PROPERTY /
INDUSTRIAL
RISK INSURANCE
INTERMEDIATE LEVEL
Contents
• All risks policy wordings
• The pros and cons of different
methods of setting the sum
insured and its impact of...
INSURANCE POLICY
WORDINGS
INTERMEDIATE LEVEL
Property / Industrial All Risk Insurance
• Covers All Risks of Physical
Loss, Destruction or Damage to
the insured propert...
Coverage
• The Policy form consist of:
a)
b)

Section I - Material Damage
Section II - Business Interruption

The cover In...
Coverage Section of Material Damage
 Cover:
 unforeseen, sudden and accidental physical
loss destruction or damage at th...
Coverage – Section 1: Material Damage
(Cont)
Property insured will include:
i.
ii.
iii.
lv.

Buildings, Contents
Stocks an...
Coverage – Section II: Business Interruption
• Covers all the premises specified/listed in the
Schedule which Is interrupt...
All Risk Type
• PAR/IAR has predominated in the property insurance market because of the
benefits it provides to both Insu...
General Exclusions
 Perang, invasi, tindakan musuh asing, permusuhan atau operasi
menyerupai perang (baik perang dldeklar...
General Exclusions (Cont)
2

 Radiasi ionisasi atau kontaminasi oleh radioaktivitas dari bahan
bakar nuklir atau limbah n...
General Condition – Section I & II
1. Definition

2. Policy Avoidance

3. Berakhirnya Polis

4. Warranties

lkhtisar Bagia...
General Condition – Section I & II (Cont)
5. Reasonable
Precautions

6. Right of Inspection

Tertanggung harus
melakukan s...
General Condition – Section I & II (Cont)
8. Indemnity

9. Interest Payment

10. Mediation/
Arbritation

11. Subrogation

...
General Condition – Section I & II (Cont)
12. Other Insurance

13. Period

• A loss is to be apportioned
• The period of I...
General Condition – Section I & II (Cont)
15. Deductible

16. Sum Insured

• This policy does not cover the amounts of the...
General Conditions (More Slides)
14. Average


The Policy shall be subject to condition of average.
 Section l:
Under In...
General Conditions (More Slides)
15. Deductible






The number of deductibles applicable to a loss can be a cause of...
General Conditions (More Slides)
16. Sum Insured
 Amount fixed In the policy which usually serves for three
purposes:

...
General Conditions (More Slides)


Calculation of the sum Insured under Section I takes the following Into
account:
 His...
Special Exclusions – Section I
Loss destruction of or damage to:
1. Property in the course of construction or erection
2. ...
Special Exclusions – Section I
7. Land (including topsoil, backfill, drainage, or culvert), driveways, pavements, roads,
r...
Special Exclusions – Section I (Cont)
Loss destruction of or damage to the property insured directly or indirectly
caused ...
Special Exclusions – Section I (Cont)
Loss destruction of or damage to the property insured directly or indirectly
caused ...
Special Exclusions
The 'wear and tear" exclusion precludes coverage
for normal or ordinary damage to property that
occurs ...
Intrepeting Special Exclusions (Cont)
• Viewed in that light, losses falling within the scope of the exclusion for wear an...
Special Exclusions – Section I (Cont)
THE "INHERENT VICE" EXCLUSION
"Inherent vice” (sifat natural dari objek itu sendiri)...
Special Exclusions – Section I (Cont)
THE “LATENT DEFECT" EXCLUSION

The “latent defect” exclusion is intended to preclude...
Special Exclusions – Section I (Cont)
"Latent Defects" and "Design Defects"

It is generally recognized that “latent defec...
Special Exclusions – Section I (Cont)
5. MECHANICAL OR ELECTRICAL BREAKDOWN OR DERANGEMENT IN OR ON THE
PREMISES, UNLESS F...
Special Exclusions – Section I (Cont)
6. Pollution or contamination
unless caued by fire, lightning,
explosion, aircraft, ...
Special Exclusions – Section I (Cont) – Mulai
dari sini
7.

