Marine Insurance

Insurance Claims and Marine Insurance CORPORATE LAW SUBMITTED TO: SIR ASIF ALI

SUBMITTED BY: SAQLAIN SHAH KAZMI(11-BBA-023) M.SAQIB ASGHAR(11-BBA-014) GHAYAS ALI(11-BBA-006)

Insurance Claims:An insurance claim is the actual application for benefits provided by an insurance company. Policy holders must first file a claim before any money can be disbursed to the hospital or repair shop or other contracted service. The insurance company may or may not approve the claim, based on its own assessment of the circumstances. Individuals who take out home, life, health, or automobile insurance policies must maintain regular payments called premiums to the insurers. Most of the time, these premiums are used to settle another person's claim or to build up the available assets of the insurance company. Occasionally, however, an accident will happen that causes real financial damage, such as an automobile wreck, a tornado, or a work-related accident. At this point, the injured policy holder has the right to file an insurance claim in order to receive money from the insurance company. In general, the insurance claim is filed with a local representative of the insurance company. This agent becomes responsible for investigating the specific details of the claim and negotiating the payment from the main insurers. Many times, a recognized authority, like a medical professional, repair shop, or building contractor, can file the necessary forms directly with the insurance company. The policy holder may not want to file if the damage is minor or another party has agreed to pay out-of-pocket for their mistake. Claims and loss handling is the materialized utility of insurance; it is the actual "product" paid for. Claims may be filed by insured’s directly with the insurer or through brokers or agents. The insurer may require that the claim be filed on its own proprietary forms, or may accept claims on a standard industry form, such as those produced by ACORD. Insurance company claims departments employ a large number of claims adjusters supported by a staff of records management and data entry clerks. Incoming claims are classified based on severity and are assigned to adjusters whose settlement authority varies with their knowledge and experience. The adjuster undertakes an investigation of each claim, usually in close cooperation

with the insured, determines if coverage is available under the terms of the insurance contract, and if so, the reasonable monetary value of the claim, and authorizes payment. The policyholder may hire their own public adjuster to negotiate the settlement with the insurance company on their behalf. For policies that are complicated, where claims may be complex, the insured may take out a separate insurance policy add on, called loss recovery insurance, which covers the cost of a public adjuster in the case of a claim. Adjusting liability insurance claims is particularly difficult because there is a third party involved, the plaintiff, who is under no contractual obligation to cooperate with the insurer and may in fact regard the insurer as a deep pocket. The adjuster must obtain legal counsel for the insured, monitor litigation that may take years to complete, and appear in person or over the telephone with settlement authority at a mandatory settlement conference when requested by the judge. If a claims adjuster suspects under-insurance, the condition of average may come into play to limit the insurance company's exposure. In managing the claims handling function, insurers seek to balance the elements of customer satisfaction, administrative handling expenses, and claims overpayment leakages. As part of this balancing act, fraudulent insurance practices are a major business risk that must be managed and overcome. Disputes between insurers and insured’s over the validity of claims or claims handling practices occasionally escalate into litigation.

Five types of insurance claims are following: Auto Insurance Claim Homeowners Insurance Claim Life Insurance Claim Accident Insurance Claim Home Insurance Claim

Auto Insurance Claim: Auto insurance protects the policy holder against financial loss in the event of an incident involving a vehicle they own, such as in a traffic collision. Auto Insurance Claim is any request for payment under acceptable terms of a signed auto insurance policy. The difficult part is proving to the insurance company that your situation is covered by the original terms of the contract. This application for benefits should be sent to the car insurance company who then must investigate the accident before any money can be disbursed.

Report an Auto Insurance Claim 1. If there are injuries, please call for assistance. 2. Notify police immediately. 3. Please collect the following: Names of people involved in the accident Addresses License plate numbers Name of insurance company and policy number 4. If your vehicle is not drivable, remove and take all personal items with you, such as personal information, valuables and clothing. 5. Call Nationwide claims service from the scene of the accident 24/7.

Homeowners Insurance Claim: Homeowners' insurance protects homeowners from losses relating to their dwelling, including damage to the dwelling; personal liability for injury to visitors; and loss of, or damage to, property in and around the dwelling. Renters' insurance covers many of the same risks for persons who live in rented dwellings.

Report a Homeowners Insurance Claim: Take reasonable steps to prevent potential safety risks and/or further damage

If the loss is caused by theft, notify the police Notify banks and credit card companies about any missing debit or credit cards Keep accurate records of what you spend repairing things Separate items that may be cleaned and/or repaired Check with your claim representative before you discard any items you plan to claim as damaged Review your policy for specific coverage information.

Life Insurance Claim: Insurance providing for payment of a stipulated sum to a designated beneficiary upon death of the insured. Large groups of individuals equalize the burden of financial loss from death by distributing funds to the beneficiaries of those who die.

