Insurance introduction

1. Insurance

2. Concept and Nature of Insurance
• Method which provides security and protection
against financial loss up to some limit
• Means of shifting the risks to insurer in
consideration of a nominal cost called premium
• Insurance is a contract of indemnity under which
insurance company or insurer agrees to pay a
certain sum of money to compensate loss caused
by the occurrence of uncertain event in
consideration of certain periodical payments

3. Concept and nature of insurance
• Insurance is a cooperative device by which
risks are distributed among large number of
persons
• Insurance provides security against losses or
risks
• Based on the law of probability, contribution
of each person is calculated and a common
fund is raised out of which losses are
compensated
• Is a plan in which losses of uncertain events
are secured

4. Features of Insurance
• Offer and acceptance
• Lawful object
• Contract
• Consideration
• Co-operative device
• Protection of financial risks
• Good faith
• Contract of indemnity
• Certainty and contingency
• Insurance is not gambling
• Subrogation
• Insurable interest
• Insurance cannot be named as charityg

5. Functions of Insurance
Primary functions
Provides certainty
Distributes risks
Provides security
Secondary functions
Provides capital
increases efficiency
Helps in judging the viability of major
projects
Helps in loss reduction

6. Functions of insurance
Other functions
Economic development
 expansion of foreign trade
Provides funds to invest
Encouraging savings
Self-confidence and goodwill
Social security
Credit facilities

7. Essentials of an Insurance Contract
• Written agreement
• Consideration
• Competency
• Lawful object
• Mutual faith
• Certain
• Possibility of performance
• Contract of subrogation
• Insurable interest

8. Fundamental Principles of
Insurance
• Insurable interest
• Utmost good faith
• Indemnity
• Subrogation
• Contribution
• Proximate cause
• Mitigation of loss

9. Insurable interest
• Precondition for a valid contract of insurance
• Person getting an insurance policy must have
an insurable interest in the subject matter to
be insured
• Person is said to have an insurable interest in
the property if he is financially benefitted by
its existence and is prejudiced by its loss,
destruction or non-existence
• A person taking life insurance policy must
have an insurable interest in the life of the
insured person.

10. Insurable interest
• Distinguishes insurance from gambling or
wagering transactions.
• Subject matter of insurance must be
certain
• Insured must bear a legal relationship to
the subject matter or he must be the owner
• Insured must be the owner or may possess
the legal rights or interest in the subject
matter to be insured.

11. Insurable Interest in Life Insurance
• A person has unlimited insurable interest in
his own life
• A husband in the life of his wife
• A wife in the life of her husband
• A father in the life of his son
• A creditor in the life of a debtor
• A partner in the life of his co-partner
• A employer in the lives of his employees
• An agent in the life of his principal

12. Existence of Insurable Interest
• Life insurance: Insurable interest should be
present in the life of the insured at the time of
the taking of the policy. May or may not be
present at the time of death of the person or
at maturity
• Fire insurance: Insurable interest must exist
both at the time of taking out the policy and
also at the time when the loss occur and a
claim is filed with the insurance company

13. Existence of Insurable Interest
• Marine Insurance: Insurable interest
should be present at the time of loss

14. Utmost good faith
• Contract of insurance are contracts of
uberimae fidei, means which require
absolute and utmost good faith
• Acc. to the Indian Contract Act, 1872 all
commercial contracts require that good
faith must be observed, otherwise the
contract would be null and void

15. Utmost good faith
• Materiality of facts
• Insurance contract different from ordinary
business contracts (caveat emptor)
• Material information is that information
which enables the insurance company to
decide whether to accept of not to accept
any risk
• If accepted, what rate of premium and on
what terms and condition

16. Utmost good faith…exemptions
• Facts already known to the insurer
• Facts which reduce the risk one way or the other
• Facts which the insurer himself does not want to be
disclosed
• Facts which every insurer is ought to know or possess
• facts whose disclosure becomes unnecessary due to
the presence of warranty in the contract
• Facts governing the terms and conditions of the policy
• facts whose nature is such that they are commonly
known to the public
• Facts which can be concluded or inferred from the
information of facts already provided by the insured