Enforcement of ordinances or
decisions by a government
authori...
Special Exclusions – Section I (Cont) – Mulai
dari sini

FOR THE COST:
1. Of rectifying defective materials, faulty
workma...
Special Conditions – Section I
1. SUM INSURED

The Sum Insured
shall not be less
than the cost of
reinstatement

2. BASIS ...
Special Conditions – Section I
3. First Loss
Insurance

4. Debris
Removal
Coverage of
additional cost
items in a
property ...
Special Exclusion – Section I
1. This policy does not cover any loss resulting from
interruption of or interference with t...
Basic of Insurance – Section II
Reduction of Turnover
The sum produced by applying the Rate of Gross Profit to the amount ...
Basic of Insurance – Section II
Reduction of Turnover
Menurunnya omset perusahaan



Basis of Insurance: the policy will ...
Reduction of Turnover - EXAMPLE

Basic of Insurance – Section II
Basic of Insurance – Section II
Increase on Cost Working

Increase on cost working are incurred to:
 Reduce the severity ...
Definition
1. GROSS PROFIT

2. UNINSURED
WORKING EXPENSES

Means the amount by
which:
1. The sum of the turnover
and the a...
Definition
3. DIRECT OR INDIRECT COST

 Direct cost include those cost which directly related to the cost of production o...
Definition
Examples of Fixed Costs:
 Office expenses such as
supplies, utilities, a telephone for the
office, etc.
 Sala...
Definition
4. INDEMNITY
PERIOD

3. TURNOVER

The money (less discount
allowed) paid or payable to
the Insured for goods so...
Definition
5. ANNUAL
TURNOVER

6. STANDARD TURNOVER
(HISTORICAL STANDARD)

The sum derived by adjusting the
Turnover obtai...
Basic of Insurance – Section II
HOW DO YOU CALCULATE THE REDUCTION IN TURNOVER?







The turnover during the perio...
Basic of Insurance – Section II
SIMPLE EXAMPLE
Basic of Insurance – Section II
Increased Cost of Working - ICOW
Add. Increased cost of working -AICOW


ICOW This is add...
Rewrite and arrange by:
AkademiAsuransi.Org
Subject to Permit on copying
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Transcript of "Property all risk and business interruption training"

