Chapter Two Flashcards

Understanding Contracts (37 cards)

1
Q

What are the possible…

Parties of a Contract

A

People enter into insurance contracts for the protection they provide.
* First Party – Insured
* Second Party – Insurer
* Third party claimants - insurance contracts that provide payment of claims to third parties. (ie. liability insurance policies)

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2
Q

What are the…

Alberta Limitation Periods

A
  • Occupier’s Liability, Fire Property, Auto Property, Product Liability, Medical Malpractice: 2 years.
  • Motor Vehicle Accidents - 2 years or longer (Personal injury and Fatality 2 years).
  • Life Insurance - 2 years after provision of evidence or 6 years after happening of event (whichever comes first).
  • Highway Crown - Notice 1 month, Action 2 years.
  • Municipal - Notice 21 days (snow, ice slush) Notice 30 days (nonrepair); Action 2 years.
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3
Q

What is the…

IBC

A

Insurance Bureau of Canada
* The national industry association which represents the majority of Canada’s private home, car, and business insurers.

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4
Q

What is…

Consideration

A

Consideration is something of value that has been exchanged between the parties. In the case of insurance contracts, consideration is the premium the insured agrees to exchange for the promise of indemnity in the event a covered loss occurs.
* Does not always need to be in the form of money.
* Can be a promise to do or not do an act.
* Can be a return promise.

“The Five Elements of All Contracts”

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5
Q

What is a…

Premium

A

The amount paid for an insurance policy. Typically paid monthly or annually, and may change over time. Must be paid in Canadian currency.

Premium costs increase as deductibles are lowered.

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6
Q

What is a…

Signature Clause

A

The requirement that insurance policies be signed by an individual authorized by the
insurance company (ie. President, Senior VP, or CFO).
* Written by hand, printed, stamped, etc. is sufficient.
* The Insurance Act requires the broker to countersign the policy (though law varies between provinces).

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7
Q

What are some…

Additional Conditions

A
  • Notice to Authorities: When the loss to insured property is caused by a criminal act, authorities must be notified immediately.
  • Sue & Labour: Insured must take all reasonable steps to recover lost or damaged property. Insurer will share the costs of this recovery.
  • No Benefit to Bailee: In the event of a bailee (eg. car repair shop) causing loss, bailee must have
    their own liability insurance.
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8
Q

What is an…

Endorsement / Rider

A

Endorsements / Riders are used interchangably to refer to changes made to the insurance policy (such as additions, deletions, amendments, and exclusions).
* These are used most often for commercial property policies.
* Outlined on a seperate document which is attatched to the original policy.
* Ie) Theft & Burglary coverage as an addition to a policy.

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9
Q

What is a…

Policy Period

A

The defined period of time most insurance policies are issued for.
* Normally one year, though contracts may be issued for shorter policy periods (ie. 3, 6, 9 month periods).
* Policy periods for property policies tend to commence and expire at 12:01 AM Standard Time at the address of the insured property.

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10
Q

What is…

Utmost Good Faith

A

The principle that all parties are expected to be completely honest with one another at all times.
* Insurance contracts demand a higher standard of honesty and trust from all parties than is required for other contracts.
* It is a requirement of all insurance contracts that all parties treat one another in the spirit of utmost good faith.
* Provincial legislation mandating ethical standards for insurance dealings and public policy govern how utmost good faith will be judged.

“Special Characteristics of Insurance Contracts”

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11
Q

What are…

Material Facts

A

Important information which is relevant to a decision being made and which could reasonably alter that decision.
* Especially decisions regarding acceptance of applicants and premium rates.
* Must be disclosed during the initial application and/or in all negotions prior to final issuing of the insurance policy.

