In managing the claims handling function, insurers seek to balance the elements of customer satisfaction, administrative handling expenses, and claims overpayment leakages. As part of this balancing act, fraudulent insurance practices are a major business risk that must be managed and overcome. Disputes between insurers and insureds over the validity of claims or claims handling practices occasionally escalate into litigation (see insurance bad faith).
For example, life insurance companies may require higher premiums or deny coverage altogether to people who work in hazardous occupations or engage in dangerous sports. Liability insurance providers do not provide coverage for liability arising from intentional torts committed by or at the direction of the insured. Even if a provider desired to provide such coverage, it is against the public policy of most countries to allow such insurance to exist, and thus it is usually illegal.[citation needed]
In the states with no-fault insurance, insured drivers are typically paid for medical expenses by their own insurers, regardless of who caused the accident. Nonetheless, BI liability coverage is still required in no-fault states because if injuries are bad, the at-fault driver may be sued by the injured party. If that happens, your BI coverage can help cover your liability expenses.
Insurable interest – the insured typically must directly suffer from the loss. Insurable interest must exist whether property insurance or insurance on a person is involved. The concept requires that the insured have a "stake" in the loss or damage to the life or property insured. What that "stake" is will be determined by the kind of insurance involved and the nature of the property ownership or relationship between the persons. The requirement of an insurable interest is what distinguishes insurance from gambling.

Calculable loss: There are two elements that must be at least estimable, if not formally calculable: the probability of loss, and the attendant cost. Probability of loss is generally an empirical exercise, while cost has more to do with the ability of a reasonable person in possession of a copy of the insurance policy and a proof of loss associated with a claim presented under that policy to make a reasonably definite and objective evaluation of the amount of the loss recoverable as a result of the claim.
Choosing the lowest price/inadequate coverage. The lowest prices will typically leave you vulnerable on the back end; should an accident or collision occur, your lower premium will require you to spend much more out of pocket. The same goes for inadequate coverage. Specifically, don’t cut corners when it comes to liability coverage; instead, shop around for the provider that will protect you most while also catering to your needs, lifestyle, and budget.
In determining premiums and premium rate structures, insurers consider quantifiable factors, including location, credit scores, gender, occupation, marital status, and education level. However, the use of such factors is often considered to be unfair or unlawfully discriminatory, and the reaction against this practice has in some instances led to political disputes about the ways in which insurers determine premiums and regulatory intervention to limit the factors used.

In the states with no-fault insurance, insured drivers are typically paid for medical expenses by their own insurers, regardless of who caused the accident. Nonetheless, BI liability coverage is still required in no-fault states because if injuries are bad, the at-fault driver may be sued by the injured party. If that happens, your BI coverage can help cover your liability expenses.


Claims and loss handling is the materialized utility of insurance; it is the actual "product" paid for. Claims may be filed by insureds directly with the insurer or through brokers or agents. The insurer may require that the claim be filed on its own proprietary forms, or may accept claims on a standard industry form, such as those produced by ACORD.
Comprehensive car insurance covers damages from an "act of God," or events that are not caused by a car driving into something else. An "act of God" can include things like damage from a heavy tree branch falling on your car. Since you have no control over when or why a tree branch would fall on your car, this kind of accident would be covered under your comprehensive policy.
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