Insurance For Beginners

Welcome to the global business guide. In this context, we will be taking about the insurance industry, the general definition of insurance, adequate and precise explanation of the definition, brief talk about the history, the insurer, the insured, classes of insurance, the role of the underwriter in the industry and how you as an individual can benefit maximally when you get yourself, your car, your house, even that your business insure. We do hope you will enjoy reading this article and the essence of your quest for the topic above will be met.
Insurance is a financial institution classified as a non bank financial institution. They are important financial inter-mi diaries. It is believed to have originated from the ancient practices of inhabitants of the valleys of rivers Tigris and Euphrates in the present day Iraqi in about 4.000BC. History has it that in 1800BC, the Babylonians code of Hammurabi contained provisions which had elements of insurance in the laws that govern their commerce. But today what we have in the industry, both locally and internationally had moved from just an agreement between two persons into a very big industry across the globe.
Going by definition, we learn that insurance means a situation whereby someone protects his or herself against risk and reduce effects of uncertainties as well as distribute loss. Other explanation to this owe it to the situation whereby a certain amount of money when collected from someone by an insurance company agrees to pay a compensation or render services to that person if and whenever that person suffers the kind of loss specified in the insurance agreement; and from the explanation, this is where an insurance company comes into play since they are the people that will go into agreement with the person taking any insurance policy against any of his belongings. This industry has widely been believed as a means whereby people reduce the risk of unforeseen circumstances. As financial intermediaries, they act as middlemen between the surplus units and deficit units of the economy thereby sustaining the general growth of the economy.
One may ask, how do insurance companies generate the money used in compensating their policy holder when affected by any mishap? The answer to this question, will lead us into talking about the various means via which the insurance companies make their money and how their policy holders are compensated. The truth is that, the money they collect from their policy holder (i.e one that has an agreement with the insurance company) is invested in the form of premiums (an extra sum of money paid in addition to the normal cost of something. by BBC. Eng. dict) and that money is invested in Bonds, in stocks, mortgages (i.e house) and government securities (in our subsequent article, we will explain more of this: Bonds, stocks, mortgages and govt. securities). They generate income for themselves and those who are in their service. They invest their policy holder's money in better business that has short term maximum returns on investment and from there meet their numerous needs when needed in claims and losses. These funds themselves are invested, that not only do they earn interest to be added to the funds, but they also benefit the government, public authorities, and industries whose securities the investment are spread, because of the investment policy of the insurer (we will explain later), their reserve funds are not left idle butt are used productively.
Another way via which the insurance companies compensate those who are in their service is that the contribution of many is used to compensate the few among them who were affected by the misfortune insured against. So the loss of few people is share by many.
We hope that to this extend, you must have understood the above explanation about insurance company. Now the next thing we will be considering is the functions of the insurance companies.
Amongst other functions, the main function of the insurance company is risk bearing, the financial losses of individuals are judiciously distributed among many people, for example, in the case of fire, the policy holder in fire insurance pays a premium into a common pool, out of which those who suffer loss are compensated.
FUNCTIONS INCLUDE
1. The insurance industry encourages thrift (i.e money conservation) especially via it's life policies which provide funds for family, welfare and old age provisions. It provides employment opportunity for those that have the interest of working with the industry.
The insurance companies works hand in hand with commerce. It owes it's existence to commerce (i.e business in general both industrial etc) and commerce in return owes it's strong stability to insurance, this is because it helped in various ways to enhance the general trend in business.
Before we proceed further to other functions, let's explain this two terms: the insurer; the insured as it will aid us in our understanding.
The insured: This is the party affecting the insurance in other words, the individual or individuals which is taking the insurance policy. This can be done either directly or indirectly or via an agent or broker.
The insurer: This is the party providing the protection to cover by the policy. The insurer covers every other terms which includes the underwriter who is a senior official of an insurance company whose business lies in undertaking new business for the company.
The insurance company has a contract which promises to pay compensation at a future date for a consideration known as premium (i.e. the money paid by the insured to the insurer for the insurance cover provided in the policy). Like the way we have it in other contracts, i.e having it that contracts is based on the principles of offer and acceptance, consideration and capacity to contract. These contract, especially in insurance involves two parties i.e. the insurer and the insured.
FUNCTIONS 2
Insurer, by reason of their principal function accumulate large funds which they hold as custodians and out of which claims and losses are met. Like in some countries, their insurers operate in many parts of the world and earn vast sums in overseas market in terms of underwriting profit and investment income. This tells us that insurance forms a considerable part of that country's invisible exports.
As we continue in our functions, let's see the role of the insured and the insurer.
ROLES OF THE INSURED:
In insurance, when the proposer becomes insured the party effecting an insurance is known as the proposer throughout the negotiations, and until the contract is in full force. The insurer plays a vital role in making this aforementioned contract to come into force, knowing that in insurance contract, just like we said before is base on the principle of offer and acceptance, consideration and capacity to contract, the contracts are always evidenced in writing which is made up of various forms to be filled and signed. If the insured does not accept the insurance offer and giving meticulous consideration to that, there can hardly be capacity to contract i.e the insurance contract can never be. So, from this, we now learn that this two parties (i.e the insurer and the insured) must be involved before an insurance contract can becomes a policy.
ROLES OF THE INSURER
Here we are considering the roles of the insurer as a subsidiary functions of insurance; this is because in general sense (they have a very wide range of function), the insurer is the one providing the necessary insurance services, benefits to the insured, should any mishap, depending on the insurance policy undertaken. The insurer helps also in loss-prevention in the following ways:
We know that the extend to which loss prevention is seen, is mostly on property. An individual or a population can suffer great loss materially, if it were not for the intervention of loss prevention scheme by insurance companies to their policy holders.
The insurer also assists in boasting business venture: Many large -scale enterprise today can make their business in good faith, having transferred all their risk to the insurance company, in other words. The insurance companies help to maintain and to stabilize the atmosphere of the present day large-scale business and organizations.
Many questions had risen by on onlookers, as on how the policy holder can be compesated, should there be any mishap on the policy covered. It is better for us to note that the insurance company, when a loss is incurred to the policy holder can make for his or her loss, but that can only compensate him and make him return to his normal financial position before the occurrence of the incidence and not to profit him from the misfortune. This is generally because, no amount of financial compensation can pay adequately for the life and health of persons, so life and personal accidents are regarded as benefit policies. So let there be no misconception on this fact when mishap occurs, where the public is looking for the victim to be given everything lost, and having a meager compensation given to him or her. So let's not distrust insurance companies in this area, knowing that it's only the restoration to the exact position before the loss that is provided.
Now, as we have gone so far in understanding the functions of the insurance companies, the roles of the insured and the insurer, we will be proceeding forward to look at the various ways via which one can benefit from being insured in all spheres of life. For those who against all odds, accept insurance policy adequately, benefits, awaits them in areas like
1. pecuniary insurance
2. personal insurance
3. property insurance
4. liability insurance
We will take our time to give you enough explanation in all the sub-sections of these areas that will be of help to you.
1. PECUNIARY INSURANCE: This has to do with money or relating to something of such nature. This insurance policy benefits mostly company owners, directors, managers e.t.c This insurance policy provides cover to the employer against the loss of money unintentionally, or in a situation where an employee defrauds his or her employer on certain amount of money placed under his or her custody or in things relating to other occurrence/loss. Other policies under pecuniary insurance are; fidelity guarantee (known also as surety ship), legal expenses, credit insurance and business interruption insurance. All of these have their various function which in one way or the other relates to pecuniary. Like earlier stated, pecuniary insurance provides cover for C.E.O., M.D'S etc in case of loss of money either by intent or accident placed under the care of their employee or any officer of higher responsibility. These type of insurance cover, which their employee has will help to compensate them (i.e the employer's) and also ease the employee the fear and tension which the mishap might generate for him or her. It is therefore advisable you consider this policy very well as an MD, C.E.O. etc, especially with the assistance of your insurance broker so as to adequately know, and be directed properly on how to go about it.
2. PERSONAL INSURANCE
This involves all classes of life assurance and also accident policies. There are other types of person insurance, and the purpose of each is to meet the different need of individuals in their aim to provide for the future either for themselves or for their dependents. Other sub-divisions of personal insurance are:
i. Life assurance
ii. Personal accident and sickness insurance,
iii. Permanent health insurance,
iv. Social security
These sub-divisions has various similarities which come out at the end to meet the same aim, like in life assurance, personal accident and sickness insurance, this policy ensures that the policy holder when befallen by any misfortune, which resulted into permanent disability or death will still be able to fend for his or herself and also for his or her dependants in the case of death.
3. PROPERTY INSURANCE
Property insurance policy involves insurance cover for property should any risk of damage or loss by fire, accident, burglary or other risks that may occur. Under this, there are other sub-divisions which include:
i. Motor Insurance
ii. Marine Insurance
iii. Fire Insurance
iv. Burglary Insurance
v. Special peril Insurance
vi. All risk Insurance
In all these sub-divisions of property insurance, respective insurance cover is given to them all should there be any damage or loss relating to the type of policy the holder has.
4. LIABILITY INSURANCE
This provides cover for the insured against his legal liability to others. This can arise via negligence of the insured in failing to act in a reasonable manner. Such manners like crossing the road without properly looking on both side of the road which might result in accident. This may also arise via the insured's unlawful disturbance of another person in the enjoyment of his or property (i.e constituting a nuisance to them) or via the insured's trespass which is an unlawful act committed with force or violent on another person's property. Liability insurance is also sub-divided into employer's liability to his employee and public liability by the insured. The two sub-divisions of liability insurance owe their explanation to their respective liabilities, and since liability generally arises from lawsuits, liability policy covers only claims which the insured becomes legally obligated to.
We should also bear in mind that no insurance policy can prevent theft, fire, or other misfortune or the creation of legal liability, but can provide financial assistance in such situations. It does not also protect for example, the material property which is the subject matter of the insurance, but the financial interest of the insurer. This mean that the insurer can only get a financial compensation when any mishap happens to any thing insured against and not having the property restored back in case of fire or collapse (for building).
CONCLUSION
In all, we do hope that all these explanation will give you a better insight towards getting what you want on the good step to take while taking your insurance policy. But, always make sure that you don't do anything without first of all consulting your insurance broker ( who will take more time to tell you one-on-one the policy that will be suitable for you) before going to any insurance company knowing already that the cost of insurance is less than what would be the cost of insurance because the cost of insurance to industrialist for e.g is passed on to consumers along with other product cost and the consumers benefits from the existence of insurance via reduced prices. So make sure you get insured today. Till I see you again. Thank you.

