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Claim Administration

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Closing Claims
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Closing Claims

 
  Field No.   Field Name   Entry Description
  47   Disposition Code   Required Required if case is closed.  If case is open, do not enter.  Enter the final disposition from the following Disposition Code table.

  Code   Disposition Description
  01   Before litigation General used for claims; no litigation was filed.
  02   Suit filed but not prosecuted Formal litigation filed, but abandoned by plaintiff.
  03   Voluntary dismissal Including settlement of suit - Dismissed by the plaintiff.  Some settlement of litigation as a defendant paying the plaintiff money also include agreement of the plaintiff to dismiss litigation.
  04   Involuntary dismissal Litigation dismissed by action of the court, not at request of plaintiff.
  05   Judgment for plaintiff Case closed after verdict in favor or plaintiff.  These cases are commonly settled for a sum less than the actual verdict.  The key is that a jury verdict was rendered with no appeal.
  06   Judgment for defendant A defense verdict by the finder of fact (either judge or jury).
  07   Judgment NOV for plaintiff Occasionally, the judge trying the case will find that the jury's verdict is against the weight of the evidence and reverse it.  Use this code for those situation where the judge changes a defense verdict to one in favor of the plaintiff.
  08   Judgment NOV for defendant Use this code for those situations where the judge changes a plaintiff verdict to one in favor of the defense.
  09   Directed verdict plaintiff A plaintiff verdict rendered by the judge without having had the case submitted to the jury.
  10   Directed verdict defendant A defense verdict rendered by the judge without having had the case submitted to the jury.
  11   For plaintiff after appeal Use this code for cases in which the appeals process has been completed and the outcomes in favor of the plaintiff.
  12   For defendant after appeal Use this code for cases in which the appeals process has been completed and the outcomes in favor of the defense. 
  13   Award for plaintiff
  (binding arbitration)
Use only with those cases where the outcome was determined by arbitration and in favor of the plaintiff.
  14   Award for defendant
  (binding arbitration)
Use only with those cases where the outcome was determined by arbitration and in favor of the defendant.
  15   Mediation Used only with those cases where the outcome was determined by an alternate dispute resolution or mediation.
  16   Non-binding arbitration Outcome was determined by non-binding arbitration which usually results in a payment to the plaintiff.
  17   Contract liability agreement Outcome was determined by a prearranged contract with the plaintiff.  See Section 11 for more details.
  18   Early Offer Claims  
  98   Can't be Determined  

Table 8-A

 
  Field No.   Field Name   Entry Description
  48   Disposition Time   Required Required if case is closed.  If case is open, do not enter.  Enter the final disposition from the following Disposition Time table.
 
  Code   Disposition Time Description
  01   Before litigation Case closed while in a claim status.
  02   After suit filed but not before
  litigation
Used to indicate that the closure was not in close proximity to the trial date.
  03   Within 45 days of trial Used for cases closed close to the set date for the commencement of the trial.
  04   On first day of trial Disposition achieved on trail date, but before jury verdict is announced.
  05   During trial Disposition reached after jury selection has begun but before jury verdict is announced.
  06   By verdict or judgment Disposition reached by verdict or judgment will no threat of appeal.
  07   After verdict or judgment but
  before appeals
Disposition reached after verdict but before completion of the appeal process.  Use this code in cases where the appeal process has been threatened but not commenced.
  08   During appeal Disposition is achieved during the appeal process.
  09   After appeal Disposition is not achieved until after the appeal process has been completed.
  10   Arbitration/mediation dismissal
  or abandonment
Used when a case was dismissed or abandoned when arbitrating/mediation was scheduled.
  11   Arbitration/mediation settlement Used to indicate a settlement was made as a result of arbitration/mediation.
  98   Can't be Determined  

Table 8-B


  Field No.   Field Name   Entry Description
  49   Company Liability Decision   Optional Enter the code from the table that reflects the liability decision reached by your company.

  Code   Company Liability Decision
  1   Indefensible
  2   Defensible 
  3   Gray area
  4   Not Applicable
  5   Unknown

Table 8-C


 
  Field No.   Field Name   Entry Description
  50   Previous Claims Experience   Optional Has the insured has prior claims or suits with your company.  Enter "y" for yes or "n" for no.
 

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