Coverage changes

Coverage lines carry a line number, code, limit, deductible, exclusion and effective interval. The parent policy identifies whose coverage is being described. The owner can compare these lines with the policy effective date before a loss is assessed. An endorsement records its own effective date, reason, revision, carrier receipt and approver name.

A coverage line can be revised without rewriting the original claim record. The endorsement explains a dated change and keeps a carrier receipt beside it. During review, the team should choose the coverage effective at the loss date and read the exclusion as written. A later change does not silently alter the basis for an earlier decision.

• Date the line. Record the start and end of the coverage interval with limit and deductible.
• Record the change. Keep the endorsement reason, approval name and carrier receipt with the policy.
• Read the loss date. Compare the claim date with the terms that applied then.

Agree who may change a coverage line and who records an endorsement approval. Decide how to retain the earlier line when a revision changes a limit or exclusion. Confirm how the carrier receipt is collected and how the reviewer compares it with the effective date. Rehearse a loss that occurred near a change and have Claims Reviewer explain the selected terms.

Start with a policy that has a crop coverage line and a deductible. Record a dated endorsement with the change reason and carrier receipt. Open a claim whose loss date falls near the change. Compare the loss date with the line interval and endorsement effective date, then show the reviewer which terms apply. Keep the original line and endorsement available when the reviewer explains the decision.

The Independent Reviewer should locate both the dated line and endorsement when reading the policy revision. Claims Reviewer should see which exclusion and deductible applied on the loss date. A carrier receipt is a reference to check with the carrier; the policy team keeps the original dated record for later review.

• Coverage terms — Open dated coverage lines to compare limits and deductibles on a policy.
• Issued policy register — Find issued policies whose terms may be relevant to a reported loss.

Follow the related operating process and use the record definitions when checking a field or relationship.