Insurance Printout 2
Insurance Printout 2
Insurance Printout 2
The oldest form of insurance business. It is a device to secure protection from loss or
damage to property while in shipment. It covers loss or damage to vessels or to
cargo or passengers during transportation on the high seas.
Marine Insurance consists in insurance of property against losses due to marine
perils, that is perils consequent on or incidental to the navigation of the sea.
B.-Definition:
A contract of Marine Insurance can be defined as a contract whereby one party for
an agreed consideration, undertakes to indemnify the other against loss arising from
certain perils and sea risks to which a shipment merchandised and other interests in
a marine adventure may be exposed during a certain voyage or certain period of
time.
(a) Proposal :
The broker will prepare a slip upon receipt of instructions to insure from ship
owner, merchant or other proposers. The original slip is accompanied with other
material information which the broker deems necessary for the purpose. The brokers
are expert and well versed in marine insurance law and practice.
(b) Acceptance :
The original slip is presented to the Lloyd’s Underwriters or other insurers or to the
Lead of the insures, who initial the slip and the proposal is formally accepted. But
the contract cannot be legally enforced until a policy is issued. The slip is evidence
that the underwriter has accepted insurance and that he has agreed subsequently to
sign a policy on the terms and conditions indicated on the slip. If the underwriter
should refuse to issue or sign a policy, he could not legally be forced to do so.
(c) Consideration:
The premium is determined on assessment of the proposal and is paid at the time of
the contract. The premium is called consideration to the contract.
(d) Issue of Policy:
Having effected the insurance, the broker will now send his client a cover note
advising the terms and conditions, on which the- insurance has been placed. The
broker’s cover note is merely an insurance memorandum and naturally has no value
in enforcing the contract with the underwrites.
The policy is prepared, stamped and signed without delay and it will be the legal
evidence of the contract. However, after issue of the policy the court has power to
order the rectification of the policy to express the intention of the parties to the
contract as evidenced by the terms of the slip.
The doctrine of caveat emptor (let the buyer beware) applies to commercial
contracts, but insurance contracts are based upon the legal principle of uberrimae
fides (utmost good faith). If this is not observed by either of the parties, the contract
can be avoided by the other party. Any non-disclosure of a material fact enables the
underwriter to avoid the contract, irrespective of whether the non-disclosure was
intentional or inadvertent. The duty of the disclosure of all material facts falls even
more heavily on the broker. He must disclose every material fact which the assured
ought to disclose and also every material fact which he knows.
Exception :
In the following circumstances, the doctrine of good faith may not be adhered to:
(i) Facts of common knowledge.
(ii) Facts which are known should be known to the insurer.
(iii) Facts which are not required by the insurers.
(iv) Facts which the insurer ought reasonably to have in furred from the details
given to him.
(v) Facts of public knowledge.
(4) Indemnity
A contract of marine insurance is a contract of indemnity. The basis of indemnity is
always a cash basis as underwriters cannot replace the lost ship and cargoes and the
basis of indemnification is the value of the subject matter. If the value of the subject
matter is determined at the time of taking policy, it is called insured value. When the
loss arises, the indemnity will be measured in the proportion that the assured sum
bears to the insured value.
Extent of Liability of Insurer for loss: In case of an unvalued policy, the full extent
of insurable value can be recovered by the assured and in the case of valued policy,
that of the value fixed by the policy. If there are more than one insurers, they are
liable to contribute such proportion of the measure of indemnity as the amount of
When there is total loss of subject matter, in case of valued policy, the measure of
indemnity is the sum fixed by the policy and in case of unvalued policy, the
insurable value of the subject matter insured can be recovered.
Exceptions:
1. Profits allowed: The doctrine of indemnity says that the market price of the loss
should be indemnified and no profit should be permitted, but in marine a certain
margin of anticipated profit is also permitted. Such profit is also treated as loss
and hence payable under the policy.
2. Insured value: The doctrine of indemnity is based on the insurable value
whereas marine insurance is mostly based on insured value.
The subscription bears to the value fixed by the policy in case of valued policy or to
the insurable value in case of unvalued policy.
(6) Contribution
The principle of contribution applies to marine insurance also. The Marine Insurance
Act provides that, where the assured is over assured by double insurance, each
insurer is bound as between himself and other insurers to contribute rateably to the
loss in proportion to the amount for which he is liable under the contract. If insurer
pays more than his proportion of the loss, he is entitled to maintain a suit for
contribution against other insurers and is entitled to the like remedies as a surety
who has paid more than his proportion of the debt.
According to Section 55 (1) Marine Insurance Act,’ Subject to the provisions of the
Act and unless the policy otherwise provides the insurer is liable for any loss
proximately caused by a peril insured against, but subject to as aforesaid he is not
liable for any loss which is not proximately caused by a peril insured against.’
The insurer is not liable for any loss attributable to the wilful misconduct of
the assured, unless the policy otherwise provides , but he is liable for any loss
proximately caused by a peril insured against.
The insurer will not be liable for any loss caused due to delay unless
otherwise provided.
The insurer is not liable for any wear and tear, ordinary leakage and breakage
or for any loss proximately caused by rats or vermin, or for any injury to the
machinery not proximately caused by maritime perils.
The insurer is liable for any loss proximately caused by a peril insured against but is
not liable for any loss which is not proximately caused by a peril insured against
given above. Thus the proximate cause is the actual cause of the loss. There must be
direct and non-intervening cause. The insurer will be liable for any loss proximately
caused by peril insured against.
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(write a short note of warranties in essentials of insurance contract)
WARRANTIES
A warranty is that by which the assured undertakes that some particular thing shall
or shall not be done, or that some conditions shall be fulfilled or whereby he affirms
or negatives the existence of a particular state of facts.
Warranties are the statements according to which the insured person promises to do
or not to do a particular thing or to fulfil or not to fulfil a certain condition. It is not
merely a condition but statement of fact.
Warranties are more vigorously insisted upon than the conditions because the
contract comes to an end if a warranty is broken whether the warranty was material
or not. In case of condition or representation the contract comes to end only when
these were material or important.
Further, in insurance law the warranty may be either a condition precedent tor
condition subsequent. The marine insurance act defines it to mean a promissory
warranty, that is to say, a warranty by which the assured undertakes that some
particular thing shall or shall not be done, or that some condition shall be fulfilled, or
whereby he affirms or negatives the exitance of a particular state of facts. In short,
the term warrant is used in two different senses, namely, one is in sense of a
condition to mean the breach of which gives rides to a right to avoid the contract and
secondly, to denote a mere limitation or, or an exception from, the general tenure of
the policy.
Warranties are of two types:
(1) Express Warranties, and (2) Implied Warranties.
1. Express Warranties:
Express warranties are those warranties which are expressly included or
incorporated in the policy by reference.
2. Implied Warranties :
These are not mentioned in the policy at all but are tacitly understood by the parties
to the contract and are as fully binding as express warranties.
Warranties can also be classified as (1) Affirmative, and (2) Promissory. Affirmative
warranty is the promise which insured gives to exist or not to exist certain facts.
Promissory warranty is the promise in which the insured promises that he will do or
not do a certain thing up to the period of policy. In marine insurance, implied
warranties are very important. These are:
1. Seaworthiness of Ship.
2. Legality of venture.
3. Non-deviation.
All these warranties must be literally complied with as otherwise the underwriter
may avoid all liabilities as from the date of the breach.
However, there are two exceptions to this rule when a breach of warranty does not
affect the underwriter’s liability: (1) where owing to a change of circumstances the
warranty is no longer applicable. (2) Where compliance would be unlawful owing to
the enactment of subsequent law.
1. Seaworthiness of ship :
The warranty implies that the ship should be seaworthy at the commencement of the
voyage, or if the voyage is carried out in stages at the commencement of each stage.
This warranty implies only to voyage policies, though such policies may be of ship,
cargo, freight or any other interest. There is no implied warranty of seaworthiness in
time policies.
A ship is seaworthy when the ship is suitably constructed, properly equipped,
officered and manned, sufficiently fuelled and provisioned, documented and
capable of withstanding the ordinary strain and stress of the voyage. The
seaworthiness will be clearer from the following points:
1. The standard to judge the seaworthiness is not fixed. It is a relative term and may
vary with any particular vessel at different periods of the same voyage. A ship may
be perfectly seaworthy for Trans-ocean voyage.
A ship may be suitable for summer but may not be suitable for winter. There may be
different standard for different ocean, for different cargo, for different destination
and so on.
2. Seaworthiness does not depend merely on the condition of the ship, but it includes
the suitability and adequacy of her equipment, adequacy and experience of the
officers and crew.
3. At the commencement of journey, the ship must be capable of withstanding the
ordinary strain and stress of the sea.
4. Seaworthiness also includes “Cargo-Worthiness”. It means the ship must be
reasonably fit and suitable to carry the kind of cargo insured. It should be noted that
the warranty of seaworthiness does not apply to cargo. It applies to the vessel only.
There is no warranty that the cargo should be seaworthy.
It should be noted that the ship should be seaworthy at the port of commencement
of voyage or at the different stages if voyage is to be completed in stages.
Section 41(3) of the Marine Insurance Act 1963 says that a ship is seaworthy when
she is reasonably fit in all respects to encounter the ordinary perils of the seas of the
adventure insured. The seaworthiness of a vessel includes the crew, in terms of both
numbers and competence with reference to foreseeable circumstances of voyage.
2. Legality of Venture;
This warranty implies that the adventure insured shall be lawful and that so far as
the assured can control the matter it shall be carried out in a lawful manner of the
country. Violation of foreign laws does not necessarily involve breach of the
warranty. There is no implied warranty as to the nationality of a ship. The implied
warranty of legality applies total policies, voyage or time. Marine policies cannot be
applied to protect illegal voyages or adventure. The assured can have no right to
claim a loss if the venture was illegal.
The example of illegal venture may be trading with an enemy, violating national
laws, smuggling, breach of blockade and similar ventures prohibited by law.
Illegality must not be confused with the illegal conduct of the third party e.g.,
barratry, theft, pirates, rovers. The waiver of this warranty is not permitted as it is
against public policy.
a. Warranty of neutrality: Section 36(1) of the Marine Insurance Act 1963 says
where insurable property, whether ship of goods, is expressly warranted neutral,
there is an implied condition that the property shall have a neutral character at
the commencement of the risk, and that so far as the assured can control the
matter, its neutral character shall be preserved during the risk. This clause deals
with the cases where the subject-matter of the policy is either a ship or goods.
The net clause deals with the cases subject-matter of the policy is a ship and it is
expressly warranted to be ‘neutral’ in with case section 36(2) says that there is an
implied condition that so far as the assured can control the matter, she shall be
properly documented.
b. Warranty of good safety: when the assured knows the condition of the subject-
matter of insurance or but for his wilful abstention form inquiry which he ought
to have made or gross negligence he would have known it is his duty to disclose
the fact under his ‘duty of disclosure’ delt with under section 18, and if he fails to
do it in spite of his knowledge, actual or constructive, the insurer can avoid the
contract.
No implied warranty: the statue make it clear the there is no implied warranty of
nationality and that the goods are seaworthy.
Case Laws:
IN THE CASE OF PIPON V. COPE, where the ship is arrested in England for
the smuggling operations of the master with the connivance of the owner, it was
held that the insurer was not liable.
