Commercial, Pecuniary, BI, Liability Flashcards
Fire insurance developed alongside the need for businesses to insure their assets.
True
Initially the need for insurance was seen as very straightforward, to insure property against damage or destruction by fire.
True
Fire insurance
The insurance market sees the ‘Standard Fire Policy’ (the ABI recommended wording) as the basis for its wordings.
True
ABI recommended wording
Although individual insurers have since issued their own plain English versions which provide standard fire cover, and then ‘extra’ perils (known as special perils or in some insurers’ policies as specified contingencies) can be added.
True
It is now common to issue policies covering fire and special perils as standard.
True
ABI recommended wording
So what is ‘standard’ fire cover ?
Standard fire cover is made up of three parts:
Fire (excluding explosion resulting from fire, earthquake or subterranean fire, and its own spontaneous fermentation or heating);
lightning; and
explosion (restricted to explosion of boilers or gas used for domestic purposes only
‘Domestic’ can still apply to industrial and commercial premises, as it relates to the use of the boiler.
True
For example, heating the property or where gas is used in a canteen.
True
‘standard’ fire cover
The special perils that may be included are as follows, each is preceded by ‘damage caused to the property by’ and can be added individually or in combinations.
True
Cyber risks
which exclude damage resulting from risks such as computer viruses etc.
Exclusions apply where damage is caused by
in Explosion:
(bursting of a boiler or other equipment that belongs to or is under the control of the policyholder where the internal pressure is due to steam only (these are items insurable under an engineering explosion policy).
Aircraft (excluding sonic bang), i.e. an aircraft or aircraft parts falling through the roof of a building.
Covered peril under ‘special perils’
Covered peril under ‘special perils’:
Riot and civil commotion,
(The Public Order Act 1986)
Public Order Act 1986 defines a riot as a group of twelve or more people, gathered for and carrying out a common purpose with intent, and force if necessary, and in such a way as to alarm a person of reasonable firmness and courage.
This will only USUALLY cover riots in England, Scotland and Wales, as the Government has a separate scheme in place for Northern Ireland.
Covered peril under ‘special perils’
Riot and civil commotion,
(The Public Order Act 1986)
Insurers apply a condition that riot claims are notified to insurers within an agreed period, NORMALLY
Seven days.
This is because insurers can claim damages from the local police authority for damage incurred as a result of riot activity, and this needs to be lodged with the police within
42 days.
Following the riots in the UK in August 2011,
the Riot Compensation Act 2016 (which replaces the Riot Damages Act 1886 and the Riot Compensation Regulations 2017 which both came into force on 6 April 2017.
The Riot Compensation Act 2016 limits to what can be recovered from the police.
The Act: applies a limit?
£1 million limit for any one claim;
It will not apply to any consequential loss;
True
The Riot Compensation Act 2016
Confirms the time period for bringing a claim against the police as?
42 days.
Allows a further 90 days to submit full claims details;
True
The Riot Compensation Act 2016
Permits replacement goods and property (with some exclusions) on :
A new-for-old basis.
Most insurance policies do not limit what is covered in respect of riot or civil commotion, either under the material damage or business interruption sections.
True
Most insurance policies provide cover up to the sum insured, set by the insured, subject to compliance with policy terms, conditions and exclusions ,
(e.g. notification within a specified timescale).
Recovery by insurers and uninsured claimants from the police is what is limited under the Act and Regulations.
True
Malicious damage, i.e.
Vandalism.
Earthquake:
In some countries ‘earthquake‘ is classed as a fundamental risk due to the frequency and severity of earthquake incidents.
UK insurers are prepared to accept the risk of earthquake damage due to ?
The minimal earthquake activity in this country.
This is still the case despite several larger, albeit localised, earthquakes over the last few years, as the damage has been manageable and not excessive.
True
Spontaneous fermentation or heating or Subterranean fire – otherwise known as underground fire.
Particularly important if you live in an area with former mining activity.
Storm and flood. These two perils are USUALLY written together as quite OFTEN….
Storm is the proximate cause of flood.
An insurer is UNLIKELY to offer flood in isolation and terms are applied to both perils to avoid ambiguity in respect of claims settlement.