  1. 1. PROPERTY / INDUSTRIAL RISK INSURANCE INTERMEDIATE LEVEL
  2. 2. Contents • All risks policy wordings • The pros and cons of different methods of setting the sum insured and its impact of claims • Indemnity, Reinstatement Day One Reinstatement, Valued Policies, First Loss, Deductibles and Other • Clauses that effect value • Assess EMUPML factors and retention levels • Industrial Special Risk policy wordings and some extensions cover • Case studies
  3. 3. INSURANCE POLICY WORDINGS INTERMEDIATE LEVEL
  4. 4. Property / Industrial All Risk Insurance • Covers All Risks of Physical Loss, Destruction or Damage to the insured property occurring during the policy period subject to terms, conditions and exclusions. • Wider coverage than Fire and Allied Perils Insurance Policy. • In Indonesia, we usually use Munich-Re PAR / lAR wording.
  5. 5. Coverage • The Policy form consist of: a) b) Section I - Material Damage Section II - Business Interruption The cover In its widest from will Include the following perils/covers:     Fire and all Special Perils Burglary Machinery Breakdown/ Boiler Explosion/ Electronic Equipment Insurance Business lnterruption (Fire and all Special Perils) .
  6. 6. Coverage Section of Material Damage  Cover:  unforeseen, sudden and accidental physical loss destruction or damage at the premises(s)  other than those specifically excluded in the General or Special Exclusions.  In a manner necessitating repair or replacement,  Indemnify  In cash, replacement or repair (at the Insurers' option)  Up to an amount not exceeding the sum insured or in any one event the limit of indemnity where applicable
  7. 7. Coverage – Section 1: Material Damage (Cont) Property insured will include: i. ii. iii. lv. Buildings, Contents Stocks and materials in trade Furniture, Fixtures, Fittings, Office and Business Equipments Plant, Machinery
  8. 8. Coverage – Section II: Business Interruption • Covers all the premises specified/listed in the Schedule which Is interrupted or interfered with in consequence of loss destruction or damage indemnifiable under Section I. • Indemnify the Insured for the amount of loss as hereinafter defined resulting from such interruption or interference • provided that the liability of the Insurers in no case exceeds the total sum to be insured
  9. 9. All Risk Type • PAR/IAR has predominated in the property insurance market because of the benefits it provides to both Insureds and Insurers. • For Insureds, the All-Risk Form eases concerns about gaps in coverage; • For insures;, it promotes efficiency by reducing the probability of underwriting the same risk mutiple times. • which party bears the burden of proof : • Insureds generally bear the burden of proving that coverage for a particular cause of loss Is triggered, while • Insurers bear the burden of proving any exceptions to coverage. When an exclusion applies, the burden usually shifts back to the Insured to establish any exceptions to the exclusion.
  10. 10. General Exclusions  Perang, invasi, tindakan musuh asing, permusuhan atau operasi menyerupai perang (baik perang dldeklarasikan atau tidak) atau perang saudara : 1  Kerusuhan, pemogokan, penghalangan pekerja, tindakan jahat, penjarahan, pembangkangan, huru-hara, pembangkltan militer, pembangkitan rakyat, pemberontakan, revolusi, kekuatan militer atau pengambil-alihan kekuasaan militer, penyitaan, pengambil-alihan atau nasionalisasi, tindakan terorisme. "Terorisme‘’ berarti penggunaan kekerasan untuk tujuan politik dan termasuk penggunaan kekerasan apapun dengan tujuan untuk membuat publik atau bagian dari publik dalam ketakutan
  11. 11. General Exclusions (Cont) 2  Radiasi ionisasi atau kontaminasi oleh radioaktivitas dari bahan bakar nuklir atau limbah nuklir dari pembakaran bahan bakar nuklir  Bahan peledak beracun radloaktif atau barang berbahaya lain dari bahan peledak nuklir rakitan atau komponen nuklirnya 3  Tindakan sengaja atau kelalaian sengaja Tertanggung atau wakilnya 4  Penghentian pekerjaan total atau parsial
  12. 12. General Condition – Section I & II 1. Definition 2. Policy Avoidance 3. Berakhirnya Polis 4. Warranties lkhtisar Bagian dan Endosemen dan Kuesioner dianggap menjadi kesatuan pada dan bagian yang tidak terpisahkan dari polis itu. Polis ini dapat menjadi tidak berlaku dalam hal salah deskripsi, salah penyajian atau tidak diungkapkannya setiap keterangan materiil. Bagian I polis ini menjadi tidak berlaku berkenaan dengan Harta Benda yang diasuransikan terdapat suatu perubahan setelah berlakunya asuransi ini karena pemindahan, risiko meningkat, atau kepentingan tertanggyng berakhir, kecuali diakui oleh Penanggung secara tertulis. Bagian II Polis ini menjadi tidak berlaku jika setelah berlakunya asuransi ini usaha ditutup atau dijalankan oleh likuidator atau kurator atau dihentikan secara permanen atau, kepentingan tertanggung berakir, risiko meningkat, kecuali diakui oleh penanggung secara tertulis. Setiap janji yang disyaratkan (express) atau mungkin disyaratkan sejak saat Janji tersebut melekat (lmplied) selama berlakunya polis, etc
