- covers LOSS or LIABILITY arising fromACCIDENT or MISHAP, excluding certain typesof loss which by law or custom areconsidered as falling exclusively within thescope of other types of insurance such asmarine, fire, suretyship and life.
- presumed to include any loss or damage when an accident is the cause of the loss. (casualty = accident)a. Employer’s liability insuranceb. Workmen’s compensation insurancec. Public liability insuranced. Motor vehicle liability insurancee. Plate glass insurancef. Burglary and theft insuranceg. Personal accident and health insurance as written by non-life companies
- except Compulsory Motor vehicleInsurance - the terms of the contract which are notviolative of the laws and by the generalprovisions applicable to all types of insurance
which affect the person which give rise to third-and/or property of the party liability on theinsured: part of the insured:• plate glass insurance • employer’s liability• burglary and theft insuranceinsurance • workmen’s• personal accident and compensation insurancehealth insurance as • public liability insurancewritten by non-life • motor vehicle liabilitycompanies insurance
Third party liability Person or property of the insured1. Insurable - The insured has interest - The insured has interestinterest in the safety of persons on his own life (section 10) who may maintain, or in and on his property (section the freedom from damage 13). of property which may become the basis of suits against him in case of their injury or destruction.2. When -Attaches when the - Action against the insurerpayable? liability of the insured to lie only when there is an the injured 3rd party actual loss sustained by the attaches, regardless of insured. actual loss at that time.
Third party liability Person or property of the insured3. Right of - 3rd persons to whom the - 3rd persons cannotinjured person insured is liable, can sue proceed against theto sue insurer directly the insurer upon insurer. Their recourse the occurrence of the is limited to theof party at injury or event upon which insured alone.fault the liability depends.4. Basis of - Based on contract - Based on contractinsurer’sliability5. Extent of - Extent of policy - Extent of policyinsurer’sliability
Accident Insurance - reimburses the insured for pecuniary loss suffered as a result of injuries sustained in an accident Health Insurance - reimburses the insured for pecuniary loss arising out of disease-related illness.
GENERAL RULE: Death or injury does NOT result from accident if it is the NATURAL RESULT of the insured’s voluntary act, unaccompanied by anything unforeseen except the death or injury.
EXCEPTION: If the death or injury is NOT THE NATURAL RESULT of the insured’s voluntary act or if something UNFORESEEN OCCURS in the doing of the act which produces the injury, the resulting death is within the protection of the insurance policy.
ACCIDENT – happens by chance, fortuitously, without intention, design, and which is unexpected, unusual, and unforeseen. INTENTIONAL – which implies the use of reasoning faculties, consciousness, and volition.
FORMULA: cause + result of the death or injury = accidental RECOVERY cause is intentional NO RECOVERY