Professional Documents
Culture Documents
24
Submitted by
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INSURANCE AND ITS APPLICATION
Bachelor of Commerce
Banking & Insurance
Semester VI
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Vidyasagar, Principal K.M. Kundnani Chowk, 123,D.W. Road, Church gate,
Mumbai 400 020.
DECLARATION
This is to certify that Sheri / Miss HIREN RAJESH KALINANI of
B.Com.-Banking & Insurance Semester VI (2016-2017) has
successfully completed the project on FUNDAMENTAL
PRINCIPLES OF INSURANCE AND ITS APPLICATION under the
guidance of Poonam Jain.
HIREN
KALINANI
Roll No.24
ACKNOWLEDGEMENT
All praises and thanks to God, the Almighty, the Merciful and the
Omniscient whos Blessings enabled me to complete this work. With great
pleasure, I express my gratitude to all those personalities, who extended their
fullest co-operation for the successful completion of the present endeavor.
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First of all, I would like to express my deep sense of gratitude and
indebtedness to the authorities of the Mumbai Uni0versity, Mumbai for providing
me an opportunity to undertake the present research work.
At the end, I would like to thank all those who provided information for this, and
who generously shared details of their experiences and technical aspects about this
research.
CONTENTS
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Chapter No. Chapter Title Page No.
Acknowledgement 5
Chapter 1 Introduction pf risk and insurance 8-11
Chapter 2 History of insurance 12-18
Chapter 3 Fundamental principle of insurance 19-39
Implication of insurance in different types of
Chapter 4 insurance 40-44
Chapter 5 Conclusion 45-59
Bibliography 60
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CHAPTER 01
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situation in which we are not sure whether there will be loss of a certain kind,
or how much will be lost. It is this uncertainty and the undesirable element
found with risk that underlie the wish and need for insurance.
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advance, which person will suffer the losses,
It is possible to work out how many persons on an average out of the
group, may suffer losses. When risk occurs, the loss is made good out of the
common fund .in this way each and every one shares the risk in fact they
share the loss by payment of premium, which is calculated on the likelihood
of loss .in olden time, the contribution make the above-stated notion of
Insurance.
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The insurer who received the premium,
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C. The compensation will be made in certain definite sum, i.e., the loss or the
policy amount which ever may be, and
D. The payment is made only upon a contingency
More specifically, insurance may be defined as a contact between two
parties, wherein One party (the insurer) agrees to pay to the other party (the
insured) or the beneficiary, a certain sum upon a given contingency (the risk)
against which insurance is required
Oxford definition of Insurance
"An arrangement by which a company or the state undertakes to provide a
guarantee of compensation for specified loss, damage, illness, or death in
return for payment of a specified premium."
CHAPTER 02
HISTROY OF INSURANCE
History of insurance
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History of insurance is divided on two parts
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EARLY METHOD
MODERN METHOD
Early methods:
Methods for transferring or distributing risk were practiced
by Chinese and Babylonian traders as long ago as 3rd and 2nd millennia BC,
respectively. Chinese merchants travelling treacherous river rapids would
redistribute their wares across many vessels to limit the loss due to any single
vessel's capsizing and much more
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Insurance became more sophisticated in Enlightenment era Europe, and
specialized varieties developed. Some forms of insurance developed
in London in the early decades of the 17th century. For example, the will of
the English colonist Robert Hayman mentioned two "policies of insurance"
taken out with the diocesan Chancellor of London, Arthur Duck. Of the value
of 100 each, one related to the safe arrival of Hayman's ship in Guyana and
the other was in regard to "one hundred pounds assured by the said Doctor
Arthur Ducked on my life"
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of London, which in 1666 devoured more than 13,000 houses. The
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devastating effects of the fire converted the development of insurance "from a
matter of convenience into one of urgency, a change of opinion reflected in
Sir Christopher Wren's inclusion of a site for 'the Insurance Office' in his new
plan for London in 1667".[4] A number of attempted fire insurance schemes
came to nothing, but in 1681, economist Nicholas Baron and eleven
associates established the first fire insurance company, the "Insurance Office
for Houses", at the back of the Royal Exchange to insure brick and frame
homes. Initially, 5,000 homes were insured by his Insurance Office
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Describe As Primary and Others as Ancillary or Secondary, As Follows:
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Insurance involves pooling funds
from many insured, entities (known
as exposures) to pay for the losses
that some may incur. The insured
entities are therefore protected from
risk for a fee, with the fee being
dependent upon the frequency and
severity of the event occurring. In
order to be an insurable risk, the risk
insured against must meet certain
characteristics. Insurance as
a financial intermediary is a
commercial enterprise and a major
part of the financial services
industry, but individual entities can
also self-insure through saving
money for possible future losses.