insurence agency

Are you one of the plain insurance agents? Agents often prefer to upgrade their title as an insurance specialist or financial advisor on their business card. Names like life advisor reflect positive experience and knowledge. Which of these different terms distinguishes you from being just one of the insurance agents? Here are 101 top choices to pick from.
There is a lot more to a name then may realize. Calling yourself an agent or sales agent makes you sound run of the mill. It also projects the sound of a salesman trying to sell you something. Few people enjoy feeling a person is selling them anything, it stinks of pressure. This is why in this list of different terms you will see how high words like specialist, expert, and professional rank. The prospect gets a completely new perspective, just by the title you give yourself! Prospects closely take notice when an agent jointly works with them in reaching a decision on what is the best plan of action. Prospective clients want to feel like they are part of the decision process.
Important internet search tip: to get an accurate count use quote marks around your term, "insurance specialist" will only give you that term in that exact order. Without the quotes you would also get all instances of people searching terms such as specialist insurance, specialist in writing insurance claims, specialist in automobile insurance sales, etc.
To give this article value, in front of each of the insurance agents distinctions is the number of current Google listings. This way you can easily see how often internet views "insurance agent " look-up terms like specialist, planner, representative, and. advisor. Please remember the Google count figures often change daily.
1. 10,600,000 = financial advisor
2. 6,690,000 = insurance agent
3. 4,280,000 = financial planner
4. 2,120,000 = investment advisor
5. 1,780,000 = insurance agents brokers
6. 1,600,000 = investment adviser
7. 999,000 = insurance guide
8. 735,000 = insurance specialist
9. 638,000 = financial expert
10. 604,000 = financial professional
11. 590,000 = financial specialist
12. 513,000 = life pro
13. 433,000 = insurance professional
14. 431,000 = health insurance agent
15. 322,000 = insurance expert
16. 271,500 = insurance salesman
17. 269,000 = life professional
18. 268,000 = life insurance agent
19. 253,000 = insurance consultant
20. 252,000 = insurance advisor
21. 244,000 = insurance sales representative
22. 219,000 = insurance manager
23. 218,000 = estate advisor
24. 217,000 = insurance executive
25. 189,000 = estate planner
26. 186,000 = independent insurance sale
27. 179,000 = insurance sales agent
28. 155,000 = insurance seller
29. 130,000 = insurance producer
30. 126,000 = investment representative
29. 120,000 = insurance authority
30. 119,000 = insurance representative
31. 112,000 = life agent
32. 107,000 = life insurance specialist
32. 104,000 = life specialist
33. 102,000 = insurance adviser
34. 89,900 = insurance sales manager
35. 86,200 = licensed insurance agent
36. 85,200 = insurance manager
37. 71,000 = health agent
38. 66,600 = insurance pro
39. 65,100 = insurance sales rep
40. 60,000 = insurance designer
41. 59,400 = insurance sales person
42. 55,600 = life consultant
43. 54,500 = group agent
44. 52,200 = ins agent
45. 50,100 = estate adviser
46. 50,000 = insurance pros
47. 46,800 = insurance counselor
48. 43,800 = financial pro
49. 43,400 = insurance salesperson
50. 40,200 = insurance sales specialist
51. 37,700 = life producer
52. 37,000 = insurance sales executive
53. 35,400 = independent insurance brokers
54. 34,700 = long term care professional
55. 34,500 = financial planning advisor
56. 33,900 = medical insurance specialist
57. 31,300 = health insurance professional
58. 29,300 = life insurance expert
59. 29,000 = insurance rep
60. 28,900 = financial planning advisor
61. 27,500 = health insurance specialist
62. 26,000 = health insurance advisor
63. 25,500 = independent insurance professional
64. 24,700 = employee benefits specialist
65. 24,000 = life advisor
66. 22,900 = life insurance advisor
67. 21,800 = life insurance sales specialist
68. 19,900 = life insurance professional
69. 19,300 = insurance producer
70. 19,200 = licensed financial planner
71. 16,200 = health insurance producer
72. 14,900 = insurance sales consultant
73. 14,000 = term life insurance broker
74. 12,800 = long term care specialist
75. 12,700 = annuity specialist
76. 12,500 = estate planning specialist
77. 12,200 = insurance marketer
78. 11,950 = life insurance representative
79. 11,900 = insurance planner
80. 10,600 = insurance sales professional
81. 10,400 = life insurance advisor
82. 10,200 = insurance writer
83. 9,650 = insurance recruiter
84. 9,480 = financial planning advisor
85. 9,030 = estate planning advisor
86. 8,570 = annuity broker
87. 7,520 = insurance general manager
88. 7,070 = insurance trainee
89. 6,800 = long term care insurance specialist
90. 6,670 = term life insurance agent
91. 6,440 = long term care insurance agent
92. 5,870 = licensed life agent
93. 5,300 = financial insurance agent
94. 5,270 = annuity agent
95. 5,080 = ins professional
96. 5,030 = medical insurance professional
97. 5,010 = disability insurance agent
98. 4,990 = employee benefits professional
99. 4,430 = mortgage insurance agent
100. 4,200 = disability insurance specialist
101. 3,900 = long term care agent
For your own sake, never tell prospective clients that you are one of 1,500,000 insurance agents licensed to sell life, health, annuities, and financial policies. The term insurance specialist or insurance professional immediately makes your prospect more confident of your abilities. However, please do not use the overused and abused terms of financial planner or estate planner unless you actually are qualified to be one.
If case, you are interested, here are more titles with over 1,000 Google entry occurrences that did not make the top 101 list. They include group health professional, ins specialist, insurance marketing representative, health insurance adviser, ins representative, term life insurance specialist, mortgage life insurance agent, insurance marketing specialist, disability insurance broker, life ins agent, term life agent, senior market specialist, life investment adviser, MDRT insurance agent, and insurance saleswoman.
Should you want to get more attention on major search engines like Google, Yahoo, and Ask, here are some tips. On the front of your website entry page, use the title and first line to put a more descriptive term about the services you provide. Rather than announcing "insurance agent for many products", try this, "medical insurance professional and disability insurance specialist." Both these titles only have about 5,000 competing entries, which could include 3,500 to 4,000 weak ones each. Now it depends on following the advice given, and internet search engine skills you possess. An internet searcher might now find you in the top 100 listings for each of the terms! On an "insurance agent" search, with well over 6,000,000 listings, it might take a 24/7 week to find you listed toward the end of the heap.

Well published author, Don Yerke likes to concentrate on what you don't know or what no one else dares to print. Tell it like it is.
Watch for his new paperback book debuting on Amazon early this summer. It is loaded with great insurance marketing and recruiting information.
Come and get your FREE "Think and Grow Rich" Ebook by Napoleon Hill instantly. The website address is [http://www.agentsinsurancemarketing.com]

Insurance Appraisal Process

Insurance Appraisal Process - A Policyholder's Best Chance to Resolve an Insurance Claim Dispute!

