Chapter 2 Flashcards

1
Q

An example of an insurance benefit policy is a

A

Personal accident policy

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2
Q

Where a claim involved a ‘chain of events’ and the dominant reason for the events is unclear, the insurers will apply

A

The Doctrine of proximate cause

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3
Q

What document is most used for placing risks on the London Market?

A

Market reform contract

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4
Q

An insurance contact can be terminated if the contact has been fully performed. This is known as:

A

Fulfilment

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5
Q

Timings of insurable interest:
Life insurance contracts
Marine insurance contracts
General insurance contracts

A

Life insurance - insurable interest must exist at inception but need not exist at the time of a loss.

Marine insurance - insurable interest must exist at the time of a loss but need not exist at inception, although a reasonable expectation of acquiring one is required.

General insurance - insurable interest must exist at both inception and at loss. However an anticipated interest may be sufficient at inception.

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6
Q

Under the Consumer Insurance (disclosure and representations) act 2012, what are the two types of misrepresentations?

A
  • Careless

- Deliberate or reckless

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7
Q

What happens if the insurer can prove deliberate or reckless misrepresentation?

A

Their remedies are avoidance of the contract and refusing all claims, and in addition need not to return any premium unless it would be unfair to the consumer.

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8
Q

What are the matters that do not need to be disclosed to the insurers?

A
  • that lessens the risk
  • that the insurer knows
  • that the insurer ought to know
  • that the insurer is presumed to know or;
  • waived by the insurers
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9
Q

Original placement: if the breach was reckless or deliberate what Can the insurer do

A

They can avoid the policy from inception and keep the premium (ab inito)

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10
Q

What is the doctrine of proximate cause?

A

Proximate cause is a key principle of insurance and is concerned with how the loss or damage actually occurred and whether it is indeed as a result of an insured peril. … The active, efficient cause that sets in motions train of events which brings out a result, without the intervention of any force started and working actively from a new and independent source.

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11
Q

The 3 types of perils are?

A
  1. Insured perils
  2. Excepted or excluded perils
  3. Uninsured or unnamed perils
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12
Q

Insured perils are?

A

Those named in the policy wordings

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13
Q

Excepted or excluded perils are?

A

Those named in the policy as specifically not covered.

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14
Q

Uninsured or unnamed perils are?

A

Those perils not mentioned at all in the policy.

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15
Q

Indemnity definition

A

Indemnity can be defined as ‘financial compensation sufficient to place the insured in the same financial position after a loss as they enjoyed immediately before the loss occurred.’

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16
Q

Reinstatement meaning

A

Reinstatement means that the insurer agrees to restore a building (or piece of machinery) that has been damaged by an insured peril.

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17
Q

Difference between reinstatement and repair

A

Reinstatement would apply only to buildings (and occasionally machinery) and is concerned with bringing the property back to its pre-loss condition. To achieve this purpose the insurer effectively takes occupation of the premises (or what is left of them) to reinstate. The option to repair does not carry with it the ‘occupation’ aspect.

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18
Q

What are not contracts of indemnity?

A

Life and personal accident policies are not contracts of indemnity as the insured cannot be restored to the same financial position after a loss.

19
Q

How to calculate indemnity (property insurance)

A

The measure of indemnity is the replacement cost less
an amount for wear and tear.

In the case of partial damage, indemnity is the repair cost less an allowance for wear and tear

20
Q

How to calculate indemnity (liability insurance)

A

liability policy provides indemnity to the insured in respect of their legal liability to pay damages and legal costs (both for the insured and potentially the claimant’s costs/lawyers’ fees). (Which is left to the courts to decide and its clear about whether the insured’s defence costs are included within the stated policy limit or will be paid in addition.

21
Q

Measuring indemnity - Marine insurance

A

The insurable value of an unvalued policy must be calculated using the formula in the Marine Insurance Act 1906

22
Q

Measuring indemnity - Property insurance (Buildings: basic cover)

A

Insurers calculate the indemnity for loss of, or damage to, buildings as the cost of repair or reconstruction at the time of loss.
They make allowances for anything that cannot be exactly repaired as it was before the loss and where the replacement has had to be new. This is termed betterment.