IN THE CASE OF DOUGLAS V. SCOUGALL, the ship sailed and soon after
encountered a storm, became leaky, put back, and was found on the survey to be
materially decayed, and damage discovered which could not be fairly considered
as the effect of the storm. It was held that the ship was not seaworthy when she
sailed on the voyage insured.
Characteristics of warranty:
1. A warranty must be exactly complied with Section 35(3), which lays down that
subject to any express provision in the policy, the insurer is discharged from
liability as from the date of the breach of warranty.
2. The warranty need not be material to the risk {Section 35(3)}.
3. There is no remedy for breach.
4. No defence for breach.
Chinnaswamy Nadar v Home Insurance Company, Madras; held that where cargo
was damaged by sea water on sea becoming rough, held that insurer is liable to
indemnify cargo owner. Thus what is really insured is the risk of adventure, that is
the pecuniary interest of the assured in the subject-matter in or in respect of the
property exposed to the peril and not the subject-matter itself. (EXTRA CASE
LAW)
Kinds of Marine insurance Policies
1. Valued policy: A valued policy is one in which the agreed value of the subject
matter insured is specified in the policy and in absence of fraud such agreed
value is conclusive of the insurable value as between the insurer and the insured
whether the loss be total or partial. In the absence of fraud or misrepresentation,
the declared value of the policy is the measure of indemnity. In case of total loss
of the goods, the insurance company is required to pay the declared amount to
the insured and in case of partial losses, the liability of the insurance company is
determined on the basis of the assessment made by then officials of the partial
damaged goods.
In valuing the subject matter insured there may be just valuation or over-
valuation or under- valuation. If the valuation is just and bona fide, the
valuation is a valued policy and is deemed to be conclusive between the
parties.
If there is over-valuation, it was thought that it would become a wagering
policy because a contract of marine insurance is a contract of indemnity.
IN the case of THAMES MERSEY INSURANCE CO V. GUNFORD, it was held
that a valued policy is not a wagering policy just because the value is excessive.
In case of under-valuation, the insured is deemed to be his own insurer in
respect of uninsured balance.
2. Unvalued policy: An unvalued policy or open policy is the one in which the
value of the subject matter of insurance is not stated, but is left to be ascertained
and proved later on when the loss occurs.
The insurable value is to be ascertained as per the provisions set out in Section 18.
It is ascertained as follows;
As regards the ship, the insurable value is the value of the ship at the
commencement of risk and it includes her output, provisions and stores, money
advanced for wages and disbursement to make the ship fit for the voyage plus
the charges of insurance on the whole.
As to freight, the value is the gross freight at the risk of the assured including
charges of insurance.
As regards goods and merchandise, the value is the prime cost of the property
insured plus the expenses of and incidental to shipping and the charges of
insurance.
The residuary clause provides that in the case of any other subject-matter, the
insurable value is the amount at the risk of the assured when the policy attaches
plus charges of insurance.
3. Floating policy: These policies are taken in general terms and the particulars as
filled by subsequent declarations. Therefore, a floating policy is defined as a
policy which describes the insurance in general terms, and leaves the name of the
ship or ships and other particulars to be defined by subsequent declarations. The
subsequent declaration or declarations may be made by endorsement on the
policy, or in other customary manner. The declarations, must in the case of
goods, comprise all consignments within the terms of the policy and the value of
the goods or other property must be honestly stated. Where an assured bona fide
make an erroneous declaration or omits to make one in regard to the valuation, it
may be rectified even after loss or arrival. Unless otherwise provided, if a
declaration of value is not made until notice of loss or arrival the policy should be
treated as an unvalued policy. In the case of UNION INSURANCE SOCIETY OF
CANTON V. WILLS AND CO, a floating policy was effected on goods with a
provision that declarations of interest to be made to insurer’s agents ‘as soon as
possible’. The ship sailed on 21st August and it was destroyed by fire on 12th
September. The assured made declaration on the next day, that is, September
13th. It was held by the Privy Council that the declaration was too late and the
assured cannot recover.
5. Voyage policy: When the contract is to insure the subject matter at and from, or
from one place to another or others e.g. Bombay to Karachi or Calcutta to Tokyo
or Madras to London, the policy is called a “voyage policy”. The voyage insured
must be accurately described in a voyage policy i.e. the local limit of risk must be
specified. It is generally done by specifying the port where the voyage is to
commence called ‘terminus quo’ and the port where the voyage is concluded
called ‘terminus ad quem’.
It also may be noted that the policy may cover the risk ‘from a port’ or ‘at and
from a port’. If the policy is from a port, the risk starts when the ship sails from a
particular port. But, if the policy is at and from a port, it protects the subject
matter insured both while ship is at the port of departure and also from the time
of the sailing of the ship on her voyage till it reaches port of destination. This
policy is more suitable for cargo insurance.
6. Mixed Policy
A contract for both voyage and time included in the same policy is called mixed
policy. A mixed policy combines the characteristics of a time policy and a voyage
policy. For example: “From Bombay to Liverpool for six months”, or from 1st
January to 30th June, “Madras to Bombay”. These policies are also known as
“Time and Voyage Policies” and are issued for ships and steamers operating over
particular routes, or sailing between certain fixed ports.
Apart from the above, there are certain other marine insurance policies such as:
(a) PPIPolicies
These are also called wager policies. The letters P, P and I stand for ‘Policy Proof
of Interest’ and such policies are also familiarly called ‘Interest or no interest’
policies. The subject matter can be insured in the usual manner by PPI Policy.
(b) Single Vessel and Fleet Policy
When the owner of the vessels or ships insures his individual vessels separately,
it is called ‘Single Vessel Policy’, but when an individual or corporation insures
whole fleet of liners or steamers under one policy, it is called ‘Fleet Policy’. Fleet
literally means “number of ships, aircraft, buses, etc moving or working under
one command or ownership.
A voyage policy contains a contract to insure the subject-matter ‘at and from’ or
‘from’ one place to another or others. Sections 44-51 of the Marine Insurance Act
1963 deal with voyage.
The voyage to be performed by a ship must be described in the policy. The ship
must follow the course mentioned in the policy or if no course is specified, it must
follow the usual and customary course, otherwise the risk will not attach. A voyage
is defined if the place where it is to commence and the place where it is to end are
specified in the policy.
Where after the commencement of the risk/voyage, the destination of the ship is
voluntarily changed from the destination contemplated by the policy, there is said to
be a change of voyage. When there is a change of voyage, the insurer is discharged
from the liability from the time the determination to change the voyage is
manifested, unless the policy otherwise provides. It is therefore of great importance
that:
The voyage should be accurately described.
The voyage should be properly performed and
There should be the literal fulfilment of this condition.
If the ship sails from the port of departure, changes the route and again resumes
back to the original route, or she returns to the port of departure after sail, there is
change of voyage.
Change of voyage discharges the insurer of his liability as there is no contract to
cover the new voyage and the covered voyage under the policy is deemed to have
been abandoned unless the policy contains a clause which states that insured will be
‘held covered in the event of the voyage being changed or of any deviation at a
premium to be arranged’.
Sec 45 deals with change of voyage. Change of voyage amounts to breach of
warranty.
DELAY
It is imperative that;
The vessel must sail from the agreed port within a reasonable time and;
The voyage should be completed within a reasonable time; otherwise the
underwriter will not be responsible.
When the insurance policy is taken, ship must start sailing from the specified port
without unreasonable delay. If the voyage is not commenced as described in the
policy, the underwriter is discharged, not only the port of discharge be proceeded to
without delay but the venture should also be completed within reasonable time.
Hence, there should be neither unreasonable delay in commencing the adventure
nor in completing the adventure, failing which; the underwriter is discharged from
liability from the time when the delay became unreasonable.
DEVIATION
In common usage, deviation means “turning aside or away”. But in marine
insurance, deviation occurs when a vessel departs from the course of the voyage
described in the policy, or where the course is not specifically designated one, from
the customary course. In simple words, deviation means a departure or deviation
from the voyage described in the marine insurance policy. The Act provides that
there is a deviation from the voyage: (Sec 49)
If the course of the voyage is specifically designated by the policy and that
course is departed from; or
Where the course of voyage is not mentioned in the policy the usual and
customary course is departed from; or
Where several ports of discharge are specified in the policy, the ship may go
to any of them, but that should be in the order designated in the policy. Any
change of the order will be a deviation. (when ship does not sail in the
geographical order)
The effect of deviation is the same. If the ship without any lawful excuse, deviates
from the voyage contemplated or mentioned by the policy the insurer is
discharged from liability as from the date of deviation and it is immaterial that
the ship may have regained its course before any loss occurs. (Sec 48)
Reardon Smith Lives Ltd V. Black Sea And Baltic General Insurance Co Ltd, a vessel
to sail from Poti in the Black Sea to Sparrow’s point in the USA sailed to Constanza
which is not on her direct geographical route, to take in oil fuel and was stranded
there. The evidence showed that about a quarter of the oil burning vessels proceeded
from the Black Sea port bunker at Constanza and so it was held that there was no
deviation.
Peril of the sea may be defined to cover everything that happens to the ship in the
course of a voyage by the immediate act of God without the intervention of human
agency. It refers only to fortuitous accidents or casualties not attributable to the free
will and desire of a human being. Even if acts of God it does not include the natural
and ordinary action of the winds and waves.
It may be noted that the expression is ‘perils of the sea’ but not ‘perils on the seas’.
All the ‘perils of the sea’ are maritime perils but all maritime perils are not ‘perils of
the sea’. Maritime perils include peril of the seas, fire, war perils, pirates, rovers,
thieves, captures, seizures, restraints, detainments of princes and peoples, jettisons,
barratry and any other peril either of the like kind, or which may be designed by the
policy.
The term peril or accident involves the idea of something unexpected and
unforeseen and Lord Halsbury expressed this in HAMILTON V. PENDROFF,
where the cargo was damaged by sea water which entered through a hole caused by
the rats in the galvanizing pipe. The House of Lords held that the loss was caused by
the perils of the sea. The burden of proving a loss by perils of the sea lies on the
insured.
Examples of perils of the sea: Collision, sinking of vessel when it strikes upon a
sunken rock, shoals and heavy storms.
If the loss takes place on account of any of the perils insured against with the insurer,
the insurer will be liable for it and shall have to make good the losses to the assured.
If the peril is insured, the insurer will indemnify the assured, otherwise not. The
doctrine of causa-proxima is to be applied while calculating the amount of loss. It
means for payment of losses, the real or proximate cause is to be taken into account.
If the proximate cause is insured, the insurer will pay, otherwise not.
Marine losses can be divided into two main parts containing several subparts;
A. Total loss;
1. Actual total loss
2. Constructive total loss
B. Partial loss/ Average loss;
1. Particular average losses
2. General average losses
3. Particular charges
4. Salvage charges
A Total loss - There is an actual total loss where the subject matter insured is
destroyed or so damaged as to cease to be a thing of the kind insured or where the
assured is irretrievably deprived thereof. Losses are deemed to be total or complete
when the subject- matter is fully destroyed or lost or ceases to be a thing of its kind.
It should be distinguished from a partial loss where only part of the property
insured is lost or destroyed. In case of total loss, the insured stands to lose to the
extent of the value of the property provided the policy amount was to that limit.
