Study seven Flashcards
(22 cards)
Define negligence.
- is doing something that a reasonable person would not do or omitting to do something that a reasonable person would do
Define damages.
- is a sum of money claimed or awarded as compensation for loss/injury
Define special damages.
- are for out-of-pocket items such as medical expenses, loss of earnings or damage to property substantiated by a specific invoice or estimate of repair
Define general damages.
- are less definite and are awarded for such things as pain and suffering, total/partial disability, or disfigurement
Define compensatory damages.
- special damages & general damages
- they compensate the plantiff for some kind of loss
Define punitive/exemplary damages.
- are intended as punishment against the defendant and as a deterrant to others
- not usually covered by an insurance policy
- rewarded in situations with gross negligence
- ## usually awarded in libel & slander cases
Define legal liability.
- means responsibility at law or liability assumed under a contract
- liability policies only pay losses when the insures is legally liable (with some exclusions)
Define accident basis.
- the injury/damage must be due to an event that is sudden, unintended and unexpected
Define occurrence basis.
- the injury/damage can occur over a period of time but still must be unintentional and unexpected
- may be defined as an accident, including continuous or repeated exposure to substantially the same harmful conditions
What are ways we can be held liable?
a) your premises
b) your personal acts and acts of family/employees
c) your children under certain circumstances
d) ownership of animals
e) ownership of property
f) work you do
g) goods you manufacture/retail
h) services you provide
i) thinks you say/write
j) mistakes you make in your business/profession
What information is required in respect to personal liability coverages?
1) swimming pool, and whether or not its fenced
2) saddle/draft animals and number
3) any incidental office use
4) day care - # of kids
5) watercraft - details
6) # of servants - inside, outside, chauffeur, occasional
7) any commercial operations on premises
8) any other income producing activities
9) any additional residences/properties
Define personal liability coverage.
- is designed to protect individuals and their families against the liability imposed upon them by law arising out of their daily activities which result in bodily injury/property damage to others
Define business.
- means the continuous or regular pursut of a trade, profession, or occupation for financial gain
Define business property.
- is a place where business is conducted or an area rented to others
What is covered under liability policy?
1) person insured under property section of policy
2) anyone who becomes legally liable for damages caused by watercraft or animals owned by the named insured
3) residence employees while performing duties in connection with the ownership, use, or occupancy of motorized vehicles which coverage is provided under homeowners policy
4) legal representative having custody of premises after insureds death
5) any person insured by the policy at the time of the insureds death and who continues to reside in the insured premises
What premises are specified to be covered under liability policy.
1) all premises where the named insured/their spouse, maintains residence
2) other residential premises specified on coverage summary page
- not business property or farms
3) individual or family cemetary plots of burial vaults
4) vacant land in canada that the insured owns/rents
- not farm land
5) land in canada on which a one,two, or three family residence is being built which whill be occupied by insured
6) premises the insured is using or where the insured is temporarily residing if such premises are not owned
What is found under Coverage E - legal liability section of the policy?
1) personal liability - arising out of the insureds personal actions anywhere in the world
Exclusions include:
a) personal actions of any named insured who does not live on teh described premises
b) ownership, use, or operation of any motorized vehicle, trailer/watercraft
- except those which coverage is shown for
c) damage to property the insured owns, uses, or occupies, or leases
d) damage to property in the insureds care, custody, or control
e) damage to personal property/fixtures as a result of work done on them by insured or anyone on their behalf
f) bodily injury to insured or to any person residing in his/her household other than a residence employee
2) Premises liability - arising out of the insureds ownership, use, or occupancy of the premises as define earlier
Exclusions include:
a) damage to property the insured owns, uses, occupies, leases
b) damage to property in insured’s care, custody, or control
c) damage to personal property/fixtures as a result of work done on them by insured or anyone on his/her behalf
d) bodily injury to insured or to any person residing in his/her household other than a residence employee
- exclusions are intended to ensure insureds take reasonable care of property they use, occupy, or lease.
3) Tenants’ legal liability - for property damage to premises or their contents which insureds are using, renting or have in their custody or control caused by fire, explosion, water escape or smoke.