  13. 13. General Condition – Section I & II (Cont) 5. Reasonable Precautions 6. Right of Inspection Tertanggung harus melakukan segala tindakan pencegahan yang wajar untuk mencegah kerugian kehancuran atau kerusakan Wakil penanggung pada tiap waktu berhak menginspeksi dan mengkaji risiko dan Tertanggung harus memberikan kepada wakil Penanggung semua keterangan rinci dan informasi yang diperlukan untuk penilaian risiko. 7. Claim Procerudes Menjaga bagian yang terkena dampak kerugian dan membuatnya tersedia untuk diinspeksi oleh penanggung; Menyerahkan semua informasi yang diminta oleh Penanaggung Segera memberitahu polisi/pihak yang berwenang dalam hal kehilangan atau kerusakan karena pencurian atau pembongkaran atau kerusakan akibat perbuatan jahat Tertanggung tidak berhak mengabandon harta benda kepada Penanggung baik yang diambil alih oleh Penanggung atau tidak Tidak ada klaim yang dapat dibayar kecuali syarat-syarat dari Kondisi ini telah dipenuhi. Jika suatu klaim curang dalam hal apapun atau jika cara curang digunakan oleh Tertanggung atau yang mengatasnamakan dia maka semua manfaat berdasarkan polis ini menjadi hilang.
  14. 14. General Condition – Section I & II (Cont) 8. Indemnity 9. Interest Payment 10. Mediation/ Arbritation 11. Subrogation • Penanggung akan mengembalikan posisi keuangan Tertanggung sebelum kerugian terjadi, tidak lebih baik, tidak lebih buruk. • Penanggung mengganti kerugian melalui penggantian atau perbaikan atau pembayaran nilai kerugian. • Penanggung berhak untuk menahan ganti rugi jika ada keraguan dan sehubungan dengan hukum pidana. Penanggung tidak bertanggungjawab membayar bunga selain bunga karena gagal bayar. Klausul yang menyediakan sarana untuk menyelesaikan perselisihan antara tertanggung dan perusahaan asuransi. • • • Penanggung memperoleh hak kepemilikan atas kerugian yang telah dibayarkan oleh Penanngung. Penanggung dapat melaksanakan hak hukum yang dilasanakan atas nama Tertanggung. Penanggung berhak menuntut kepada pihak yang menyebabkan kerugian untuk jumlah yang dibayarkan dalam polis.
  15. 15. General Condition – Section I & II (Cont) 12. Other Insurance 13. Period • A loss is to be apportioned • The period of Insurance is one among insurers when more than year. Inception and expiry shall one policy covers the same loss. both be 12 o'clock noon at the • Some policies provide no dates entered in the Schedule. coverage when other insurance is • The insurance is automatically in place some pay a pro rata renewed for a year. unless share, and others apply in excess. Insurer or Insured request in • Comply with the principle of writing indemnify which states than an • the termination at the expiry insred should not profit from an date, giving 30 days notice. insured loss 14. Average In instances of underinsurance, i.e. if a sum insured is less than the value to be insured, the indemnity may be proportionately reduced.
  16. 16. General Condition – Section I & II (Cont) 15. Deductible 16. Sum Insured • This policy does not cover the amounts of the • The sum(s) insured shall not be reduced by any deductibles stated in the Schedule In respect of each indemnity payments. and every loss as . ascertained after the application • (STANDARDS) of all other terms and conditions of the policy Including any condition of Average. • Warranted that the Insured shall not effect Insurance In respect of the amounts of the deductibles stated in the Schedule.
  17. 17. General Conditions (More Slides) 14. Average  The Policy shall be subject to condition of average.  Section l: Under Insurance on each item Insured will be considered as being own Insurer for the difference  Section ll: Provided that If lhe sum Insured by this item be less than the sum produced by applying the Rate of Gross Profit to the Annual Turnover (or to a proportionately increased multiple there of where the Maximum Indemnity Period exceeds twelve months) the amount payable shall be proportionately reduced.
  18. 18. General Conditions (More Slides) 15. Deductible     The number of deductibles applicable to a loss can be a cause of contention (argument). This is particularly the case where there are potentially multiple causes of the property damage and business Interruption Example of flood, wind or storm, the policy would normally defined wheter flood, wind or storm constitutes one occurence, and therefore one deductible is payable by the Insured, by reference to a temporal limit, for for example 72 hour. Multiple occurences would impact upon the number of deductibles and affect the amount paid by the insured, insurer or reinsurer. On the particularly large losses, where there are excess layers on both insurance and reinsurance levels, this can create significant Issues due to the varying Interests Involve
  19. 19. General Conditions (More Slides) 16. Sum Insured  Amount fixed In the policy which usually serves for three purposes:    as policy limit of liability In the application of average for premium calculation  Sum Insured under section I relates to:   Building, Machineries, Furniture, Fixtures, Fittings & Electrical Installations shall be on Reinstatement Value basis only; The Stocks shall be covered on Market Value basis.
