Legal principles of insurance
Soumya V
1. Principle of indemnity
To Compensate

 Two fundamental purposes:
a. To prevent the insured from profiting from a
   loss
b. To reduce moral hazard
Actual cash value in property insurance
   - Replacement cost less depreciation
   - Fair market value
   - Broad evidence rule
2. Principle of insurable interest
 The insured must be in a position to lose
  financially if the loss occurs
 Purposes:
a. To prevent gambling
b. To reduce moral hazard
c. It measures the amount of insured’s loss in
   property insurance
Examples of insurable interest
 In property and liability insurance:
a. Ownership of property
b. Potential legal liability
c. Secured creditors
d. A contractual right
In life insurance:
a. Own life
b. Life of close family ties
c. Pecuniary interest in life of third person
When must insurable interest exist?

• In property insurance - at the time of loss

• In life insurance - at the time of inception of the
  policy
3. Principle of subrogation
 Substitution of the insurer in the place of the
  insured to claim indemnity from a third person
  for a loss covered under insurance
 Purposes:
a. Prevents insured from collecting twice for the
   same loss
b. It is used to hold the guilty person responsible
   for the loss
c. Helps to hold down insurance rates
Corollaries to the principle of
subrogation
• The insurer is entitled to recover only the
  amount it has paid under the policy
• The insured cannot impair the insurer’s
  subrogation rights
• The insurer can waive its subrogation rights in
  the contract
• Subrogation does not apply to life insurance and
  to most individual health insurance contracts
• The insurer cannot subrogate against its own
  insureds
4. Principle of Utmost good faith
 Imposes high degree of honesty on the applicant
  for insurance
 This principle is supported by 3 important legal
  doctrines – representations, concealment and
  warranty
a. Representations – statement made by applicant
   for insurance. The insurance contract is
   voidable at the option of the insurer if the
   representation is
  a. Material
  b. False
  c. Relied on by the insurer
b. Concealment – intentional failure of the
  applicant for insurance to reveal a material fact
  to the insurer
c. Warranty – 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
5. Causa proxima
Proximate cause

6. Contribution

 In case of double insurance, the insurers are to
   share the loss in proportion to the amount
   insured by each of them.
 Conditions:
a. The subject matter of insurance must be same
b. The event insured must be same
c. The insured must be the same
7. Mitigation of loss
The insured must make necessary effort to
 minimise the loss


8. Nature of Contract
Requirements of an insurance contract
•   Offer and acceptance
•   Consideration
•   Competent parties
•   Legal purpose
Distinct legal characteristics of
insurance contracts
•   Aleatory contracts
•   Unilateral
•   Conditional
•   Personal
•   Contract of adhesion

Insurance principles

  • 1.
    Legal principles ofinsurance Soumya V
  • 2.
    1. Principle ofindemnity To Compensate Two fundamental purposes: a. To prevent the insured from profiting from a loss b. To reduce moral hazard Actual cash value in property insurance - Replacement cost less depreciation - Fair market value - Broad evidence rule
  • 3.
    2. Principle ofinsurable interest The insured must be in a position to lose financially if the loss occurs Purposes: a. To prevent gambling b. To reduce moral hazard c. It measures the amount of insured’s loss in property insurance
  • 4.
    Examples of insurableinterest In property and liability insurance: a. Ownership of property b. Potential legal liability c. Secured creditors d. A contractual right In life insurance: a. Own life b. Life of close family ties c. Pecuniary interest in life of third person
  • 5.
    When must insurableinterest exist? • In property insurance - at the time of loss • In life insurance - at the time of inception of the policy
  • 6.
    3. Principle ofsubrogation Substitution of the insurer in the place of the insured to claim indemnity from a third person for a loss covered under insurance Purposes: a. Prevents insured from collecting twice for the same loss b. It is used to hold the guilty person responsible for the loss c. Helps to hold down insurance rates
  • 7.
    Corollaries to theprinciple of subrogation • The insurer is entitled to recover only the amount it has paid under the policy • The insured cannot impair the insurer’s subrogation rights • The insurer can waive its subrogation rights in the contract • Subrogation does not apply to life insurance and to most individual health insurance contracts • The insurer cannot subrogate against its own insureds
  • 8.
    4. Principle ofUtmost good faith Imposes high degree of honesty on the applicant for insurance This principle is supported by 3 important legal doctrines – representations, concealment and warranty a. Representations – statement made by applicant for insurance. The insurance contract is voidable at the option of the insurer if the representation is a. Material b. False c. Relied on by the insurer
  • 9.
    b. Concealment –intentional failure of the applicant for insurance to reveal a material fact to the insurer c. Warranty – 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
  • 10.
    5. Causa proxima Proximatecause 6. Contribution In case of double insurance, the insurers are to share the loss in proportion to the amount insured by each of them. Conditions: a. The subject matter of insurance must be same b. The event insured must be same c. The insured must be the same
  • 11.
    7. Mitigation ofloss The insured must make necessary effort to minimise the loss 8. Nature of Contract
  • 12.
    Requirements of aninsurance contract • Offer and acceptance • Consideration • Competent parties • Legal purpose
  • 13.
    Distinct legal characteristicsof insurance contracts • Aleatory contracts • Unilateral • Conditional • Personal • Contract of adhesion