23
Q

Reinstatement memorandum

A

is that the sum insured must represent the full value at the time of reinstatement. This means that the insured pays a premium based on the higher amount.

24
Q

Day One reinstatement

A

Insurers provide an automatic uplift to allow for inflation (usually an extra 50% of the ‘declared value’) but only charge a modest increase for this inflation element (15% of the premium).

25
Q

Measuring indemnity - Machinery and contents (basic cover)

A
  • If there is a second-hand market then it is the second-hand price plus costs of transportation and installation that would be payable.
  • Where there is not a second-hand market, it is the cost of repair or replacement less an allowance for wear and tear, if applicable.
26
Q

Measuring indemnity - Manufacturers’ stock in trade

A

Indemnity value is the cost of raw materials, at the time and place of loss, plus labour and other costs incurred in respect of work in progress and finished stock.

27
Q

Measuring indemnity - Wholesalers’ and retailers’ stock in trade

A

Indemnity here is the cost of replacing the stock, at the time of the loss, including the costs of transport to the insured’s premises and handling costs. It is not possible to insure stock on any kind of reinstatement basis

28
Q

What is this an example of? if their carpet is
damaged then they receive the cost of a new one, rather than having to obtain a new one and then finding that insurers will only pay part of the cost.

A

New for old cover.

29
Q

Which body is responsible for The implementation and administration of the International financial sanctions in effect in the UK?

A

HM Treasury

30
Q

Measuring indemnity - Liability insurance

A

is measured as the amount of any court award (or more

commonly, negotiated ‘out of court’ settlement) plus the costs and expenses arising in connection with the claim.

31
Q

The formula used to calculate a claim payment is?

A

Sum insured / value of all goods at risk x loss

32
Q

Rateable proportion - By sum insured calculation

A

policy sum insured / total sums insured x loss

33
Q

Rateable proportion - By independent liability calculation

A

independent liability under this policy / total of independent liabilities under all policies x loss

34
Q

When there is an overlap between travel, all risks, household and the personal effects section of a motor policy - what agreement is this?

A

Association of British Insurers (ABI)

35
Q

the concept of indemnity

A

Do not forget that the concept of indemnity is to place the insured in the financial position
they were in immediately before the loss.

36
Q

Tort

A

At common law, everyone has a duty to act in a reasonable way towards others. A breach of this duty is called a tort. The person who has suffered damage or injury is entitled to compensation.

E.g. Someone crashes into the wall of your property in a vehicle and knocks it down.

37
Q

Riot Compensation Act 2016

A
  • a claim can be made by a property owner, anyone else with a legal interest in the property (such as a tenant or mortgagee) or by an insurer.
  • It must be made within 43 days of the riot, or a decision by an insurer not to pay all or part of a riot related claim
38
Q

salvage.

A

In some types of insurance, a total loss under the policy will be offered to the insured when the subject-matter of insurance is not completely destroyed but is perhaps so badly damaged that the repair costs will exceed the sum insured.
Of course, when this happens there may be some residual value in the item insured

39
Q

mutual hold harmless

A

where each side agrees to deal with their own damage and injuries and not claim against the other.

40
Q

Contract law

A

A valid insurance contract cannot be created without the essential ingredients of offer, acceptance and consideration.

41
Q

Cancellation of insurance contracts

A
  • If there is a deliberate breach of the duty of disclosure, then the other party can decide whether to cancel the contract.

• If there is a lack of a vital ingredient of the contract such as offer or acceptance, then the contract will never actually exist.

42
Q

Proximate cause

A

Proximate cause is the most powerful operative cause of loss, not necessarily the last thing to happen.

43
Q

Indemnity

A
  • This means putting the insured back in the same financial position as they were in prior to the loss.
  • Indemnity is not necessarily done through a cash payment; it could be repair, replacement or reinstatement.
  • Certain policies such as health and accident policies are benefit policies not indemnity policies as a value cannot be put
44
Q

Subrogation

A

Subrogation is the right of the insurers to claim against a responsible third party having first indemnified the insured.

the right of an insurer following payment of a claim,
to take over the insured’s rights to recover payment from a third party responsible for the loss.