Wa0058 PDF

BANKING&INSURANCE Chapter 1

The main objective of every insurance contract is to give financial security and
protection to the insured from any future uncertainties.
Insured must never ever try to misuse this safe financial cover.
Seeking profit opportunities by reporting false occurrences violates the terms
and conditions of an insurance contract.
- This breaks trust, results in breaching of a contract and invites legal penalties.
 ‫مبدأ الرجوع على الغير‬
Substitution of the insurer in place of the insured for the purpose of claiming
indemnity from a third party wrongdoer for a loss paid by the insurer.
– Why?
 To prevent collecting twice
 To hold the negligent party responsible
 To hold down insurance rates
The insurer is entitled only to the amount it has paid under the policy.
 What if the insurer collects more, from the negligent party, than the amount
the insurer paid to its insured?
– The insured cannot impair the insurer’s subrogation rights.
 Subrogation does not apply to life insurance and to individual health insurance
contracts.

According to the Principle of Loss Minimization, insured must always try his
level best to minimize the loss of his insured property, in case of uncertain
events like a fire outbreak or blast, etc.
The insured must take all possible measures and necessary steps to control and
reduce the losses in such a scenario.
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- The insured must not neglect and behave irresponsibly during such events just
because the property is insured.
- Hence it is a responsibility of the insured to protect his insured property and
avoid further losses.

- Principle of Causa Proxima (a Latin phrase),
The cause having the most significant impact in bringing about the loss under a
first-party property insurance policy, when two or more independent perils
operate at the same time (i.e., concurrently) to produce a loss.
Courts employ a set of proximate cause rules to resolve causation disputes when
a property policy states that it covers or excludes losses "caused by" a peril and
there is more than one peril at work in a fact pattern.

A cargo ship's base was punctured due to rats and so sea water entered, and
cargo was damaged.
Here there are two causes for the damage of the cargo ship:
(i) The cargo ship getting punctured because of rats, and
(ii) The sea water entering ship through puncture.
 The risk of sea water is insured but the first cause is not.
 The nearest cause of damage is sea water which is insured and therefore
the insurer must pay the compensation.
 It is a corollary of the principle of indemnity. It applies to all contracts of

indemnity, if the insured has taken out more than one policy on the same
subject matter.
 According to this principle, the insured can claim the compensation only to
the extent of actual loss either from all insurers or from one insurer.
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 So, if the insured claims full amount of compensation from one insurer then he
cannot claim the same compensation from other insurer and make a profit.
 Secondly, if one insurance company pays the full compensation then it can
recover the proportionate contribution from the other insurance company.

Mr. Ali insures his property worth $ 100,000 with two insurers "AIG Ltd." for
$ 90,000 and "MetLife Ltd." for $ 60,000. Ali's actual property destroyed
worth’s $ 60,000, and then Mr. Ali can claim the full loss of $ 60,000 either
from AIG Ltd, or MetLife Ltd, or he can claim $ 36,000 from AIG Ltd. and $
24,000 from MetLife Ltd.
 It states that the person getting insured must have insurable interest in the
object of insurance o the insured must have insurable interest in the subject
matter of insurance.
 A person has insurable interest when the physical existence of the insured
object gives him some gain but its non-existence will give him a loss.
In simple words, the insured person must suffer some financial loss by the
damage of the insured object.
- Note that insurable interest is applicable to all contracts of insurance.
 In property insurance, insurable interest must exist at the time of a loss; an

insured must have insurable interest.
 In life Insurance, insurable interest must exist at the time of a policy inception,
but not at the time of a loss (death).
 ‫مبدأ التعويض‬
 Indemnity means security, protection and compensation given against

damage, loss or injury.
 The insurer agrees to pay no more than the actual amount of the loss
suffered by the insured.
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 Why?
- The purpose of the insurance contract is to restore the insured to the same
economic position as before the loss.
- The insured should not profit from a loss.
- It reduces the moral hazard by eliminating the profit incentive.
 In an insurance contract, the amount of compensations paid is in proportion to

the incurred losses.
 The amount of compensations is limited to the amount assured or the actual

losses, whichever is less.
 The compensation must not be less or more than the actual damage.
Compensation is not paid if the specified loss does not happen due to a
particular reason during a specific time period.
 Thus, insurance is only for giving protection against losses and not for making
profit.
 However, in case of life insurance, the principle of indemnity does not apply
because the value of human life cannot be measured in terms of money.

A manufacturing co. has an insurance policy for $500,000 regarding its own
building which was destroyed. The market value at the time of the accident
was $750,000, which the total loss of the fire was $450,000.
- According to proportionate rule, the amount the insurer pays is calculated as

follows:
Value of the policy / Market value * Act. Loss
500,000 / 750,000 * 450,000 = $300,000
 Hence the loss borne by the insured is $150,000.
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- :-
 ‫مبدا حسن النية‬
 This principle applies to all contracts of insurance and can be relatively
easily explained as being about trust.
 A higher degree of honesty is imposed on an insurance contract than is

imposed on other contracts.
 Honesty is mainly imposed on the insurance applicants.
 It is supported by three legal doctrines:
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- The insured must provide the insurer complete, correct and clear information
of subject matter facts that are material (and should therefore be disclosed)
include the following:
 The fact that goods are of high value.
 The fact that goods are fragile.
 The fact that goods are second hand.
 Information about geographical trading areas.
 Information about storage periods.
 Information about storage premises.
 The fact that another insurer has refused to renew a policy of the type
being negotiated.
 Your previous claims experience.
- Similarly, the insurer must provide the insured complete, correct and clear
information regarding terms and conditions of the contract.

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BANKING&INSURANCE Chapter 1

 It is a corollary of the principle of indemnity. It applies to all contracts of

- Note that insurable interest is applicable to all contracts of insurance.

 In property insurance, insurable interest must exist at the time of a loss; an

 Indemnity means security, protection and compensation given against

 In an insurance contract, the amount of compensations paid is in proportion to

 The amount of compensations is limited to the amount assured or the actual

- According to proportionate rule, the amount the insurer pays is calculated as

500,000 / 750,000 * 450,000 = $300,000

 Hence the loss borne by the insured is $150,000.

 A higher degree of honesty is imposed on an insurance contract than is

 The fact that goods are of high value.

 The fact that goods are fragile.

 The fact that goods are second hand.

 Information about geographical trading areas.

 Information about storage periods.

 Information about storage premises.

 Your previous claims experience.

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