In case of actual total loss, notice of abandonment of property need not be given. In
such total losses, the insurer is entitled to all rights and remedies in respect of
damaged properties. In no case, amount over the insured value or insurable value is
recoverable in a total loss form the insurers. If the property is under-insured, the
insured can recover only up to the amount of insurance. If it is over insured he is not
over-benefited but only the actual loss will be indemnified. Where the subject-matter
had ceased to be of the kind insured, the assured will be given the full amount of
total loss provided there was insurance up to that amount, and the insurer will
subrogate all rights and remedies in respect of the property. Any amount realized by
the sale of the material will go to the insurer.
Salvage loss
Where actual total loss occurred, and the subject-matter is so damaged as to cease to
be a thing of the kind insured or when they have been sold before reaching the
destination, there is a constructive total loss. The usual form of settlement is that the
net sale proceeds will be paid to the assured.
The net sale proceeds are calculated by deducting expenses of the sale from the
amount realized by the sale.
The insured will recover from the insurer the total loss less the net amount of sale.
This amount received from the insurer is called a ‘salvage loss’.
The general average loss or expense is voluntarily done for the common safety of all
the parties insured.
But, the particular average loss is fortuitous or accidental. It cannot be partially
shifted to others but will be borne by the persons directly affected. The particular
average loss must fulfil the following conditions:
1. The particular average loss is a partial loss or damage to any particular interest
caused to that interest only by a peril insured against.
2. The loss should be accidental and not intentional.
3. The loss should be of the particular subject-matter only.
4. It should be the loss of a part of the subject-matter or damage thereto or both. The
distinguishing feature in this matter is that where the properties insured are all of
the same description, kind and quality and they are valued as a whole in the
policy, the total loss of a part of this whole is a particular loss, but where the
properties insured are not all of the same description, kind and quality and they
are separately valued in the policy, the loss of an apportionable part of the
interest is a total loss.
Particular charges
Where the policy contains a “sue and labour” clause, the engagement thereby
entered into is deemed to be supplementary to the contract of insurance and the
assured may recover from the insurer any expenses properly incurred pursuant to
the clause. The clause requires the insurers to pay any expenses properly incurred by
the assured or his agents in preventing or minimizing loss or damage to the subject-
matter by an insured peril. The essential features of the clause are as below:
The expenses must be incurred for the benefit of the subject matter insured. The
expenses incurred for the common benefit will be a part of the general average.
The expenses must be reasonable and be incurred by “the assured, his factors, his
servants or assigns” and this provision effectively excludes salvage charges.
They are recoverable only when incurred to avert or minimize a loss from a peril
covered by the policy.
UNIT 1
The aim of all insurance is to protect the owner from a variety of risks which he
anticipates. He who seeks this protection is called the assured or insured and the
other person who takes the risk by undertaking to protect the other from loss is
called the underwriter or insurer and he does this for a small consideration call
premium.
6. Subrogation- This principle says that once the compensation has been paid, the
right of ownership of the property will shift from the insured to the insurer. So
the insured will not be able to make a profit from the damaged property or sell it.
Subrogation means that one party stands in for another. In the insurance context,
subrogation will arise if you are injured by a negligent third party, and your
insurance company reimburses you for your damages. Under the principle of
subrogation, your insurance company can stand in your shoes and recover the
pay-out from the negligent party. The goal of this principle is to encourage
responsibility and accountability by holding negligent parties responsible for
injuries they cause.
7. Contribution- This principle applies if there are more than one insurers. In such a
case, the insurer can ask the other insurers to contribute their share of the
compensation. If the insured claims full insurance from one insurer he losses his
right to claim any amount from the other insurers. For example, imagine that
you own a truck that is insured by both Company A and Company B. If another
driver hits your truck and it will cost you $5,000 to fix it, you can submit your
claim to Company A, Company B, or to both companies. If Company A
compensates you fully, then it can claim a proportionate contribution from
Company B. However, if both companies compensate you fully, you can't keep
the full amount and turn a profit, because this would amount to an unfair
windfall.
8. Proximate Cause- This principle states that the property is insured only against
the incidents that are mentioned in the policy. In case the loss is due to more than
one such peril, the one that is most effective in causing the damage is the cause to
be considered. The principle of proximate cause, or nearest cause, comes into
play when more than one event or bad actor causes an accident or injury. An
example would be if two separate landowners carelessly burn piles of leaves, and
the fires eventually join together and burn down your house. The insurance
principle of proximate cause dictates that nearest or closest cause should be taken
into consideration to decide the liability.
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In Medical Defence Union Ltd v. Department of Trade, some medical and dental
practitioners formed the ‘Medical Defence Union’ which was to conduct legal
proceedings on behalf of its members, indemnifying members against claims for
damages and costs and giving advice to members on various matters and providing
educational guidance. Members had the right to request for the Unions help. The
members in return had to pay an appropriate annual subscription for their class of
membership. The Department of Trade sought a declaration that the Union was
doing insurance business under the general law and therefore within the 1974 Act.
The union sought a declaration that they did not carry on any class of insurance
business.
The court held that on the occurrence of some event, there had to be a right to
receive money or money’s worth and where the entitlement was merely to some
benefit other than money or money’s worth, the contract was not one of insurance,
and so the union was not an insurance company.
Agreement: Insurance is a contract between the insurer and the insured. Like every
other contract, a contract of insurance is also concluded through proposal and its
acceptance between the insurer and the insured. Mere mental assent to an offer does
not conclude a contract. The offeror may, however, indicate the mode of
communication acceptance of his proposal. Acceptance will only be completed when
it is communicated to the offeror.
General Assurance Society v Chandmull Jain, where it was observed that contract is
formed when insurer accepts the premium and retains it, the decision further said
that in case of assured, a positive act on his part by which he recognizes or seeks to
enforce the policy amounts to an affirmation to it.
Legal relationship: When 2 parties enter into an agreement their intention must
be to create a legal relationship between them. Informal or social agreements
such as arrangement to give a friend a lift in one’s car or inviting a friend for
dinner, in such cases there is never any intention of legal consequences should
the agreement for some reason be carried out.
Free and Genuine consent: There must also be free and genuine consent of the
parties to the agreement. If the agreement is induced by coercion, undue
influence, fraud, misrepresentation etc, then there is absence of free consent, such
a contract would be voidable at the option of the insurer under section 45 of
Insurance Act, 1938.
Lawful object: The object of the contract must be lawful. It must not be illegal,
immoral or opposed to public policy. If agreement suffers from any legal flaw, it
would not be enforceable by law.
In New India Insurance co ltd v Kesavan Ramamurthy, it was held that there is
nothing unlawful in a vehicle insurance policy providing that no compensation
would be payable if the vehicle was being driven at the time of the accident by an
unlicensed person or by a learning license holder.
Agreement not declared void: The agreement must not have been expressly
declared void by any law in force in the country, such agreements are void.
For example: Insurance on goods being traded with an enemy national in times of
war.
Death Advantage: This is the most important benefit of life insurance; in the event of
the insurer’s untimely death, the insurance provider pays a lump sum amount
depending on the amount insured. Individuals can save tax on the premium sum
charged under section 80C, up to a maximum of one lakh rupees. Some insurance
firms will also lend you money if you take out a policy. The loan amount is normally
determined by the Sum Assured and the length of the loan.
Riders: Certain life insurance policies have Riders, which are additional benefits to
the regular insurance policy, in addition to life insurance coverage. Riders are
beneficial in extending the insurance coverage.
The quick pace of industrialization of the modern age has rendered man and his
property most vulnerable to different types of risk and uncertainties in life. Thus,
while uncertainties of death, unemployment, sickness are constantly staring at the
face of a man, his property is exposed to the risks arising from fire, water, accident,
sea perils, floods etc. However with growth of the industrialized society and
consequently a rapid increase in number of situations in which human life and
property get exposed to risk, an effective solution of reducing the burden of losses
has been devised by shifting these risks to agencies or persons willing to share them.
This is known as Insurance. There are various types of insurance i.e. Life, Marine,
Fire, Motor vehicle.
MEANING
Life insurance is one of the most popular forms of insurance. Life insurance is a
contract in which one party agrees to pay a given sum upon the happening of a
particular event contingent upon the duration of life in exchange of payment of
consideration. The person who guarantees the payment is called the insurer, amount
guaranteed is the policy amount and the person on whom life payment is
guaranteed is called the insured. The particular event on which payment is to be
made is called death or maturity and consideration paid is called premium.
As early as 600 BC there was evidence that greeks & romans recognised societies &
provided death benefits & funeral expenses for members. First insurance policies
hasd been made on lives of slaves in voyages. In the origins of England life
insurance took the form of society arrangements for death & funeral expenses & life
insurance was recognised in England since the 15 th century. By 1830’s between 30-
50% of lives were insured in UK.
Insurance has been written about in the ancient texts of Manu (Manusmrithi),
Yagnavalkya (Dharmasastra) and Kautilya (Arthasastra), where emphases were laid
upon pooling of resources. When disaster struck, this pool of resources would get
redistributed to help those affected within the community or village the distressed
was part of. Taking care of dependents of the deceased has also been mentioned
from the times of the Indus valley civilization.
In 1818, the first insurance company in India was established in Calcutta (modern
day Kolkata), The Oriental Life Insurance Company. Similarly, Bombay (Mumbai)
had the Bombay Mutual Assurance Society and Madras (Chennai) had the Madras
Equitable Assurance Company, which were started in and around 1870. In the initial
days, Indians had to pay an extremely high premium than compared to the British
residents. It was the Bombay Life Assurance Company, which became the first
insurance company established by an Indian that started insuring Indians without
charging extra premiums.
The history of the first half century may be divided into the following periods:
1972
In 1972, the General Insurance Business (Nationalisation) Act was passed which
nationalised all general insurance companies in India. The 107 odd companies
existing around the time were all merged into four companies:
New India Assurance Company Ltd.
National Insurance Company Ltd.
Oriental Insurance Company Ltd.
United India Insurance Company Ltd.
1999
As per the recommendations made by the Malhotra Committee, two things
happened in the year 1999: one, the private sector was permitted to enter the
insurance business and, two, the Insurance Regulatory and Development Authority
of India (IRDAI) was constituted. IRDAI was incorporated in April 2000 and is now
an autonomous body that works towards growing the insurance industry.
Till date, IRDAI frames regulations under Section 114A of the Insurance Act, 1938.
History And Development Of General Insurance In India
General Insurance in India has its roots in the establishment of Triton Insurance
Company Ltd., in the year 1850 in Calcutta by the British. In 1907, the Indian
Mercantile Insurance Ltd, was set up. This was the first company to transact all
classes of general insurance business.
1957 saw the formation of the General Insurance Council, a wing of the Insurance
Association of India. The General Insurance Council framed a code of conduct for
ensuring fair conduct and sound business practices.
In 1968, the Insurance Act was amended to regulate investments and set minimum
solvency margins. The Tariff Advisory Committee was also set up then.
In 1972 with the passing of the General Insurance Business (Nationalisation) Act,
general insurance business was nationalized with effect from 1 st January, 1973. 107
insurers were amalgamated and grouped into four companies, namely National
Insurance Company Ltd., the New India Assurance Company Ltd., the Oriental
Insurance Company Ltd and the United India Insurance Company Ltd. The General
Insurance Corporation of India was incorporated as a company in 1971 and it
commence business on January 1sst 1973.