  20. 20. General Conditions (More Slides)  Calculation of the sum Insured under Section I takes the following Into account:  Historical fugures are used but the bussines interruption lnsurance Insures future losses ( trends and plans)  The maximum lndemnity period  Business interruption may start any time -o.g. end of Insurance period   Business lnterruption policy Insures Gross Profit Insured's last published financial statements are used In determining Gross Profit The Gross Profit Is adjusted for inflation and any known events that may affected the business results a.g. Pending installation of new machineries or plants to increase production. The length of the Indemnity period will also be considered. Annual figures need to be proportionately Increased for periods longers than a year. lnterruption may occur at any time even on the last day of Insurance. This means that an lndemnity period at least 12 months more than what is required should be applied. For 12 months - use a trend of 2 years ahead, etc.   
  21. 21. Special Exclusions – Section I Loss destruction of or damage to: 1. Property in the course of construction or erection 2. Property being worked upon and actually arising from the process of manufacture, testing, repairing, cleaning, restoring, alteration, renovation, or servicing 3. Property in transit by road, rail, air, or water 4. Licened road vehicles, railway locomotives and rolling stock, watercraft, aircraft, spacecraft, and the like 5. Jewellery, preious stones, precious metals, bullion, furs, curiosities, rare books, or works of art 6. Standing timber, growing crops, animals, birds, fish
  22. 22. Special Exclusions – Section I 7. Land (including topsoil, backfill, drainage, or culvert), driveways, pavements, roads, runways, railways lines, dams, reservoirs, surface water, underground water, canals, rigs, wells, pipelines, cables, tunnels, bridges, docks, piers, wharves, mining property underground, offshore property 8. Property in the possession of customers under Rental Aggrements or Hire Purchase, Credits, or other Suspensive Sale Agreements 9. Property which at the time of the happening of loss descruction or damage is insured by or would but for the existence of this policy be insured by any marine policy or policies.
  23. 23. Special Exclusions – Section I (Cont) Loss destruction of or damage to the property insured directly or indirectly caused by or arising out of or aggravated by: Delay loss of market or other consequential or indirect loss or damage of any kind or description whatsoever Dishonesty, fraudulet act, truct, device, or other false pretence Disappearance unexplained or inventory shortage
  24. 24. Special Exclusions – Section I (Cont) Loss destruction of or damage to the property insured directly or indirectly caused by or arising out of or aggravated by: 4. Joint leakage, failure of welds, cracking, fracturing, collapse or overheating of boilers, economisers, super heaters, pressure vessels, or any range of steam and feed piping in conection therewith mechanical or electrical breakdown or derangement in respect of the particular machine apparatus of equipment in which such breakdown or derangement originates. If leakage or seepage of water (including humidity or vapor) occurs for a period of longer than 14 days, damage to real property caused by the seepage may be excluded from coverage A “mechanical breakdown” of the moving parts of machinery will also be excluded if the breakdown results from intemal defects in the machinery. This exclusion, which is based upon the notion that fortuitous losses are not covered, applies to perils that are intrinsic to or hidden within the property itself
  25. 25. Special Exclusions The 'wear and tear" exclusion precludes coverage for normal or ordinary damage to property that occurs over the period of its useful life. The related exclusion for "corrosion" excludes coverage for rust, decay, and deterioration of property. These exclusions relate to the broader concept of 'inherent vice or latent defect’. The "mold' exclusion, for which questions of causation and ensuing loss are particularly important to the coverage analysis. 5. All gradually operating causes, including but not limited to wear and tear, rust, corrosion, mildew, moul d, fungus, wet or dry rot, gradual deterioration, latent defect, inherent vice, slowly developing deformation or distortion, incects larvae or vermin of any kind, microbes of any kind, unless sudden and unforseen physical loss destruction or damage ensues in which case insurers liability sall be limited to such ensuing loss damage or descrution.