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12
Q

What are…

The Five Elements of All Contracts

A
  1. Offer
  2. Acceptance
  3. Consideration
  4. Mutuality of Obligation
  5. Competency and Capacity
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13
Q

What is a…

Certificate of Insurance

A

A certificate which confirms that insurance coverage has been put into place for the risk.
* May include a brief overview of the amounts and types of insurance purchased.
* Provides evidence of insurance to concenred parties (property management firms, lessors, etc.)

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14
Q

When is Consent of Insurer
Needed?

A

Consent of the insurer is needed in the event that the insured wishes the insurance contract be transferred to another individual. The initial contract is between the insured and the insurer and as such both must give consent for transfer.

“Assignment of Insurance Contracts”

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15
Q

What is…

Insureable Interest

A

An insurable interst exists when
* A person would suffer financially from loss or damage to the property insured by the contract, or;
* Arising out of their legal responsibilities to others.

In other words, the insured must have a financial relationship to the property to be insured (ie. owner, mortgagee, lessee, bailee, consignee, etc.)

“Special Characteristics of Insurance Contracts”

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16
Q

Refresher! What is…

Indemnity

A

The attempt to put the insured person back in the same position they were in immediately prior to their loss.

Insurance can only be purchased for risks which have the potential for financial loss, and no chance for financial gain, as insurance contracts are not instruments for profit.

The insurance company is required to pay only the amount of the insured’s loss - no more and no less.

“Special Characteristics of Insurance Contracts”

17
Q

When is Consent of Insurer NOT
Needed?

A

The insurer shall be liable for loss or damage occurring:
* After an authorized assignment under the Bankruptcy Act; or
* After a change of title by succession; either by operation of law or by death.

The insured may also assign any payments due from the insurance company to another party such as a mortgagee, without the insurer’s consent.

“Assignment of Insurance Contracts”

18
Q

When is a Contract Satisfied?

A

Contracts are automatically satisfied or discharged at the end of the policy term (3, 6, 12, or more months).
* It is possible that an insurance contract (or a portion of it) will be satisfied when the insurance has been fully paid out by the insurance company.
* The insurance contract can be terminated prior to the expiry date by agreement between the parties.

19
Q

What is an…

Offer

A

Subject matter of a contract.
* Its terms and conditions must be agreed upon by a meeting of the minds without secrets.
* A definite offer must be communicated by one party to the other.

“The Five Elements of All Contracts”

20
Q

What is a…

Void Contract

A

A contract which the law considers as having never existed.
* A mistake in terms can cause a void.
* Premium must be returned to the insured from the insurer.

21
Q

What is…

Pair and Set Insurance

A

Insured property which comes in a pair or set.
* Items not damaged / lost will be appraised and that amount will be deducted from the claim.
* ie) $1,200 set of earrings where one earring is lost. The remaining earring is valued at $350, so $850 is the total claim payout.

22
Q

What is…

Warranty

A

A promise made by the insured to the insurer that the conditions upon the initial contractual agreement will remain the same.
* ie) No spray painting warranty for auto repair shops. Warranties are attached to the policy and signed.
* Coverage can be denied even when breaching warranty is not related to the cause of the loss.

23
Q

What is a…

Floater

A

Similar to riders, however floaters are designed to insure mobile property rather than fixed property.
* Ie) Boat & Motor floater which insures the watercraft while in motion and while stationed at locations designated within the policy.
* Ie) Jewelry floater which insures jewelry while at home or any other location designated within the policy.

24
Q

What is a…

Voidable Contract?

A

Parties have the choice to continue despite a compromised contract.
* Insurer may cancel the contract.
* The main difference between a cancelled contract and a void contract is that the insurance company keeps the premium paid by the insured in a cancelled contract.

