FUNDAMENTAL PRINCIPLES
PRESENTED
BY
R . R . JOSHI
INSURABLE INTEREST
INSURABLE INTEREST IS THE LEGAL RIGHT
TO INSURE
IT ARISES OUT OF THE INSURED’S FINANCIAL
INTEREST IN THE SUBJECT MATTER OF
INSURANCE SUCH THAT HE BENEFITS BY ITS
CONTINUANCE AND IS PREJUDICED BY LOSS
OR DAMAGE THERETO
INSURABLE INTEREST ARISES OUT OF
OWNERSHIP/BAILEESHIP/MORTGAGE/BONDS
INSURABLE INTEREST…contd
WHEREAS THE SUBJECT MATTER OF INSURANCE IS
LIFE/LIMB/PROPERTY/ INTEREST/LIABILITY,THE SUBJECT MATTER
OF INSURANCE CONTRACT IS THE FINANCIAL INTEREST OF THE
INSURED IN THE SUBJECT MATTER OF INSURANCE
CREATION OF INSURABLE INTEREST—3 WAYS
AT COMMON LAW - OWNER/BAILEE/TORTS
BY CONTRACT/BOND
BY STATUTE—eg.M.V.ACT/W.C.ACT/PLI ACT
APPLICATION OF I/I:
LIFE POLICIES ARE BENEFIT POLICIES
MARINE CARGO POLICIES ARE FREELY ASSIGNABLE
AGREED VALUE POLICIES ARE ISSUED FOR MARINE
HULL/CARGO/FREIGHT
ASSIGNMENT OF POLICY PROCEEDS—NOMINATION/ASSIGNMENT
ASSIGNMENT IS THE TRANSFER OF RIGHTS AND LIAILITIES OF THE
INSURED TO A THIRD PARTY WHO HAS ACQUIRED INSURABLE
INTEREST IN THE SUBJECT MATTER OF INSURANCE
UTMOST GOOD FAITH
INSURED MUST DISCLOSE ALL MATERIAL
FACTS
HE MUST DISCLOSE NOT ONLY THE MATERIAL
FACTS WHICH HE KNOWS BUT ALSO THE
MATERIAL FACTS WHICH HE OUGHT TO KNOW
A MATERIAL FACT IS A FACT WHICH WILL INF
-LUENCE THE JUDGEMENT OF A PRUDENT
UNDERWRITER WHETHER TO ACCEPT THE
RISK OR NOT AND IF SO AT WHAT RATE OF
PREMIUM
UTMOST GOOD FAITH…..contd
EXAMPLES OF UTMOST GOOD FAITH :
FIRE—construction/situation/occupation
MARINE---nature of cargo/method of
packing/mode of carriage/transhipments
BURGLARY—nature and value of
stock/security arrangements/situation of
premises
MONEY—single carrying limit/annual
estimated carryings/mode of
carriage/distance involved
UTMOST GOOD FAITH…..contd
FACTS WHICH MUST BE FACTS WHICH NEED NOT
DISCLOSED BE DISCLOSED
FACTORS WHICH INCREASE FACTS OF LAW
THE HAZARD FACTS OF COMMON
FACTS RELATING TO THE KNOWLEDGE
DESCRIPTION OF THE FACTS WHICH DIMINISH
SUBJECT MATTER THE RISK
PREVIOUS CLAIMS HISTORY FACTS REVEALED BY PRE-
ANY OTHER POLICY ACCEPTANCE INSURANCE
COVERING THE SAME SURVEY
PROPERTY/SUBJECT FACTS WHICH COULD BE
MATTER AGAINST SIMILAR ASCERTAINED FROM THE
PERILS INFORMATION SUPPLIED BY
PREVIOUS THE PROPOSER
DECLINATURE/SPECIAL
TERMS IMPOSED BY
INSURERS
UTMOST GOOD FAITH…..contd
BREACH OF UTMOST GOOD FAITH MAY
OCCUR IN FOUR DIFFERENT WAYS:
INADVERTANT NON-DISCLOSURE
INTENTIONAL NON-DISCLOSURE
(CONCEALMENT)
INNOCENT MISREPRESENTATION
FRAUDULENT MISREPRESENTATION
CONTRACT BECOMES NULL AND VOID IN
CASE OF CONCEALMENT AND
FRAUDULENT MISREPRESENTATION. IT IS
VOIDABLE IN CASE THERE IS
INADVERTANT NON-DISCLOSURE OR
INNOCENT MISREPRESENTATION
INDEMNITY
INDEMNITY IS A MECHANISM BY WHICH INSURERS
PROVIDE FINANCIAL COMPENSATION IN AN
ATTEMPT TO PLACE THE INSURED IN THE SAME
FINANCIAL POSITION AFTER A LOSS WHICH HE
OCCUPIED IMMEDIATELY BEFORE THE LOSS
INDEMNITY RESTRICTS THE COMPENSATION
UNDER THE POLICY WITHIN THE FOUR CORNERS
OF INSURABLE INTEREST.INSURED CANNOT GAIN
MORE THAN HIS I/I BECAUSE HE CANNOT LOSE
MORE THAN HIS I/I
THUS, AS PER THE PRINCIPAL OF INDEMNITY,THE
INSURED WILL NOT BE ALLOWED TO MAKE A
