Chapter 8 Key Points Flashcards
what does the doctrine of privity do
only the parties to a contract can enforce its rights and duties
exceptions to the doctrine of privity
assignment
agency
trusts
policies with additional insureds
under statute
how does assignment work with claiming on an insurance policy
legal assignee or beneficiary can claim in their own name
equitable assignee can benefit through a claim made by the assignor but not claim in their own name
what must the insured establish to discharge the burden of proof
that the loss was caused by an insured peril
amount of the loss
what does ICOBS 8 set out
basic obligations on insurers when handling claims
what does the doctrine of proximate cause state
the loss in question must result directly from the operation of an insured peril if the insurance is to respond
what are independent perils
combine to cause a loss, each would have caused the loss on its own
what are interdependent perils
combine to cause a loss, neither would have caused a loss on its own
what happens when an insured peril and and excluded peril combine
no liability for the loss and exclusion prevails
what happens when an insured peril and an insured peril combine
full liability for the loss and insured peril prevails
what can the doctrine of proximate cause be excluded or modified by
particular words in the insurance contract
what are the four types of fraud in claims
falsification of a loss
deliberate loss
exaggeration of a loss
lying about the circumstances of a genuine loss
where are there tests for determining fraud
fraud act 2006
case of derry v peek
where are the remedies set out if an insurer can establish that there has been fraud by the insured
insurance act 2015
