Which of the following must be considered when addressing a claim made by a third party?

When addressing a claim made by a third party, it is essential to consider the conditions laid out in the insurance policy. The insurance policy serves as the foundational document that details the rights and responsibilities of both the insurer and the insured. It specifies coverage limits, exclusions, conditions under which claims can be made, and the obligations of all parties involved.

In the context of third-party claims, understanding the specific terms and conditions of the policy will guide the adjuster in determining whether the claim is valid, how much compensation may be owed, and under what circumstances the insurer is liable. This ensures that the claim is managed fairly and in accordance with the contractual agreement.

Other considerations, such as the preferences of the certificate holder, the insurer's previous claim history, and the type of certificate issued may provide context or additional insights but do not carry the same weight as the explicit terms outlined in the insurance policy itself in determining the handling of a third-party claim.