PROFIT OUT OF THE LOSS
METHODS OF INDEMNITY—
CASH PAYMENT
REPAIR
REPLACEMENT
REINSTATEMENT
INDEMNITY…contd
MEASURE OF INDEMNITY:
BUILDINGS-- COST OF REPAIRS – DEPN. ON M/C
PLANT/MACHINERY---COST OF REPAIRS-DEPN.ON THE VALUE
OF PARTS REPLACED
WHOLESALER’S STOCK—MANUFACTURER’S SELLING PRICE
+HANDLING/TRANSPORTATION TO THE INSURED’S
PREMISES
RETAILER’S STOCK—WHOLESALE PRICE+H/T
STOCK-IN-PROCESS:RAW MATERIAL COST
+PROPORTIONATE O/H AND LABOUR
RAW MATERIAL—COST OF REPLACEMENT FROM SUPPLIER
FINISHED PRODUCT----RAW MATERIAL COST +O/H AND
LABOUR
LOSS OF PROFITS---N/P+INSURED STANDING CHARGES
LIABILITY INSURANCE—AS PER COURT AWARD, SUBJECT TO
LIMITS OF LIABILITY
F/G POLICY-FINANCIAL LOSS SUFFERED,SUBJECT TO LIMITS
OF GUARANTEE
INDEMNITY…contd
EXCEPTIONS TO THE PRINCIPLE OF INDEMNITY:
MARINE POLICIES ARE AGREED VALUE POLICIES
LIFE AND P. A . POLICIES ARE BENEFIT POLICIES
REINSTATEMENT VALUE POLICIES PAY NEW FOR
OLD
FACTORS LIMITING APPLICATION OF INDEMNITY:
SUM INSURED
CONDITION OF AVERAGE
EXCESS/FRANCHISE
LIMITATIONS IMPOSED BY POLICY CONDITIONS—eg
Limit per bottom/limit per location in marine
special decl. policies
Single carrying limit in money policy
AOA/AOY LIMIT IN LIABILITY POLICIES
SALVAGE
SUBROGATION
SUBROGATION IS A COROLLARY TO THE
PRINCIPLE OF INDEMNITY
IT IS DEFINED AS THE TRANSFER OF RIGHTS AND
REMEDIES OF THE INSURED TO THE INSURER
WHO HAS INDEMNIFIED HIM IN THE EVENT OF
LOSS/DAMAGE
SUBROGATION PREVENTS THE INSURED FROM
RECOVERING FROM MORE THAN ONE SOURCE
AND MAKING A PROFIT OUT OF THE LOSS
SUBROGATION ARISES UNDER TORTS/STATUTE
/CONTRACT/SALVAGE AND IS IMPLIED IN ALL
CONTRACTS OF INDEMNITY
SUBROGATION CAN ONLY BE TO THE EXTENT OF
INDEMNIFICATION
FIRE POLICY PROVIDES FOR ENFORCEMENT OF
SUBROGATION RIGHTS EVEN BEFORE
INDMNIFICATION
CONTRIBUTION
CONTRIBUTION IS ALSO A COROLLARY TO THE
PRINCIPLE OF INDEMNITY
CONTRIBUTION IS THE RIGHT OF AN INSURER,
WHO HAS PAID A LOSS UNDER A POLICY,TO
RECOVER A PROPORTIONATE AMOUNT FROM
OTHER INSURERS WHO ARE LIABLE FOR THE
SAME LOSS i.e. THE LOSS GETS SHARED IN
PROPORTION TO THE RESPECTIVE SUMS INSURED
UNDER THE VARIOUS POLICIES
REQUIREMENTS FOR SUBROGATION—
COMMON PERIL/SUBJECT MATTER/INTEREST
MORE THAN ONE POLICY IN FORCE ON THE DAY OF LOSS
LIABILITY ADMITTED UNDER ALL THE POLICIES
PROXIMATE CAUSE
PROXIMATE CAUSE MEANS THE ACTIVE, EFFICIENT CAUSE THAT
SETS IN MOTION A CHAIN OF EVENTS WHICH BRINGS ABOUT
THE RESULT, WITHOUT THE INTERVENTION OF ANY FORCE
STARTED AND WORKING ACTIVELY FROM A NEW AND
INDEPENDENT SOURCE
IT MEANS THE MOST DOMINANT / EFFECTIVE / DIRECT CAUSE
WHICH IS MOST CLOSELY CONNECTED WITH THE LOSS
SINGLE CAUSE – LOSS IS PAYABLE IF THE CAUSE IS AN INSURED
PERIL
SUCCESSIVE CAUSES - LOSSESS PAYABLE IF THE ORIGINAL
CAUSE IS AN INSURED PERIL
CONCURRENT CAUSES – LOSS IS PAYABLE IF AN INSURED AND
UNINSURED PERIL ACT CONCURRENTLY. LOSS IS NOT PAYABLE
IF AN INSURED AND AN EXCEPTED PERIL ACT CONCURRENTLY.
IF THE RESULTS OF THE OPERATION OF THE INSURED PERIL
CAN BE SEPARATED FROM THE EFFECTS OF THE EXCLUDED
PERIL, THE LIABILITY UNDER THE POLICY WILL BE RESTRICTED
TO THE LOSS DUE TO THE INSURED PERIL
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