Claims Practices. It is the Company’s sole decision to determine whether to investigate, contest, compromise or litigate a claim; however, the Company is responsible for investigating, contesting, compromising or litigating Reinsured Policy claims in accordance with applicable law and policy terms. The Company acknowledges that it obtains a certified death certificate to the extent one exists, otherwise such other documentation as may be agreed to by the Reinsurer for that particular death claim to ascertain the fact, time, and manner of an insured’s death, and follows industry standard and investigates claims with any of the following criteria:
Claims Practices. The Company is responsible for the investigating, contesting, compromising or litigating any Reinsured Policy claims in accordance with applicable law and policy terms. It is the Company’s sole decision to determine whether to investigate, contest, compromise or litigate a claim. The Company acknowledges that it follows industry standard and investigates claims with any of the following criteria:
Claims Practices. It is the Company's sole decision to determine whether to investigate, contest, compromise or litigate a claim; however, the Company is responsible for investigating, contesting, compromising or litigating Reinsured Policy claims in accordance with applicable law and policy terms. The Company acknowledges that it follows industry standards and investigates claims with any of the following criteria:
Claims Practices. (a) The Reinsured shall notify Reinsurer of any material changes that the Reinsured makes to its claims handling practices after January 1, 2017, including claims staffing models, which impact the Covered Business, which notice shall include an explanation of the rationale for such changes (the “Change Notice”). If the Reinsured changes its claims practices or, without a formal change, engages in a pattern of claims practices having, in the aggregate, the effect of such a change, in a manner that Reinsurer determines has had a material adverse effect on Reinsurer’s Liability or the attachment of Reinsurer’s Liability, including, without limitation, because of a material difference in the claims operation for the Covered Business as compared to the long-tail commercial business not covered (i.e., accident years 2016 and later), the Reinsurer must raise any such determination promptly after its discovery thereof. If the Reinsured agrees, the Parties will work together in good faith to modify such change to the practices.
Claims Practices. The Company acknowledges that it obtains a death certificate or other reliable proof of death for death claims.
Claims Practices. It is the Company’s sole decision to determine whether to investigate, contest, compromise or litigate a claim; however, the Company is responsible for investigating, contesting, compromising or litigating Reinsured Policy claims in accordance with applicable law and policy terms. The Company acknowledges that it obtains certified death certificates for death claims that are over $250,000 and obtains a copy of the certified death certificate for death claims of $250,000 or less.
Claims Practices