True
Property which is vulnerable to such losses is USUALLY excluded,
e.g. gates and fences, as are changes in the water table level.
Escape of water commonly referred to as
‘Burst pipes’ cover
Covered in The Riot Compensation Act 2016
Some package policies may ALSO make reference to escape of heating oil.
True
Impact (including own vehicles).
(Covered in The Riot Compensation Act 2016)
Sprinkler leakage – offered to companies with sprinkler fire protection in their premises provided the systems are maintained.
(Covered in The Riot Compensation Act 2016)
Subsidence, ground heave and landslip (with special exclusions).
(Covered in The Riot Compensation Act 2016)
Certain geographical locations in the UK are prone to subsidence-related damage due to the soil type in the area. Clay soils are also of particular concern, as is surrounding vegetation, and insurers will ALSO be interested in local mining activity, both past and present. Although excluded under some insurers’ definitions of ‘special perils’, sinkholes may ALSO be covered under some policies, as they are NORMALLY found under personal lines household policies.
True
In fact, some insurers will pay for costs where there is no damage to property (yet), to avoid possible future damage if something like a sinkhole is left untouched.
TRUE
( The Riot Compensation Act 2016)
Standard exclusions :
Certain causes of damage are excluded.
Some of these are because they are regarded as fundamental risks…
(War, Riot, Radiation, Pollution), and others because they are more properly insured under other types of commercial insurance policy (marine, consequential losses).
Directors are to:
- Act within the company’s constitution and properly exercise powers.
- Avoid conflicts of interest. (Directors must authorise any individual director’s conflict of interests. They may do so provided there is no conflict with the constitution of the company).
- Declare an interest in any proposed transaction with the company. This must include the nature and extent of that interest.
- Exercise independent judgment.
- Exercise reasonable care, skill and diligence.
- Not accept benefits from third parties, unless this is unlikely to give rise to a conflict of interests.
- Promote the success of the company for the benefit of its members.
Some insurers do not exclude religious and ideological acts by deliberately omitting them from the terrorism definition;
True
These are USUALLY insurers offering capacity within the Lloyd’s Market, which is NOT backed by Pool Re, and OFTEN carries individual location and policy annual aggregate limits.
True
Most insurers’ policies will respond to ‘gap cover’;
Most insurers’ policies will respond to ‘gap cover’;
What is gap cover?
Where a ‘terrorist-type’ incident occurs, but does NOT meet the definitions of terrorism under an insurer’s policy. (This is sometimes referred to as ‘lone wolf’ cover.)
Most insurers’ policies will respond to ‘gap cover’;
True
Northern Ireland excluded perils.
Excluded mainly
Pollution or contamination unless caused by an insured peril or it causes an insured peril to occur.
Excluded mainly
Marine policies.
Excluded mainly
‘More specifically insured’ clauses.
For example, a motor vehicle left in a building overnight that is lost to fire would USUALLY be covered in its own right under a private car motor policy.
Excluded mainly
‘Consequential loss’ exclusion.
For example, loss of profits or income following and consequent upon a loss proximately caused by an insured peril.
Excluded mainly
Sonic bangs.
Excluded mainly
Cyber risks
Which exclude damage resulting from risks such as computer viruses etc.
Although we have said that these insured and excluded perils are GENERALLY standard, you should be aware that ::
The exact wording does differ slightly between the general company market and the Lloyd’s Market.
‘All risks’ insurance ?
Demand arose for a policy which offered cover for accidental damage as well as the standard perils.
All risks insurance developed in response to this, although the name ‘all risks’ is slightly misleading as it does not cover everything, it simply covers :
Everything that is not specifically excluded.
It was realised GENERALLY that uncertainty of loss is NOT restricted to events brought about by fire and special perils, neither limited to events occurring on or about the insured’s premises.
True
The ABI has a recommended wording adding special perils to a basic fire policy and then adding the ‘all risks’ element, with its exclusions.
True
Therefore, some exclusions can be restricted to only the extra ‘accidental damage’ cover, leaving the named perils intact.
True
In essence, all loss, destruction of or damage to the property insured is recoverable as long as it has occurred accidentally in respect of the insured, and the cause is not specifically excluded.
There are no optional extensions: everything is covered, unless specifically excluded.
