BAER.INTRO Flashcards
types of insurance carriers (4)
- individual U/W
- joint stock co.
- mutual ins. co.
- reciprocal/inter-insurance exchange
IBC’s 5 objectives (formed in 1964)
STUDY legislation
COLLECT/analyze data
ENGAGE in research
DISCUSS general insurance
PROMOTE public understanding
what has been the focus of Cdn Ins regulation since Confederation
MOTHS
MARKETING: marketing integrity & improvement of insurance contract
OWNERSHIP: encourage Cdn ownership
TAXES: collection of taxes
HONESTY: honesty & competence of intermediaries (Ex: agents)
SOLVENCY: keep insurer’s solvent to protect policyholders
identify examples of Canadian regulation/legislation (federal or provincial ) that promote insurer solvency (6)
CIR-CAF
CREATION: oversee creation of (domestic) & licensing (foreign) of insurers
INVESTMENTS: restrictions on types of investments that are permitted (to reduce risk)
RATING: authorization of rating bureaus for info-sharing
COMPLIANCE: give Govt depts authority to enforce compliance with legislation
ADEQUACY: create boards to oversee and ensure adequacy of rates
FILE F/S: require regular filing of Financial Statements
what conditions eventually led to public control regarding solvency
- insurer bankruptcies in the 1860s/70s
- the recognition short-term price competition is bad
- insurance involves a significant savings component (prepaid premiums) & policy holders must be protected
difference between guideliness & legislation for insurance regulation
- guidelines are more flexible than legislation
- legislation must go through senate, house of commons, and get royal approval
defn: what is the ‘principle of indemnity’
after covered loss, return insured to former financial position (before loss), and neither penalize nor reward
defn: what is a ‘contract of indemnity’
contract where amount recoverable is measured by insured’s pecuniary loss
identify conditions for recovering under an indemnity policy (2)
- event must be covered
- requires proof of AMOUNT of loss
Glynn v Scottish Union & National Ins Co
FACTS: - Glynn injured in auto accident
- was reimbursed by other driver’s insurer (including medical)
- Glynn sued to DOUBLE-RECOVER medical from own insurer
ISSUE: - does Glynn’s insurer have right to subrogation
- in other words:
- can Glynn’s insurer claim benefits from guilty party’s payment to PREVENT double-recovery by Glynn
RULING 1: for insured: Glynn gets double-recovery
RULING 2: for insurer
- subrogation concept applies because auto policy is contract of indemnity
- so Glynn’s insurer does NOT have to pay
Tort Recovery vs Collateral Sources: identify the 4 loss-sharing options
ELECTION (pick ONE OF tort recovery OR collateral source)
CUMULATION (pick BOTH tort recovery AND collateral source)
REIMBURSEMENT (amount not covered by tort recovery IS COVERED by collateral source)
RELIEF (tortfeasor’s liability REDUCED by collateral source)
Fletcher v MPIC
FACTS: - customer relied on MPIC
- there was NO MENTION of UIM (Under-insured Motorist) coverage on application or insurance certificate
ISSUE 1:
→ is a government insurer responsible for informing customers of available coverages?
ISSUE 2:
→ what is the extent of the government’s liability should it fail to do so?
RULING 1: judge finds for plaintiff (insured wins)
RULING 2: overturned on appeal (MPIC wins)
RULING 3: SCC (Supreme Court of Canada) reinstates original ruling (insured wins)
Final Interpretation:
→ both private agents and government institutions owe a duty of care
→ but private agents owe a higher duty-of-care because of their promised expertise
Criteria for duty of care MPIC (3)
MPIC owes a duty of care to its customers if:
(1) customers rely on the information
(2) their reliance is reasonable
(3) MPIC knew (or should have known) the customer would rely on this information
Dillon v Guardian Ins Co
FACTS: - Guardian rejected a settlement that was LESS THAN the policy limit
- subsequent jury award GREATER THAN policy limit
- insured sued insurer for excess amount of award above policy limit
Arguments for absolute liability
AVOIDS: determining whether 1st offer was reasonable
LOWERS: probability of insurer gambling with insured’s money
(insurer, insured): have different monetary interests
OUTCOME:
- insurer liable for amount exceeding policy limit
- they could have settled but didn’t
- therefore insurer is absolutely liable
define the standard of absolute liability
IF settlement possible BUT rejected by insurer THEN insurer is liable for all costs (even in excess of policy limit)