlement practices act.
Regulation of insurers' claim settlement practices - ANSMany states base their unfair claims
settlement practices laws on Model Act, but not all of them.
Requirements to prove intentional misconduct by a claims representative - ANSA complainant
must show that the CE intended both the misconduct and the consequences.
Compensatory damages - ANSCompensation to claimsts for their bodily injury or property
damages resulting from a covered loss.
Includes contractual damages, consequential damages, and/or emotional distress damages.
What is a defense to bad-faith claim? - ANSStatutes of limitations that apply to a particular
lawsuit can vary by state.
What does the litigation process begin with? - ANSReceipt of the summons and complaint
Allegations - ANSSpecify what the plaintiff expects to prove to obtain a judgment against the
defendant. Cause of action is the set of facts that make up the grounds for the lawsuit.
Cross-claim - ANSWhen defendant files a lawsuit against other defendants in a claim.