This millennium has seen insurance come a full circle in a journey extending to
nearly 200 years. The process of re-opening of the sector had begun in the early
1990s and the last decade and more has seen it been opened up substantially. In
1993, the Government set up a committee under the chairmanship of RN Malhotra,
former Governor of RBI, to propose recommendations for reforms in the insurance
sector. The objective was to complement the reforms initiated in the financial
sector. The committee submitted its report in 1994 wherein , among other things, it
recommended that the private sector be permitted to enter the insurance industry.
They stated that foreign companies be allowed to enter by floating Indian
companies, preferably a joint venture with Indian partners.
Following the recommendations of the Malhotra Committee report, in 1999, the
Insurance Regulatory and Development Authority (IRDA) was constituted as an
autonomous body to regulate and develop the insurance industry. The IRDA was
incorporated as a statutory body in April, 2000. The key objectives of the IRDA
include promotion of competition so as to enhance customer satisfaction through
increased consumer choice and lower premiums, while ensuring the financial
security of the insurance market.
The IRDA opened up the market in August 2000 with the invitation for
application for registrations. Foreign companies were allowed ownership of up to
26%. The Authority has the power to frame regulations under Section 114A of the
Insurance Act, 1938 and has from 2000 onwards framed various regulations ranging
from registration of companies for carrying on insurance business to protection of
policyholders’ interests.
In December, 2000, the subsidiaries of the General Insurance Corporation of India
were restructured as independent companies and at the same time GIC was
converted into a national re-insurer. Parliament passed a bill de-linking the four
subsidiaries from GIC in July, 2002.
Today there are 34 general insurance companies including the ECGC and
Agriculture Insurance Corporation of India and 24 life insurance companies
operating in the country.
The insurance sector is a colossal one and is growing at a speedy rate of 15-20%.
Together with banking services, insurance services add about 7% to the country’s
GDP. A well-developed and evolved insurance sector is a boon for economic
development as it provides long- term funds for infrastructure development at the
same time strengthening the risk taking ability of the country.
Insurance Industry plays a vital role in the Indian market. Today there exist around
34 general insurance companies and 24 life insurance companies.
- The life insurance sector in India has recorded growth of around 12% (2016-17)
by receiving a premium income of around 1.87 trillion rupees during the year.
- The Life insurance sector offers about 360 million policies, considered as the
largest in the world. There exists lots of opportunities in the Indian insurance
market. Currently general insurance business in Indian market accounts for more
than 70,000 crore premiums yearly and has been growing at a positive rate.
Major developments- The IRDA has formulated guidelines for insurance companies
in India.
HDFC ergo car insurance and max life insurance co are now merged and expected to
establish India’s largest private sector insurance company.
Best development in Indian insurance market is Lloyd’s – Uk based which entered
into the Indian market in 2017 after IRDA’s approval.
A number of initiatives have been taken by the govt to boost insurance sector in
India as well such as:
- Union budget made a provision that foreign investment would be allowed up to
49% through automatic route.
- GST fixed at 18%.
- IRDA created 2 committees to explore, suggest and promote e-commerce in the
insurance sector.
- IRDA formulated a regulation imposing obligations on insurance providers
towards offering insurance coverage to rural and financially weaker sections of
the societies.
- The GOI has also announced several insurance schemes .
Thus the future of the life insurance industry is promising with various changes in
its way of functioning.
In 1825 the alliance British and foreign fire insurance company was established in
Delhi. In 1938, the general insurance council constituted a tariff committee operating
in Bombay, Delhi and Madras which dealt with fire, marine insurances.
Insurance is classified (i) basis of business point of view; (ii) risk point of view; (iii)
as per nature of event.
1. Life Insurance- the subject matter of insurance is the life of a human being. The
insurer will pay the fixed amount of insurance at the time of death or at the
expiry of a certain period. At present, life insurance enjoys maximum scope
because life is the most important property of an individual. Each and every
person requires insurance. This insurance provides protection to the family at the
premature death or gives an adequate amount at the old age when earning
capacities are reduced. Under personal insurance, a payment is made at the
accident. The insurance is not only a protection but is a sort of investment
because a certain sum is returnable to the insured at the death or the expiry of a
period.
Fire Insurance- Fire Insurance covers the risk of fire. In the absence of fire
insurance, the fire waste will increase not only to the individual but to the society as
well. With the help of fire insurance, the losses arising due to fire are compensated
and the society is not losing much. The individual is preferred from such losses and
his property or business or industry will remain approximately in the same position
in which it was before the loss. The fire insurance does not protect only losses but it
provides certain consequential losses also war risk, turmoil, riots, etc. can be insured
under this insurance, too.
Other Forms of Insurance- Besides the property and liability insurances, there are
other insurances that are included in general insurance. Examples of such insurances
are export-credit insurances, State employees’ insurance, etc. whereby the insurer
guarantees to pay a certain amount at certain events. This insurance is extending
rapidly these days.
Health Insurance
• Cover for medical and surgical expenses
• Room rent waiver, Maternity cover, critical illness cover, Hospital cash.
• Comprehensive health insurance cover, family floater cover, surgery cover,
individual cover.
Travel insurance
• Baggage, trip delay, and other incidental expenses.
• Flight delay, loss of baggage or passport, medical emergencies, hijack, distress
allowance, Accidental death while travel, Financial emergency assistance.
• International travel insurance, Student travel insurance, Group travel insurance,
Senior citizen travel insurance, Domestic travel insurance, Corporate travel
insurance
Home Insurance
• Protection to the entire house and secures all the belongings.
• Fire and Peril (Due to Fire, Explosion, Aircraft damage, lightning, missile testing,
earthquake, storm, hurricane, landslide, cyclone, riot, strike, theft, burglary)
Commercial insurance
• Profit making organisations
• Risk of business related requirements.
• Automotive, aviation, construction, chemicals, foods and beverages,
manufacturing, oil and gas, pharmaceutical, power, technology, telecom, textiles,
transport and logistics.
• Marine insurance- ship and cargo inside
• Liability insurance- insurance from risk of liabilities.
• Energy insurance- Insurance for refineries, Petrochemicals and chemical plants,
Gas works, Terminals and Tank farms, Underground storage and chemical
fertilizer plants.
Definition of Insurance
Nature of Insurance:
1. By nature insurance is a devise of sharing risk by large number of people among
the few who are exposed to risk by one or the other reason.
2. If a large number of subscribers to insurance serve the purpose of compensation to
few among them exposed to uncertain risks appears as a co-operative look.
3. Valuation of risk is determined as per predefined terms and conditions of the
insurance policies.
4. Insurance provides facility of financial help in case of contingency.
5. However it depends on the value of insurance for which payment is made in case
of contingency. This provides basis of the amount to be paid.
6. Insurance is a policy regulated under laws and therefore the amount of insurance
can neither be paid as gambling nor as charity.
Need of Insurance:
Life of everyone is full uncertainties. Nobody knows what is going to happen in next
moment. This element of unknown situation always hounds around the mind of a
person and keeps him worried to think as to what will happen in future in case of
any mis happening. This worry is to think about the future of the person and his
family. Among a number of worries the main and very important is economic
uncertainty of himself or his family. If anyone is satisfied with his present earnings,
he also thinks whether or not his present day capacity of earning will last for long.
Perhaps there remains an iota of fear that it may not last for the long. On this very
point everyone thinks about to secure his future. Under the impression of securing
future one thinks about the adoption of saving and investment plans. . He not only
thinks about himself but also about his family. In case of any miss happening
everyone is worried as to what shall happen to his family.
Everyone knows that there is no substitute in case of death of an earning member of
the family and no compensation is able to fulfil the gap in case of death of the
earning member. But for supporting economically upto some extant the method
adopted is known as insurance. The life insurance is such a cover that provides
security to the family of insured in case of his death. Life Insurance in such cases
provides some solutions to the worries of family members.
Once upon a time it was very difficult to convince people for getting an insurance
cover but today it has become a need of the day. Today the life insurance does not
cover the risk of life only but also provides many added benefits also in the field of
saving and investments. People need insurance because the unexpected does
happen. Whether it is a fire, a car wreck, illness or a death, the financial
consequences can be devastating if you are uninsured. Insurance helps people have
peace of mind when life’s unexpected events happen.
1. You never know what is going to happen
2. You can’t trust nature
3. You can’t trust other people
4. It’s not as expensive as you might think
5. For your peace of mind
Characteristics of Insurance
It is a contract for compensating losses.
Premium is charged for Insurance Contract.
The payment of Insured as per terms of agreement in the event of loss.
It is a contract of good faith.
It is a contract for mutual benefit.
It is a future contract for compensating losses.
It is an instrument of distributing the loss of few among many.
The occurrence of the loss must be accidental.
Insurance must be consistent with public policy.
Nature of Insurance (summary)
Sharing of Risks
Co-operative Device
Valuation of Risk
Payment made on contingency
Amount of Payment
Large Number of Insured Persons
Insurance is not gambling
Insurance is not charity
7 Functions of Insurance
3. Risk-Sharing- The risk is uncertain, and therefore, the loss arising from the risk is
also uncertain. When risk takes place, the loss is shared by all the persons who are
exposed to the risk. The risk-sharing in ancient times was done only at the time of
damage or death; but today, based on the probability of risk, (he share is obtained
from every insured in the shape of premium without which protection is not
guaranteed by the insurer.
7. It helps Economic Progress -The insurance by protecting the society from huge
losses of damage, destruction, and death, provides an initiative to work hard for the
betterment of the masses. The next factor of economic progress, the capital, is also
immensely provided by the masses. The property, the valuable assets, the man, the
machine and the society cannot lose much at the disaster.
Re- Insurance and Double Insurance
RE-INSURANCE
When an insurer issues a policy to the insured he is said to have entered into a
contract of insurance. In doing insurance business it may issue a number of policies
and at a particular stage it may feel that the risk undertaken by it is beyond its
capacity, then it may retain the risk which it can bear and the balance may be
transferred to another insurer called the reinsurer under contract of insurance.
In other words, Re-insurance refers to insurance that is purchased by one insurance
company from one or more other insurers and risk is shared among the insurers.
Thus a contract of insurance creates in the insurers an insurable interest sufficient to
support reinsurance to the full amount of their liability on the original policy.
DOUBLE INSURANCE
Double Insurance is a situation in which the same risk is insured by two overlapping
but independent insurance policies. It is lawful to obtain double insurance, and the
insured can make claim to both insurers in the event of a loss because both are liable
under their respective polices. The insured, however, cannot profit (recover more
than the loss suffered) from this arrangement because the insurers are law bound
only to share the actual loss in the same proportion they share the total premium. It
is also called as dual insurance.
Features of double insurance are:
1. The subject matter is insured with two or more insurance companies.
2. The insured can claim the amount from the policies.
3. The insurer cannot claim more than the actual loss.
Assignment of Life, Fire and Marine policies.
When the legal right or interest in a policy is transferred to a third person the policy
is said to have been assigned. The person who transfers the policy is called the
‘assignor’ and person to whom policy has been assigned is called the ‘assignee’.
