SUP 16.27 General insurance value measures reporting

“add-on policy” means

a policy that is sold in connection with, or alongside, another product.

“average claims pay-out” means

total claims pay-out cost divided by the number of claims where all or part of the claim has been accepted and a pay-out has been made and/or benefits provided and the claim is closed at the end of the reporting period.

“average number of policies in force” means

the average number of policies in force during the relevant reporting period, calculated by adding up the total policies in force at the end of each month and dividing by the total number of months in the reporting period.

“claim” means

any claim made by a potential beneficiary, including queries in respect of a potentially claimable event or loss (which has taken place).

“claims acceptance rate” means

(a) the number of claims registered; less

(b) the number of claims rejected; divided by

(c) the number of claims registered.

“claims accepted” means

claims where all or part of the claim has been accepted and a pay-out has been made and/or benefit provided, and the claim is closed or settled during the reporting period.

“claims complaints” means

complaints of a type that are reported in column O of the DISP 1 Annex 1R Table 4 or would have been reported if the threshold of 500 opened complaints was disregarded.

“claims complaints as a percentage of claims” means

the percentage calculated using the formula:

A/B x 100

where:

(a) A = claims complaints

(b) B = claims registered

“claims frequency” means

the number of claims registered divided by the average number of policies in force.

“claims pay-out cost” means

the total costs of providing benefits to policy beneficiaries in relation to claims accepted during the reporting period including:

(a) the total monetary value (£) of claim pay-outs;

(b) the total cost incurred by the provider firm in providing non-monetary benefits; and

(c) specific claims costs incurred by the provider firm in handling individual claims including claims investigation costs.

“claims registered” means

all claims during the reporting period less the number of:

(a) claims walkaways;

(b) claims in respect of which the potential beneficiary reports an event or loss giving rise to the claim but does not wish to make a claim;

(c) claims rejected for insurance fraud; and

(d) claim rejected because the policy has been lawfully voided by the insurer.

“claims rejected” means

claims by potential beneficiaries of the policy, declined or rejected in the reporting period, regardless of:

(a) when the claim was registered;

(b) whether or not the claim is rejected at the first notification of loss;

(c) whether the claim is rejected for breach of a policy condition, pursuant to an applicable policy exclusion, due to the application of an excess or otherwise,

but excluding claims rejected for insurance fraud or because the policy has been lawfully voided by the insurer.

“claims walkaways” means

claims closed during the reporting period due to the potential beneficiary not pursuing the claim.

“distribution arrangement” means

in relation to the relevant product, each distribution arrangement through which the product is sold, as identified by the consumer facing firm or brand.

“no claims bonus protection” means

a contract of insurance which will, in the event of a claim, within certain limits, protect the purchaser’s number of years during which a person is deemed not to have made a claim for the purposes of calculating the no claims bonus discount incorporated by a provider into the price of a motor insurance product.

“policy sales” means

policies sold in the reporting period, including renewals, and regardless of the period covered by the contracts.

“reporting period” means

(a) the period beginning on 1 January and ending on 31 December; or

(b) any shorter period in accordance with SUP 16.27.12 (2).

“stand-alone policy” means

a policy that is not sold in connection with, or alongside, another product.

“total gross retail premiums (written)” means

the total amount of gross written premium, based on the premiums charged to the end consumer (excluding insurance premium tax) in relation to policies sold during the reporting period.

“value measures data” means

the data required to be included in a value measures report and set out in SUP 16.27.10R to 16.27.11R.

“value measures report” means

the report referred to in SUP 16.27.7R.

An insurer other than a TP firm or Gibraltar-based firm2

all contracts of insurance effected by the insurer.

A TP firm or Gibraltar-based firm2

all contracts of insurance effected by the TP firm or Gibraltar-based firm2 from an establishment of the firm2 (or its appointed representative) in the UK.

A TP firm or Gibraltar-based firm2

all contracts of insurance effected by the firm2

(a) from an establishment outside the UK with a customer in the UK2; and

(b) which were not manufactured by a firm2 operating from an establishment in the UK.

A firm2 manufacturing from an establishment in the UK

all contracts of insurance effected by a TP firm or Gibraltar based-firm from an establishment outside the UK with a customer in the UK2.

A firm, a TP firm or a Gibraltar-based firm2 which, from an establishment in the UK, either:

(1) manufactures; or, if not,

(2) advises on or proposes contracts of insurance which it does not manufacture.

all contracts of insurance effected by a firm2 from an establishment outside the UK with a customer in the UK without carrying on a regulated activity in the UK2.

An insurance intermediary

contracts of insurance in relation to which:

(a) the insurance intermediary carried on or was responsible for insurance distribution activities; and

(b) the provider entering into the contract as principal is not an authorised person in relation to that activity. References to firms in SUP 16 include references to these unauthorised providers, where the context requires.

A managing agent

any contracts of insurance written at the Society.