  26. 26. Intrepeting Special Exclusions (Cont) • Viewed in that light, losses falling within the scope of the exclusion for wear and tear are not risks at all, but rather Inevitable consequences. • Consensus that these types of losses are not to be covered explains why there are so very few decided cases concerning the precise scope of the exclusion. • One decision that does provide some guidance in this area is Cyclops Corp. v. Home Insurance Co.,51 where the Court stated:  Construing the words "wear and tear” In their everyday common usage, we are convinced that the words "wear and tear” mean simply and solely that ordinary and natural deterioration or abrasion which an object experiences by Its expected contacts between Its component parts and outside objects during the period of Its natural life expectancy.  When the insurer does rely upon the wear and tear exclusion, the insured will argue that the deterioration is remarkable or extraordinary, thereby removing the loss from the Intended scope of the exclusion
  27. 27. Special Exclusions – Section I (Cont) THE "INHERENT VICE" EXCLUSION "Inherent vice” (sifat natural dari objek itu sendiri) generally involves internal decomposition or some quality which brings about an object’s own damage or destruction. The inherent vice exclusion simply restates the need to demonstrate that a loss arose from an “external cause”. If the property contains the seeds of its own loss then the loss cannot be treated as the result of an external cause. To the extent that a policy expressly requires proof of an external cause (i.e., “all risks of direct physical loss of or damage ... from any external cause except as hereinafter provided”), the exclusion is superfluous.
  28. 28. Special Exclusions – Section I (Cont) THE “LATENT DEFECT" EXCLUSION The “latent defect” exclusion is intended to preclude indemnity if the loss or damage to the insurable property is attributable to a defect which could not be discovered by known or customary tests. The purpose of the exclusion Is to ensure that the insurer does not become a guarantor of the quality or fitness of the insured's property. That function is performed through enforcement of the contractual obligations which the supplier of the property owes to the insured.
  29. 29. Special Exclusions – Section I (Cont) "Latent Defects" and "Design Defects" It is generally recognized that “latent defect” does not embrace "design defect”. In Mattis v. State Farm Fire & Casualty Co., it was indicated that "latent defect" was limited in its scope to any defects in the materials used for construction and did not include matters of design or construction.
  30. 30. Special Exclusions – Section I (Cont) 5. MECHANICAL OR ELECTRICAL BREAKDOWN OR DERANGEMENT IN OR ON THE PREMISES, UNLESS FIRE ENSUES There has been some progress by the courts with respect to the Interpretation of terms such as "mechanical breakdown" and "derangement". As will be seen below, the courts have attempted to resolve the uncertainty surrounding these terms by examining them in light of the rest of the policy and by looking at the context in which the policy was drafted. For example, in Jeffrey v. Insurance Corporation of British Columbia, 34 In reaching its conclusion, the court was guided by decisions in two similar cases and quoted the following paragraph from a British Columbia Court of Appeal decision: 34 ( “Mechanics/ breakdown, It seems to me, must be interpreted in the circumstances of this case and in its context as a failure in operation due to some mechanical defect In some parts or parts of the equipment when properly assembled to constitute a crane. Here the figure to operate was due to negligence in assembling the machine so that it could function as an operating unit... There was an operating failure not due to any mechanical defect but to negligences”
  31. 31. Special Exclusions – Section I (Cont) 6. Pollution or contamination unless caued by fire, lightning, explosion, aircraft, or other aerial devices or articles dropped there from riot, civil commotion, strikes, locked out workers, persons taking part in lapour disctubances, malicious persons (other than thieves), earthquake, storm, flood, escape of water from any tank, apparatus or pipe or impact by any road vehicle or animal. The scope of the “pollution” exclusion, has been the subject of much dispute. In the property insurance context, most courts limit the exclusion to “environmental pollution” as that terms is commonly understood.
  32. 32. Special Exclusions – Section I (Cont) – Mulai dari sini 7. Enforcement of ordinances or decisions by a government authority. The "ordinance or law“ excusion precludes coverage for losses related to compliance with building codes, for example, while the "governmental authority" exclusion precludes coverage for seizure, condemnation, or confiscation of property by a government actor. Enforcement of any ordinance or law regulating the costruction, repair or demolition of any Property Insured hereunder except as provided for in the public authorities memorandum incormorated in this Section 8. Shrinkage, evaporation, loss of weight, change in flaour, colour, texture or finish, action of light 9. Change in temperature or humidity, failure or inadequate operation of any air conditioning cooling or heating system due to operating error. The burden of proof that no operating error occurred, shall be upon the Insured 10. Exposure to weather conditions where property is left in the open or not contained in fuly enclosed buildings