Till 1938, the general rules relating to assignment of actionable claims governed the
assignment of life policies. Section 130 of the Transfer of Property Act which is now
repealed provided that the transfer of an actionable claim, with or without
consideration is effected by the execution of an instrument in writing signed by the
transferor or his duly authorized agent and the same becomes complete and
effectual upon the execution of the instrument of transfer and all rights and remedies
of the transfer vest in the transferee whether any notice of such transfer is given or
not except in case of transfers of marine and fire policies.
Therefore under Transfer of Property Act, before 1938, for an assignment of a claim
under life policy to be valid, it must be affected only by an instrument in writing and
signed by assignor or his authorized agent. But after passing of Insurance Act 1938,
assignment of life policies is governed by Section 38 of Insurance Act 1938.
Section 38(1) provides for transfer or assignment of policy of life insurance. Every
assignment must satisfy the following requirements:
It should be in writing. This writing may be either (a) as an endorsement on
the policy itself, or (b) by a separate document.
In either case it must be signed by the assignor, transferor or his duly
authorized agent.
It must be attested at least by one witness, and
It must specifically set forth the fact of transfer or assignment.
It may be made with or without consideration.
Assignment must be attested by at least one witness.
such as:
Apart from the above requirements, there are certain other conditions of a valid
assignment
The assignment must not be opposed to any law for the time being in force in
the country.
The assignment must be either for valuable consideration or without
consideration. When it is for consideration it may be by way of sale or
mortgage but when it is for no consideration it may be a gift or a legacy or
even a donation mortis causa.
WHO CAN EFFECT AN ASSIGNMENT?
Any person competent to contract and having title to the policy of life insurance or
authority to transfer the policy of life insurance if it is not his own, may assign a
policy. If a transferor himself has no title to a property, he may still transfer it
provided he has the authority to do so by virtue of law or express power granted to
him by the owner
Once the formalities prescribed by this section for assignment are one through
subject to the terms and conditions of the transfer, the insurer shall recognize the
assignee as the only person entitled to claim under the policy.
TYPES OF ASSIGNMENT:
1. Absolute- absolute assignment is one by virtue of which all the rights; title and
interest which revert to the former or his estate in any event. The policy vests
absolutely in the assignee and forms a part of the assignee’s estate on his death.
2. Conditional – conditional assignment is an assignment which provides that the
policy will revert to the assured in the event of his surviving the date of maturity
or on the death of the assignee, as the fulfillment of the condition does not
depend on the will of the assignor. The effect of such assignment is that assignee
obtains an immediate vested interest in the policy and the assignment would
become inoperative upon the subsequent happening of either of the conditions
mentioned in the assignment.
A life insurance policy once assigned and validly executed cannot be cancelled or
rendered ineffectual at the mere will of the assignor. But the only way in which
an assignment may be cancelled or rendered ineffective is to have the policy
properly reassigned in the assignors favor by the assignee or a person claiming
title through him provided he is a major and competent to contract.
Section 2 of the Insurance Act, 1938, had authorized the Central Government to
appoint the Controller of Insurance to regulate the insurance business of India. It
had the supervisory and regulatory powers. However, after the nationalization of
the life insurance industry in 1956 and the general insurance industry in 1972, the
role of Controller of Insurance had diminished in significance. The Government of
India in April, 1993 setup a high powered committee known as The Malhotra
Committee , to examine the structure of insurance industry and recommended
changes to make it more efficient and competitive.
A chairman,
Not more than five whole time members, and
Not more than four part time members.
The chairman and the members are to be appointed by the Central Government
from amongst persons of ability, integrity and standing who have knowledge or
experience in life insurance, general insurance, actuarial science, finance, economics,
law, accountancy which would be useful in the opinion of Central Government.
The chairperson and other whole time members shall hold office for 5 years or until
the age of 65 in the case of chairman and 62 in case of other whole time members
whichever is earlier and they are eligible for reappointment subject to age
consideration. A part time member can hold office for a term not exceeding 5 years.
The Central Government may remove a member from office if he has or at any time
has been adjudged as:
An insolvent, or
Has become mentally or physically incapable of acting as a member, or
Has been convicted of any offence involving moral turpitude, or
Has acquired financial interest as is likely to affect prejudicially his functions as a
member, or
Has abused his position as to render his continuation detrimental to the public
interest.
He can be removed only after giving him a reasonable opportunity of being heard in
the matter.
Section 14 of the Act provides for the duties, powers ad functions of IRDA. The only
duty of the Authority is to regulate, promote and ensure orderly growth of the
insurance and the reinsurance business.
Section 14(2) describes and delineates the powers and functions of the Authority
and it contains clauses (a) to (q).
(d) Specifying the code of conduct for surveyors and loss assessors;
(e)Promoting efficiency in the conduct of insurance business;
(g) Levying fees and other charges for carrying out the purposes of this Act;
(h)Calling for information from, undertaking inspection of, conducting inquiries and
investigations including audit of the insurers, intermediaries, insurance
intermediaries and other organizations connected with the insurance business;
(i)Control and regulation of the rates, advantages, terms and conditions that may be
offered by insurers in respect of general insurance business not so controlled and
regulated by the Tariff Advisory Committee under Section 64U of the Insurance Act
1938;
(j)Specifying the form and manner in which books of account shall be maintained
and statement of accounts shall be rendered by insurers and other insurance
intermediaries;
(p)Specifying the percentage of the life insurance business and general insurance
business to be undertaken by the insurer in the rural or social sector; and
A. Introduction
Ubberima fides (uberrimae fidei) is a latin phrase meaning utmost good faith and is
a legal doctrine governing insurance contracts. Every insurance contract is a contract
of utmost good faith (uberrimae fidei). It is a condition of every insurance contract
that both the parties should display utmost good faith towards each other in regard
to the contract. This implies that at the time of entering into an insurance contract
both parties must disclose all the material facts and circumstances to each other. The
insured should not make any misrepresentation and at the same time disclose all
facts. Utmost good faith requires each party to tell the other “the truth, the whole
truth and nothing but the truth.
Commercial contracts are generally subjected to the principle of Caveat emptor i.e.
let the buyer beware but in insurance contracts this principle does not apply.
Lord Mansfield is said to be the father of the principle of good faith. The principle
was laid down in the land mark case of CARTER V. BOEHM, Insurance is a
contract based upon speculation. The special facts, upon which the contingent
chance is to be computed, lie most commonly in the knowledge of the insured only
the underwriter trusts to his representation and proceeds upon the confidence that
he does not keep back any circumstance in his knowledge to mislead the underwriter
into a belief that the circumstance does not exist and to induce him to estimate the
risk as if it did not exist.
The other jurist who is greatly associated with this principle i.e. Jessel M.R. who held
in LONDON ASSURANCES V. MANSEL , Good faith forbids either party by
concealing what he privately knows to draw the other into a bargain from his
ignorance of that fact and his believing the contrary.
In India, the same principle has been followed by the Supreme Court in LIFE
INSURANCE CORPORATION OF INDIA V. ASHA GOEL , where it was held that,
contracts of insurance are contracts uberrimae fidei and every material fact must be
disclosed, otherwise there is a good ground for recession of the contract.
The duty to disclose material facts continues right up to the conclusion of the
contract.
In United India Insurance Co Vs. MKJ Corp, held that just as insured has a duty to
disclose it is the duty of the insurer and their agents to disclose all material facts
within their knowledge since obligation of good faith applies to them equally with
the assured.
D. Duty To Disclose Material Facts: The assured must disclose to the insurer before
the contract is concluded, every material circumstances which is known to the
assured. If he fails to make such disclosure, the insurer may avoid the contract. The
insurer too cannot withhold information in his private possession to the detriment of
the insured although occasions for such disclosure by the insurers are rare. The
insurer must also inform the insured about the terms and conditions of the policy
that is going to be issued to him. He must issue the policy in conformity with the
terms mutually agreed with the insured. The duty to disclose is absolute. It is
positive and not negative. Utmost good faith requires that there should be no
concealment, misrepresentation, wrong statements, half-truths or any silence on a
material fact.
Materiality of facts: Utmost good faith requires the disclosure of material facts. A
material fact is one which goes to the root of the contract of insurance. Every
circumstance is material which would influence the judgment of a prudent insurer in
fixing premium or determining the risk. What is material in the technical sense
cannot be left entirely to the discretion of the party concerned, in every case it is a
matter of fact, to be decided by the court, if necessary. Material facts are of 2 types:
(a) those facts which affect the nature of incidence of risk, and,
(b) those facts which affect the character of the insured.
In the case of BANARASI DEVI V. NEW INDIA ASSURANCE CO ., it was laid down
that a material fact is one:
1. Which increases the risk, or
2. Whether the insurer would have rejected to give a policy on these terms if the
fact had been disclosed.
G. Breach Of Utmost Good Faith: The various circumstances under which the
parties may be guilty of breach of utmost good faith may be classified into 4
categories:
(a) Non-disclosure : Omission to disclose unintentionally or inadvertently or
because the proposer did not recognize that the fact in question was material.
(b) Concealment: Intentional suppression of a fact which is material, e.g. failure to
disclose that his proposal with some other insurance company was not accepted.
(c) Innocent misrepresentation: A statement which is inaccurate but which is made
without any fraudulent intention.
(d) Fraudulent misrepresentation: A statement made knowingly or without belief in
its truth or recklessly without caring whether it be true or false.
When there is breach of duty of utmost good faith, the contract may be either void
or voidable but if there is fraudulent misrepresentation, contract is void.
is returnable.
H. Conclusion
Thus, it can be concluded that contracts of insurance are contracts of utmost good
faith and both the parties must disclose all material facts. The reason of the rule is to
prevent fraud and to encourage good faith.
Third Party or Compulsory Insurance Of Motor Vehicles Act
Every person who runs a motor vehicle is under a duty not to use or to cause or
permit any other person to use it on a road unless any liability, which may be
incurred thereby in respect of death or bodily injury to any person caused by or
arising out of the use is covered by a policy of insurance. The object of this type of
policy is to protect the insured against his liability to third parties arising out of an
accident caused by the use of a motor vehicle on a public road and it is also made
compulsory.
In law of torts, if a person negligently drives his vehicle and causes injury or death to
third party, the driver whose negligence caused the death is liable to the third party.
The insurance policies that deal with the liability of the owner to third party for
causing them injury or death by the use of the motor vehicle is known as third party
or compulsory insurance of motor vehicles.
The contract in this type of policy is also one of indemnity like any other contract of
insurance. The object of this type of policy is to protect the insured against his
liability to third parties arising out of an accident caused by the use of a motor
vehicles on a public road and it is also made compulsory. The general effect of the
act is that every person who runs a motor while is under a duty not to use or to
cause or permit any other person to use in on a road unless any lability, which may
be incurred thereby in respect of the death or bodily injury to any person caused by
or arising out this user is covered by a policy of insurance.
Section 146 of the Motor Vehicles Act 1988 says that no person shall use except as a
passenger or cause or allow any other person to use a motor vehicle in a public
place, unless there is in force in relation to the use of the vehicle by that person or
other person as the case may be, a policy of insurance complying with the
requirements of this chapter.
Third party insurance is a must for running a motor vehicle in a public place.
However, the vehicles belonging to the Central and State government and used by
them for purposes unconnected with their commercial enterprises need not be
insured.