Accident Insurance Claim: Insurance coverage against loss by accidental bodily injury. These insurance policies pay out a sum of money when an accident occurs. The amount paid out depends on the injury, and policy documents will detail amounts paid for different injuries or death. If any kind of traffic accident, whether a car accident, truck accident, or motorcycle accident, you will inevitably have to deal with your insurance company as well as the insurance agents of others involved in the accident. Filing an insurance claim and handling insurance adjusters can be quite a task.

Home Insurance Claim: A type of property insurance that covers a private residence. It is an insurance policy that combines various personal insurance protections, which can include losses occurring to one's home.

Marine Insurance: Marine insurance covers the loss or damage of ships, cargo, terminals, and any transport or cargo by which property is transferred, acquired, or held between the points of origin and final destination. Marine insurance is split between the vessels and the cargo. The Marine Insurance Act includes, as a schedule, a standard policy, which parties were at liberty to use if they wished. Because each term in the policy had been tested through at least two centuries of judicial precedent, the policy was extremely thorough. However, it was also expressed in rather archaic terms. In 1991, the London market produced a new standard policy wording known as the MAR 91 form and using the Institute Clauses. The MAR form is simply a general statement of insurance; the Institute Clauses are used to set out the detail of the insurance cover. In practice, the policy document usually consists of the MAR form used as a cover, with the Clauses stapled to the inside. Typically each clause will be stamped, with the stamp overlapping both onto the inside cover and to other clauses; this practice is used to avoid the substitution or removal of clauses.

Protection and Indemnity: A marine policy typically covered only three-quarter of the insured's liabilities towards third parties. The typical liabilities arise in respect of collision with another ship, known as "running down", and wreck removal. In the 19th century, ship-owners banded together in mutual underwriting clubs known as Protection and Indemnity Clubs (P&I), to insure the remaining onequarter liability amongst themselves. These Clubs are still in existence today and have become the model for other specialized and noncommercial marine and non-marine mutuals, for example in relation to oil pollution and nuclear risks. Clubs work on the basis of agreeing to accept a shipowner as a member and levying an initial "call". With the fund accumulated, reinsurance will be purchased, however, if the loss experience is unfavorable one or more "supplementary calls" may be made. Clubs also typically try to build up reserves, but this puts them at odds with their mutual status.

Warranties and Conditions: A peculiarity of marine insurance, and insurance law generally, is the use of the terms condition and warranty. In English law, a condition typically describes a part of the contract that is fundamental to the performance of that contract, and, if breached, the non-breaching party is entitled not only to claim damages but to terminate the contract on the basis that it has been repudiated by the party in breach. By contrast, a warranty is not fundamental to the performance of the contract and breach of a warranty, while giving rise to a claim for damages, does not entitle the non-breaching party to terminate the contract. The meaning of these terms is reversed in insurance law. Indeed, a warranty if not strictly complied with will automatically discharge the insurer from further liability under the contract of insurance. The assured has no defense to his breach, unless he can prove that the insurer, by his conduct has waived his right to invoke the breach, possibility provided in section 34(3) of the Marine Insurance Act 1906 (MIA). Furthermore in the absence of express warranties the Marine Insurance Act will imply them, notably a warranty to provide a seaworthy vessel at the commencement of the voyage in a voyage policy (section 39(1)) and a warranty of legality of the insured voyage.

Marine Insurance Act 1906: The Marine Insurance Act 1906 is a UK Act of Parliament regulating marine insurance. The Act was drafted by Sir Mackenzie Dalzell Chalmers. The Marine Insurance Act 1906 is of huge significance, as it does not merely govern English Law, but dominates marine insurance worldwide. The Act applies not only to "commercial" marine insurance, but also to protection and indemnity insurance The most important sections of this Act include: S.4: a policy without insurable interest is void. S.17: imposes a duty on the insured of uberrimae fides, i.e. those questions must be answered honestly and the risk not misrepresented. S.18: the proposer of the insurer has a duty to disclose all material facts relevant to the acceptance and rating of the risk. Failure to do so is known as non-disclosure or concealment and renders the insurance voidable by the insurer.

S.33(3): If a warranty be not complied with, then, subject to any express provision in the policy, the insurer is discharged from liability as from the date of the breach of warranty, but without prejudice to any liability incurred by him before that date. S.34 (2): where a warranty has been broken, it is no defense to the insured that the breach has been remedied, and the warranty complied with, prior to the loss. S.34 (3): a breach of warranty may be waived by the insurer. S.50: a policy may be assigned. Typically, a ship-owner might assign the benefit of a policy to the ship-mortgagor. S.60-63: deals with the issues of a constructive total loss. The insured can, by notice, claim for a constructive total loss with the insurer becoming entitled to the ship or cargo if it should later turn up. S.79: deals with subrogation i.e. the rights of the insurer to stand in the shoes of an indemnified insured and recover salvage for his own benefit.