25
Legality of Object
The contract must be for a lawful purpose. | "Additional Elements to a Contract"
26
# What is... Genuine Intention
Both parties must have genuine intent to enter into a legally enforceable contract. * Both parties must enter into the contract by their own free will. * Both parties must have a clear understanding of the contract terms and conditions. * Examples of unfair business practices include fraud, deceit, non-disclosure of important facts, coercion, duress, force, or the use of undue influence. The fundamental difference between a contract and a simple agreement (Offer & Acceptance) is that contracts are enforceable by law. | "Additional Elements to a Contract"
27
# What is... Mutuality of Obligation
A contractual requirement that both parties in an agreement must perform their obligations. If either party doesn't perform their obligations, the law may treat the agreement as invalid. * Any changes must be advised to the insured. * A person has up to 2 weeks (no limit in Quebec) to reject contract after notice of changes. | "The Five Elements of All Contracts"
28
# What is... Competency and Capacity
Refers to the legal ability of a person to enter into a contract. * All parties involved in the contract must be considered legally competent and capable. * Competency and Capacity are generally presumed of an individual unless that person is a minor, mentally incapacitated, insane, under duress or intoxicated. | "The Five Elements of All Contracts"
29
# What is... Parts Insurance
Insured property made up from many parts. * The insurer is only responsible to pay for the damaged parts and the service of repairing them (not the entire). * ie) If a patio door has a damaged window, the insurer doesn’t pay for replacement of the entire door, or for a new window frame, they only only pay for the repair of the broken glass itself.
30
# What are... Material Changes
Increases in hazard which occur after the insurance policy has been issued. * These must be disclosed if the hazard increases beyond that of the initial hazard present at the creation of the contract.
31
# What is a... Deductible
A portion of the loss which is paid by the insured before they are entitled to receive any payment from the insurance company. The amount in excess of the deductible (if any) will then be received. * Dollar amount - most common * Percentage amount - Specialty insurance (aviation, marine, earthquake, etc.) * Franchise clause - no deductible if loss is greater than a specific amount.
32
# What are... Conditions
Requirements regarding the actions and behaviors of the insured. * Coverage can be denied if the breach of a condition is directly related to the cause of the loss. * There are both general and statutory conditions. * ie) Maintenance of fire alarms as a condition for insurance.
33
# What is a... Loading
An additional rate for insuring aditional perils. This rate will be over and above the fire rate. * Fire Rate - Building $0.64 * Extended Coverage (Named Perils) Policy Loading - $0.04 * Broad Form Building (All Risk) Policy Loading - $0.06 ie) A loading of $0.04 for extended coverages (named perils) could be offered versus a $0.06 loading for all risk coverage. If all risk coverage is chosen, that rate combined with the fire rate ($0.64 per $100 of insurance) would amount to $0.70 per $100 of insurance.
34
# What is an... Application Form
A form used by applicants for insurance to make a formal request or offer to enter into a contract with the insurance company. The application is designed by the insurance company in order to evaluate the risk involved. The underwriter must make an informed assessment of the physical hazard and, as much as possible, the extent of moral hazard pertaining to the applicant. Existing law allows insurer to void the insurance policy if the insured witheld a material fact.
35
# What is... Acceptance
An offer which is unconditionally accepted by the other party. * A counter-offer makes original offer invalid. * Negotiation does not make an agreement. Once accepted, the offer cannot be withdrawn, but it can be cancelled in accordance with the termination provisions included in the offer. | "The Five Elements of All Contracts"
36
Insurance Contract / Policy
A written contract of insurance or a certificate between the insurance company and the insureds that states the details of the insurance. * Includes all documents (clauses, riders, endorsements, etc.) attached to and forming a part of the contract between the parties. * Many insurance companies use model contracts provided by IBC (Insurance Bureau of Canada), and IFC (Informco) rather than developing their own policies. * There is no one standard insurance policy used by all insurance companies.
37
# What is a... Declarations Page
The cover page of the insurance contract. Includes: * Name of insurance company * Policy Period * Property being insured * Amounts or limits of insurance Brokers must review and countersign on behalf of the insurance company. Failure to properly review endorsements, riders, floaters, etc. can result in future claims problems and omission claims against the brokerage.