17. Principle of indemnity
• Applies to all contracts of insurance
except the contracts of life insurance
• Loss of individual’s life cannot be
measured in money terms.
• The insured can be indemnified only upto
the extent of actual loss
• The sum of indemnity can never exceed
the value of the policy taken out

18. Principle of indemnity
• In case of under insurance the loss is
indemnified proportionately in the
following manner=
• Actual Loss X Value of the policy
Value of the subject matter

19. Main features of principle of
indemnity
• All contracts of insurance, except life
insurance and personal accident are
contracts of indemnity
• There exists indirect relationship between
the principle of indemnity and principle of
insurable interest because the insured has
to proved the amount of actual loss and
his interest therein in order to get
compensation

20. Main features of principle of
indemnity
• The amount of compensation shall never
exceed the amount of actual loss or the value
of the policy.
• All contracts of insurance, except the life
insurance and personal accident insurance
are contracts of indemnity
• There exists indirect relationship between the
principle of indemnity and principle of
insurable interest because the insured has to
prove the amount of actual loss and his
interest therein in order to get compensation

21. • After the settlement and payment of claim
of compensation the doctrine of
subrogation applies which is an extension
of the principle of indemnity

22. Methods of indemnity
• Cash payment
• Repairs
• Replacement
• reinstatement

23. Principle of subrogation
• Also known as the Doctrine of Rights
Substitution
• It is the transfer of rights and remedies of the
insured in the subject matter to the insurer
after the indemnification
• The insurer steps into the shoes of the
insured and become entitled to all rights of
action against the third party to cover the
loss from the person responsible regarding
the subject matter of insurance after the claim
of the insured has been fully settled and paid

24. Important features of subrogation
• Is an extension and an outcome of the
principle of indemnity and is applicable to all
contracts of indemnity
• Common law of subrogation as applied to all
contracts of indemnity arises only after the
payment of claim is made to the insured by
the insurer
• The rights of subrogation may arise even
before indemnification of the insured except
in case of marine insurance policies

25. • The insured is required to provide all
necessary assistance to the insurer while
enforcing the rights of subrogation against
the defaulter party
• The insurer is granted the right to sue the
third party in insured’s name but the
expenses of litigation are to be borne by
the insurer

26. • If the insured gets any money on account of
compensation from a third party, after being
indemnified by the insurer, he shall hold the
amount of such compensation as a trustee for
the insurer.
• The rights of subrogation arises from the acts
of torts, contracts and salvage
• The principle of subrogation is automatically
applied even without any express condition
in the contract

27. • The insurer cannot recover anything more
than the amount of indemnification paid
to the insured, from the defaulter party.

28. Principle of Contribution
• Contribution is the right of an insurer,
who has paid under a policy, to call upon
other insurers or otherwise liable for the
same loss to contribute the payment
• The total loss suffered by the insured is
contributed by different insurers in the
ratio of the value of policies issued by
them for the same subject matter

29. Proportion of a particular insurer
• Sum insured by the insurer X Loss
Total sum insured

30. Need and practical applicability of
the principle of contribution
• Insured cannot be placed in a better position
than that prior to the loss and thereby the
basic principle of indemnity will fail.
• Insured cannot recover anything more than
the amount of loss incurred and insurers
shall follow the principle of contribution.
• Insured will contribute the proportion of loss
as per the policy issued by them

31. Pre-condition for the application of
principle of contribution
• The subject matter of insurance must be
common to all policies
• The peril which causes the loss or damage
must be common to all policies in order to
attract the principle of contribution
• The policy must be legally enforceable
• The policies must be in force at the time of
loss

32. Proximate Cause
• Causa proxima- nearest or proximate or
immediate cause.
• Helpful in deciding the actual cause of
loss when a number of causes have
contributed to the occurrence of loss.
• While determining the liability of the
insurer, the nearest or proximate cause
and not the remote cause of the loss is to
be taken into account

33. Principle of mitigation of loss
• Means to minimise or decrease the
severity of loss.
• Duty of the insured to minimize the loss
• Insured should not become careless and
passive at the time of loss simply because
his property is insured.