- smoke due to a sudden, unusual and faulty operation of any heating or cooking unit (not smoke from fireplaces)
- water damage same meaning as section I
- liability assumed by contract is not insured unless legal liability would have applied even if no contract had been in force
4) Employers’ liability - for bodily injury to residence employees arising out of and in the course of their employment by the insured
- claims resulting from ownership, use, or operation of aircraft while being operated/maintained by employees is not covered
- no coverage for liability imposed upon or assumed by insured under workers compensation
What are the additional payments covered by the insurer? (defence, settlement, supplementary)
- is in addition to the limit of insurance
- will pay for defending insured against any claims insured under Coverage E alleging bodily injury/property damage and seeking compensatory damages, even if claims are groundless, false, or fraudulent
- insurer reserves the right to investigate, negotiate, and settle any claims/suits if they feel its appropriate
- only legal counsel selected by insurer will be paid
1) all expenses insurer incurs
2) all costs charged against insured in any suit insured under Coverage E
3) any interest accruing after judgment on that part of the judgment which is within the amount of insurance of Coverae E
4) premiums for appeal bonds required in any insured lawsuit involving the insured and bonds to release any property that is being held in security, up to the amount of insurance
- insurer is not obligated to apply for or provide these bonds (insured must)
5) expenses which the insured incurs for emergency medical or surgical treatment to others following an insured accident or occurrence
6) reasonable expenses, including loss of earnings, up to $100/day, which the insured incurs at the request of the insurer
What does Coverage F cover?
- voluntary medical payments
- policy will pay reasonable medical expenses incurred within one year of the date of the accident, if the insured unintentionally injures another person, or if the person is accidentally injured on the insured premises
- medical expenses include:
a) surgical
b) dental
c) hopsital
d) nursing
e) ambulance services
f) funeral expenses - also included for residence employees
- intended as a goodwill gesture
- payment under this section is made at the insured discretion
- does not apply to any expenses covered by:
a) other insurance
b) workers comp
c) insured under policy/residing with named insured (except residence employees)
d) claims arising out of ownership, use, or operation of any motorized vehicle, trailer or watercraft (except for those which coverage is shown in policy)
What is covered under Coverage G?
1) voluntary payment for damage to property
- will pay for unintentional direct damage caused by the insured to property of others even though there is no legal liability to do so
- may also be used to reimburse others for direct property damage caused intentionally by anyone included as an insured under section II, and are 12 years of age or under
- may be used at the discretion of the insured (goodwill)
- no coverage for:
a) property owned/rented by insured
b) belongings to tenants of insured
c) claims resulting from ownership, use, operation of motorized vehicle, trailer, or watercraft (except those for which coverage is provided by policy)
d) loss of use, disappearance, or theft of property
2) voluntary compensation for residence employees
- can form part of policy or be added by endorsement
- it lists a schedule of benefits for:
a) loss of life, limb, sight, or hearing
b) weekly indemnity for disability
c) medical expenses
- should the injured residence employee sue the insured, the insurer could withdraw benefits available under this part of the policy
What are the special limits?
1) watercraft
a) owned - claims arising out of ownership, use, or operation of waterscraft up to a specified size and/or horse power
- is automatic coverage for up to 30 days if a boat/motor is acquired after the effective date of policy
b) non-owned - claims arising out of use or operation of non-owned waterscraft provided it is used with the owners consent
- does not belong to anyone who would be included as an insured under this policy
2) motorized vehicle
- claims made against insured for certain motorized vehicles (including trailers) which they own, use, or operate are insured
- vehicles such as lawn mowers, snow blowers, small garden tractors, golf carts, wheelchairs, and scooters are insured
- as this is TPL coverage there is no insurance for damage to insureds vehicle even if the insured does not own it
Exclusions for watercraft/motorized vehicles:
a) carrying passengers for compensation
b) business purposes
c) racing
d) rental
3) trailers
- insures against claims arising out of ownership, use, or operation of any trailer or its equipment, provided that such trailer is not being towed by, attached to, or carried on a motorized vehicle
4) business and business property
- provides certain coverage for claims arising from business/business property
- commonly personal liability and limited personal coverage are granted for legal liability
- Activities insured include:
a) actions during the course of insured’s trade, profession, or occupation which are not directly related to trade, profession, or occupation.
What are the exclusions?
1) invasion, war/civil war, insurrection, rebellion, revolution, terrorist acts, military/armed forces engaged in hostilities, whether war be declared or not
2) bodily injury/property damage which is required to be insured by the Nuclear Insurance Association of Canada or any other group of insurers
3) business pursuits or business use of premises - except as otherwise stated in policy
4) rendering of or failure to render any professional services
5) liability imposed by any workers comp statute
6) bodily injury/property damage caused by any intentional act/criminal act or failure to act by:
a) anyone insured by this policy
b) any person at the direction of an insured
7) any type of abuse (sexual, physical, emotional, psychological) including corporal punishment commited by, at the direction of, or with the knowledge of the insured
- any failure on the part of insured to take steps to prevent any abuse
8) the transmission of a communicable disease by a insured
9) ownership, use, or operation of any motorized vehicle, trailer or watercraft except as provided in this policy
10) ownership, use, or operation of any aircraft or premises used as an airport/landing facility