Many homeowners and business owners find themselves disagreeing with their insurance company's analysis of their insurance claim. However, most are unaware that they can dispute the insurance company's findings via the insurance appraisal process! Even though the policyholder (you) submits a contractor's estimate, receipts for repairs or materials, or even photos showing damages that the insurance company did not include for repairs... they still won't budge.
Most policyholders are unaware of how to dispute and resolve their claim with the insurance company. Policyholders have a choice and a voice within their policy for this very purpose. It's called The Appraisal Clause - also know as The Appraisal Provision. Now, don't let this scare you. It may seem like a fancy clause that would take a law degree to understand. However, a simple way to understand it is that it's the insurance industry's version of arbitration. Although similar, the Appraisal Process is NOT an arbitration or mediation and the umpire is not an arbitrator, mediator, or judge. Insurance Appraisal, Mediation, and Arbitration are separate things.
In short; Arbitration requires attorneys and a legal process, where Insurance Appraisal does not require attorneys or a legal process. Arbitration is a dispute between two parties for any reason, where as, the Insurance Appraisal Process is a dispute between the "value or cost," to repair or replace property only - bee it an automobile, plane, train, couch, house, commercial building, etc.
Most Policies Have the Appraisal Clause
If you feel you're at a dead end with your insurance company and want to resolve your claim you'll need to check your policy for the Appraisal Clause. Most policies will have the provision listed under the "What to do after a loss," section or the "Conditions" section of the policy. Below, you will find a sample of a typical Insurance Appraisal Clause included in most policies. Keep in mind that policies can be different in each state. Therefore, you should read your own policy to see if this clause exists. It will say something similar to the following ;

"APPRAISAL - If you and we fail to agree on the amount of loss, either one can demand that the amount of the loss be set by appraisal. If either makes a written demand for appraisal, each shall select a competent, independent appraiser. Each shall notify the other of the appraiser's identity within 20 days of receipt of the written demand. The two appraisers shall then select a competent, impartial umpire. If the two appraisers are unable to agree upon an umpire within 15 days, you or we can ask a judge of a court of record in the state where the residence premises is located to select an umpire. The appraisers shall then set the amount of the loss. If the appraisers fail to agree within a reasonable time, they shall submit their differences to the umpire. Written agreement signed by any two of these three shall set the amount of the loss."

OK, But How Does the Insurance Appraisal Process Work?The Appraisal Process allows the policyholder (you) to hire an independent appraiser to determine the value of their damages. In turn, the insurance company will also hire their own independent appraiser. The two appraisers will then get together and select an umpire. The umpire is basically the arbitrator, or what you might call the judge. If a disagreement between the two appraisers arises, they can present their differences to the umpire who will make a ruling.
OK; so far so good, the basics of the insurance appraisal process are beginning to come together. We have an independent appraiser for the policyholder. We have an independent appraiser for the insurance company. Finally, there is an Umpire. These three individuals are known as The Appraisal Panel. The object of the Appraisal Panel is to set or determine The Amount of Loss. The Amount of Loss is the total dollar amount needed to return the damaged property back to its original condition, either by repair or replacement.
Once the Appraisal Panel is set, the policyholder's chosen appraiser and the insurance company's chosen appraiser will review the documents, estimates, and differences between them. The two independent appraisers will try to discuss and resolve the differences in damage and in cost. For example; the insurance company may determine that brick on a home does not need to be replaced. Where as, the contractor or appraiser for the policyholder says that it does have to be replaced. The two appraisers will discuss their reasons for their position and try to come to an agreement, first if it should be repaired or replaced, and secondly the cost to return the brick back to it's original condition prior to the loss.
One benefit of the Insurance Appraisal Process is that the two independent appraisers have not been subject to the bickering and anger between the policyholder and the insurance company. Basically, it's the hope that cooler heads will prevail. All the appraisers really have is the amount of the damage and the difference between the two estimate numbers. They do not have the previous baggage or anger that led up to the Appraisal. The process was designed so that these two individuals, who have no interest in the outcome, could discuss a settlement based on the facts presented to them.
Sometimes issues arrive where the two independent appraisers can't agree on certain items. In this event, the two appraisers will submit their differences to the chosen umpire. The three will discuss the issues and try to reach an agreed settlement of the differences. As stated above; the settlement or final number is called The Amount of Loss. The final amount is known as the Appraisal Award. The Award is signed by the individuals who agree on The Amount of Loss. However, only TWO of the three individuals need to agree. (An agreement between the two independent appraisers, or the umpire and either appraiser) Once any TWO of the three individuals on the Appraisal Panel sign the award... the dispute is over! The amount on the Award binding and is paid by the insurance company, to the policyholder.
Can I Use An Insurance Attorney To Dispute My Claim?
The Appraisal Clause was initiated to lower the number of lawsuits filed against insurance companies. The courts found that many lawsuits were entering the legal system where the cost to repair or replaced damaged property was being disputed. In many cases the suites were being resolved when professional engineers and contractors could address the issues. The Appraisal Process was created to get such individuals together and keep these disputes out of the courtroom. Assuming you acquired an estimate of repair to your property for $100,000, from a contractor or insurance claims expert. Your insurance company has created an estimate for $30,000. This would be a clear dispute between the amounts of damage. This type of dispute is exactly what the Appraisal Clause was developed to resolve.
The clause allows parties on both sides of the insurance policy to dispute their differences using this less costly provision. Let's face it; the courts are filled with lawsuits. The Insurance Appraisal Process allows for the dispute to be settled out of court. Using Insurance Attorneys and lawsuits can have insurance claims tied up in court for years. The Appraisal Provision was designed to keep these disputes out of court for a less costly and timelier resolution.
Insurance Claim Attorneys will usually represent policyholders for bad faith practices. Bad Faith is a whole other issue and sometimes happens after the Appraisal Process has been completed. Bad Faith claims are for much larger suites against insurance companies when it is alleged that they did not act with good faith of the policy they sold to the policyholder. In summary; disputes between the amount of damages and repairs will follow the Appraisal Process before entering into the legal system. Many Insurance Attorneys will also advise the policyholder to engage in the Appraisal Process before any lawsuits will begin.
How Do I know if the Insurance Appraisal Process is a Good Option for My Claim?
If the Appraisal Clause is in your policy then it is always an option. However, it's wise to point out that Appraisal is usually an option when there is a substantial difference in the amount between the two estimate totals. For example; let's say a fire completely destroys a house and the homeowner's personal property within it (Know as the Contents). The differences between what the insurance company wants to pay and what you wish to receive is $5,000. In this situation, the Appraisal Process is not the best idea. After paying the fees involved for the appraisal, you may not end up with much of the $5,000 being disputed.
Now, if we take the same fire that destroys the property and the dispute between the policyholder and the insurance company is $40,000, appraisal should be considered. The policyholder now has a chance to recover substantially more money than originally offered.
Also, the Appraisal Clause is only applicable if a dispute arises from a covered loss. If the insurance company denied the claim as something not covered then this is not a dispute on the amount to repair, but rather a dispute on coverage. For example; homeowners and business policies due not cover floods. Flood policies are purchased separately. So, if there is no coverage for the flood damages then the Appraisal Process is not an option.
Simply put, the Insurance Appraisal Process is to determine the "amount of loss," to property only. The Appraisal Panel is not to determine coverage, policy provisions, deductibles, how much was previously paid on the claim, etc. Let's say there was an appraisal for a grand piano that fell off a delivery truck on the highway. The Appraisal Panel's job is not to determine who's at fault, the policy coverage limit, if the truck had a registration, or anything other than "How Much is the Piano Worth."
As with our example earlier, if the insurance company offers a settlement of $10,000 to repair a roof and the policyholder has contractor bids for $15,000, then the Appraisal Process may not be the best option. The Appraisal Process may cost more than the $5,000 that's being disputed. Unfortunately, the differences in repair/replacement costs are usually much greater. When an insurance company generates an estimate for a claim of $75,000 and the policyholder has acquired professional bids several contractors of $200,000 or more, its time to invoke the appraisal clause.
Beginning The Appraisal Process
Either party associated with the policy can invoke the Appraisal Process. However, such a request must be made in writing. Each policy will have a time limit of when this can take place. Even if a claim has been closed for many years, either party can still dispute the claim and reopen for review. It's recommended that the request to invoke appraisal be sent via certified mail. Once the request to invoke the Appraisal Clause has been initiated, as explained earlier, each party, the insurance company and policyholder, appoints an Independent Appraiser. (If you wish to invoke the appraisal clause in your policy you need to submit a letter to your insurance company. Find more information at http://www.insurance-appraisal-services.com/invoke-appraisal.html )
Choosing An Independent Appraiser
It's important to select an Independent Appraiser that has experience with the damages being disputed in the claim. A person with expert knowledge of insurance claims handling and firsthand knowledge of the damaged property and its replacement cost. For example; a person with expert knowledge of insurance claims handling and with expert knowledge of the Appraisal Process, with little experience on the costs to replace an antique grand piano may not be the best choice. In the case of a home or building fire; a good Appraiser is someone who can generate their own line-item detailed estimate to repair or replace the damaged property, can secure multiple bids from reputable contractors to back up their findings, knows building codes, and can articulate unforeseen costs of repairs. If a building has historic features with materials like, solid Adler doors, large detailed moldings, and custom cabinets, a great amount of research with a salvager may be needed. The Appraiser should have experience with building procedures, materials and the cost of such terms to create an accurate "amount of loss," to return the property to the same condition it was prior to the loss. See, the policy provides coverage to replace the damaged property with those of like kind and quality. An Independent Appraiser that is not familiar with, or that does not have experienced contractors, engineers, and other experts to consult with about mold, demolition, cost associated with contents, and in some cases, additional living expenses, does not sound like a good candidate. You should choose your Independent Appraiser wisely. Look and interview someone with experience of the type of damage you have and with the type of property damaged, as well as a specialist when it comes to the Insurance Appraisal Process and also Insurance Claims Handling.
Many people confuse the words Independent Appraiser with that of a real estate appraiser. As you can see, a real estate appraiser is far from what is needed for an Insurance Appraisal. An Independent "Insurance," Appraiser is an insurance claims expert on costs and processes to repair or replace damaged property. The next question is, "Who will have such knowledge?" People requesting assistance in the past have asked if the following experts with the following backgrounds are good choices ;