Section 196 of the Act provides a punishment for driving an uninsured motor
vehicle by stating that whoever drives a motor vehicle or causes or allows a motor
vehicle to be driven in contravention of the provisions of Section 146 shall be
punished with imprisonment which may extend to three months or with fine which
may extend to Rupees 1000 or with both.
A person driving an uninsured motor vehicle merely as a paid employee, shall not
be deemed to act in contravention of Section 146(1) unless he knows or has reason to
believe that there is no such policy in force.
A public vehicle cannot ply without permit and the rules framed by the State
Governments prescribe in the Insurance Certificate is a condition precedent for the
insurance of a permit.
Persons Governed
It applies to all persons. It includes any company or association or body of
individuals, whether incorporated or not. The duty imposed under the section is
absolute. The only category of persons exempted from this duty is passengers.
Normally the duty imposed by the section is on the owner of a vehicle because
generally an owner uses his vehicle or causes or allows it to be used on a public
road.
The question of motor insurance arises only if it is a ‘motor vehicle’ and is in ‘use’.
IN THE CASE OF BUGGE V. TAYLOR, where a motor vehicle was left unattended
during hours of darkness on the forecourt of a hotel to which the public has access,
the defendant was held to have been properly convicted of leaving an unattended
vehicle on a road even though the place where it was left was a private property.
******
RIGHTS OF THIRD PARTIES
The statutory rights, as against the insurers of the injured third party are not
governed by Section 149 and 150 of Motor vehicles Act, 1988. Following essentials
must be satisfied before imposing a duty:
A certificate of insurance must have been delivered to the policy holder under
Section 148(4).
Judgment must have been obtained against any person insured in respect of
any such liability as is required to be covered by a policy under Section 148. If
no claim is made and no decree is passed against the insured, the insurance
company is not liable.
Subject to Section 149(2) such liability must be covered by the policy.
The fact that the insurer is entitled to avoid or cancel, or may have avoided or
cancelled the policy is no defence against the third party.
(1) By Section 149(2), the insurer is not made liable to pay any money under such
judgment where;
(i) He had not been given notice, before or after the commencement of the
proceedings in which judgment is given, of the bringing of the proceedings or;
(ii) Execution on the judgment is stayed pending an appeal.
(2) By Section 149(2) it is provided that when the insurer is given notice of the
proceedings he shall be entitled to be made a party thereto. When he is made a party
he can defend the action on any of the following grounds:
1. (a) That there has been a breach of a specified condition of the policy, being one
of the following conditions namely;
1. (i) A condition excluding the use of vehicle:
For hire or reward
For organized racing and speed testing
For a purpose not allowed by the permit under which the vehicle is used,
where the vehicle is a transport vehicle or
Without a side-car being attached, where vehicle is a motor-cycle.
2. (ii) A condition excluding driving by a named person or persons or by any person
who is not duly licensed, or by any person who has been disqualified for holding or
obtaining a driving license
3. (iii) A condition excluding liability for injury caused by condition of war, civil war,
riot or civil commotion or;
2. (b) That the policy is void on the ground that it was obtained by the non-
disclosure of a material fact or by a representation of a fact which was false in
some material particulars.
The conditions mentioned in clause (2)(b) can be availed of by the insurer on his
defence only if they have been incorporated in the policy and not otherwise.
DEATH OF PARTIES
Where the owner of the motor vehicle dies in the accident and the injured third
party is alive, the injured third party can make his claim against the estate of the
deceased owner unless he died before the accident;
Where the third party dies as a result of the accident his legal representative can
make a claim for the compensation before the appropriate tribunal;
Where both the owner and third party die in the accident, the estate of the
deceased owner will be liable to the estate of the dead third party;
Where the third party is not dead in the accident, he can himself make the claim
within 6 months of the accident, in such a case it does not matter whether the
motor vehicle owner is alive or dead in the accident.
********
CLAIMS TRIBUNAL
Sections 110-110F of the Motor Vehicles Act 1939 provided for the establishment of
motor claims tribunals with the object of providing an expeditious and cheap mode
of enforcing the liability of the person who caused motor accidents. These sections
provided for the constitution and functions of the tribunals as an alternative forum
with a self-contained code and complete machinery for the purpose. The Supreme
Court held that the change in law under section 110-110F was merely a change of
forum. It is a change of procedural but not of substantive law. The substitution of the
Claims Tribunals in the place of civil courts intended to provide quick relief also
failed and hence a change in the substantive law also is made by Motor Vehicles Act
1988 by providing “no fault liability”. The Motor Vehicles Act 1988 re-enacted the
provision in section 110-110F of the Motor Vehicles Act 1939 under section 165-176.
Claim Application
For the claimant to file a claim application he has two options :
First, under Section 163 A of the Act where the claim is assessed based on
‘Structured Formula’.
Second, under Section 166 of the Act where the judge assesses the case based on the
evidence available.
The application can be against any of the following people :
Owner of the vehicle
Driver
Insurer
Once the complaint about the accident has been registered by the police it is then
forwarded to the Claims Tribunal within 30 days from the date the report was
prepared.
***********
NO FAULT LIABILITY IN MOTOR VEHICLES ACT
Sec 140 of Motor Vehicles Act, 1988 deals with the liability without fault. The
claimant involved in a motor vehicle accident is not required to prove wrongful act,
neglect, or default on the part of the owner of the vehicle or by any other person.
The claim under these provisions is neither defeated or affected in any way, by any
wrongful act, neglect or default on the part of the claimant; nor can be of the
claimant’s share of responsibility for the accident. In other words, the legal defence
of ‘contributory negligence’ is not available to the motorist and his insurer.
These provisions apply in cases where the claimant suffers death or permanent
disablement, as defined in the Act. The amounts of compensation are fixed as
follows:
No fault liability
Section 140 in The Motor Vehicles Act, 1988
140. Liability to pay compensation in certain cases on the principle of no fault.—
(1) Where death or permanent disablement of any person has resulted from an
accident arising out of the use of a motor vehicle or motor vehicles, the owner of the
vehicle shall, or, as the case may be, the owners of the vehicles shall, jointly and
severally, be liable to pay compensation in respect of such death or disablement in
accordance with the provisions of this section.
(2) The amount of compensation which shall be payable under sub-section (1) in
respect of the death of any person shall be a fixed sum of fifty thousand rupees and
the amount of compensation payable under that sub-section in respect of the
permanent disablement of any person shall be a fixed sum of twenty-five thousand
rupees.
(3) In any claim for compensation under sub-section (1), the claimant shall not be
required to plead and establish that the death or permanent disablement in respect
of which the claim has been made was due to any wrongful act, neglect or default of
the owner or owners of the vehicle or vehicles concerned or of any other person.
(4) A claim for compensation under sub-section (1) shall not be defeated by reason of
any wrongful act, neglect or default of the person in respect of whose death or
permanent disablement the claim has been made nor shall the quantum of
compensation recoverable in respect of such death or permanent disablement be
reduced on the basis of the share of such person in the responsibility for such death
or permanent disablement.
(5) Notwithstanding anything contained in sub-section (2) regarding death or bodily
injury to any person, for which the owner of the vehicle is liable to give
compensation for relief, he is also liable to pay compensation under any other law
for the time being in force: Provided that the amount of such compensation to be
given under any other law shall be reduced from the amount of compensation
payable under this section or under section 163A.
WHAT ARE RISKS AND ITS SCOPE AND ELEMENTS?
Risk and Insurance are interwoven with each other. The life-blood of an insurance
contract is the risk it deals with. A contract of insurance is a contract which the
insurer undertakes to protect the insured from loss if it occurs. The insured is afraid
of loss which is called the risk of loss and the insurer undertakes to indemnify him
from the loss if it occurs for a consideration called premium. The insurer is able to
make an estimate of premium only if he knows the nature and degree of likely risk;
on part of the assured, it is of great importance to know the exact extent of his cover,
so as to avoid unnecessary double or over insurance.
However, all the risks cannot be insured, though hundreds of risks can be insured in
which the degree of such risks is measurable. The following points must be taken
into note:
Risk should be uncertain.
Loss arising from such risks should be capable of approximate calculation.
The greater the risk, the higher the cost of insurance, and
The risk should not be a speculative one, but a real one.
SCOPE OF RISK
IN XANTHOS’S CASE, the scope of the risk is described as: ‘It is open to the parties
by agreement to extend or limit the liability of the insurer in respect of the operation
of the risk’. In the absence of such agreement:
the risk includes:
(a) the loss caused, i.e., risk brought about by the negligence not only of the insured
but even by his servants or strangers and
(b) risk brought about wilfully or maliciously by the insured’s servants or strangers,
but,
the risk does not include:
a) loss caused by the wilful misconduct of the insured or caused with his
convenience whether it amounts to a crime or not;
(b) loss due to ordinary wear and tear and
(c) inherent vice of the subject matter insured
(d) the risk is such that it must happen
(e) the risk in insurances is that which may happen and not which must happen.
ELEMENTS OF RISK
Risk depends upon various elements of the event insured against in its happening
soon or later. These circumstances must be disclosed by the insured and the insurers
generally calculate the premium with reference to these elements.
IN LIFE INSURANCE, the risk depends upon;
habits in life or mode of living
occupation
environment
position and status in life
character
heredity
previous illness, and
Opportunities for exposure to special damages.
TERMINATION OF RISK
Generally the risk terminates on the expiry of the term of the policy, i.e., the time
fixed for the duration of the risk in the policy. However, the termination may also be
brought unilaterally by the insurer or insured in exercise of their rights to terminate
the policy under the policy. Both insurer and insured may agree to terminate the
policy and substitute a new one in its place.
LIFE INSURANCE
Synopsis: Introduction
Definition of Life Insurance
Meaning of Life Insurance
Nature of Life Insurance
Kinds of Life Insurance
Rules governing the assignment of Life Insurance
-Introduction: In India, some Europeans started the first life insurance company in
Bengal called the Orient Life Insurance Company in 1818. In Independent India,
there was a boom in the insurance business and there were about 250 Insurance
Companies by 1955. As there was no protection or guarantee to the policy holders’
money, the central government nationalized the life insurance industry and formed
the Life Insurance Corporation of India on 1/09/1956. Later, on the recommendation
of the Malhotra Committee, the government opened the insurance sector for
participation by the private insurance entities. The Government then enacted the
Insurance Regulatory and Development Authority (IRDA) Act, 1999 to protect the
interests of holders of insurance policies, to regulate, promote, and ensure orderly
growth of the insurance industry.
Benson – “Life insurance is a contract between two persons; one person agreeing to
pay a given sum on the happening of an event, contingent upon the duration of
human life; the other person agreeing to pay the prescribed amount in installments
or in lump sum; the period of payment being death or efflux of the agreed period,
whichever is early”.
Dalby Vs. London and Indian Life Insurance co. – In this case life insurance was
defined as “ a contract to pay a certain sum of money on the death of a person on a
consideration of a due payment of certain annuity for his life calculated according to
the probable duration of life”.
Section 2(11) of the Insurance Act – provides that a life insurance contract
comprises of any contract in which one party agrees to pay a given sum upon
happening of a particular event contingent upon the duration of human life”.