  33. 33. Special Exclusions – Section I (Cont) – Mulai dari sini FOR THE COST: 1. Of rectifying defective materials, faulty workmanship or design 2. Of normal upkeep, normal making good, maintenance 3. Arising from false or unautorised programming, punching, labelling or inserting, inadvertent cancelling of information or discarding of data media and from loss information caused by magnetic fields. The faulty workmanship and faulty design exclusions are commonly disputed in the construction industry. Some courts limit the faulty Workmanship exclusion to defects in the final product, while others apply the exclusion to all losses caused by negligence during construction, even those caused by third parties
  34. 34. Special Conditions – Section I 1. SUM INSURED The Sum Insured shall not be less than the cost of reinstatement 2. BASIS OF LOSS SETTLEMENT The indemnification under this section shall be the reinstatement or replacement of the property loss destroyed or damaged. • Rebuilding or replacemet of property loss or destroyed to a condition equivalent to or substantially the same as but not better or more extensive than its condition when new. • The insurer shall not be liable for the difference between the actual cash value and the reinstatement costs unless reinstatement commences ad proceeds without unreasonable delay
  35. 35. Special Conditions – Section I 3. First Loss Insurance 4. Debris Removal Coverage of additional cost items in a property policy. e.g. debris removal cost, for which a full Value cannot be assessed. Avemga does not apply. 5. Capital Additions Coverage for the cost of removal of debris of covered property damage by an insured peril. This coverage is included in most commercial property insurance pollcies This Insurance extends to cover: • Any newly acquired assets • Alterations, additions, and improvements of the Insured assets during the current period of lnsurance at any of the Insured premises provided that • Each location this Increase shall not exceed 5%of Sl per Item • To advise Insurers within 3 mils of the particular of any such capital addition and pay such additional premiums as the Insurers may require
  36. 36. Special Exclusion – Section I 1. This policy does not cover any loss resulting from interruption of or interference with the business directly or indirectly attributable to: i. Any resctiction on reconstruction or operation impossed by any public authority ii. The insured’s lack of sufficient capital for timely restoration or replacement of property lost, destroyed, or damaged iii. Loss of business due to causes such as suspension, lapse, or cancellatuon of a lease licence or order etc. which occurs after the date when the items lost destoyed or damaged are again in operating condition and the business could have resumed, if said lease license or order etc had not lapsed or had not been suspended or cancelled 2. This Policy does not cover the deductible stated in the Schedule to be bome by the insured.
  37. 37. Basic of Insurance – Section II Reduction of Turnover The sum produced by applying the Rate of Gross Profit to the amount by which the Turnover during the Indemnity Period shall fall short of the Standard Turnover In consequence of the loss destruction or damage Increase on Cost Working The additional expenditure necessarily and reasonably incurred for the sole purpose of avoiding or diminishing the reduction In Turnover which but for that expenditure would have taken place during the Indemnity Period In consequence of loss destruction or damage, but not exceeding the sum produced by applying the Rate of Gross Profit to the amount of the reduction thereby avoided
  38. 38. Basic of Insurance – Section II Reduction of Turnover Menurunnya omset perusahaan  Basis of Insurance: the policy will set out the basis upon which the business Interruption claim is to be calculated.  Often this is limited to the 'loss of Gross Profit, due to the Reduction In Turnover.  However, there may be the option of presenting a claim on an output alternative or loss of production Income basis.  The basis on which the claim is presented can impact slgnificanly upon the resources and skill sets required for the calculation of the loss, as well as the amount of the loss.  Often the starting point of the calculation will be to look at the financial year immediately before the date of damage In order to assess standard turnover or output.
  39. 39. Reduction of Turnover - EXAMPLE Basic of Insurance – Section II
