Claims and Loss Adjustment Expense. X. Xxxxxx shall be reported by the Company in summary form as hereinafter provided, but the Company alone and at its full discretion shall adjust, settle or compromise all claims and losses hereunder. The Company shall be the sole judge as to:
1. What constitutes a claim or loss covered under any policy;
2. The Company's liability thereunder;
3. The amount or amounts proper for the Company to pay thereunder. The Reinsurer shall be bound by the judgment of the Company as to the obligations and liabilities of the Company under any policy.
B. All loss settlements made by the Company, whether under strict policy conditions or by way of compromise (including loss in excess of policy limits and extra contractual obligations), shall be binding upon the Reinsurer, and the Reinsurer agrees to pay or allow, as the case may be, its proportion of each such settlement in accordance with the Reports and Remittances Article. It is agreed, however, that if the Reinsurer's share of any loss is equal to or greater than $100,000, the Reinsurer, if requested by the Company, will pay its share of said loss within 10 days after the proof of loss or demand for payment is transmitted to the Reinsurer. If such loss or claim payment is not received within the 10 days, interest will accrue on the payment or amount overdue (as specified in the Late Payments Article) from the date the proof of loss or demand for payment was transmitted to the Reinsurer.
C. In the event of a claim under a policy subject hereto, the Reinsurer shall be liable for its proportionate share of loss adjustment expense incurred by the Company in connection therewith, and shall be credited with its proportionate share of any recoveries of such expense.
D. A Special Circumstance Reinsurer shall not have the right to deny payment of a claim if the sum of the percentage shares of Active Subscribing Reinsurers that have paid the claim exceeds 50.0% of the sum of the percentage shares of all Active Subscribing Reinsurers. "Active Subscribing Reinsurer" as used herein shall mean a Subscribing Reinsurer that is not a Special Circumstance Reinsurer as of the due date of the claim (as specified in the Late Payments Article).
Claims and Loss Adjustment Expense. A. Losses shall be reported by the Company in summary form as hereinafter provided, but the Company shall notify the Reinsurer immediately when a specific case involves unusual circumstances or large loss possibilities. The Reinsurer shall have the right to participate, at its own expense, in the defense of any claim or suit or proceeding involving this reinsurance.
B. All loss settlements made by the Company, whether under strict policy conditions or by way of compromise, shall be binding upon the Reinsurer, and the Reinsurer agrees to pay or allow, as the case may be, its proportion of each such settlement in accordance with the Reports and Remittances Article. It is agreed, however, that if the Reinsurer’s share of any loss is equal to or greater than $250,000, the Reinsurer will pay its share of said loss as promptly as possible after receipt of reasonable evidence of the amount paid by the Company.
C. In the event of a claim under a policy subject hereto, the Reinsurer shall be liable for its proportionate share of loss adjustment expense incurred by the Company in connection therewith, and shall be credited with its proportionate share of any recoveries of such expense.
Claims and Loss Adjustment Expense. A. All loss settlements, judgments, and all interest on said judgments (including extra contractual obligations awards and loss in excess of policy limits judgments made against the Company, including interest on said judgments) made by the Company, or the Company’s designated representative, whether under strict policy conditions or by way of compromise, shall be unconditionally binding upon the Reinsurer.
B. The Reinsurer shall be liable for an amount of loss adjustment expense equal to 14.0% of the premiums earned during each underwriting year hereunder.
Claims and Loss Adjustment Expense. A. Losses shall be reported by the Company in summary form as hereinafter provided, but the Company shall notify the Reinsurer immediately when a specific case involves unusual circumstances or large loss possibilities. The Reinsurer shall have the right to participate, at its own expense, in the defense or control of any claim or suit or proceeding involving this reinsurance.
B. All loss settlements made by the Company, whether under strict policy conditions or by way of compromise, shall be binding upon the Reinsurer, and the Reinsurer agrees to pay or allow, as the case may be, its proportion of each such settlement in accordance with Article XII.
C. In the event of a claim under a policy subject hereto, the Reinsurer shall be liable for its proportionate share of loss adjustment expense incurred by the Company in connection therewith, and shall be credited with its proportionate share of any recoveries of such expense. Loss adjustment expense shall include litigation expenses, both prejudgment and postjudgment interest, and legal expenses incurred in direct connection with legal actions, including but not limited to declaratory judgment actions. "Declaratory judgment actions" are defined as those actions brought to determine the Company's defense and/or indemnification obligations that are allocable only to specific policies and claims covered under this Contract. Any declaratory judgment expense shall be deemed to have been fully incurred on the same date as the original loss (if any) giving rise to the action. Loss adjustment expense shall not include office expenses or salaries of the Company's regular employees.
Claims and Loss Adjustment Expense. A. Losses shall be reported by the Company in summary form as hereinafter provided, but the Company shall notify the Reinsurer immediately when a specific case involves unusual circumstances or large loss possibilities. Further, the Company shall notify the Reinsurer whenever a claim involves a fatality, amputation, spinal cord damage, brain damage, blindness or extensive xxxxx, regardless of liability. The Reinsurer shall have the right to participate, at its own expense, in the defense of any claim or suit or proceeding, involving this reinsurance.
B. All loss settlements made by the Company, whether under strict Policy conditions or by way of compromise, shall be binding upon the Reinsurer, and the Reinsurer agrees to pay or allow, as the case may be, its proportion of each such settlement in accordance with the Reports and Remittances Article. It is agreed, however, that if the Reinsurer’s share of any loss is equal to or greater than $250,000, the Reinsurer will pay its share of said loss within 15 days after receipt of reasonable evidence of the amount paid by the Company.
