Billing guidelines are an insurer's rules governing how defense counsel bills, covering rates, task coding, prohibited entries, and invoice submission...

A bulk reserve is an actuarially determined amount set across a group of claims rather than on individual files.

A case reserve is the insurer's estimate of the ultimate cost of a specific claim, set and revised as the claim develops.

Claim closure is the administrative conclusion of a claim file after resolution, payment, and satisfaction of remaining obligations.

The claim file is the insurer's complete record of a claim, including investigation materials, notes, evaluations, reserves, and communications.

Claim investigation is the insurer's factual inquiry into how a loss occurred, who is responsible, and what damages resulted.

Claims handling is the process by which an insurer investigates, evaluates, reserves, negotiates, and resolves a claim under a policy.

Coverage investigation is the insurer's inquiry into whether the policy responds to a claim, conducted separately from the liability investigation.

A diary entry is an adjuster's dated note in the claim file recording activity, analysis, and next steps.

An examination under oath is a formal sworn interview of an insured conducted by the insurer as a condition of the policy during claim investigation.

First notice of loss is the initial report of a claim or incident to the insurer, which starts the claims handling process and the insurer's response...

Incurred but not reported reserves cover losses that have occurred but have not yet been reported to the insurer.

Litigation guidelines are the rules an insurer imposes on defense counsel governing staffing, reporting, approvals, budgets, and permitted activities in...

A loss run is a report of an insured's claims history with a carrier, showing dates, descriptions, payments, and reserves.

A proof of loss is a sworn statement by the insured detailing the claimed loss, required as a condition of first-party coverage.

A recorded statement is an audio-recorded account taken by an insurer from an insured, claimant, or witness during claim investigation.

Reserve adequacy is whether an insurer's reserves are sufficient to cover the ultimate cost of its claims obligations.

Reserves are the funds an insurer sets aside to pay the estimated ultimate cost of a claim, including indemnity and defense expense.