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INSURANCE CONTRACT
MA. Ton Thi Thanh Huyen
Insurance Faculty- NEU
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Main points
1. Introduction to insurance contract
2. Forming insurance contract
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1. Introduction to Insurance contract
What is Insurance Contract?
Commitment in the written word
2 parties: Insurer Participant
transforming the risk
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Insurance Contract
Civil contract or
Commercial contract?
Conditional contract
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Requirements of a valid ins. contract
On the subject matter
On parties capability
On parties acceptance
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Requirements of a valid ins. contract
On the subject matter
Existence of the subject matter
Origin of the subject matter
On parties capability
Legal ability
Financial ability
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Requirements of a valid ins. contract
On parties acceptance
No default
No duress
No misunderstanding
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Types of insurance contract
Voluntary/compulsory ins. contract
Core/additional ins. contract
Group/private ins. contract
Package/single ins. contract
Ins. contract for the interest of own participant/for the
interest of the third person
Property/ Liability/Health & Life ins. Contract
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Stakeholders of ins. contract
The Insurer
The Purchaser
The Insured
The Beneficiary
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Rights & Obligations of the parties
The participant
?????
The insurer
???????
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Features of insurance contract
Bi-lateral
Adhesion
Utmost good faith
Aleatory
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2. Forming an insurance contract
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Announcing the refusal
The Proposal
Issuing Insurance policy
Declaring informationof risks
The proposer
Evaluating
proposed
risks
Issuing cover noteThe insurer
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The Proposal
The questionnaire designed by the insurer in order to
gather all information of proposed risks.
Expressing the applicants will to reach an insurance
contract. Supplying information to evaluate the proposed risks.
Main content of a proposal have to:
Describe the subject matter;
Describe the risk;
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Structure of the proposal including 4 parts:
(1) General questions
(2) Specific questions related to the proposed risks
(3) Commitments(4) Warnings
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The Proposal
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Obligation of information disclosure
Basic facts
Misrepresentation or non-representation
Innocent? Intentional?
Responsibility of proof
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The Cover Note
A temporary certification of insurance commitment
between 2 parties.
To get a cover note:
After the proposal is considered preliminarily
After the premium is paid in total or in a part (exceptions for some
insurance)
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The Cover Note
The effect of a cover note
Temporary (normally in 30 days)
All claims in these days belongs to the responsibilityof the insurer
Being ceased when:
?????
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The Policy
The evidence in writing of an insurance contract
Principles of representing the policy:
Strict, logical structure
Standard grammar rules
Simple words
Clear language
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The Policy - Structure of the policy
Heading
Preamble
Signature clause
Operative clause
Exceptions
Conditions
Schedule Definition
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General clauses:
Being applied for all policies in the same insurance line;
Designing the standard form for the insurance line:
Insurable risks;Exceptions;
Authority;
Rights and obligations of parties;
Limited time for making claim;
The place of adjusting; paying; etc.
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The Policy-operative clauses
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Specific clauses: making differences among various
policies in the same insurance line:
personal data;
the subject matter;
features of insured risks;
The premium; etc.
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The Policy-operative clauses
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The Policy-conditions
In order to regulate the coverage of the policy:
What the insurer or the insured is able to do?
What they have not to do?
What they have to do? And
What they do?
Example:
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