Insurance Flashcards
Insurance - concept of indemnity
when persons suffer a loss, they should be made whole. They should not profit from a loss, but should be reimbursed for the loss.
subrogation
the right of an insurance company that has paid for a loss to recover its payments if it is determined that a different insurance company or person is responible for the loss and required to pay for it. prevents insured from collecting twice for the same loss
when does concept of indemnity not apply?
when the collateral source rule applies. if others cause you to suffer a loss, they are obligated to pay you for your loss and they do not have their liability reduced just b/c you had insurance to cover the loss.
if payments are made from property insurance and health insurance policies? subrogation?
the insurance company that paid your claim has the right to seek repayment from the person causing the loss before you can try to receive any additional compensation from that person
with life and disability insurance? collateral source rule and subrogation?
your policy will pay, and the person causing the loss is still obligated to pay you or your estate, no provision that requires the guilty party to pay the insurance company rather than you
are insurance contracts unilateral or bilateral?
unilateral - only one party can enforce the contract. a policy owner can enforce the terms of the contract bu tthe insurance company may not force the policy owner to pay the premium
doctrine of waiver
means that a party, by their own actions, has voluntarily relinquished or surrendered a known right (ex: ins company receives an application that doesn’t meet underwriting criteria, but issues the policy anyway - if a subsequent claim is filed, the ins company is barred from denying the claim)
doctrine of estoppel
prevents a party from asserting a right to which he or she would otherwise be entitled where, b/c of their own actions, they misled someone unintentionally. If one of two innocent persons must suffer, the one who caused the loss must bear it. So the insurer would be estopped from asseting its right to deny the claim
rescission
an equitable remedy by which the original contract is deemed null from the beginning (generally sought by insurer rather than insured), insurer would be required to return premiums rather than pay out benefits
reformation
equitable remedy by which the contract is changed to express the original intentions of the parties - it must be shown that there was a mutual mistake
four elements of negligence
1- a duty is owed
2- the duty was breached
3- there were actual damages
4-there was proximate cause
tort terms: survival of tort actions
the right to sue generally survives the death of the victim or the tortfeasor
attractive nuisance
like a swimming pool, something about a property that is liekly to attract and possibly injure children
negligence per se
where the duty or standard of care owed by the defendant is determined by reference to a statute, like if someone speeds through a school zone and hits a child (if they hit a parent, it would jsut be negligence)
absolute liability
when person or organization is held responsible for any damages, even where there is no negligence or fault