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CHAPTER 3
FUNDAMENTAL PRINCIPLES OF
INSURANCE
PRINCIPLE OF INSURABLE INTEREST
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The word interest can have a number of meanings. In the present
context, it means a financial relationship to something or someone. There
are a number of features to be considered with insurable interest, as below.
1 Definition
Insurable interest is a persons legally recognized relationship
to the subject matter of insurance that gives them the right to effect insurance
on it. Since the relationship must be a legal one, a thief in possession of
stolen goods does not have the right to insure them.
(a) there must be some person (i.e. life, limbs, etc.), property, liability or legal
right (e.g. the right to repayment by a debtor) capable of being insured;
(b) that person, etc. must be the subject matter of the insurance (that is to say,
claim payment is made contingent on a mishap to such person, etc.);
(c) the proposer must have the legally recognised relationship to the subject
matter of insurance, mentioned in above, so that financial loss may
result to him if the insured event happens. (However, insurable interest is
sometimes legally presumed without the need to show financial
relationship. For example, any person is regarded as having an insurable
interest in the life of their spouse.
How It Arises
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Insurable interest arises in a variety of circumstances, which may be
Considered under the following headings:
Ownership of property
Potential legal liability
Secured creditor
A contractual right
IN LIFE INSURANCE :
Own life
Life of close family lies
Pecuniary interest in life of third party
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It may be said that utmost good faith involves a duty of disclosure by the
proposer/insured. Technically, the insurer is under the same duty, but here we will
concentrate on the proposer's duty. This duty has some features that we should
note:4
(a) Duration (at common law): Those material facts which do not come to
the proposers (or his agents) knowledge until the insurance contract has been
concluded do not have to be disclosed. Suppose a proposal for a one-year medical
insurance commencing on 15 January 2011 was accepted on 2 January, and the
insured had a routine medical examination on 10 January which revealed to him on
16 January the contraction of malaria. important question to ask is: Is the insured
legally obliged to disclose such finding to his insurer? Applying the legal rule just
said, the insured is not obliged to do so, assuming that the terms of insurance are
silent on this point. Of course, the policy will normally contain an exclusion for
preexisting diseases, in which case the insurer may rely on this exclusion rather
than a breach of utmost good faith in trying to deny a claim in respect of malaria.
(c) Renewal: when the policy is being renewed, the duty of utmost good
faith revives.
(Note: the duty of utmost good faith does not revive when a life policy is
approaching its anniversary date.)
(d) Contract alterations: If these are requested during the currency of the
policy, the duty of utmost good faith applies in respect of these changes. Where,
for example, the insured of a fire policy is requesting an extension to cover theft,
he is immediately obliged to disclose all material facts relating to the theft risk, e.g.
the physical protections of the insured premises and his record of theft losses, if
any.
Types of Breach of Utmost Good Faith
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A breach of utmost good faith can be in the form of either a
misrepresentation (i.e. the giving of false information) or a non-d
isclosure (i.e. failure to give material information). Alternatively, it can be
classified into fraudulent breach and a non-fraudulent breach (i.e. a breach
committed either innocently or negligently, rather than fraudulently). Both
classifications combine produce a four-fold categorisation as follows:
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Definition
A. Cash payment (to the insured): This is the most convenient method, at
least to the insurer.
