IF3.3 Insurance Policies Flashcards
The Consumer Insurance (disclosure and representations) Act 2012
Insurers duty
requires that all questions are exact and clear enough for consumers to understand
Policy Schedule
Contains all the variable information concerning the insured and the details of the risks insured
Consumer Rights Act 2015
If a term is not transparent or prominent, it can be assessed for unfairness and can not bind the consumer to it.
Insurance Act 2015 (needs for insured and insurer)
Both parties must be clear about the policy terms and requirements including remedies when things go wrong, BEFORE entering the contract
Contra Proferentem
When the insured interprets a contract term in a different way to expected (gives the insurer incentive to be particularly clear)
What will all insurance policies contain (structure)
- heading
- preamble (recital clause)
- signature clause
- operative clause
- exclusions
- conditions
- policy schedule
- information and facilities
What does the preamble/recital clause do?
sets the scene for what follows in the policy - outlines the contract.
How does the policy wording and the schedule interact?
the policy wording is generic and the schedule links the personal features with the policy.
parol evidence rule
neither party can rely on the negotiations leading up the the contract (only the contract itself)
Operative clause
the actual cover is outlined (in a number of clauses), specific exceptions are outlined
What does an operative clause begin with
“The company will…” or something similar
What are the 3 types of exclusions
General, Market & specific
What are General Exclusions
apply to all sections of the policy and allow the insurer to deny cover under the policy
What are Market exclusions
exclusions that apply across the market to all GI insurances
What are specific exclusions
apply to particular sections of the policy
Condition
a contractual term that the insured agrees to comply with during the period of cover
Express conditions
always stated in the policy
Implied conditions
implied by common law and practise (do not need to appear in the policy)
Policy Schedule
Where the policy is made personal and specific including personal info and risk specific info (not pre-printed and applicable to all)
variable parts of a policy
- insureds name
- insured address
- premium
- policy period
- details of the subject matter
- sum insured/liability limit
- policy number
- reference to specific exclusions, conditions or aspects of cover.
- operative sections
What will information and facilities in the policy contain
definitions, customer service standards statement, complaints procedure & claims information
Enterprise Act 2016
duty of insurers to pay claims promptly
Exclusions examples
- war and related perils
- radioactive contamination and explosive nuclear assemblies
- terrorism
- pollution and contamination (excluded unless in the form of an insured peril)
- cyber risks
- marine policies
- contractual liabilities
- sonic bangs