Meaning of life insurance: Life insurance is a contract of insurance whereby the
insured agrees pay certain sums called premiums, at specified times, and in
consideration thereof the insurer agrees to pay certain sum of money on certain
conditions and in a specified way, upon happening of a particular event contingent
upon the duration of human life.
Life insurance imports a mutual agreement whereby the insurer, in consideration of
the payment by the assured of a named sum annually or at certain times, stipulates
to pay a large sum at the death of the assured. The insurer takes into consideration,
among other things the age and health of the parents and relatives of the applicant
for insurance together with the applicant’s own age, course of life, habits, present
physical condition, and the premium extracted from the insured, probable duration
of his life, calculated upon the basis of past experience in the business of insurance.
Thus, Life insurance is protection given to a person against the damage he may
suffer through the death of another.
Based on duration
1. Whole-life Insurance Policy: Under the whole-life insurance policy, premium
payments are made during the life time of the life assured and the sum assured is
payable only on death. It is exactly a term assurance plan for an indefinite term; the
term being linked to the duration of human life. The whole-life policies can be
affected either by payment of single premium or continuous premium payment or
limited premium.
2. Limited Payment Whole-life Policy: Premium under this plan is higher than the
premium payable under a whole-life plan. This plan is suitable for persons in whose
case the need for money would arise not only on the happening of death, but who
either on account of personal and family history are not eligible for a whole life plan
or do not want to extent the premium paying period beyond their earning years.
3. Convertible Whole-life Policy: Under this plan, the policy is originally issued as a
whole-life limited payment plan with a premium ceasing at age 70 with an option to
convert into an endowment plan after 5 years. This plan will be ideally suited for
young persons with a limited income to start with and possibility of increase in later
years. If the policy is converted into endowment, the premium is suitably increased.
Based on Endowment:
An endowment policy is essentially a life insurance policy which, apart from
covering the life of the insured, helps the policyholder save regularly over a specific
period of time so that he/she is able to get a lump sum amount on the policy
maturity in case he/she survives the policy term. This maturity amount can be used
to meet various financial needs such as funding one's retirement, children's
education and/or marriage or buying a house. Endowment plans, thus, fulfill the
dual need for a life cover and savings under a single plan. The key benefits of any
endowment plan include financial protection of loved ones, goal-based savings, tax
benefits under section 80C and 10(10D) of the Income Tax Act and the options to
obtain loan against the policy, in case of any financial emergency. Thus, any life
insurance plan with a saving component and lump sum maturity benefit can be
termed as an endowment plan.
2. Multiple Life Policy: In this policy more than one person is insured. It may be:
a) Joint Life Policy: This policy covers two or more lives and the policy amount
is payable on the first death.
b) Last Survivorship: This policy amount is payable at the last death. So as long
as any one of the insured is alive, no payment will be made.
Rules governing the assignment of Life Insurance and Fire Insurance : Interest
in a life insurance policy can be transferred from the policyholder to a lender or
relative by assignment of policy. Here the policyholder is known as the assignor
and the person in whose favor the policy has been assigned is called assignee.
DOCTRINE OF SUBROGATION AND DOCTRINE OF CONTRIBUTION
Synopsis for Doctrine of Subrogation:
Definition of Subrogation
Meaning of Subrogation
Ways in which the right to Subrogation may arise
Limitation of the Doctrine of Subrogation
Doctrine of Subrogation
Definition of Subrogation
1. Black’s Law Dictionary – “The Principal under which an insurer that has paid a loss
under an insurance policy is entitled to all the rights and remedies belonging to the
insured against a third party with respect to any loss covered by the policy”.
2. Evelyn Thomas, subrogation is defined as “right to which one person has to stand in
the place of another and avail himself of all the rights and remedies of that other”.
3. Dan B. Dobb’s Law of Contract – “Subrogation simply means substitution of one
person for another; that is, one person is allowed to stand in the shoes of another and
assert that person’s rights against the defendant. Factually, the case arises because
for some justifiable reason, the subrogation plaintiff has paid a debt owned by the
defendant.”
The term subrogation is derived from the Latin words: sub, meaning “under” and
rogare, meaning “to ask”. Thus, subrogation literally means “asking (for payment)
under another’s name.”
Subrogation means restitution of the rights of an assured in favor of the insurer
against third party for any damages caused by the third party, after the insurer has
indemnified the assured for the loss.
In accordance with this principle the insurance company acquires the right of the
insured to sue the third party to compensate for the loss inflicted, when it
indemnifies the insured for the losses suffered by him. The principle of subrogation
is applicable to all insurance contracts which are by their nature contracts of
indemnity. Subrogation occurs in property/casualty insurance when a company
pays one if its insured’s for damages, then makes its own claim against others who
may have caused the loss, insured the loss, or contributed to it
EXAMPLE: Suppose another driver runs a red light and hits your car. You have
insurance policy on your car, so you call your insurance company and they pay you
for all your expenses related to the accident. Your insurance company, realizing that
the other driver had an insurance policy, then seeks reimbursement from the at fault
party’s insurance company
Ways in which the right to Subrogation may arise: The right of subrogation may
arise in any of the following ways:
(a) Right arising out of tort: A tort is a “civil wrong” and the most common types of
tort being negligence and nuisance. When a duty owed to a third party is breached,
the injured person will have a right of claiming damages from the wrong doer.
When an insured has suffered a loss due to a negligent act of another then the
insurer having indemnified the loss is entitled to recover the amount of indemnity
paid from the wrong doer. The insurer has a right in tort to recover the damage from
the individuals involved.
(b) Right arising out of contract: Where a contract imposes on a third person the
obligation of making compensation to the insured in respect of the loss, the benefit
of the obligation shall pass over the insurer.
(c) Right arising by Statue: Sometimes, Acts of Parliament give subrogation rights
which might not otherwise exist, for e.g. in marine insurance, subrogation arises by
statute, i.e. by operation of Section 79 of the Marine Insurance Act, 1963.
(d) Subrogation arising out of salvage: Where an insured is paid for a total loss,
ignoring the monetary value of the wreckage or remains of the insured article, the
subrogation rights arise out of the subject-matter of the insurance.
Doctrine of Contribution
Synopsis:
Introduction
Definition of Fire Insurance
Meaning of Fire Insurance
Nature of Fire Insurance
Scope of the Fire Insurance
Who can insure the property against Fire
Rights and duties of insured in Fire insurance
Rights and duties of the insurer under Fire Insurance policy
Doctrine of proximate cause in Fire Insurance
General conditions of standard Fire Insurance policy
In case of Castellion Vs. Perton - “ Fire Insurance is a contract whereby one person
undertakes in return for the agreed consideration to indemnify another person
against loss or damage occasioned by fire up to the agreed amount”.
Section 2(6) of the Insurance Act, 1938 defined the fire insurance “as a legal contract
between an insurance company and the policyholder which guarantees that any loss
or damages caused to the policyholder's property in a fire will be paid by the
insurance company. Fire insurance provides coverage against incidents of accidental
fire, lightning, explosion, etc.”.
Meaning of Fire Insurance: Fire insurance is an agreement whereby one party (the
insurer), in return, for a consideration undertakes to the indemnify the other party
(the insured) against financial loss which he may sustain by reason of certain defined
subject matter being damaged by the destroyed by fire or other defined perils up to
an agreed amount.
The term ‘fire’ must satisfy two conditions:
The property must be damaged or burnt by fire. If the property is damaged by heat
or smoke without ignition it will not be covered under the word ‘fire’.
1) Offer & Acceptance : It is a prerequisite to any contract. Similarly, the property will be
insured under fire insurance policy after the offer is accepted by the insurance company.
Example: A proposal submitted to the insurance company along with premium on
1/1/2011 but the insurance company accepted the proposal on 15/1/2011. The risk is
covered from 15/1/2011 and any loss prior to this date will not be covered under fire
insurance.
2) Payment of Premium: An owner must ensure that the premium is paid well in advance
so that the risk can be covered. If the payment is made through cheque and it is
dishonored then the coverage of risk will not exist. It is as per section 64VB of Insurance
Act 1938. (Details under insurance legislation Module).
4) Utmost Good Faith: The property owner must disclose all the relevant information to
the insurance company while insuring their property. The fire policy shall be voidable
in the event of misrepresentation, mis-description or non-disclosure of any material
information. Example: The use of building must be disclosed i.e whether the building is
used for residential use or manufacturing use, as in both the cases the premium rate will
vary.
5) Insurable Interest: The fire insurance will be valid only if the person who is insuring the
property is owner or having insurable interest in that property. Such interest must exist
at the time when loss occurs. It is well known that insurable interest exists not only with
the ownership but also as a tenant or bailee or financier. Banks can also have the
insurable interest. Example: Mr. A is the owner of the building. He insured that
building and later on sold the building to Mr. B and the fire took place in the building.
Mr. B will not get the compensation from the insurance company because he has not
taken the insurance policy being an owner of the property. After selling to Mr. B, Mr. A
has no insurable interest in the property.
6) Contribution: If a person insured his property with two insurance companies, then in
case of fire loss both the insurance companies will pay the loss to the owner
proportionately. Example: A property worth Rs. 50 lakhs was insured with two
Insurance companies A and B. In case of loss, both insurance companies will contribute
equally.
7) Period of fire Insurance: The period of insurance is to be defined in the policy. Generally
the period of fire insurance will not exceed by one year. The period can be less than one
year but not more than one year except for the residential houses which can be insured
for the period exceeding one year also.
8) Deliberate Act: If a property is damaged or loss occurs due to fire because of deliberate
act of the owner, then that damage or loss will not be covered under the policy.
9) Claims: To get the compensation under fire insurance the owner must inform the
insurance company immediately so that the insurance company can take necessary
steps to determine the loss.
Scope of a fire insurance: Though it is called ‘Fire Insurance’, apart from the risk of
fire, it also offers cover against lightning, explosion/implosion, aircraft damage, riot,
strike and malicious damage, storm, cyclone, typhoon, hurricane, flood and
inundation, impact damage, subsidence and landslide including rockslide, bursting
and/or overflowing of water tanks, apparatus and pipes, missile testing operations,
accidental leakage from automatic sprinkler installations, bush fire etc.
A fire insurance policy usually does not cover a certain amount known as “excess”
under the policy. Loss or damage caused by war and warlike operations, nuclear
perils, pollution or contamination, electrical/mechanical breakdown, burglary and
housebreaking are excluded. Certain perils like earthquake, spontaneous
combustion etc can be covered on payment of additional premium.
Fire insurance policies are issued for one year except for dwellings, where a policy
may be issued for long term (with a minimum period of three years).
(a) Implied rights: The insurers have rights implied by law in view of the liability
they have undertaken to indemnify. Thus, they have a right to:
(i) Take all reasonable measures to extinguish the fire and to minimize the loss to
property, and
(ii) For the purpose, to enter upon and take possession of the property.
(b) Express rights: On happening of any damage the insurer and every person
authorized by the insurer may enter, take or keep possession of the building or
premises where the damage has happened or require it to be delivered to them and
deal with it for all purposes like examining, arranging, removing, selling or
disposing off the same for the account of whom it may concern.
Apart from the above, insurer has various other rights such as:
(i) Right of disclosure: A fire insurance contract is a contract of good faith. The
insured is bound to disclose to the insurer before the conclusion of the contract every
material circumstance which, in the ordinary course of business, ought to be known
by him. If the insured fails to make such disclosures, the insurer can avoid the
contract.