[Example: Suppose a husband and wife each insure their home and
contents, each thinking that the other will forget to do it. If a fire occurs
and $200,000 damage is sustained, they will not receive $400,000
compensation. The respective insurers will share the $200,000 loss.]
Apart from any policy provisions, any one insurer is bound to pay to the
insured the full amount for which he would be liable had other policies not
existed. After making an indemnity in this manner, the insurer is entitled to
call upon other insurers similarly (but not necessarily equally) liable to the
same insured to share (or to contribute to) the cost of the payment.
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contribution applies are:
When a fire occurs damaging the stock-in-trade, both the merchant and the
warehouse operator claim under their own policies for the same damage.
Immediately two basic questions come to mind. First, is the warehouse
operator, not being an owner of the damaged property, entitled to claim under
his own fire policy? Second, if both policyholders are entitled to claim, will
there be contribution between the insurers? The answer to the first question
is: the warehouse operator, being a bailed of the stock-in-trade, has insurable
interest in it at the time of loss, and is thus entitled to claim under his own
policy. Turning to the merchant, you probably will not conclude or argue that
he cannot expect to be indemnified. Now we have to wrestle with the second
question. The answer to this question hinges on that to the question of
whether the two policies cover the same interest (criterion (b)). For whose
benefit has the merchant bought his fire insurance? And what about the
warehouse operator? In fact, each of them has bought insurance for their own
benefit. In other words, the first mentioned policy covers the merchants
interest as owner, and the second one covers the warehouse operators
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interest as bailee. Is it apparent to you now that the two policies cover
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different interests, so that contribution will not apply as between them?
How Applicable
Contribution will only apply if indemnity applies. Thus, if a person
dies whilst insured by two or more separate life insurance policies, each has
to pay in full, because the insurances are not subject to indemnity.
ii Non-contribution Clause
To the effect that it is the other policies that will have to pay the loss.
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[Example: Household policies on contents may exclude items more
specifically insured. If a camera is separately insured under an All Risks
policy, that policy may be regarded as more specific than the household
policy, so that the latter policy, if it contains such a clause, will not be
liable for a, say, theft loss of the camera from the insured premises.]
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Definition
How Arising
(a) In tort: This usually arises where a third party negligently causes a
loss indemnifiable by a policy. For example, a fire insurer, after paying a fire
loss, discovers that the fire was caused by a negligent act of a neighbour of
the insured. It sues the neighbour in the name of the insured for damages
recognised by the law of tort.
(b) In contract: This arises where the insured (perhaps a landlord) has a
contractual right (perhaps under a tenancy agreement) against another
person (perhaps a tenant) for an insured loss. After indemnifying the
insured for the loss, the insurer may exercise such right against that other
person in the name of the insured.
(c) Under statute: If a person is injured at work, his employer, if any,
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will have to pay an employee compensation benefit to him in accordance
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with the provisions of the Employees' Compensation (EC) Ordinance. The
Ordinance will then grant subrogation rights to the indemnifying employer
against another person who is liable to the employee for the injury. In turn,
the employer has to pass these rights to the EC insurer who has paid the
employee compensation benefit for or on behalf of the employer.
(d) In salvage: This we have already considered (see 3.4.5 above). The
insurer may be said to have subrogation rights in what is left of the subject
matter of insurance (salvage), arising under the circumstances already
discussed.
How Applicable :
Other Considerations :
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provided a less-than indemnity on the basis of certain policy limitations, the
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insured may possibly be entitled to part of sometimes even the whole of -
the subrogation proceeds, depending on what limitations have been applied in
the process of claims adjustments. The following are illustrations of
several manners in which the sharing of subrogation proceeds between the
insured and the insurer can be done:
(3) Average: Suppose a fire insurer has paid 80% of a loss where
there is a 20% underinsurance. The insured is entitled to 20% of
subrogation proceeds as if he was a co-insurer for 20% of the risk.
PRINCIPLE OF CAUSA PROXIMA :-
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In the law, a proximate cause is an event sufficiently related to a legally
recognizable injury to be held to be the cause of that injury. There are two
types of causation in the law: cause-in-fact, and proximate (or legal) cause.
