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11 Cards in this Set
- Front
- Back
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First party claim |
A demand by an insured person or organization to recover from its insurer for a loss that is insurance policy may cover |
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Third party claim |
A demand against an insured by a person or organization other than the insured or the insurer,seeking to recover damages that may by payable by the insureds liability insurance. |
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Claimant |
A party that makes a claim and that can be either a first party or a third party claimant |
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Claims representative |
A person responsible for investigating, evaluating, and setting claims |
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Third party administrator (TPA) |
An organization that provides administrative services associated with risk financing and insurance |
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Independent adjuster |
An independent claims representative who handles claims for insurer for a fee |
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Public adjuster |
An outside organization or person hired by an insured to represent the insured in a claim in exchange for a fee |
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Ethics |
The study of what constitutes good and bad behavior, dealing with moral duty and obligation. |
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Conflict of interest |
A situation that occurs when a decision maker's personal interests interfere to the extent that he or she makes decisions that adversely affect customers or employers |
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Ex parte contacts |
Contacts in which only one party is heard |
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Fraud |
An intentional misrepresentation resulting in harm to a person or an organization. |
