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A PRESENTATION ON

“UTMOST GOOD FAITH”
The principle of utmost good faith means a higher
degree of honesty is imposed on both parties to an
insurance contract
This   principle has its historical roots in ocean marine
insurance
The    principle imposes a more higher degree of
honesty on the applicant for insurance
The principle of utmost good faith is supported
  by three important legal doctrines as follows:

 Representations


 Concealment


 warranty
Representations:

The statements made by the applicant for insurance.
That’s tell the true facts about the insured and/or the
subject matter.
( 1 ) In life insurance, the applicant should be asked
questions concerning the insured’s age, height,
occupation, state of health, family history, and other
relevant questions.
( 2 ) In property insurance, such information as
quality, quantity, location, value, so on should be stated.
( 3) Increase in hazard
     Representations:
An Insurance contract is voidable at the insurer’s option if the
      presentation is :

(1)   Material (the true facts not fitting for the required
      conditions by the insurer. )

(2)   False (not true facts, or misleading)

(3)   Relied on by the insurer (at specified /adjusted premium)

(4)   Innocent misrepresentation ( unintentional )
Concealment:

It   is intentional failure for the applicant to
reveal a material fact to the insurer. That is the
applicant deliberately withholds material
information from the insurer.
The    legal affect of a material concealment is:
The contract is voidable at the insurer’s option.
warranty:

It is a statement of fact or a promise made by the insured,
which is part of the insurance contract and must be true if
the insurer is to be liable under the contract. Examples:

   Not    drunk driving

   Locking    the door

   Fire   extinguisher

   Any breach of the warranty allows the insurer to deny
 payment of a claim.
   Against the responsibilities of Representation:
    The insurer may not take the responsibility
    due to such reasons as: negligence, mis-
    represent the facts, or conceal the facts
    deliberately .
   The legal effect of breaking the utmost good
    faith principle is that the insurer will deny the
    loss claim.
Definition   of the principle of proximate cause
In   many cases, a loss is caused by several reasons, not a
single one. Thus, the principle of proximate cause is
used in the insurance contract.


It   means among several causes, the insurer tries to
examine whether the most effective and decisive cause
is under the coverage of the insurance contract. If yes,
the insurer pay the sum of insurance amount; otherwise,
will not pay.
   Means the DIRECT, DOMINANT or effective cause of
    which the loss is the natural consequence.
   It is the cause which is most closely connected with the
    loss, not necessarily in time but in efficiency.
   Example:

   An insured sustained an accident while hunting.
    Due to shock and weakness, he was unable to walk
    and whilst lying on wet ground, he contracted cold
    which developed into pneumonia causing death
    ultimately.
   The proximate cause was considered to be the
    accident and not the pneumonia, the disease, which
    was only a remote cause. The claim was payable
    under personal accident policy.
   The principle of utmost good faith means that a higher
    degree of honesty is imposed on both parties to an
    insurance contract.
   The legal doctrine of representations, concealment and
    warranty support the principle of utmost good faith .
   There are several derived principles from the principle
    of indemnity .
Yogesh ppt

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Yogesh ppt

  • 2. The principle of utmost good faith means a higher degree of honesty is imposed on both parties to an insurance contract This principle has its historical roots in ocean marine insurance The principle imposes a more higher degree of honesty on the applicant for insurance
  • 3. The principle of utmost good faith is supported by three important legal doctrines as follows: Representations Concealment warranty
  • 4. Representations: The statements made by the applicant for insurance. That’s tell the true facts about the insured and/or the subject matter. ( 1 ) In life insurance, the applicant should be asked questions concerning the insured’s age, height, occupation, state of health, family history, and other relevant questions. ( 2 ) In property insurance, such information as quality, quantity, location, value, so on should be stated. ( 3) Increase in hazard
  • 5. Representations: An Insurance contract is voidable at the insurer’s option if the presentation is : (1) Material (the true facts not fitting for the required conditions by the insurer. ) (2) False (not true facts, or misleading) (3) Relied on by the insurer (at specified /adjusted premium) (4) Innocent misrepresentation ( unintentional )
  • 6. Concealment: It is intentional failure for the applicant to reveal a material fact to the insurer. That is the applicant deliberately withholds material information from the insurer. The legal affect of a material concealment is: The contract is voidable at the insurer’s option.
  • 7. warranty: It is a statement of fact or a promise made by the insured, which is part of the insurance contract and must be true if the insurer is to be liable under the contract. Examples: Not drunk driving Locking the door Fire extinguisher Any breach of the warranty allows the insurer to deny payment of a claim.
  • 8. Against the responsibilities of Representation:  The insurer may not take the responsibility due to such reasons as: negligence, mis- represent the facts, or conceal the facts deliberately .  The legal effect of breaking the utmost good faith principle is that the insurer will deny the loss claim.
  • 9. Definition of the principle of proximate cause In many cases, a loss is caused by several reasons, not a single one. Thus, the principle of proximate cause is used in the insurance contract. It means among several causes, the insurer tries to examine whether the most effective and decisive cause is under the coverage of the insurance contract. If yes, the insurer pay the sum of insurance amount; otherwise, will not pay.
  • 10. Means the DIRECT, DOMINANT or effective cause of which the loss is the natural consequence.  It is the cause which is most closely connected with the loss, not necessarily in time but in efficiency.
  • 11. Example:  An insured sustained an accident while hunting. Due to shock and weakness, he was unable to walk and whilst lying on wet ground, he contracted cold which developed into pneumonia causing death ultimately.  The proximate cause was considered to be the accident and not the pneumonia, the disease, which was only a remote cause. The claim was payable under personal accident policy.
  • 12. The principle of utmost good faith means that a higher degree of honesty is imposed on both parties to an insurance contract.  The legal doctrine of representations, concealment and warranty support the principle of utmost good faith .  There are several derived principles from the principle of indemnity .