1. Structural Engineers: This person may be a structural expert and could probably provide a good estimate to replace a building, but what about the contents (furniture, food, etc.) damage? Do they know anything about the insurance policy, the claims process, the software used by insurance companies, the Appraisal Process?  
2. Construction Attorney: A Construction Attorney most likely has knowledge of construction contracts and issues that building contractors have. Do they know anything about the insurance policy, the claims process, the software used by insurance companies, the Appraisal Process, the contents damaged? (NOTE: If you retain an attorney as Appraiser, remember, there is NO attorney/client privilege because the attorney is being hired as an Appraiser, not as an attorney.)  
3. Construction Superintendent or General Contractor: Again, excellent choice for generating a structural estimate, but is most likely not familiar with insurance claims... and even more importantly, the Insurance Appraisal Process.  
4. Insurance Claim Attorney / Lawyer: Keep in mind that the process was designed to keep these types of disputes out of court. You can surely use an attorney as your appraiser; however, the fees can exhaust your reward. Attorney's fees range between 30% and 40% of the amount collected. This will dig deep into the net amount you receive. An Insurance Attorney will also have expert knowledge of the policy. However, the Appraisal Provision clearly notes that no policy provisions will apply. Has the attorney represented their clients in many appraisals or mostly in court cases? How familiar are they with the Appraisal Process, building costs, construction practices, the contents damaged? Does the attorney know anything about the software used by insurance companies? (NOTE: If you retain an attorney as Appraiser, remember, there is NO attorney/client privilege because the attorney is being hired as an Appraiser, not as an attorney.)  
5. Independent Insurance Appraiser: Doesn't it make sense to hire an individual who is an expert of the process in which you are about to engage? You've heard the expression, "Would you go to your auto mechanic if you needed brain surgery?" It is highly recommended to use a qualified, professional, Insurance Appraiser. This professional will already know the Insurance Appraisal Process. They will also have qualified professionals (engineers, contractors, inspectors, etc.) at there disposal to back up their analysis.

Regardless of background, an Independent Appraiser will also require good communication skills and agree with the position they are defending. They should know about the insurance policy, the claims process, the software used by insurance companies, the Appraisal Process, contents damage, structural damages, building costs and processes, as well as materials and building codes. Makes sense, right?
Advantages to the Insurance Appraisal Process
There are several advantages to the Insurance Appraisal Process. The most obvious is costs. Insurance Attorney's will usually charge 30% to 45% of the total award. On a $200,000 claim, the attorney's fee would be in the range of Sixty to Ninety-thousand dollars ($60,000 to $90,000). That can hurt a policyholder trying to rebuild their life. Remember, the Insurance Appraisal Process was designed to keep these disputes out of the courtroom.
The advantage of invoking appraisal allows for a less formal or non-legal proceeding. An Independent Appraiser usually charges in the range of $125 to $200 per hour. Using the same example above with an award of $200,000; if the dispute took 25 to 50 hours, the cost would be in the range of Five Thousand to Ten Thousand dollars ($5,000 to $10,000). This can be a significant difference.
Another advantage is time. The courtroom can delay an insurance claim dispute for years, where the Appraisal Process usually only takes a few months. Sometimes it can last longer depending on the complexity of the claim. However, the courtroom will most certainly be longer. The result of less time and less cost becomes a less of a burden for both sides of the dispute.
Once an award is signed the insurance company has 30 to 60-days (depending on state) to settle the award.
Should I Invoke the Appraisal Clause For My Claim?
When the dispute is real and the damages are real, the policyholder usually see's a greater return at the end of the appraisal. If the policyholder's claim is supported by an Insurance Claims Expert, building or repair contractors, or an engineer - and the amount of money between the two estimates is large, the Appraisal Process is a no-brainer. However, if a contractor or Public Adjuster is trying to beef-up the damages for their own benefit, then it's the policyholder that pays dearly for it. If you're considering invoking appraisal on your claim you should consult an insurance claim expert to see if it's worth your time and effort.
Being that the Appraisal Award is binding the policyholder should be sure before they cost themselves unwanted anguish. If the outcome of your Appraisal Award is not what was to be expected, both parties must live with the result. As stated, the Appraisal Award is binding on "both parties."
At the end of the day nothing is risk free. There are no promises or guarantees with the outcome of any Appraisal. However, if you have a dispute over $20,000 you're more than likely to have a result you can live with. Do your homework and remember to choose an Independent Appraiser that is educated and experienced with the type of damages you have, what caused the damage, and the type of property damaged. Keep in mind that this is "YOUR," property and "YOUR," insurance policy. Your policy protects you with the Insurance Appraisal Process, so that...
The Playing Field Remains Level, and The Process Works Fairly
For Both Parties... Not Just The Insurance Companies!

Copyright of Insurance Claims Group, Inc. & Joseph P. Brennan: Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. Joe has been in the property loss business for more than 24-years. His loss experience began as a contractor / builder, which included water and fire damage restoration repair services. After 20-years of insurance restoration estimating and repair experience, Mr. Brennan became a licensed independent insurance claims adjuster. Joe has maintained his IICRC Certification in both Fire and Water Restoration and also maintains active adjuster licenses in 10-states. Throughout his career, he has handled many multi-million dollar losses, both commercial and residential. The amount of combined experience and knowledge of new construction, damage repairs, and insurance claims handling has advanced his ability to act as a Dispute Appraiser and Appraisal Umpire. Mr. Brennan is highly educated with the appraisal process and has acted as an appraiser and umpire on dozens of claims.