(ii) Right of control over the property: The insurer has an implied right to assume
control over the damaged property instead of leaving it in the possession of the
person having the right to obtain indemnity.
(iii) Right of entering the property: The insurer is entitled to enter upon the
premises insured or wherein the things insured are. But in order to do so, the
insured is required to give an immediate notice of the fire with the particulars of
damage done.
(iv) Right of subrogation: Subrogation is a right which equity has given in order to
enable the insurer to recoup, as far as may be, his loss under the contract.
(v) Right to salvage: When the insured property is destroyed or damaged by fire, the
insurer has a right to take possession of the salvage i.e. the property or things saved
after fire.
(vi) Right of reinstatement: The insurer has a right that instead of paying the loss to
the policy-holder in cash, he can replace or repair the property which is known as
the insurer’s right of re-instatement. This right gives option to the insurer either to
pay the indemnity money in cash or to restore to the insured the property damaged
or destroyed by fire.
(vii) Right of contribution: When the same property has been insured with more
than one insurer and if in case of loss one of the insurers has paid the full amount of
loss to the insured, the insurer has a right to claim contribution from the other co-
insurers in reasonable proportion.
Determination of Proximate Cause: The losses may occur as a result of a single cause
or a chain of events or more than one cause:
1. Loss caused by a single cause: When a loss is caused as a result of a single cause,
such as house being damaged by earthquake or car being damaged due to collision,
proximate cause can be easily found. It can easily be verified as to whether the
damage comes within the purview of the policy or not. If the proximate cause is an
insured peril, then the insurer will be liable.
2. Loss caused by more than one cause or chain of events: Generally, losses occur as
a result of more than a single cause or due to a chain of events, where it is difficult to
isolate the immediate cause of the loss.
(B) Broken sequence: Broken sequence means that there is no connected line of
events which have taken place in succession. In broken sequence each peril is
independent of the other. It can be of two types:
Broken sequence, no excepted perils involved: When a new and independent cause
arises which breaks the chain of sequence and no excepted peril is involved insurers
will be liable as all the causes are insured perils.
Broken sequence, with excepted perils involved: When the chain of events are
broken by a new and independent cause and one of the event is excepted peril, the
insurers liability will depend on whether the excepted peril occurred before or after
the insured peril.
(a) If excepted peril is involved and it precedes the insured peril, insurer is liable for
the loss caused by the insured peril.
(b) If the excepted peril follows the insured peril, the insurer is liable only for the
loss caused by the insured peril up to the time of intervention of the excepted peril.
(c) Where the perils acting simultaneously, as in, where the causes do not succeed
one another, but operate simultaneously and produce the loss and with excepted
peril involved and it is possible to isolate the effects of both insured and uninsured
perils, the insured can claim only for the insured perils and not for excepted perils.
Everett Vs. London Assurance – In this case a certain property was insured against
fire. A quantity of gunpowder belonging to a person at some distance from the
plaintiff’s property exploded, the shock of which shattered the windows and
damaged the plaintiff’s property. It was held that as the proximate cause of the
damage was the concussion of air and not fire, the plaintiff thus could not recover
damages.
Marsden Vs City and Country Assurance Co. – In this case, a fire broke out in the
adjoining premises and spread to the rear of the plaintiff’s shop but no further.
While plaintiff was shifting his stock to safety, a mob attracted by the fire, tore down
the shop shutters and broke the windows for the fire to enter into the plaintiff’s
shop. It was then held that the proximate cause of the damage was not fire, but the
lawless act of the mob.
General conditions of standard Fire policy: Policy conditions are simply provisions
of an insurance policy which along with the insuring agreement and exclusions
complete the contract. These conditions may or may not be incorporated in the
policy. These policy conditions are of two types:
(a) Implied conditions- are those conditions which are not in writing and as such
are not included in the policy itself. These implied conditions are:
That the property described in the policy which is the subject matter of the insurance
is actually in existence at the time the insurance is effected,
That the description of the property given in the policy is correct so that when a
claim arises it will readily identify the property destroyed as that intended to be
insured,
That the insured has an insurable interest,
That the insured observes good faith towards the insurer’s at all material times and
in all material particulars.
(b) Express conditions- Express conditions are created by specific words of the
parties and are set forth or expressed in the policy. A breach of express conditions
will either absolve the insurer from liability or postpone liability until they are
complied with. They are mandatory in nature and direct the insurer to perform
certain duties not only at the time of loss but throughout the period of policy. They
protect the insurer against anything being done or omitted to be done to their
prejudice.
These express conditions are of two types:
General Express Conditions which are printed in the body of the policy itself and are
common to all types of contracts;
Special Express Conditions which are applicable to a specific contract only and are
written or typed on the policy, or may be embodied in a policy by reference to a
printed slip attached.
PREMIUMS
Synopsis:
Introduction
Definition and Meaning
How is premium charged
When the right to claim a return of premium exists / What are the circumstances when
premiums can be recovered back
Conclusion
Introduction: In an insurance contract, the risk is transferred from the insured to the
insurer. For taking this risk, the insurer charges an amount called the premium. The
premium is a function of a number of variables like age, type of employment,
medical conditions, etc. The actuaries are entrusted with the responsibility of
ascertaining the correct premium of an insured. The premium paying frequency can
be different. It can be paid in monthly, quarterly, semiannually, annually or in a
single premium. Any valid contract has a consideration, and the consideration you
pay for an insurance policy is called its insurance premium.
National Insurance Company Limited defines premium as, "premium is the fixed
amount of sum paid over the period by ensured to the insurer in order to secure an
insurance policy and to complete the contract of insurance
In Lucena Vs Crawford, Lawrence J defined premium as "a price paid adequate to
the risk".
An insurance premium is the sum paid for insurance or reinsurance cover and is the
consideration paid by the (re)insured for the (re)insurer’s contractual obligation to
indemnify it against risks specified in the policy.
How is premium charged: It is the role of underwriters and actuaries to calculate the
premium in accordance with their assessment of the risk. How it is calculated
depends greatly on the particular class of insurance. Calculating a life and health
premium is mainly a mathematical task carried out by actuaries based on large data
sets of longevity and morbidity statistics, taking into account the prevailing and
long-term inflation rates and anticipated returns on investments. Certain classes of
general insurance, such as motor, may also be rated in this way where there is a
sufficiently large body of statistical data and where the number of policies
underwritten on similar terms is large enough to price policies by reference to
aggregate data rather than factors specific to each particular risk. The emergence of
sophisticated algorithms and artificial intelligence is fundamentally changing how
insurance is priced and sold.
1. Your age. Insurance companies look at your age because that can predict the likelihood
that you'll need to use the insurance. With health insurance, younger people are less
likely to need medical care, so their premiums are generally cheaper. Premiums increase
as people age and have a higher chance of needing more medical services. And teenage
drivers are still working on building experience, so they're more expensive to insure.
Likewise, older drivers—who tend to have slower reflexes—will also pay more.
2. The type of coverage. In general, you have several options when you buy an insurance
policy. The more comprehensive coverage you get, the more expensive it will be. For
example, if you have an auto insurance policy that covers liability only, it will be
cheaper than if you have a plan with collision, comprehensive, liability, medical
payments, and uninsured/underinsured motorist coverage.
3. The amount of coverage. The less coverage, the cheaper the premiums—no matter what
you're insuring. If you buy health insurance, for example, you'll pay lower premiums
for the same type of coverage if you have a higher deductible and higher out-of-pocket
maximum. Similarly, it will cost more to insure a $400,000 home than a $200,000 home.
4. Personal information. Depending on the type of insurance you're shopping for, the
insurance company may take a close look at things like your claims history, driving
record, credit history, gender, marital status, lifestyle, family medical history, health,
smoking status, hobbies, job, and where you live.
5. Actuarial tables. Most insurance companies employee actuaries, who are business
professionals that assess the risk of financial loss using mathematics and statistics to
predict the likelihood of an insurance claim, based on much of the aforementioned
criteria. They typically produce something called an actuarial table that is provided to
an insurance company's underwriting department, who uses the input to set policy
premiums.
6. Expenses and profit margins: The premium amount varies across several insurers
because the premium not only depends on the factors related to the policyholder but
also on factors related to the insurer, that is, the expenses incurred by the insurer in
writing the policy. For life insurance plans the premiums may differ because insurers
will have different cost structures, assessment of risk and investment returns. So,
although the factors used to determine premium are the same the outcomes will be
different.
Tajore Life Assurance Co. Vs. Kuppannorao, in this case it was held that fraud on
the part of the insurer entitled the insured to get back the premium paid by him.
Kettlewell Vs. Refuge Assurance Co. Ltd., it was held in this case that the holder of
the policy is entitled to recover from the company the premiums paid upon the faith
of the representation.
B. On the part of the insured : If there has been fraud on the part of the assured, the
insurer may resort to the following resources:
i. Refuse to receive the further premium and repudiate the contract;
ii. To apply to the court for cancellation of the policy;
iii. If the policy is matured, the defense of fraud may be set up for recovery of
the amount;
iv. If the evidence is more likely to be lost, a suit may be filed for a
declaratory decree under the specific relief act.
Prince of Wales etc. Assurance Co,Vs. Palma : In this case the insurer filed a suit for
the declaration of the policy to void when it was found that the defended took the
life insurance policy in the name of his brother who died due to poisoning. The court
granted the declaration, on the condition that the premium be returned and it should
be applied towards the costs of all parties.
2. Where the policy has become void ab initio: Void ab initio means from the very
beginning. The contract of insurance may become void ab initio for the following
reasons:
A. When the parties were never ad idem – In the law of contracts, when there is no
consensus or error in consensus, the contract becomes void. Parties are not said to be
at ad idem when they do not think at the same time about the same thing in the
same manner. There must be a meeting of minds. If the parties intending to enter
into a legal contract of insurance, entered by mistake an illegal contract, the
premium is returnable. However, if it is a mistake of law, the premium is not
returnable even though the mistake is due to the innocent representation made by
the agent.
B. Ultra-Vires to the Powers of the Company: When the policy is issued by a company
which is ultra-virus to its powers, the policy is void and the company is liable to
return the premium.
C. Where the terms of the contract are uncertain: As per section 29 of the contract act,
1872 the contact is void where the terms of contract are not certain or not at least
capable of being made certain. When the insurer cannot answer the subject matter of
a section contained in the policy, the contract of insurance is void for uncertainty.
D. Where the object or consideration is illegal: Under section 23 of the contract act, a
contract of insurance may become void when the object or consideration is unlawful
or opposed to public policy and the insurer is bound to return the premium under
such circumstances.
3. Where no risk is incurred by the insurer: Risk refers to the loss or destruction of
property as a consequence of peril(s) insured against. The peril in life policies is death,
in the fire policies it is the loss of property due to fire and in marine policies it is
collision, shipwreck, stranding, foundering at sea etc. Risk is a consideration for
premium to be paid. If the risk-insurance against is absent, the consideration fails and
the insured is entitled to the refund of the premium.
For example: if a person agrees to pay a high rate of premium for extra-ordinary risk
like military service, he may get returns of proportionate premium if he does not take
up the military service.