chapter 381 the contract the insurance contract the application duties of parties statutory...

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Chapter 38 1 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulatio n of the policy All provisions required by statute apply, even if not included in the contract Insured and insurer owe each other obligations imposed by the contract and by statute

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Page 1: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 1

The ContractThe

InsuranceContract

TheApplication

Duties ofParties

StatutoryProvisions

Generally partof contract by

expressstipulation of

the policy

All provisions required by

statute apply,even if not

included in thecontract

Insured and insurer owe eachother obligationsimposed by the

contract andby statute

Page 2: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 2

Kinds of Insurance1. Business Liability

• Comprehensive General Liability (CGL) Policy: broad, all-risk• Liability insurance for directors, officers• Product liability insurance• Malpractice insurance

2. Marine• Ocean marine: ships and cargo — “perils of the sea”• Inland marine: goods in transit other than on ocean

3. Fire and Homeowners• Fire: actual, hostile fire — immediate cause of loss• Homeowners: fire, liability for injuries, theft

4. Automobile• Liability: bodily injury and property damage• Medical expenses• Uninsured motorist• Collision• Comprehensive

5. Life• Term: specified number of years• Whole (Ordinary): lifetime protection with investment element• Endowment: face amount paid to: - beneficiary if insured dies during policy period - insured if alive at end of policy period

} Loss or damage to covered auto

Page 3: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 3

Subrogation A

B C

1.

A

B C

2.

A

B C

3.

Pre

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ms

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y

Original Claim

Pay

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oss

Subrogated Claim

A = InsurerB = InsuredC = Third Party Who Caused B to Sustain Loss

Page 4: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 4

Chapter 38 SummaryInsurance is a contract, called a policy. Under an insurance policy, provision is made by the insurer, in consideration of premium payments, to pay the insured or beneficiary a sum of money if the insured sustains a specified loss or is subjected to a specified liability. These contracts are made through an insurance agent, who is an agent for the insurance company, or through an insurance broker. An insurance broker is the agent of the insured when obtaining a policy for the latter.

Page 5: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 5

Chapter 38 Summary (cont.)The person purchasing an insurance contract must

have an insurable interest in the insured life or property. An insurable interest in property exists when the damage or destruction of the property will cause a direct monetary loss to the insured. In the case of property insurance, the insured must have an insurable interest at the time of loss. An insurable interest in the life of the insured exists if the purchaser would suffer a financial loss from the insured’s death. This interest must exist as of the time the policy is obtained.

Page 6: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 6

Ocean marine policies insure ships and their cargoes against the perils of the sea. Inland marine policies insure goods being transported by land, by air, or on inland and coastal waterways.

Chapter 38 Summary (cont.)

Page 7: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 7

In order for a fire loss to be covered by fire insurance, there must be an actual, hostile fire that is the immediate cause of the loss. The insurer is liable for the actual amount of the loss sustained up to the maximum amount stated in the policy. An exception exists when the policy contains a co-insurance clause requiring the insured to maintain insurance up to a certain percentage of the value of the property.

Chapter 38 Summary (cont.)

Page 8: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 8

To the extent this is not done, the insured is deemed a co-insurer with the insurer, and the insurer is liable for only its proportional share of the amount of insurance required to be carried. A homeowners insurance policy provides fire, theft, and liability protection in a single contract.

Chapter 38 Summary (cont.)

Page 9: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 9

Automobile insurance may provide protection for collision damage to the insured’s property and injury to persons. It may also cover liability to third persons for injury and property damage, and loss by fire or theft.

Chapter 38 Summary (cont.)

Page 10: Chapter 381 The Contract The Insurance Contract The Application Duties of Parties Statutory Provisions Generally part of contract by express stipulation

Chapter 38 10

A life insurance policy requires the insurer to pay a stated sum of money to a named beneficiary upon the death of the insured. It may be a term insurance policy, a whole life policy, or an endowment policy. State law commonly requires the inclusion of an incontestability clause, whereby, at the conclusion of the contestability period, the insurer cannot contest the validity of the policy.

Chapter 38 Summary (cont.)