True
Exclusions can be divided into four groups:
Absolute exclusions
Gradually operating exclusions
Aspects of cover which can be written into the policy
Property or risks more appropriate to another class of business
Absolute exclusions
war, pollution, contamination, consequential loss.
Gradually operating exclusions
corrosion/rust, wind/rain damage to property in the open.
Aspects of cover which can be written into the policy
money, glass, subsidence.
Property or risks more appropriate to another class of business
motor vehicles, aircraft.
Theft cover is USUALLY priced using the theft estimated maximum loss (EML) as a rating factor, as more OFTEN than not a 100% loss is not expected.
True
Theft cover
An EML is the amount (OFTEN expressed as a percentage of the sum insured) which is considered by the insurer to be an accurate reflection of the worst financial effect that the maximum foreseeable loss would have.
True
Theft insurance use rating factor of EML
This is the sort of assumption you could make about a ‘targeted’ theft;
What is the other factor?
An ‘opportunist’ theft which is the lack of preparation and corresponding lack of time to coordinate what is and is not taken.
In both examples, it is unlikely that ALL goods will be stolen.
TRUE
Theft cover
Who GENERALLY applies different levels of rating for the type of goods at risk?
Underwriters.
For instance, thieves are fairly unlikely to steal office desks, paper, cleaning equipment and other general contents, especially if theft attractive ‘target’ items such as office electrical equipment, computer equipment, wines, spirits, electrical stock, jewellery etc. are present.
TRUE
Theft insurance
Underwriters would therefore tend to cover general contents at a reduced rate in comparison to ‘target’ goods.
TRUE
Theft insurance
Glass would USUALLY be insured against damage caused by a fire or theft if a fire or theft policy were in place.
However, some common causes of damage to glass (accidental damage) are excluded from these standard covers, so a business with large amounts of glass will OFTEN want cover for this.
True
Glass Insurance
An example would be a high street shop as large plate glass windows can be extremely expensive.
True
Glass Insurance
What does the standard policy of glass insurance cover?
Destruction or damage to all fixed glass, including windows, doors, fanlights, showcases, mirrored glass and glazed partitions, and USUALLY includes an extension to provide for the cost of boarding up damaged glass until replacement can be effected.
If damage happens overnight the costs of this can be quite high.
True
Glass Insurance
OFTEN the police will call a 24-hour glazier to board up windows to prevent further loss or damage.
True
Glass Insurance
Cover is ‘all risks’ but scratching or chipping is USUALLY excluded.
True
Glass Insurance exclusion
It may be extended, for ADDITIONAL PREMIUM, to include damage to storefront contents because of ??
Broken glazing, and damage to washbasins and sanitary fittings in hairdressing salons.
Damage by fire, lightning and explosion is GENERALLY excluded (these perils are covered under a standard fire policy).
True
Glass Insurance exclusion
An excess, e.g. £50, is standard to avoid the small claims, although most insurers are now moving towards an excess of £250.
True
Glass Insurance excess
Money insurance:
Think about how many businesses operate, especially retail shops.
They sell goods for cash and OFTEN have large amounts of cash and cheques on the premises.
Clearly there is a risk to this money, both while on the premises, and while in transit.
As a result, many businesses will want to take out special insurance to protect against loss of money.
True
Money Insurance
Insurers in their policy wording will refer to the negotiability of money, i.e. the ease with which it can be converted to cash.
True
Money Insurance
Money, which is non-negotiable,
is difficult to convert into a cash value and, therefore, insurers offer cover at a relatively high limit,
e.g. crossed cheques.
Limits of ??
£250,000 or even £500,000 are not uncommon.
Negotiable items are??
Readily convertible to their cash value, e.g. bank or currency notes.
For these items the limits of liability are more modest and will depend upon locality and time,
e.g. ‘in safe’, ‘out of safe on the premises’, ‘in transit’ and ‘during or out of business hours’.
True
Money Insurance
In respect of negotiable items the following limits will be specified in the policy schedule:
Any other money limit.
Money in safe.
In the insured’s premises out of working hours
The private residence of a director or employee.
The limit to money while in the premises when open for business and while in transit.
In respect of money in transit insurers may stipulate an escort warranty where, depending upon the amount of money being carried, a specified number of able-bodied people may need to be present.