Cause-in-fact is determined by the "but for" test: But for the action, the result
would not have happened. For example, but for running the red light,
the collision would not have occurred. For an act to cause a harm, both tests
must be met; proximate cause is a legal limitation on cause-in-fact.
The formal Latin term for "but for" (cause-in-fact) causation, is sine
qua non causation.
It is not always that much straight forward that a loss would be caused by a
singular insured or uninsured or an excepted peril so that a claim would
clearly be either payable or not payable.
Difficult situations do occur where numbers of perils get involved
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simultaneously, some insured, some uninsured and some still accepted.
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More so, the position gets further complicated when an insured peril is
followed up by an excepted peril or an excepted peril is followed up by an
insured peril, simultaneously getting mixed up by uninsured perils.
What is this proximate cause then? It has been well defined in the leading
case of Pawsey V. Scottish Union and National (1907) as follows;
Proximate cause means the active, efficient cause that sets in motion a train
of events which brings about a result, without the intervention of any force
started and working actively from a new and independent source. It is the
immediate cause and not the remote cause. The maxim is, Causa Proxima
non remota spectatur. Immediate or proximate means Proximate in
efficiency and not necessarily in time. The consideration is what has actually
brought about the result?
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wrongly argued that has he not had scratches on his leg he would not have
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gone to the hospital and contacted cholera as such.
Certain quotations may be very helpful to the students at this stage and
they should try to realize the implications of such quotations, which would
help them in removing a number of confusions that might occur in their mind
about proximate cause.
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Once it is clear that the causa proxima is covered by the policy, it will
then be essential to calculate the loss and decide how much the Company is
liable to pay. At this point the principle of indemnity will take control.
Definition:
A rule stating that firm minimizes economic loss by producing
output in the short run that equates marginal revenue and marginal cost
if price is less than average total cost but greater than average variable
cost. In the short run, a firm incurs total fixed cost whether or not it
produces any output. As such, if the market price is falls below average
total cost, it must decide if the economic loss from producing the
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quantity of output that equates marginal revenue and marginal cost is
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more or less than the economic loss incurred with shutting down
production in the short run (which is equal to total fixed cost).
Case study
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SHORT CASE STUDIES :-
Case A
The case of Joseph Muscat v. Joseph Gas an et noe (1998) concerned a
claim for the amount of Lm3000 due to a loss of a diamond ring insured
under an Accidental Damage Insurance Policy. The defendants refused to
meet the claim on the basis of misrepresentation and non-disclosure of
material facts by the insured, which made the policy voidable. The insurers
(Gasan Insurance Agency Limited) stated that the insured (Joseph Muscat)
had answered incorrectly a question in the proposal form as regards to
previous convictions involving dishonesty. The insurers also claimed that the
insured had failed to declare that he was previously convicted of the offence
of gaming and betting and had also been imprisoned for a term of eight days.
The Court rejected the claim for the insured since the latter facts were
considered to be significant. Yet, this judgment was reversed and the Court
concluded that the offences of which the applicant was convicted did not hold
an offence concerning dishonesty and thus he was not requested to disclose
such facts. Furthermore, the Court stated that the principle of Uberrima
Fides lies also in the hands of the insurer
Case B
In Kettlewell v. Refuge Assurance (1908), the defendants fraudulent
misrepresentation persuaded the claimant to pay the premiums for four years,
after which she was untruthfully told that she would receive a free policy.
The Court concluded that the policyholder had the right to avoid the policy
and to recoup the premiums paid since the date of misrepresentation.
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Case C
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In Carter v. Boehm (1766), Mr Carter, the Governor of Fort
Marlborough, acquired an insurance policy against the fort being taken by a
foreign enemy together with Mr Boehm. A witness gave evidence that Mr
Carter knew about the fact that the fort was build to resist attacks from
citizens, not European from enemies, which at that time the French were
likely to attack. The French did attack and Mr Boehm declined to complete
the claim. Mr Carter was sued on the basis of non-disclosure of material
facts.
