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11 Cards in this Set

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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

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.

Claimant

A party that makes a claim and that can be either a first party or a third party claimant

Claims representative

A person responsible for investigating, evaluating, and setting claims

Third party administrator (TPA)

An organization that provides administrative services associated with risk financing and insurance

Independent adjuster

An independent claims representative who handles claims for insurer for a fee

Public adjuster

An outside organization or person hired by an insured to represent the insured in a claim in exchange for a fee

Ethics

The study of what constitutes good and bad behavior, dealing with moral duty and obligation.

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

Ex parte contacts

Contacts in which only one party is heard

Fraud

An intentional misrepresentation resulting in harm to a person or an organization.