Limits rarely exceed £10,000 and could be as low as £1,000 for smaller risks.
Any other money limit.
Insurers will OFTEN require a security safe to be installed if the ‘money’ at risk exceeds certain limits.
Safes are manufactured and tested to achieve a cash rating, i.e. an amount for which the safe is suitable to secure, this can range from £1,000 to £100,000 plus.
Money in safe.
It is OFTEN the job of the risk surveyor to determine whether a safe is required or assess whether an existing safe is suitable.
Money in safe.
In the insured’s premises out of working hours?
Up to, say, £250.
The private residence of a director or employee?
Nominal – up to £250.
What does the Money policy cover?
A policy covers risks of loss or damage to or destruction of money on an all risks basis, and includes damage to safes or strong rooms caused by theft or attempted theft.
Money policy can be extended to include:
personal accident/assault; and credit cards (which are not covered by a standard money policy).
The principal specific exclusions are as follows.
a safe/strong room being opened by a key left on the premises while closed for business.
Loss due to: error or omissions in accounting and book-keeping;
damage arising outside the UK, Isle of Man or the Channel Islands;
dishonesty of an employee,
not discovered within seven days;
Pecuniary Insurance?
A direct financial loss.
Policies are based on a sum insured representing the gross profit for the indemnity period
chosen.
Business Interruption
Gross profit is calculated as follows:
Turnover (with adjustment for opening stock and closing stock) less uninsured working expenses.
Gross profit = (Turnover + Closing stock) – (Opening stock + Uninsured working
Gross profit calculation in Business Interruption Insurance
Uninsured working expenses are those costs which vary in direct proportion to the
Level of turnover.
These would include :
Electricity, raw materials and such like.
The payroll element is USUALLY insured in full, although a lower rate may be applied to this element.
True
Business Interruption
The main items insured under a business interruption policy are:
- loss of gross profit;
* increased cost of working (ICOW).
Incurred in order to reduce the loss of gross profit following the insured event.
Increased cost of working (ICOW).
Such costs should be ‘economic’ and be less than the amount of the gross profit saved.
Increased cost of working (ICOW).
From these will be deducted savings made during the indemnity period.
True
(• loss of gross profit;
• increased cost of working (ICOW). )
There will USUALLY be a material damage proviso, requiring a property policy covering the physical damage for the incident, before the business interruption policy comes into operation.
True
Business Interruption
In practice, the two policies will USUALLY be linked.
True
Business Interruption and Material damage provisio
Unless there is an insurance policy in force covering damage to the property there is a good possibility that this damage will not be repaired quickly and the interruption to the business will be so longer…
Any claim under the BI policy would be likely to be much higher…
The most common policies are business interruption arising from:
Fire and special perils
All risks’
Engineering
Fire and special perils:
the standard perils are extended to include non-domestic boilers.
The special perils ALSO contains six engineering special perils not covered by the material damage policy (although the material risk will need to be covered by an engineering policy because of the material damage warranty).
‘All risks
insurers OFTEN issue a combined material damage and business interruption policy.
As in property insurance this is not all risks, it covers any risk that is not specifically excluded.
Engineering
the perils covered are USUALLY either:
– failure of the public utilities supply; or
– sudden and unforeseen damage from any accidental cause not specifically excluded.
Optional extensions
There are certain optional extensions.
The cover will be the same, or sometimes a lesser range of perils, as at the insured premises. For example:
Specified suppliers. Unspecified suppliers Specified customers. Transit Prevention of access. Public utilities Notifiable disease/murder/suicide.
Specified suppliers
Provides an indemnity to the insured if the supplier suffers a serious loss and cannot supply the insured’s goods.
Unspecified suppliers
As above, however included under most business interruption wordings and providing a pre-set limit, i.e. 10% of the gross profit sum insured, for loss of profit as a result of a loss at a supplier’s premises which has a subsequent negative effect on the insured’s profits.
Specified customers.
Similar to above except the loss has to occur at a customer’s premises, preventing them purchasing the insured’s goods.
Prevention of access.
Customers being unable to access the insured’s premises following damage to premises within the vicinity of their own could lead to loss of profits.
