Claims
Claim financials
How claim economy works in 21RISK How claim economy works in 21RISK
21RISK stores only three financial facts per claim, and calculates everything else from them. That keeps the numbers consistent: there is nothing to keep in sync, and a figure can never contradict the data it came from.
| Stored | What it is |
|---|---|
| Worst case claim estimate | The total expected cost of the claim, including the part you carry yourself. |
| Deductible | The fixed deductible (Danish: selvrisiko) that applies to the claim under the policy. |
| Payments | A dated ledger of money actually paid on the claim, each row marked as paid by the insurer or by you. |
Everything else — gross paid, gross outstanding, gross incurred, net paid and net incurred — is derived.
The formulas The formulas
| Figure | Formula |
|---|---|
| Gross incurred | Worst case claim estimate |
| Gross paid | Sum of all payments |
| Net paid | Sum of payments made by the insurer |
| Gross outstanding | Gross incurred − Gross paid |
| Net incurred | Gross incurred − min(Deductible, Gross incurred) |
Two ideas explain the whole table:
- Gross means "including your deductible", net means "the insurer's part." Gross paid is every krone that has left an account. Net paid is only what the insurer contributed.
- Money paid is what has actually moved. Gross paid and gross outstanding come from the payments ledger, so a claim where nothing has been paid shows everything as outstanding.
Net incurred uses the deductible capped at the incurred amount: you can never use more deductible than the claim is worth. A small claim that stays below its deductible therefore shows a net incurred of 0 — never a negative amount.
The payments ledger The payments ledger
Each payment is one row: a date, an amount, who paid, and an optional note. You find it under Financials on the claim.
| Paid by | Use it for |
|---|---|
| Insurer | Compensation received from the insurance company, including interim payments. |
| Own (deductible) | Money you paid yourself, that is, your deductible. |
Because both kinds live in the same ledger, gross paid is simply its sum, and you keep the dates you need when you reconcile with your insurer.
Amounts may be negative. That is useful for corrections — if a payment was registered twice or later adjusted, add a row with a negative amount instead of editing history.
Register payments as they happen, rather than as one lump sum at the end. The dates are what make the ledger useful for reconciliation and for reporting how quickly claims are settled.
A worked example A worked example
A fire damages a production line. The claim is estimated at 3,000,000 and the policy deductible is 250,000.
When the claim is created — nothing has been paid yet:
| Figure | Value | Why |
|---|---|---|
| Gross incurred | 3,000,000 | The worst case estimate. |
| Gross paid | 0 | The ledger is empty. |
| Gross outstanding | 3,000,000 | Nothing has been paid yet. |
| Net incurred | 2,750,000 | 3,000,000 − 250,000 deductible. |
You pay your deductible — add a payment of 250,000 marked Own (deductible):
| Figure | Value |
|---|---|
| Gross paid | 250,000 |
| Net paid | 0 |
| Gross outstanding | 2,750,000 |
| Net incurred | 2,750,000 |
The insurer pays 1,000,000 on account — add a payment of 1,000,000 marked Insurer:
| Figure | Value |
|---|---|
| Gross paid | 1,250,000 |
| Net paid | 1,000,000 |
| Gross outstanding | 1,750,000 |
| Net incurred | 2,750,000 |
Note that net incurred does not move as payments arrive. It answers a different question: what will this claim cost the insurer in total, not what has been paid so far.
Claims below the deductible Claims below the deductible
Many claims never exceed their deductible. A theft of 95,000 with a 250,000 deductible looks like this once you have paid it:
| Figure | Value | Why |
|---|---|---|
| Gross incurred | 95,000 | The full cost of the loss. |
| Gross paid | 95,000 | You paid it yourself. |
| Net paid | 0 | The insurer paid nothing. |
| Gross outstanding | 0 | Nothing is left to pay. |
| Net incurred | 0 | The insurer carries none of it. |
The claim is still worth registering: it counts in your claims frequency, it shows up per site and damage type, and it feeds the picture you bring to a renewal — even when the insurer never pays out.
Updating the estimate Updating the estimate
The worst case estimate is expected to change as a claim matures. Update it on the claim whenever you get better information; gross incurred, gross outstanding and net incurred follow immediately.
Every change is versioned, so the claim keeps a full history of what was estimated when, and the activity log shows who changed it.
Currency Currency
Claim amounts are registered in your organization's base currency, set under Settings > Account > Organization Currency.
Related Related
- Claims overview — lines, damage types and the claim list.
- Claims analytics — how the derived figures are grouped across the book.