Losses and Loss Adjustment Expenses. A. All loss settlements made by TICNY with regards to the Brokerage Business, whether under strict policy conditions or by way of compromise, shall be unconditionally binding upon CPIC.
B. Each Participating Company shall be liable for its percentage share per Schedule 1 of loss adjustment expenses incurred under or in connection with the Policies and shall be credited with its percentage share per Schedule 1 of any recoveries of such expense.
C. If a Participating Company pays or is held liable to pay any punitive, exemplary, compensatory, or consequential damages (hereinafter called “Extra Contractual Obligations”) because of alleged or actual negligence on its part in handling a claim under a Policy, one hundred percent (100%) of such Extra Contractual Obligations (to the extent permitted by law) shall be added to the Net Liability, if any, of such Participating Company under the Policy involved, and the sum thereof shall be subject to this Pooling Agreement; provided, however, that no such payment of Extra Contractual Obligations shall be permitted if such payment is contrary to New York law.
D. If a Participating Company pays or is held liable to pay in connection with any loss amounts in excess of the limit of its original Policy, such loss in excess of that limit having been incurred because of its failure to settle within the Policy limit or by reason of alleged or actual negligence in rejecting an offer of settlement or in the preparation of the defense or in the trial of any action against the original insured or reinsured or in the preparation or prosecution of an appeal consequent upon such action (hereinafter called an “Excess of Policy Limits Loss”), one hundred percent (100%) of such Excess of Policy Limits Loss (to the extent permitted by law) shall be added to the Net Liability, if any, of such Participating Company under the Policy involved, and the sum thereof shall be subject to this Pooling Agreement.
Losses and Loss Adjustment Expenses. A. Losses shall be reported by the Company in summary form as hereinafter provided, and the Reinsurer shall have the right to participate in the adjustment of losses subject to this Contract as its own expense.
B. All claim or loss settlements made by the Company, whether under strict policy conditions or by way of compromise, shall be binding on the Reinsurer, and the Reinsurer shall pay or allow, as the case may be, 100% of each such settlement as provided in Article VIII.
C. In the event of a claim under a policy subject hereto, the Reinsurer shall be liable for 100% of loss adjustment expenses incurred by the Company in connection therewith (including litigation expenses and interest on judgments, but not including office expenses or salaries of the Company's regular employees), and shall be credited with 100% of any recoveries of such expense.
Losses and Loss Adjustment Expenses. Losses and loss adjustment expenses paid by the Company;
Losses and Loss Adjustment Expenses. All loss settlements (other than ex-gratia payments), whether under strict policy conditions or by way of compromise, shall be unconditionally binding upon the Reinsurer in the amount of its applicable Quota Share part thereof. The Reinsurer shall bear its applicable Quota Share part of all loss adjustment expenses incurred under the ceded Contracts. In addition to indemnity amounts recoverable hereunder, the Reinsurer shall bear its proportionate share of all expenses incurred by the Company in the investigation, adjustment, appraisal or defense of all claims under policies reinsured hereunder (excluding office expenses and compensation of officers and regular employees of the Company, other than staff field adjusters and out of pocket expense of the Company's officers incurred in connection with the loss), and shall receive its proportionate share of any recoveries of such expenses.
Losses and Loss Adjustment Expenses. A. Losses shall be reported by the Company in summary form as hereinafter provided, however, whenever a loss is reserved by the Company for an amount greater than $100,000, the Company shall notify the Reinsurer. The Reinsurer shall have the right to participate in the adjustment of losses subject to this Contract at its own expense.
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 XIV. It is agreed, however, that if the Company's gross loss is equal to or greater than $100,000, the Reinsurer shall pay its share of said loss as promptly as possible after receipt of reasonable evidence of the amount paid (or scheduled to be 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.
Losses and Loss Adjustment Expenses. All claims and losses shall be adjusted, settled or compromised in accordance with the terms of the Administrative Services Agreement. All such settlements, compromises, and adjustments, including those involving coverage issues and/or the resolution of whether such claims or losses are required by law, regulation, or regulatory authority to be covered (or not to be excluded thereunder), shall be binding on Seller and Reinsurer.
Losses and Loss Adjustment Expenses. A. The Retrocessionaire shall pay to the Retrocedant, either directly or through the Underwriting Manager, its proportionate share of all loss and loss expense (including coverage dispute expense and monitoring expense), as defined in Article 6 of this Agreement.