Public utilities
Failure of gas, electricity or water to the insured’s premises thereby affecting production and subsequent profit.
Notifiable disease/murder/suicide.
This extension provides for loss following the occurrence of one of these events and thereby prevents the insured from conducting their business activities at their premises.
Clearly, the insured will be unable to produce the finished item if the raw material is unavailable, and this can expose the insurer to potentially heavy losses especially when the item supplied is specialist in its nature with no readily available alternative market.
Specified suppliers
Insurers OFTEN require surveys of the supplier’s premises if the exposure is particularly large.
Specified suppliers
This can cause problems if the supplier is located in a foreign country.
Specified suppliers
Increasingly insurers are being asked to include cover for other diseases which have become more high-profile (e.g. norovirus, ebola), even though some (e.g. norovirus) are not notifiable to local authorities.
Notifiable disease/murder/suicide.
Contract sites
An insured may incur a loss if there is damage on a contract site where they are working.
Some companies would not necessarily experience large scale, if any, loss of profits if they suffered a serious fire or other loss at their premises.
ICOW or ACOW
Increased cost of working or additional cost of working.
ICOW has been designed to provide
that type of company with an amount of money to spend getting back on its feet as quickly as possible.
So how would the loss adjuster tackle the task?
First, the company would need alternative accommodation which the loss adjuster would try to find.
If there are suitable premises in
the area this could take a few days.
Provided the accountancy firm owns its building or is responsible for insuring it, the property insurance would reinstate the building (i.e. restore it to the state it was in before the fire), although this could take up to a year to complete.
Second, the loss adjuster would hire computers and office equipment for the temporary office. The insured might decide to tell customers about the move by advertising or holding an event at its new premises. The firm could be up and running again very quickly and would not have incurred a substantial loss of profits. The ICOW cover would provide
for the costs of hiring alternative premises, office equipment and informing clients of the move.
A second scenario might involve a haulage contractor. A fire at its warehouse would destroy stock and any offices.
However, the lorries, which earn the profits, would probably be out on the road or in the yard.
The loss adjuster would simply need to hire a ‘portacabin’ office and find a temporary warehouse to hold stock pending the rebuild. The profits would not be unduly affected and ICOW would be an appropriate form of interruption cover.
A limited form of ICOW cover is provided under standard business interruption policies.
True
Business interruption insurance = ICOW
Insurers are happy to pick up additional costs should the ‘costs‘ incurred reduce the size of the overall profits claim.
True
Business interruption insurance = ICOW
A good example would be::
A bakery which supplies bread to the main supermarkets, It would be in the insurer’s financial interest to sub-contract the baking and packaging of bread to other bakeries, which may cost say, £500,000 up to the time of reinstatement and refurbishment etc. rather than cover the insured’s loss of profits.
True
Business interruption insurance = ICOW
After all, should they lose their supermarket contracts, the claim may run into millions.
True
Business interruption insurance = ICOW
The main difference between an ICOW extension under a loss of profits (business interruption) policy and a stand alone ICOW policy is that
a stand alone policy covers
uneconomic losses, i.e. the insured can allocate the money as they wish (within the terms of the policy of course)
whereas under standard profits cover, the additional costs need to be
economic, i.e. serve to reduce the size of the profits claim.
Liability insurance
Most professional indemnity insurance contain a retroactive date in the policy.
A retroactive date USUALLY predates the inception of an insurance contract, which is NORMALLY
an annual policy.
Retroactive dates are NORMALLY applied from the first date you have held
uninterrupted insurance.
They are used by insurers to exclude claims relating to work which predates
the retroactive date from which cover has been in place.
It is important to note that you do not have to have held uninterrupted insurance with the same insurer, only::
insurance has been in place.
You should not be penalised for moving insurer, however, you may find that insurers are unable to provide retroactive dates from the date you have held
uninterrupted insurance if, for example, you increase your limit of indemnity.
Dishonesty of the insured will USUALLY be excluded.
True
What is D&O insurance cover?
protects directors against personal liability for financial loss suffered by third parties.
The Companies Act 2006
codified certain responsibilities of directors and provided a statutory list of duties.
Directors are to:
- Act within the company’s constitution and properly exercise powers.
