Guide: open claims
Open claims on a loss run: what an open reserve means for your submission
An open claim is one the carrier has not closed, so it usually still carries a reserve, the carrier's current estimate of what remains to be paid. Reserves can rise or fall, so tell the underwriter what each open claim is and where it stands.
General information, not advice. This is not insurance, legal or financial advice. Requirements differ by carrier, state and market; follow the instructions of the market you are approaching.
What 'open' covers
The numbers are on the report. The story is not.
Reports use their own words: open, reopened, pending, and sometimes incident only or record only for events reported with no payment and no reserve. A reopened claim was closed and then opened again. A claim in subrogation may be open only to pursue a recovery.
For each open claim an underwriter may ask what happened, whether an attorney is involved or suit has been filed, what has been paid, what the reserve rests on, how old the claim is and when the carrier expects to close it. Those answers come from the adjuster or the claim file, not from the loss run.
Steps
How to prepare open claims for a submission
Five steps, none of which needs a prediction.
- List the open and reopened claimsCount them by policy year and sort by reserve. The largest reserves shape the picture.
- Ask the adjuster for a status noteRequest it in writing, for facts only: what happened, what has been paid, whether suit has been filed and what happens next. Keep the reply.
- Note the ageClaims still open several years after the loss date will draw questions. Have the reason ready.
- Compare with the earlier reportSet this valuation beside the last one to see new claims, reserve increases and closures. Movement often prompts questions.
- Write each note in three partsWhat happened, where it stands, what happens next. Keep to what the file supports, and attach the loss runs. For a liability account, see the general liability submission guide.
Reference
What an open claim can look like on the report
| Pattern on the report | What it can mean | What to have ready |
|---|---|---|
| Paid and reserve both present | An active claim part-way through | Paid to date, reserve remaining, next step |
| Reserve only, nothing paid | Recently reported, or still being investigated | Report date and what is being investigated |
| Expense paid, no loss paid | Legal or investigation cost with no payment to the claimant yet | Whether suit has been filed, and who is defending |
| Reopened | A closed claim was opened again | Why it reopened and what has been paid since |
| Open for several years | A slow or contested claim, or a stale status | The adjuster's current status |
| Reserve higher than on the last report | The carrier now expects to pay more | What changed |
| Incident only or record only | An event reported with no payment and no reserve | Whether the market counts these in claim totals |
Pitfalls
What goes wrong
- Guessing the outcome. A note that says a claim will close soon, with nothing behind it, can mislead and will be remembered.
- A stale status. The report is a snapshot, so a claim may have closed or reopened since its valuation date.
- A reserve read as the final cost. It is an estimate and can move either way.
- Opinion in the note. Statements about fault or coverage belong to the carrier and counsel. Stay with facts the file supports.
- Asking for a lower reserve. Reserves are the carrier's decision. You can ask for a status update on a stale claim, but do not promise a market a reduction.
The tool
How LossRun Pro helps
LossRun Pro counts open claims for each policy year, treating a reopened claim as open, and shows the reserve and the largest claim beside them in the policy-year summary. It flags open or reopened claims more than three years past the loss date, closed claims that still carry a reserve, and a claim over a quarter of the incurred in a period with two or more claims. The claim notes are yours to write. Try it on the loss run to Excel page. Free: 1 file per day, up to 10 pages, no account. Files over 10 pages are converted up to page 10 on the free allowance; a page code converts the whole file, up to 150 pages. See pricing.
FAQ
Questions about open claims
What does it mean when a claim is open?
The carrier has not closed the file. It may still be paying, investigating or defending, and it usually carries a reserve for what it expects to pay.
Is the reserve what the claim will cost?
No. It is the carrier's current estimate of what remains, and it can rise or fall. The final cost can be higher or lower. See paid, reserved and incurred.
How do underwriters treat open claims?
There is no single treatment. Many ask about litigation, age and what the reserve rests on, and some form their own view of how a claim may develop. Give them the facts and let them decide.
How old is too old for an open claim?
No threshold applies everywhere. LossRun Pro flags an open claim more than three years past its loss date as a prompt for a question, not as a standard.
What is a reopened claim?
A claim that was closed and later opened again, for example after new medical treatment or a late demand. It counts as open until it closes again.
Do I need to explain every open claim?
Explain the largest ones and any that are old or in litigation, and follow the market's instructions. A one-page list such as the large loss summary keeps the notes together.