fire ansurence

A contract of Insurance comes into being when a person seeking insurance protection enters into a contract with the insurer to indemnify him against loss of property by or incidental to fire and or lightening, explosion, etc. This is primarily a contract and hence as is governed by the general law of contract. However, it has certain special features as insurance transactions, such as utmost faith, insurable interest, indemnity, subrogation and contribution, etc. these principles are common in all insurance contracts and are governed by special principles of law.
FIRE INSURANCE:
According to S. 2(6A), "fire insurance business" means the business of effecting, otherwise than incidentally to some other class of insurance business, contracts of insurance against loss by or incidental to fire or other occurrence, customarily included among the risks insured against in fire insurance business.
According to Halsbury, it is a contract of insurance by which the insurer agrees for consideration to indemnify the assured up to a certain extent and subject to certain terms and conditions against loss or damage by fire, which may happen to the property of the assured during a specific period.
Thus, fire insurance is a contract whereby the person, seeking insurance protection, enters into a contract with the insurer to indemnify him against loss of property by or incidental to fire or lightning, explosion etc. This policy is designed to insure one's property and other items from loss occurring due to complete or partial damage by fire.
In its strict sense, a fire insurance contract is one:
1. Whose principle object is insurance against loss or damage occasioned by fire.
2. The extent of insurer's liability being limited by the sum assured and not necessarily by the extent of loss or damage sustained by the insured: and
3. The insurer having no interest in the safety or destruction of the insured property apart from the liability undertaken under the contract.
LAW GOVERNING FIRE INSURANCE
There is no statutory enactment governing fire insurance, as in the case of marine insurance which is regulated by the Indian Marine Insurance Act, 1963. the Indian Insurance Act, 1938 mainly dealt with regulation of insurance business as such and not with any general or special principles of the law relating fire of other insurance contracts. So also the General Insurance Business (Nationalization) Act, 1872. in the absence of any legislative enactment on the subject , the courts in India have in dealing with the topic of fire insurance have relied so far on judicial decisions of Courts and opinions of English Jurists.
In determining the value of property damaged or destroyed by fire for the purpose of indemnity under a policy of fire insurance, it was the value of the property to the insured, which was to be measured. Prima facie that value was measured by reference of the market value of the property before and after the loss. However such method of assessment was not applicable in cases where the market value did not represent the real value of the property to the insured, as where the property was used by the insured as a home or, for carrying business. In such cases, the measure of indemnity was the cost of reinstatement. In the case of Lucas v. New Zealand Insurance Co. Ltd.[1] where the insured property was purchased and held as an income-producing investment, and therefore the court held that the proper measure of indemnity for damage to the property by fire was the cost of reinstatement.
INSURABLE INTEREST
A person who is so interested in a property as to have benefit from its existence and prejudice by its destruction is said to have insurable interest in that property. Such a person can insure the property against fire.
The interest in the property must exist both at the inception as well as at the time of loss. If it does not exist at the commencement of the contract it cannot be the subject-matter of the insurance and if it does not exist at the time of the loss, he suffers no loss and needs no indemnity. Thus, where he sells the insured property and it is damaged by fire thereafter, he suffers no loss.
RISKS COVERED UNDER FIRE INSURANCE POLICY
The date of conclusion of a contract of insurance is issuance of the policy is different from the acceptance or assumption of risk. Section 64-VB only lays down broadly that the insurer cannot assume risk prior to the date of receipt of premium. Rule 58 of the Insurance Rules, 1939 speaks about advance payment of premiums in view of sub section (!) of Section 64 VB which enables the insurer to assume the risk from the date onwards. If the proposer did not desire a particular date, it was possible for the proposer to negotiate with insurer about that term. Precisely, therefore the Apex Court has said that final acceptance is that of the assured or the insurer depends simply on the way in which negotiations for insurance have progressed. Though the following are risks which seem to have covered Fire Insurance Policy but are not totally covered under the Policy. Some of contentious areas are as follows:
FIRE: Destruction or damage to the property insured by its own fermentation, natural heating or spontaneous combustion or its undergoing any heating or drying process cannot be treated as damage due to fire. For e.g., paints or chemicals in a factory undergoing heat treatment and consequently damaged by fire is not covered. Further, burning of property insured by order of any Public Authority is excluded from the scope of cover.
LIGHTNING : Lightning may result in fire damage or other types of damage, such as a roof broken by a falling chimney struck by lightning or cracks in a building due to a lightning strike. Both fire and other types of damages caused by lightning are covered by the policy.
AIRCRAFT DAMAGE: The loss or damage to property (by fire or otherwise) directly caused by aircraft and other aerial devices and/ or articles dropped there from is covered. However, destruction or damage resulting from pressure waves caused by aircraft traveling at supersonic speed is excluded from the scope of the policy.
RIOTS, STRIKES, MALICIOUS AND TERRORISM DAMAGES: The act of any person taking part along with others in any disturbance of public peace (other than war, invasion, mutiny, civil commotion etc.) is construed to be a riot, strike or a terrorist activity. Unlawful action would not be covered under the policy.
STORM, CYCLONE, TYPHOON, TEMPEST, HURRICANE, TORNADO, FLOOD and INUNDATION: Storm, Cyclone, Typhoon, Tempest, Tornado and Hurricane are all various types of violent natural disturbances that are accompanied by thunder or strong winds or heavy rainfall. Flood or Inundation occurs when the water rises to an abnormal level. Flood or inundation should not only be understood in the common sense of the terms, i.e., flood in river or lakes, but also accumulation of water due to choked drains would be deemed to be flood.
IMPACT DAMAGE: Impact by any Rail/ Road vehicle or animal by direct contact with the insured property is covered. However, such vehicles or animals should not belong to or owned by the insured or any occupier of the premises or their employees while acting in the course of their employment.
SUBSIDENCE AND LANDSLIDE INCULUDING ROCKSIDE: Destruction or damage caused by Subsidence of part of the site on which the property stands or Landslide/ Rockslide is covered. While Subsidence means sinking of land or building to a lower level, Landslide means sliding down of land usually on a hill.
However, normal cracking, settlement or bedding down of new structures; settlement or movement of made up ground; coastal or river erosion; defective design or workmanship or use of defective materials; and demolition, construction, structural alterations or repair of any property or ground-works or excavations, are not covered.
BURSTING AND/OR OVERFLOWING OF WATER TANKS, APPARATUS AND PIPES: Loss or damage to property by water or otherwise on account of bursting or accidental overflowing of water tanks, apparatus and pipes is covered.
MISSILE TESTING OPERATIONS: Destruction or damage, due to impact or otherwise from trajectory/ projectiles in connection with missile testing operations by the Insured or anyone else, is covered.
LEAKAGE FROM AUTOMATIC SPRINKLER INSTALLATIONS: Damage, caused by water accidentally discharged or leaked out from automatic sprinkler installations in the insured's premises, is covered. However, such destruction or damage caused by repairs or alterations to the buildings or premises; repairs removal or extension of the sprinkler installation; and defects in construction known to the insured, are not covered.
BUSH FIRE: This covers damage caused by burning, whether accidental or otherwise, of bush and jungles and the clearing of lands by fire, but excludes destruction or damage, caused by Forest Fire.
RISKS NOT COVERED BY FIRE INSURANCE POLICY
Claims not maintainable/ covered under this policy are as follows:
o Theft during or after the occurrence of any insured risks
o War or nuclear perils
o Electrical breakdowns
o Ordered burning by a public authority
o Subterranean fire
o Loss or damage to bullion, precious stones, curios (value more than Rs.10000), plans, drawings, money, securities, cheque books, computer records except if they are categorically included.
o Loss or damage to property moved to a different location (except machinery and equipment for cleaning, repairs or renovation for more than 60 days).
CHARACTERICTICS OF FIRE INSURANCE CONTRACT
A fire insurance contract has the following characteristics namely:
(a) Fire insurance is a personal contract
A fire insurance contract does not ensure the safety of the insured property. Its purpose is to see that the insured does not suffer loss by reason of his interest in the insured property. Hence, if his connection with the insured property ceases by being transferred to another person, the contract of insurance also comes to an end. It is not so connected with the subject matter of the insurance as to pass automatically to the new owner to whom the subject is transferred. The contract of fire insurance is thus a mere a personal contract between the insured and the insurer for the payment of money. It can be validly assigned to another only with the consent of the insurer.
(b) It is entire and indivisible contract.
Where the insurance is of a binding and its contents of stock and machinery, the contract is expressly agreed to be divisible. Thus , where the insured is guilty of breach of duty towards the insurer in respect of one subject matters covered by the policy , the insurer can avoid the contract as a whole and not only in respect of that particular subject mater , unless the right is restricted by the terms of the policy.
(c) Cause of fire is immaterial
In insuring against fire, the insured wishes to protect him from any loss or detriment which he may suffer upon the occurrence of a fire, however it may be caused. So long as the loss is due to fire within the meaning of the policy, it is immaterial what the cause of fire is, generally. Thus , whether it was because the fire was lighted improperly or was lighted properly but negligently attended to thereafter or whether the fire was caused on account of the negligence of the insured or his servants or strangers is immaterial and the insurer is liable to indemnify the insured. In the absence of fraud, the proximate cause of the loss only is to be looked to.
The cause of the fire however becomes material to be investigated
(1). Where the fire is occasioned not by the negligence of, but by the willful
(2) Where the fire is due is to cause falling with the exception in the contract.
LIMITATION OF TIME
Indemnity insurance was an agreement by the insurer to confer on the insured a contractual right, which prima facie, came into existence immediately when the loss was suffered by the happening of an event insured against, to be put by the insurer into the same position in which the accused would have had the event not occurred but in no better position. There was a primary liability, i.e. to indemnify, and a secondary liability i.e. to put the insured in his pre-loss position, either by paying him a specifying amount or it might be in some other manner. But the fact that the insurer had an option as to the way in which he would put the insured into pre-loss position did not mean that he was not liable to indemnify him in one way or another, immediately the loss occurred. The primary liability arises on the happening of the event insured against. So, the time ran from the date of the loss and not from the date on which the policy was avoided and any suit filed after that time limit would be barred by limitation.[2]
WHO MAY INSURE AGAINST FIRE?
Only those who have insurable interest in a property can take fire insurance thereon. The following are among the class of persons who have been held to possess insurable interest in, property and can insure such property:
1. Owners of property, whether sole, or joint owner, or partner in the firm owning the property. It is not necessary that they should possession also. Thus a lesser and a lessee can both insure it jointly or severely.
2. The vender and purchaser have both rights to insure. The vendor's interest continues until the conveyance is completed and even thereafter, if he has an unpaid vendor's lien over it.
3. The mortgagor and mortgagee have both distinct interests in the mortgaged property and can insure, per Lord Esher M.R."The mortgagee does not claim his interest through the mortgagor , but by virtue of the mortgage which has given him an interest distinct from that of the mortgagor"[3]
4. Trustees are legal owners and beneficiaries the beneficial owners of trust property and each can insure it.
5. Bailees such as carriers, pawnbrokers or warehouse men are responsible for there safety of the property entrusted to them and so can insure it.
PERSON NOT ENTITLED TO INSURE
One who has no insurable interest in a property cannot insure it. For example:
1. An unsecured creditor cannot insure his debtor's property, because his right is only against the debtor personally. He can, however, insure the debtor's life.
2. A shareholder in a company cannot insure the property of the company as he has no insurable interest in any asset of the company even if he is the sole shareholder. As was the case of Macaura v. Northen Assurance Co.[4] Macaura. Because neither as a simple creditor nor as a shareholder had he any insurable interest in it.