  40. 40. Basic of Insurance – Section II Increase on Cost Working Increase on cost working are incurred to:  Reduce the severity of the BI loss  Reduce the duration of te interruption • The policy allows for additional costs to be incurred in order to prevent a loss of Gross Profit arising, but not exceeding the amount that would be payable If lhe latter did transpire. This Is known as the 'economic limit’. • Overtime working by staff to avoid a loss of Turnover is a good example.
  41. 41. Definition 1. GROSS PROFIT 2. UNINSURED WORKING EXPENSES Means the amount by which: 1. The sum of the turnover and the amount of the Closing Stock shall exceed 2. The sum of the amount of the Opening stock and the ninsured working expenses The variable expenses of the business which are not insured by this policy: a. Turnover and prchases taxes b. Purchases (less discout received) c. Carrlage, packing and freight The fundamental rule is: • The only expenses that should be listed as uninsured are those that, in each insured’s own unique cost structure, are so totally, directly variable that they will always be saved in proportion to any lost sales • There should be no reduction of fixed cost, such as production labour or fixed factory overheads.
  42. 42. Definition 3. DIRECT OR INDIRECT COST  Direct cost include those cost which directly related to the cost of production of goods for sale, and thereore represent a cost of Sale  Indirect cost, or overheads, include expenses such as administration, nonproduction payroll, rent and insurance also referred to as “standing charges” or “continuing costs”
  43. 43. Definition Examples of Fixed Costs:  Office expenses such as supplies, utilities, a telephone for the office, etc.  Salaries and wages of office staff,  salespeople, officers and owners  Payroll taxes and employee benefits  Advertising, promotional and other sales expenses  Insurance  Auto expenses for salespeople  Professional fees  Rent.  Normal Depreciations/ Amortization Examples of Variable Costs:  Materials used  Direct labor  Packaging  Freight  Plant supervisor salaries  Utilities for a plant or a warehouse  Machinery
  44. 44. Definition 4. INDEMNITY PERIOD 3. TURNOVER The money (less discount allowed) paid or payable to the Insured for goods sold and delivered and for services rendered in the courses of the business at the Premises This is the period for which insurer will provide any indemniy It starts with the date of damage and continues for as long as the business is affected by the damage, but limited to the maximum period states in the policy Schedule
  45. 45. Definition 5. ANNUAL TURNOVER 6. STANDARD TURNOVER (HISTORICAL STANDARD) The sum derived by adjusting the Turnover obtained in the Business during the 12 months immediately before the date of the damage to provide for trends, variations or other circumstances: a. Affecting the business either before or after the damage or b. Which would have affected the business had the Damage not occurred The sum representing the turnover during that period in the 12 months immediately before the date of the Damage which corresponds with the Indemnity Period, to which adjustments are made to provide for trends, variation, or other circumstances: a. Affecting the business either before or after the damage or b. Which would have affected the business had the Damage not occurred
  46. 46. Basic of Insurance – Section II HOW DO YOU CALCULATE THE REDUCTION IN TURNOVER?       The turnover during the period of Interruption is subtracted from the turnover achieved in the same period last year (the Standard Turnover). Particularry for manufacturing businesses, a reduction in turnover has a corresponding reduction in the cost of business e.g. material costs, freight, packaging etc. Therefore, the difference, or reduction In turnover is multiplied by the rate of gross profit. The rate of gross profit is the procentage of the business turnover that was gross profit in the previous financial year. The sum of the reduction In turnover and the rate of gross profit would give a straigh forward mathematical answer to the value of the first part of the claim. Unfortunately though, it is not quite that simple. The definitions of Standard Turnover and the rate of gross profit usually include very broad adjustment clauses which allow trends and circumstances both before and after the property damage to be taken into account
  47. 47. Basic of Insurance – Section II SIMPLE EXAMPLE
  48. 48. Basic of Insurance – Section II Increased Cost of Working - ICOW Add. Increased cost of working -AICOW  ICOW This is additional expenditure reasonably and necessarily incurred by the insured for the sole purpose of avoiding or diminishing the loss in turnover as a consequence of the damage subject to economic limit  There may be an extension to the policy which provides an Indemnity or the costs Incurred by the insured which are In excess of the limits provided under the policy or the increased cost of working. This Is known as the additional increased cost of working.  A key issue in respect of daims Involving these elements is documentation of the decision making process and costs, often omitted in the haste to get back to business.
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