Case D
In the following case, Macaura v. Northern Assurance Co. Ltd (1925),
Macaura had insured an amount of timber on his land under a fire policy. He
had already sold the timber to a company of which he was the only
shareholder. When the timber was damaged by fire the insurers refused to
meet the claim on the basis that Macaura had no insurable interest in the
assets of the company but only in his shares
Case E
In England, in Lucena v. Craufurd (1806); here the Crown Commissioners
insured a number of rival ships which had been captured when they were
still on the high seas . The authority of the Commissioners took control of the
ships only when the vessels arrived at the port, subsequently the court
believed that the Commissioners had no interest in the ships. Up until that
point, they had only an expectancy of taking in charge of the vessels.
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Case F
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The following case, Leyland Shipping v. Norwich Union Fire Insurance
Society Ltd (1918) illustrates that the causa proxima may not necessarily be
the last event to occur. The ship was insured under a policy that covered
perils of the seas, however excluded war risks. The ship was hit by a torpedo
and despite the severe damage it still reached the port, where repair work was
started. When a storm blew up, the ship sank. The Court stated that the
torpedo was the proximate cause of the loss since the damage it caused had
been effective throughout.
Case G
In Richard Aubrey Film Productions Ltd v. Graham (1960), a film producer
insured against the loss of negatives and films . When a film that was soon
completed was stolen, the policyholder was entitled to recover only the
market value of the film, less the cost of competing it. Though the film was
described as the child of his artistic creation and thus the policyholder was
not permitted to recover anything on the grounds that his work reflects his
personal value and feelings.
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CHAPTER 5
TYPES OF INSURANCE
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TYPES OF INSURANCE
There are mainly four basic types of insurance i.e. Life insurance, Fire
insurance, Marine insurance, Miscellaneous insurance.
Life Insurance:
Life insurance (or life assurance, especially in the Commonwealth), is a
contract between an insurance policy holder and an insurer or assurer, where
the insurer promises to pay a designated beneficiary a sum of money (the
benefit) in exchange for a premium, upon the death of an insured person
(often the policy holder). Depending on the contract, other events such as
terminal illness or critical illness can also trigger payment. The policy holder
typically pays a premium, either regularly or as one lump sum. Other
expenses (such as funeral expenses) can also be included in the benefits.
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Life policies are legal contracts and the terms of the contract describe
the limitations of the insured events. Specific exclusions are often written
into the contract to limit the liability of the insurer; common examples are
claims relating to suicide, fraud, war, riot, and civil commotion.
Life-based contracts tend to fall into two major categories:
Protection policies designed to provide a benefit, typically a lump sum
payment, in the event of specified event. A common form of a protection
policy design is term insurance.
Investment policies where the main objective is to facilitate the
growth of capital by regular or single premiums. Common forms (in the U.S.)
are whole life, universal life, and variable life policies.
The Life Insurance Corporation of India popularly known as LIC of
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India was incorporated on September 1, 1956 by nationalizing 245 Indian
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as well as foreign companies. It was established 52 years ago with a view to
provide an insurance cover against various risk in life. The luminaries who
spearheaded this move at that time visualized an entity that will provide life
insurance to Indians, especially the vast rural people, at an economical cost
and channel the savings for the betterment of the nation. It is the largest life
insurance company in India and also the countrys largest investor. It is fully
owned by the Government of India and headquarter is Mumbai.
Today LIC function with 2048 fully computerized branch offices, 100
divisional offices, 7 Zonal offices and the corporate office. LICs wide area
Network cover 100 divisional offices and connects all the branches through a
Metro area network. LIC has tied up with some Banks and service providers
to offer on- line premium collection facility in selected cities. LICs ECS and
ATM premium payment facility is an addition to customer convenience.
Apart from on-line kiosks and IVRS, info centres have been commissioned at
Mumbai, Ahmedabad, Bangalore, Chennai, Hyderabad, Kolkata, New Delhi,
Pune and many other cities. With vision of providing easy access to its
policyholders, LIC has launched its SATELLITE SAMPARK offices.