CONCEPT OF UTMOST FAITH
As all contracts of insurance are contracts of utmost good faith, the proposer for fire insurance is also under a positive duty to make a full disclosure of all material facts and not to make any misrepresentations or misdescreptions thereof during the negotiations for obtaining the policy. This duty of utmost good faith applies equally to the insurer and the insured. There must be complete good faith on the part of the assured. This duty to observe utmost good faith is ensured b requiring the proposer to declare that the statements in the proposal form are true, that they shall be the basis of the contract and that any incorrect or false statement therein shall avoid the policy. The insurer can then rely on them to assess the risk and to fix appropriate premium and accept the risk or decline it.
The questions in the proposal form for a fire policy are so framed as to get all information which is material to the insurer to know in order to assess the risk and fix the premium, that is, all material facts. Thus the proposer is required too give information relating to:
o The proposer's name and address and occupation
o The description of the subject matter to be insured sufficient for the purpose of identifying it including,
o A description of the locality where it is situated
o How the property is being used, whether for any manufacturing purpose or hazardous trade.etc
o Whether it has already been insured
o And also ant personal insurance history including the claims if any made buy the proposer, etc.
Apart from questions in the proposal form, the proposer should disclose whether questioned or not-
1. Any information which would indicate the risk of fire to be above normal;
2. Any fact which would indicate that the insurer's liability may be more than normal can be expected such as existence of valuable manuscripts or documents, etc, and
3. Any information bearing upon the more; hazard involved.
The proposer is not obliged to disclose-
1. Information which the insurer may be presumed to know in the ordinary course of his business as an insurer;
2. Facts which tend to show that the risk is lesser than otherwise;
3. Facts as to which information is waived by the insurer; and
4. Facts which need not disclosed in view of a policy condition.
Thus, assured is under a solemn obligation to make full disclosure of material facts which may be relevant for the insurer to take into account while deciding whether the proposal should be accepted or not. While making a disclosure of the relevant facts, the
DOCTRINE OF PROXIMATE CAUSE
Where more perils than one act simultaneously or successively, it will be difficult to assess the relative effect of each peril or pick out one of these as the actual cause of the loss. In such cases, the doctrine of proximate cause helps to determine the actual cause of the loss.
Proximate cause was defined in Pawsey v. Scottish Union and National Ins. Co.,[5]as "the active, effective cause that sets in motion a train of events which brings about a result without the intervention of any force started and working actively from a new and independent source." It is dominant and effective cause even though it is not the nearest in time. It is therefore necessary when a loss occurs to investigate and ascertain what is the proximate cause of the loss in order to determine whether the insurer is liable for the loss.
PROXIMATE CAUSE OF DAMAGE
A fire policy covers risks where damage is caused by way of fire. The fire may be caused by lightening, by explosion or implosion. It may be result of riot, strike or on account of any, malicious act. However these factors must ultimately lead to a fire and the fire must be the proximate cause of damage. Therefore, a loss caused by theft of property by militants would not be covered by the fire policy. The view that the loss was covered under the malicious act clause and therefore .the insurer was liable to meet the claim is untenable, because unless and until fire is the proximate cause f damage, no claim under a fire policy would be maintainable.[6]
PROCEDURE FOR TAKING A FIRE INSURANCE POLICY
The steps involved for taking a fire insurance policy are mentioned below:
1. Selection of the Insurance Company:
There are many companies that offer fire insurance against unforeseen events. The individual or the company must take care in the selection of an insurance company. The judgment should rest on factors like goodwill, and long term standing in the market. The insurance companies can either be approached directly or through agents, some of them who are appointed by the company itself.
2. Submission of the Proposal Form:
The individual or the business owner must submit a completed prescribed proposal form with the necessary details to the insurance company for proper consideration and subsequent approval. The information in the Proposal Form should be given in good faith and must be accompanied by documents that verify the actual worth of the property or goods that are to be insured. Most of the companies have their own personalized Proposal Forms wherein the exact information has to be provided.
3. Survey of the Property/ Consideration:
Once the duly filled Proposal Form is submitted to the insurance company, it makes an "on the spot" survey of the property or the goods that are the subject matter of the insurance. This is usually done by the investigators, or the surveyors, who are appointed by the company and they need to report back to them after a thorough research and survey. This is imperative to assess the risk involved and calculate the rate of premium.
4. Acceptance of the Proposal:
Once the detailed and comprehensive report is submitted to the insurance company by the surveyors and related officers, the former makes a thorough perusal of the Proposal Form and the report. If the company is satisfied that their is no lacuna or foul play or fraud involved, it formally "accepts" the Proposal Form and directs the insured to pay the first premium to the company. It is to be noted that the insurance policy commences after the payment and the acceptance of the premium by the insured and the company, respectively. The Insurance Company issues a Cover Note after the acceptance of the first premium.
PROCEDURE ON RECEIPT OF NOTICE OF LOSS
On receipt of the notice of loss, the insurer requires the insured to furnish details pertaining to the loss in a claim from relating to the following information-
1. Circumstances and cause of the fire;
2. Occupancy and situation of the premises in which the fire occurred;
3. Insured's interest in the insured property; that is capacity in which the insured claims and whether any others are interested in the property;
4. Other insurances on the property;
5. Value of each item of the property at the time of loss together with proofs thereof , and value of the salvage ,if any; and
6. Amount claimed
Furnishing such information relating to the claim is also a condition precedent to the liability of the insurer. The above information will enable the insurer to verify whether-
(1) The policy is in force;
(2) The peril causing the loss is an insured peril;
(3) The property damaged or lost is the insured property.
Rules for calculation of value of property
The value of the insured property is-
1) Its value at the time of loss, and
2) At the place of loss, and
3) Its real or intrinsic value without any regard for its sentimental vale. Loss of prospective profit or other consequential loss is not to be taken into account.
FILING OF CLAIMS
How a claim arises?
After a contract of fire insurance has come into existence, a claim may arise by the operation of one or more insured perils on an unsecured property. There may in addition one or more uninsured perils also operating simultaneously or in succession of the property. In order that the claim should be valid the following conditions must be fulfilled:
1. The occurrence should take place due to the operation of an insured peril or where both insured and other perils operated , the dominant or efficient cause of the loss must have been an insured peril;
2. The operation of the peril must not come within the scope of the policy exceptions;
3. The event must have caused loss or damage of the insured property;
4. The occurrence must be during the currency of the policy;
5. The insured must have fulfilled all the policy conditions and should also comply with requirements to be fulfilled after the claim had arisen.
MATERIAL FACTS IN FIRE INSURANCE: PREVIOUS CONVICTION OF THE ACCUSED
The criminal record of an assured could affect the moral hazard, which insurers had to assess, and the non-disclosure of a serious criminal offence like robbery by the plaintiff would a material non-disclosure.
INSURED'S DUTY ON OUTBREAK OF FIRE, IMPLIED DUTY
On the outbreak of a fire the insured is under an implied duty to observe good faith towards the insurers and the in pursuance of it the insured must do his best to avert or minimize the loss. For this purpose he must (1) take all reasonable measures to put out the fire or prevent its spread, and (2) assist the fire brigade and others in their attempts to do so at any rate not come in their way.
With this object the insured property may be removed to a place of safety. Any loss or damage the insured property may sustain in the course of attempts to combat the fire or during its removal to a place of safety etc., will be deemed to be loss proximately caused by the fire.
If the insured fails in his duty willfully and thereby increases the burden of the insurer, the insured will be deprived of his right to revive any indemnity under the policy.[7]
INSURER'S RIGHTS ON THE OUTBREAK OF FIRE
(A) Implied Rights
Corresponding to the insured's duties the insurers have rights by the law, in view of the liability they have undertaken to indemnify the insured. Thus the insurers have a right to-
o Take reasonable measures to extinguish the fire and to minimize the loss to property, and
o For that purpose, to enter upon and take possession of the property.
The insurers will be liable to make good all the damage the property may sustain during the steps taken to put out the fire and as long as it in their possession, because all that is considered the natural and direct consequence of the fire; it has therefore been held in the case of Ahmedbhoy Habibhoy v. Bombay Fire Marine Ins. Co [8] that the extent of the damage flowing from the insured peril must be assessed when the insurer gives back and not as at the time when the peril ceased.
(B) Loss caused by steps taken to avert the risk
Damage sustained due to action taken to avoid an insured risk was not a consequence of that risk and was not recoverable unless the insured risk had begun to operate. In the case of Liverpool and London and Globe Insurance Co. Ltd v. Canadian General Electric Co. Ltd., [9] the Canadian Supreme Court held that "the loss was caused by the fire fighters' mistaken belief that their action was necessary to avert an explosion , and the loss was not recoverable under the insurance policy, which covered only damage caused by fire explosion., and the loss was not recoverable under the insurance policy, which covered only damage caused by fire or explosion."
(C) Express rights
Condition 5- in order to protect their rights well insurers have prescribed for better rights expressly in this condition according to which on the happening of any destruction or damage the insurer and every person authorized by the insurer may enter, take or keep possession of the building or premises where the damage has happened or require it to be delivered to them and deal with it for all reasonable purposes like examining, arranging, removing or sell or dispose off the same for the account of whom it may concern.
When and how a claim is made?
In the event of a fire loss covered under the fire insurance policy, the Insured shall immediately give notice thereof to the insurance company. Within 15 days of the occurrence of such loss, the Insured should submit a claim in writing, giving the details of damages and their estimated values. Details of other insurances on the same property should also be declared.
The Insured should procure and produce, at his own expense, any document like plans, account books, investigation reports etc. on demand by the insurance company.
HOW INSURANCE MAY CEASE?
Insurance under a fire policy may cease in any of the following circumstances, namely:
(1) Insurer avoiding the policy by reason of the insured making misrepresentation, misdescription or non-disclosure of any material particular;
(2) If there is a fall or displacement of any insured building range or structure or part thereof , then on the expiry of seven days wherefrom, except where the fall or displacement was due to the action of any insured peril; notwithstanding this, the insurance may be revived on revised terms if express notice is given to the company as soon as the occurrence takes place;
(3) The insurance may be terminated at any tie at the request of the insured and at the option of the company on 15 days notice to the insured
CONCLUSION
Tangible property is exposed to numerous risks like fire, floods, explosions, earthquake, riot and war, etc. and insurance protection can be had against most of these risks severally or in combination. The form in which the cover is expressed is numerous and varied. Fire insurance in its strict sense is concerned with giving protection against fire and fire only. So while granting a fire insurance policy all the requisites need be fulfilled. The insured are under a moral and legal obligation to be at utmost good faith and should be telling true facts and not just fake grounds only with the greed to recover money. Further all insurance policies help in the development of a Developing nation. Hence insurance companies have a burden to help the insured when the insured are in trouble.
REFERENCE:
1. (1983) VR 698 (Supreme Court of Vienna)
2. Callaghan v. Dominion Insurance Co. Ltd. (1997) 2 Lloyd's Rep. 541 (QBD)
3. Small v. U.K Marine Insurance Association (1897) 2 QB 311
4. (1925) AC 619
5. (1907) Case.
6. National Insurance Company v. Ashok Kumar Barariio
7. Devlin v. Queen Insurance Co, (1882) 46 UCR 611.
8. (1912) 40 IA 10 PC
9. (1981) 123 DLR (3d) 513 (Supreme Court of Canada)
Books Referred:
1. The Economics of Fire Protection by Ganapathy Ramachandran
2. Modern Insurance Law, by John Birds
3. The Handbook of Insurance Regulatory and Development Authority Act and Regulations with Allied Laws ,by Nagar