B. The Retrocessionaire agrees to abide by all disposition of claims, including exgratia settlements, directed by the Retrocedant and/or the Original Company and/or the Underwriting Manager as the Original Company's agent, or as directed or amended by enactment or interpretation by any legislative, regulatory, or judicial body, provided that: (i) the Original Company and/or the Underwriting Manager, as applicable, shall settle all claims in accordance with the underlying policies and applicable law, and (ii) the Original Company and/or the Underwriting Manager shall comply with all provisions of this Article.
C. The Retrocedant, either directly or through the Underwriting Manager as its agent, shall report promptly to the Retrocessionaire, as in the Original Reinsurance
Losses and Loss Adjustment Expenses. A. Subject to the provisions of Article III, the Reinsurer, in proportion to its participation, shall pay to the Company a pro rata share of sums actually paid by the Company in settlement of losses under its policies including amounts paid for managed care arrangements, such as network access fees, bill repricing services and other usual and customary managed care facilities. However, in the event of the insolvency of the Company payment of loss for which the Company is liable shall be made by the Reinsurer to the liquidator, receiver or statutory successor of the Company in accordance with the provisions of Article XI of this Agreement.
B. Subject to the provisions of Article III, the Reinsurer shall bear in proportion to its participation expenses incurred by the Company in the investigation, adjustment and litigation of all claims under its policies, excluding the office expenses of the Company and the salaries and expenses of its officials and employees.
C. The Reinsurer shall benefit pro rata in all salvages, discounts and other recoveries.
D. The Company has the obligation to investigate and, to the extent that may be required by the policies reinsured hereunder, defend any claim affecting this reinsurance and to pursue such claim to final determination.
Losses and Loss Adjustment Expenses. A. Losses shall be reported by the Company in summary form as hereinafter provided. The Reinsurer shall have the right to participate in the adjustment of losses subject to this Contract at its own expense.
B. All loss settlements made by the Company, whether under strict policy conditions or by way of compromise (excluding ex gratia payments made by the Company), 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 provisions of 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 expenses incurred by the Company in connection therewith (including litigation expenses, prejudgment interest and postjudgment interest, but not including office expenses or salaries of the Company's regular employees), and shall be credited with its proportionate share of any recoveries of such expense.
Losses and Loss Adjustment Expenses. 12.1 Reinsurer shall assume 100% of the risks covered by this Agreement and shall be liable for and pay on behalf of Company 100% of all losses, judgments, interest on judgments, settlements whether under strict policy conditions or because of compromise, and expenses incurred by Company (including, but not limited to, costs, expenses and fees, including attorneys' fees and expenses, resulting from a declaratory judgment or injunctive action brought by or against an insured or other person). Reinsurer shall be credited with 100% of any amount received by Company as salvage, subrogation or recovery.
12.2 Company hereby empowers Reinsurer to accept notice of and investigate any claim arising under any of the Policies, to pay, adjust, settle, resist, or compromise any such claim. Reinsurer will exercise the authority granted hereunder in good faith and shall pay all valid claims, if, when, and as they become due.
12.3 Company will promptly notify Reinsurer of any claim, suit or action brought against Company under any of the Policies when Company actually is notified of such a claim, suit or action against Company, and will promptly furnish to Reinsurer all summons, citations, complaints, petitions, counterclaims and other pleadings and legal instruments served upon Company in connection therewith. Company hereby further empowers Reinsurer to dispose of any salvage received as the result of any loss settlement hereunder, and to enforce any right of Company against any person or organization for damages or equitable relief for any loss under any of the Policies, employing legal counsel where necessary, and all sums received as a result thereof will be treated as current loss recoveries by Company and Reinsurer. Company further agrees to furnish Reinsurer any and all legal instruments necessary to implement the foregoing authorizations. Upon request, Reinsurer shall furnish to Company any or all documents and correspondence relating to the subject matter hereof.
12.4 All records pertaining to claims arising under the Policies shall be deemed to be jointly owned records of Company and Reinsurer, and shall be made available to Company or Reinsurer or their representatives or any duly appointed examiner for any State within the United States. Company and Reinsurer agree that they will not destroy any such records in their possession without the prior written approval of the other Party, except that Company shall not be required to retain files longer than required...
