Insurance, in the form of a policy, is a contractual arrangement providing financial protection to individuals or entities against damage to their property. It involves reimbursement from an insurance company for losses, both big and small. This financial security is encapsulated in a legal agreement known as an insurance policy, a pact between the insured individual/entity and the insurer.
In simpler terms, insurance is a promise. The insurer pledges to assist in times of loss due to unforeseen events, and the insured commits to paying a premium in return for this assurance.
To ensure the effectiveness of an insurance contract, seven fundamental principles guide the relationship between the insured and the insurer:
1. Utmost Good Faith
This principle emphasizes transparency and honesty. Both parties must provide clear information about the terms and conditions of the contract. Failure to disclose crucial details can impact the validity of the agreement.
Example: Jacob, a health insurance policyholder, failed to disclose his smoking habit. Later, when diagnosed with cancer, the insurer was not liable as important facts were concealed.
2. Proximate Cause
Also known as the principle of ‘Causa Proxima’ or the nearest cause, this principle identifies the primary cause of loss when multiple factors contribute. The insurance company assesses the proximate cause to determine compensation eligibility.
Example: Fire damages a building, leading to its ordered demolition. If the proximate cause is fire, the claim is payable. However, if a storm is the proximate cause, the claim may not be payable under the fire policy.
3. Insurable Interest
The insured must have a financial interest in the subject matter of the insurance contract. This means the insured gains financially from the subject and experiences a financial loss in the event of damage or loss.
Example: The owner of a vegetable cart has an insurable interest in it as it generates income. Selling the cart would terminate this interest.
4. Indemnity
The principle of indemnity ensures that insurance compensates for the actual loss incurred, preventing the insured from making a profit from the contract. It aims to restore the insured to the same financial position as before the loss.
Example: A commercial building owner is indemnified for repair costs after structural damage from fire, ensuring no excessive profit.
5. Subrogation
Subrogation grants the insurer the right to stand in for the insured after compensation. The insurer can then claim from third parties responsible for the loss, helping recover the amount paid as a claim.
Example: After compensating Mr. A for a road accident injury, the insurer can sue the reckless third party to recover the claim amount.
6. Contribution
When an insured has multiple insurance policies for the same subject matter, the contribution principle prevents profiting. The insured cannot claim the same loss from different policies or companies.
Example: If a property is insured with two companies, Company A and Company B, contribution ensures proportional reimbursement and avoids double claiming.
7. Loss Minimization
Owners must take necessary steps to minimize loss to the insured property. Negligence or irresponsibility is not allowed simply because the property is insured.
Example: In the event of a factory fire, the owner must take reasonable steps to extinguish it, preventing further damage.
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