- Avoid conflicts of interest. (Directors must authorise any individual director’s conflict of interests. They may do so provided there is no conflict with the constitution of the company).
- Declare an interest in any proposed transaction with the company. This must include the nature and extent of that interest.
- Exercise independent judgment.
- Exercise reasonable care, skill and diligence.
- Not accept benefits from third parties, unless this is unlikely to give rise to a conflict of interests.
- Promote the success of the company for the benefit of its members.
Legislation states that unlike a company, for individual directors. Liability is ??
Unlimited
Standard policy cover offered under a D&O policy has two elements:
- cover for directors and officers in their personal capacity when they are unable to claim an indemnity from the company; and
- cover to protect the company in circumstances where it is permitted to indemnify the directors or officers, such as in the repayment of legal defence costs.
Errors and omissions (E&O) insurance?
As a regulated business, intermediaries are required to hold professional indemnity insurance, specifically referred to as errors and omissions insurance. Insurance brokers owe a duty to their clients (and to insurers) when arranging insurances.
They must carry out their client’s instructions and give them proper advice. Any breach of this duty may impact their ?
Legal liability.
E&O claims occur ?
The broker has made a mistake that has caused their client to suffer a loss.
This NORMALLY comes to light after the client has made a claim.
True
E&O insurance policy
The client is indemnified by
The insurance broker’s E&O insurance policy.
The minimum limits and maximum level of policy excess are set according to the size of the ?
intermediary
Medical malpractice insurance ?
People in the medical professions may be subject to claims on the grounds that they failed to use reasonable care.
There is ALSO the possibly of spurious claims when treatment or advice has been suitable.
True
Medical malpractice insurance
Patients may claim that they did not recover as satisfactorily or quickly as they had expected, implying that another form of treatment may have been more appropriate.
True
Medical malpractice insurance
(Medical malpractice insurance ) cover is for ?
NHS trusts, doctors (including surgeons and consultants), nurses, dentists, pharmacists and ‘alternative’ practitioners.
Standard policy cover provides ?
Protection against damages and defence costs for any claims for bodily/personal injury or damage.
Cyber insurance is still emerging both in terms of its availability and purpose.
True
Cyber Insurance
Who defines cyber insurance as covering ‘the losses relating to damage to, or loss of information from, IT systems and networks’.
ABI
This is an important and OFTEN overlooked protection for consumers and commercial customers.
True
Cyber Insurance
Think about your own home, internet access/connectivity is key, so much so that some now refer to it as a basic utility (like water, gas and electricity), and even as a human right.
True
Cyber Insurance
Cyber insurance can relate to both damage of physical property (including the data on it),
True
Cyber Insurance
Pecuniary loss following interruption,
True
Cyber Insurance
Liability to third parties in respect of loss of or damage to third party property or loss of third party data.
True
Cyber Insurance
Even with the high profile data breaches reported in the media, take up of these policies is mixed.
True
Cyber Insurance
Their availability ALSO varies.
True
Cyber Insurance
Which insurers offer comprehensive off-the-shelf products that have been built on more bespoke programmes for larger customers.
Specialist Insurers
Other insurers offer enhancements to their basic products, with inner limits and restricted covers or restrictive conditions or exclusions.
True
Cyber Insurance
It would make sense to separate out such scenarios – you can think of them as first party (i.e. in relation to the proposer’s assets or finances) or third party (i.e. in relation to the
Proposer’s duty of care to third parties and their property).
For example, retail banks and other organisations holding sensitive customer information, particularly consumer information, may need more protection than a metal working business,
for example, with commercial customers only.
The availability of such products can be affected by the proposer
– what existing protections do they have in place?
For example, do they have adequate network security?
Do they regularly back up their data to an external location and, if so, how frequently?
In the widening of its cover to members to include limited forms of protection against cyber events.
The need for this cover has even been recognised by?
Pool Re
This is a new and emerging cover requirement for most:.
businesses
The suitability of the product will be dictated by the
Business seeking the insurance.
For example, retail banks and other organisations holding sensitive customer information, particularly consumer information, may need more protection than a metal working business,
For example, with commercial customers only.
This is a new and emerging cover requirement for most:.
Businesses
Demand is not yet being seen in the consumer space, such as:
Home insurance.