Executive Liability Insurance

Since its inception about fifty years ago, D&O insurance has evolved into a family of products responding differently to the needs of publicly traded companies, privately held businesses and not-for-profit entities and their respective board members, officers and trustees.
Directors' & Officers' Liability, Executive Liability or Management Liability insurance are essentially interchangeable terms. However, insuring agreements, definitions, exclusions and coverage options vary materially depending upon the type of policyholder being insured and the insurer underwriting the risk. Executive Liability insurance, once considered a necessity solely for publicly traded companies, particularly due to their exposure to shareholder litigation, has become recognized as an essential part of a risk transfer program for privately held companies and not-for-profit organizations.
Optimization of protection is a common goal shared by all types of organizations. In our opinion, the best way to achieve that objective is through engagement of highly experienced insurance, legal and financial advisors who work collaboratively with management to continually assess and treat these specialized enterprise risk exposures.
Private Company D&O Exposures
In 2005, Chubb Insurance Group, one of the largest underwriters of D&O insurance, conducted a survey of the D&O insurance purchasing trends of 450 private companies. A significant percentage of respondents gave the following reasons for not purchasing D&O insurance:
• did not see the need for D&O insurance,
• their D&O liability risk was low,
• thought D&O risk is covered under other liability policies
The companies responding as non-purchasers of D&O insurance experienced at least one D&O claim in the five years preceding the survey. Results showed that private companies with 250 or more employees, were the subject of D&O litigation during the preceding five years and 20% of companies with 25 to 49 employees, experienced a D&O claim.
The survey revealed 43% of D&O litigation was brought by customers, 29% from regulatory agencies, and 11% from non-publicly traded equity securities holders. The average loss reported by the private companies was $380,000. Companies with D&O insurance experienced an average loss of $129,000. Companies without D&O insurance experienced an average loss of $480,000.
Some Common Examples of Private Company D&O Claims
• Major shareholder led buy-outs of minority shareholders alleging misrepresentations of the company's fair market value
• purchaser of a company or its assets alleging misrepresentation
• sale of company assets to entities controlled by the majority shareholder
• creditors' committee or bankruptcy trustee claims
• private equity investors and lenders' claims
• vendors alleging misrepresentation in connection with an extension of credit
• consumer protection and privacy claims
Private Company D&O Policy Considerations
Executive Liability insurance policies for privately held companies typically provide a combination or package of coverage that includes, but may not be limited to: Directors' & Officers' Liability, Employment Practices Liability, ERISA Fiduciary Liability and Commercial Crime/ Fidelity insurance.
D&O policies, whether underwritten on a stand-alone basis or in the form of a combination-type policy form, are underwritten on a "claims-made" basis. This means the claim must be made against the Insured and reported to the insurer during the same effective policy period, or under a specified Extended (claims) Reporting Period following the policy's expiration. This is a completely different coverage trigger from other liability policies such as Commercial General Liability that are traditionally underwritten with an "occurrence" trigger, which implicates the insurance policy that was in effect at the time of the accident, even if the claim is not reported until years later.
"Side A" coverage, which protects individual Insureds in the event the Insured entity is unable to indemnify individuals, is a standard agreement contained within many private company policy forms. These policies are generally structured with a shared policy limit among the various insuring agreements resulting in a more affordable insurance product tailored to small and mid-sized enterprises. For an additional premium, separate policy limits may be purchased for one or more of each distinct insuring agreement affording a more customized insurance package.
Also, policies should be evaluated to determine whether they extend coverage for covered "wrongful acts" committed by non-officers or directors, such as employees, independent contractors, leased, and part-time employees.
Imputation of Knowledge & Severability
Coverage can be materially affected if an Insured individual has knowledge of facts or circumstances or was involved in wrongful conduct that gave rise to the claim, prior to the effective date of policy under which the claim was reported. Policies differ as to whether and to what extent, the knowledge or conduct of one "bad actor" may be imputed to "innocent "individual Insureds and / or to the Insured entity.
"Severability", is an important provision in D&O policies that is often overlooked by policyholders until it threatens to void coverage during a serious pending claim. The severability clause can be drafted with varying degrees of flexibility-- from "partial" to "full severability." A "full severability" provision is always most preferable from an Insured's standpoint. Many D&O policies, impute the knowledge of certain policy-specified senior level officer positions to the Insured entity. That imputation of knowledge can operate to void coverage that might have otherwise been available to the Insured entity.
M&A and "Tail Coverage" Considerations
The "claims-made" coverage trigger is critically important in an M&A context where contingent liability risks are inherent. In these contexts, it's important to evaluate the seller's policies' options to purchase a "tail" or "extended reporting period" for each of the target company's policies containing a "claims-made" trigger.
A "tail" coverage option allows for the reporting of claims alleging "wrongful acts" that occurred during the expired policy period, yet were not actually asserted against the Insured until after the policy's expiration, but instead were asserted during the "extended reporting" or "tail" period. An acquiring company's insurance professional should work closely with legal counsel's due diligence team to identify and present alternatives to manage contingent exposures.
What a Director or Officer Doesn't Know Will Hurt Them
Directors' & Officers' Liability insurance policies were originally created solely to protect the personal assets of the individuals serving on public company boards and executive officers. In 1992, one of the most prominent D&O insurers led a major transformational change in D&O underwriting by expanding coverage to include certain claims against the insured entity. Entity coverage for publicly traded companies is typically restricted to securities claims, while privately held companies and not-for-profit organizations benefit from more comprehensive entity coverage because they lack the public securities risk exposure of publicly traded companies.
The "Claims- Made" Coverage Trigger
D&O policies are universally underwritten on a 'claims-made' basis. This translates to an unequivocal contractual requirement that the policyholder report claims made against an Insured to the insurer during the effective policy period. The only exception is in the case where an optional reporting 'tail' is purchased which affords the Insured the ability to report claims during a specified "extended reporting period," as long as the wrongful act occurred during the effective period of the immediately preceding policy.
Defense
D&O policies issued to public companies generally contain no explicit duty to defend and some require the Insured to select from a pre-approved panel of pre-qualified defense counsel. In contrast, many private company D&O policies do contain a provision placing the defense obligation squarely upon the insurer, and still other policies contain options allowing the defense to be tendered by the Insured to the insurer within a specific period of time. Some D&O policies contain defense cost provisions that require an allocation or sharing of the defense costs between the Insured and Insurer, based upon a determination of covered versus non-covered allegations.
Settlement Hammer
D&O policies typically contain a "settlement hammer" provision. This clause operates to limit an insurer's obligation to indemnify in the event the Insured refuses to consent to a settlement that is acceptable to the insurer. Some policies may express the amount the insurer will pay for covered loss under this circumstance as a percentage of the ultimate covered settlement or judgment. Other D&O policies may limit their economic exposure to the amount for which the case could have historically settled, but for the Insured's refusal.
Regulatory Proceedings and Investigations
Most D&O insurance policies afford qualified protection against "regulatory and governmental" investigations, "administrative or regulatory proceedings," and criminal proceedings. Policies often require the proceedings to be directed against a natural person Insured, to be commenced and maintained in a manner specified in the policy, such as a 'formal' order of investigation, and only for policy-defined defense expenses incurred after the issuance of a formal order or an indictment.
D&O policies' definitions and other corresponding provisions and exclusions vary, and should be carefully evaluated to determine whether they encompass informal investigations from the time a subpoena is received, or from the time an Insured person is identified in writing as a person against whom charges may be filed.
Learning the A,B,C's and D's of D&O Coverage
The three main Insuring Agreements found in public company D&O policies, are typically referenced as "Side A, B, and C coverage". They are sometime supplemented with an optional Coverage D.
"Side A "Coverage - Individual Insured Coverage
"Side A Coverage," also known as the "Non-Indemnifiable Loss Insuring Agreement," provides coverage to individual officers and directors against claims for their policy-defined wrongful acts in their official capacities, under fairly rare circumstances in which the Insured entity either cannot or will not provided indemnification.
The policy's "Side A" coverage for non-indemnifiable claims against directors and officers, almost universally provides that no retention is required to be paid by individual Insureds. A separate "Side A" limit may be available in addition to the traditional D&O policy's aggregate limit of liability. "Side A" excess D&O policies have become more commonplace in the past several years, and certain "Side A" excess policies may also offer "difference in conditions" ('DIC') coverage that generally provides a feature of 'dropping down' to respond to claims either not paid by the primary or underlying D&O policy insurer, or in the event indemnification is unavailable from the Insured entity, the underlying limits are eroded by covered claims against the entity, or the underlying D&O insurers deny coverage to the directors. Some Side A policies are underwritten as non-rescindable by the insurer. Purchasers of this coverage should also consider, if available, an option for reinstatement of policy limits for the outside directors, in the event of premature policy limit exhaustion.
"Side B" Coverage - Corporate Reimbursement Coverage
This insuring agreement reimburses the Insured entity for covered loss under claim circumstances where the corporation is indemnifying its directors and officers. This provision does not afford any coverage to the Insured entity for its own potential liability, and is subject to a self-insured retention ("SIR") that must be paid by the Insured entity before an Insurer will make any payments. It's important to note that many Insureds do not realize they are contractually obligated to obtain the insurer's prior consent to incur costs and expenses, and only those costs and expenses approved in advance by the insurer will be deemed to have satisfied the Insured entity's SIR obligation. It's important for policyholders to understand they run a serious risk of losing some or all of their otherwise available coverage, if they incur legal expenses prior to reporting the claim, or if they enter into negotiations or reach a settlement agreement in principle without the insurer's prior knowledge and consent.
"Side C" Coverage - Entity Coverage
This insuring agreement affords coverage to the publicly traded Insured entity only for it own liability and is typically restricted to coverage for securities-related claims. "Securities Claims" is a policy-defined term, encompassing only claims arising from the Insured entity's own securities. Privately held companies and organizations are afforded substantively different coverage under this insuring agreement.
"Side D" Coverage - Outside Entity Insured Person Coverage
This insuring clause is available as an option on most D&O policies. It provides coverage to designated "Insured Persons", for their liability as a result of their membership on an "Outside Entity" board. This coverage applies on a "double excess" basis, meaning it is triggered after the exhaustion of any indemnification provided by the Outside Entity to the Outside Entity director, as well as any insurance coverage available from the Outside Entity. Traditional D&O policies typically extend automatic coverage to insured Individuals who are designated by the policyholder to participate as a board member of a not-for-profit organization.
Some Additional Considerations
In addition to the topics highlighted earlier, D&O insurance purchasers should gain familiarity with how their policies may respond under bankruptcy situations, potential coverage issues arising from a Special Committee's investigative activity, potential issues involving priority of payments among Insureds, hidden D&O insurance program design flaws that can render excess D&O policies unresponsive to catastrophic claims, and the changing requirements of international D&O coverage to remain compliant with local country regulations. These topics will be covered in a future article.
This article provides general information and is neither intended to provide any legal advice nor to provide any advice with regard to the specific interpretation or operation of any insurance policy. Any insurance policy's applicability is highly fact specific. Qualified legal counsel should be consulted regarding laws that may apply with respect to policy coverage interpretation in the state in which the policy will be interpreted.