C. In the event of a claim under a Policy subject hereto, the Reinsurer shall be liable for its proportionate share of Loss Adjustment Expense incurred by the Company in connection therewith, and shall be credited with its proportionate share of any recoveries of such expense.
Claims and Loss Adjustment Expense. A. Whenever a claim is reserved by the Company for an amount greater than 50% of its retention hereunder and/or whenever a claim appears likely to result in a claim under this Contract, the Company shall notify the Reinsurer. The Reinsurer shall have the right to participate, at its own expense, in the defense or control of any claim or suit or proceeding involving this reinsurance.
B. All claim settlements made by the Company, provided they are within the terms of this Contract, shall be binding upon the Reinsurer, and the Reinsurer agrees to pay all amounts for which it may be liable upon receipt of reasonable evidence of the amount paid by the Company.
C. In the event of loss hereunder, loss adjustment expenses incurred by the Company in connection therewith which do not reduce the Company's limit of liability under the policy involved shall be shared by the Company and the Reinsurer in the proportion the ultimate net loss paid or payable by the Reinsurer bears to the total loss paid or payable by the Company, prior to any reinsurance recoveries, but after deduction of all salvage, subrogation and other recoveries. However, if a verdict or judgment is reduced by any process other than by the trial court, resulting in an ultimate saving to the Reinsurer, or a judgment is reversed outright, the expenses incurred in securing such reduction or reversal shall be shared by the Company and the Reinsurer in the proportion that each benefits from such reduction or reversal, and the expenses incurred up to the time of the original verdict or judgment which do not reduce the Company's limit of liability under the policy involved shall be shared in proportion to each party's interest in such original verdict or judgment. The Reinsurer's liability for such loss adjustment expenses shall be in addition to its liability for ultimate net loss.
Claims and Loss Adjustment Expense. A. Whenever a claim is reserved by the Company for an amount greater than 66.0% of its retention hereunder and/or whenever a claim appears likely to result in a claim under this ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Page 7 ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Contract, the Company shall notify the Reinsurer. All cases of serious injury which, regardless of considerations of liability or coverage, might result in a claim under this Contract, shall be reported to the Reinsurer, including but not limited to the following: 1. Brain injury with significant cognitive, behavioral or physical residual damages;
Claims and Loss Adjustment Expense. A. All decisions to settle or defend Claims under policies covered by this Agreement shall be made by the Reinsurer. The Company shall provide such information regarding Claims as may be reasonably requested by Reinsurer. The Reinsurer shall have the exclusive power and authority to assume the Company's defense of any Claim and to direct any and all actions to be taken by or on behalf of the Company in connection with the settlement or defense of Claims, except to the extent that the authority to settle or defend Claims may from time to time be delegated to the Company by Reinsurer.
B. The Reinsurer shall be liable for its proportionate share of losses and allocated and unallocated loss adjustment expense incurred in connection with the defense and settlement of Claims as herein provided. Reinsurer agrees to pay or allow as the case may be its proportionate share of all such losses and loss adjustment expenses in accordance with Article XI hereof.
C. Notwithstanding anything in this Article VII to the contrary, nothing in this Contract shall be construed as an assignment of the Company's rights and non-delegable duties and obligations under the Company's policies relating to the claims reinsured hereunder.
Claims and Loss Adjustment Expense. A. Losses shall be reported by the Company in summary form as hereinafter provided, but the Company shall notify the Reinsurer immediately when, in the sole judgment of the Company, a specific case involves unusual circumstances or large loss possibilities. Further, the Company shall notify the Reinsurer whenever a claim involves a fatality, amputation, spinal cord damage, brain damage, blindness and/or extensive xxxxx, regardless of liability. The Reinsurer shall have the right to participate, at its own expense, in the adjustment of any such losses.
B. All loss settlements made by the Company, whether under strict Policy conditions or by way of compromise, shall be binding upon the Reinsurer, and the Reinsurer agrees to pay or allow, as the case may be, its proportion of each such settlement in accordance with Article XVI.
C. In the event of a claim under a Policy subject hereto, the Reinsurer shall be liable for its proportionate share of Loss Adjustment Expense incurred by the Company in connection therewith, and shall be credited with its proportionate share of any recoveries of such expense.
Claims and Loss Adjustment Expense. A. Losses shall be reported by the Company in summary form as hereinafter provided, but the Company shall notify the Reinsurer immediately when a specific case involves unusual circumstances or large loss possibilities. Further, the Company shall notify the Reinsurer whenever a claim involves a fatality, amputation, spinal cord damage, brain damage, blindness, extensive xxxxx or multiple fractures, regardless of liability. The Reinsurer shall have the right to participate, at its own expense, in the defense or control of any claim or suit or proceeding involving this reinsurance.
B. All loss settlements made by the Company, provided they are within the terms of the original policies (other than extra contractual obligations and loss in excess of policy limits), shall be binding upon the Reinsurer, and the Reinsurer agrees to pay or allow, as the case may be, its proportion of each such settlement in accordance with Article XIV. It is agreed, however, that if the Reinsurer's share of any loss is equal to or greater than $250,000, the Reinsurer will pay its share of said loss as promptly as possible after receipt of reasonable evidence of the amount paid by the Company.
C. In the event of a claim under a policy subject hereto, the Reinsurer shall be liable for its proportionate share of loss adjustment expenses incurred by the Company in connection therewith, and shall be credited with its proportionate share of any recoveries of such expense.