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indicates that the policyholder will not be compensated by the insurer
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beyond his economic loss. This regulatory principle is not as relevant to
life insurance as it is to property insurance. In life insurance, the payout
is not based on the value of the insureds life (as it is immeasurable);
instead the sum assured is paid at death.
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Fire insurance covers damage or loss to a property because of fire. It is
a specific form of insurance in addition to homeowners or property
insurance, and it covers the cost of replacement and repair or reconstruction
above what the property insurance policy covers. Fire insurance policies
cover damage to the property, and may also cover damage to nearby
structures, personal property and costs because of not having the capacity to
live in or use the property if damages occur.
Valued Policy.
Valuable Policy.
Specific Policy.
Floating Policy.
Average Policy.
Excess Policy.
Declaration Policy.
Adjustable Policy.
Reinstatement Policy.
Comprehensive Policy.
Escalation Policy.
1. Valued Policy
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The value of the property to be insured is determined at the inception of the policy.
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2. Valuable Policy
The valuable policy is that policy where claim amount is to be determined at the
market price of the damaged propert
. Specific Policy
Where a specific sum is insured upon a specified property in case of a specified
period, the whole of the actual loss is payable provided it does not exceed the
insured amount.
4. Floating Policy
The floating policy is the policy taken to cover one or more kinds of goods at one
time under one sum assured for one premium and in relation to the same owner.
Miscellaneous Insurance
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against any loss or damage. To property by fire, explosion, riot or strike,
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malicious damage, burglary, house - breaking, theft, robbery or hold-up or
being carried, conveyed, distributed outside specified premises for the
purpose of business. To furniture, fixtures and fittings as well as other
business appliances inside the premises.
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worry too. For the sake of farmers in the country, the government has
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launched crop insurance to lighten the heavy risk associated with agriculture.
Marine Insurance:
The sea poses many risks that include bad weather, water damage and
pirates. Insurance companies offer cargo insurance, freight insurance and hull
insurance on ships and boats. Marine insurance not only provides financial
protection for the ship but also the cargo being transported. Find out the best
marine insurance policies designed to suit your needs.
Liability Insurance:
Liability insurance covers specific needs in cases where individuals or
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companies need protection against risks that involve being legally held or sued for
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negligence, malpractice or injury. Some business operations involve a great deal of
risk, and employers might find the need to insure themselves or the business
against such risks.
Annuities Insurance:
A dignified retirement is what many of us hope for and for this insurance
companies offer schemes to ensure you are financially secure once you are not
working. Annuity is an investment product that guarantees you income for a certain
number of years or till your demise.
Pets Insurance:
Pets can become our beloved family members. Taking out a pet insurance
policy will help in covering veterinary expenses in case of any medical problems
and injuries. These policies will also pay out if the pet is stolen or in case of its
demise to cover funeral expenses.
Mortgage Insurance:
Mortgage insurance is important for two reasons, one, the policy will cover
your mortgage in the event that you cannot pay it back. Two, the insurance policy
can make you eligible for a loan when you dont meet the criteria otherwise. Get a
policy to cover your mortgage to ensure your credit score doesnt take a hit in the
event you fall behind on your payments.
Business Insurance:
Business insurance applies to those enterprises that have their own premises
wherein contents or stock are held. This insurance policy will cover public liability
as well as fires and other defined events that could disrupt the functioning of the
business. Any business is a means of livelihood and profit and its important to
insure it with a good insurance policy. .
Workers Compensation Insurance:
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Workers Compensation Insurance can help employers to
avoid being sued and going through legal course of action in case
an employee is injured during the course of employment. The
insurance will provide wage replacement and medical benefits to
employee. This policy is important for employers who run
businesses where the chances of injuries are high.
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CHAPTER 5
CONCLUSION
Conclusion
According To The Research Done By Me, I Came To Know
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That Insurance Is Growing Very Fast. There Was Higher Growth In
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Revenue Insurance Sector; There Are Chances Of High Fraud And
Misleading.
Bibliography
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Bibliography
Bankbazzar.Com