The author, James J. Ilardi, CPCU, is a Chartered Property and Casualty Underwriter and President of SECURA RISK GROUP, LLC.
SECURA RISK GROUP is a New York based, independent commercial insurance brokerage and advisory firm. The firm specializes in the evaluation, design and procurement of business insurance policies and insurance programs for privately held enterprises, publicly traded companies, non-profit organizations and professional service firms. SECURA RISK GROUP also provides claims advisory and support services.

Auto Insurance Principles Should Apply to Health Insurance

Many Americans rely on their automobiles to get to work. No automobile means no job, no rent or mortgage money, no food. A single parent, struggling to make ends meet in the suburbs with 100,000 miles on the odometer, would presumably welcome the guaranteed opportunity for low-priced insurance that would take care of every possible repair on her auto until the day that it reaches 200,000 miles or falls apart, whichever comes first. Especially if the insurance is valid regardless of whether she even changes the oil in the interim.
So why aren't the auto insurance companies writing such coverage, either directly or through used auto dealers? And given the importance of reliable transportation, why isn't the public demanding such coverage? The answer is that both auto insurers and the public know that such insurance can't be written for a premium the insured can afford, while still allowing the insurers to stay solvent and make a profit. As a society, we intuitively understand that the costs associated with taking care of every mechanical need of an old automobile, particularly in the absence of regular maintenance, aren't insurable. Yet we don't seem to have these same intuitions with respect to health insurance.
If we pull the emotions out of health insurance, which is admittedly hard to do even for this author, and look at health insurance from the economic perspective, there are several insights from auto insurance that can illuminate the design, risk selection, and rating of health insurance.
Auto insurance comes in two forms: the traditional insurance you buy from your agent or direct from an insurance company, and warranties that are purchased from auto manufacturers and dealers. Both are risk transfer and sharing devices and I'll generically refer to both as insurance. Because auto third-party liability insurance has no equivalent in health insurance, for traditional auto insurance, I'll examine only collision and comprehensive insurance -- insurance covering the vehicle -- and not third-party liability insurance.
Bumper to Bumper
The following are some commonly accepted principles from auto insurance:
* Bad maintenance voids certain insurance. If an automobile owner never changes the oil, the auto's power train warranty is void. In fact, not only does the oil need to be changed, the change needs to be performed by a certified mechanic and documented. Collision insurance doesn't cover cars purposefully driven over a cliff.
* The best insurance is offered for new models. Bumper-to-bumper warranties are offered only on new cars. As they roll off the assembly line, automobiles have a low and relatively consistent risk profile, satisfying the actuarial test for insurance pricing. Furthermore, auto manufacturers usually wrap at least some coverage into the price of the new auto in order to encourage an ongoing relationship with the owner.
* Limited insurance is offered for old model autos. Increasingly limited insurance is offered for old model autos. The bumper-to-bumper warranty expires, the power train warranty eventually expires, and the amount of collision and comprehensive insurance steadily decreases based on the market value of the auto.
* Certain older autos qualify for additional insurance. Certain older autos can qualify for additional coverage, either in terms of warranties for used autos or increased collision and comprehensive insurance for vintage autos. But such insurance is offered only after a careful inspection of the automobile itself.
* No insurance is offered for normal wear and tear. Wiper blades need replacement, brake pads wear out, and bumpers get dings. These aren't insurable events. To the extent that a new car dealer will sometimes cover some of these costs, we intuitively understand that we're "paying for it" in the cost of the automobile and that it's "not really" insurance.
* Accidents are the only insurable event for the oldest automobiles. Accidents are generally insurable events even for the oldest autos; with few exceptions service work isn't.
* Insurance doesn't restore all vehicles to pre-accident condition. Auto insurance is limited. If the damage to the auto at any age exceeds the value of the auto, the insurer then pays only the value of the auto. With the exception of vintage autos, the value assigned to the auto goes down over time. So whereas accidents are insurable at any vehicle age, the amount of the accident insurance is increasingly limited.
* Insurance is priced to the risk. Insurance is priced based on the risk profile of both the automobile and the driver. The auto insurer carefully examines both when setting rates.
* We pay for our own insurance. And with few exceptions, automobile insurance isn't tax deductible. As a result, the fear of increasing insurance rates due to traffic violations and/or accidents changes our driving behavior and we sometimes select our automobiles based on their insurability.
Each of the above principles is supported by solid actuarial theory. Although most Americans can't describe the underlying actuarial theories, most everyone understands the above principles of auto insurance at the intuitive level. For sure, as indispensable automobiles are to our lifestyles, there is no loud national movement, accompanied by moral outrage, to change these principles.