1 All change Is it the end of the line for professional indemnity and construction all risk insurance? Paul Reed QC April 2015
2 Risk, the need to reform construction insurance, Integrated Project Insurance and the Insurance Act 2015 Change in profile of construction risk Insurance Act 2015 Integrated Project Insurance in place of Professional Indemnity (PI) and Construction All Risks Insurance (CAR) Reforming Insurance Market Wordings.
3 Domestic Claims The Gherkin The Cheese Grater Heron Tower The Shard The Walkie Talkie
4 Large Policy Claims
5 Professional Indemnity and CAR Major Insurers are no longer prepared to provide insurance cover for construction industry professionals. Construction industry professionals, particularly architects and engineers, are more willing to rely on inadequate professional indemnity cover.
6 Professional Indemnity and CAR In 2014 several leading insurers announced their withdrawal from Architects and Design and Build Insurance. "As part of our strategy to improve the business performance of the Group we are sharpening our focus on target markets and segments where we can deliver sustainable returns and growth".
7 New forms of Construction
8 Innovative Design
9 Largest Losses by Severity Severity % of total incurred value 30% Frequency % of total incurred value 30% 25% 25% 20% 20% 15% 15% 10% 10% 5% 5% 0% Fire DES/W F A/D Coll Other 0% A/D DES/W F Fire Coll Other
10 Analysis 225 claims over $300m 16 major categories Frequency and severity similar. Design and workmanship the second most frequent and severe.
11 Trends in Total Incurred Value of Top Losses Fire D/W Flood Acc damage Collapse
12 Analysis A significant drop in losses caused by collapse and subsidence. Linked to improvement in building regulations and practices. Increase in flooding due to climate change. Increase in design and workmanship now second area of loss. Fire losses are large and usually preventable.
13 Frequency of National Category Perils Growing concern regarding frequency of national category perils. Earthquake Hurricane/typhoon Flood
14 Flood 70% 60% 50% 40% 30% total value % of total claim count 20% 10% 0%
15 Causes Failure to identify risk Flooding due to hurricane/typhoon Mould in humid climates Inadequate supply of quality materials
16 Causes Failure to manage risk Lack of knowledge of local conditions: Site location and layout Project design Construction sequencing
17 Causes Working with unfamiliar Joint Venture partners Working with unfamiliar major subcontractors
18 Rise of Flood as a Natural Peril 70% 60% 50% 40% 30% other % of total claim count 20% 10% 0%
19 Losses in Emerging Markets 120% 100% 80% 60% Flood Other 40% 20% 0%
20 Causes Disproportionate rise Less knowledge of geo technical conditions Reliance of local joint venturers Less rigid building regulations Different standard of materials
21 Domestic Claims Fire Design Value Engineering Flood
22 Allocating Risk More risk placed on Owner Caps, exclusions, deductibles for professionals Fewer Insurers, possible increase in premiums
23 Integrated Project Insurance Part of Government Construction Strategy Published July 2014 by Cabinet Office The Government Construction Strategy (2011) set out to achieve savings in construction procurement of up to 20%. Reforming procurement practices to effect behavioural and cultural change underpins this effort.
24 Objective The proposition is that IPI will cost no more than traditional project insurances, but the real benefits are from collaborating as a virtual company to eliminate process and procedural waste and deliver improved project performance and efficiency savings which achieve the expectations of Government Strategies.
25 Framework for IPI The IPI model requires the creation of an Alliance or Virtual Company Each practice or firm has a seat on the Board which collectively appoints an Alliance Manager. Staff are seconded to form an Integrated Project Team reporting to the Alliance Manager and Board. IPI is the crucial enabler for this model.
26 The Alliance Contract A flat structure of the client and other alliance members that brings together key parties. Free flows of information, including costing and payment (through a project bank account). The IPI policy which insures cost overrun above a shared deductible.
27 Capped Financial Exposure The pain-share is the excess under the financial loss section of the IPI policy. The Alliance members financial exposure is capped at their agreed share of the total pain-share.
28 Insured Outcomes IPI covers project outcomes and not individual liabilities: IPI pays the cost overrun beyond the excess subject to minimal exceptions. cover for incidents during design and construction, such as physical damage and third party claims. no fault latent defects insurance for 12 years.
29 Conditions IPI is only available as part of the IPI Model. Insurers agree a wider range of cover than under traditional project policies. Expected to recognise and fund overspends promptly after they have been identified and verified.
30 Study for the Office of Government Commerce The combined premium cost of traditional construction all risks, public liability and professional indemnity insurances on a commercial development throughout the supply chain amounted to 2.5%. The cost of IPI fixed at 2.5% of the project cost.
31 Cover Section 1: Construction All Risks (including Terrorism Extension) Section 2: Third Party Liability (including Non-Negligent Liability) Section 3: Delay in Completion (resulting from damage under Section 1) Section 4: Financial Loss cover Latent Defects cover (for 12 years) a no fault commercial latent defects insurance policy.
32 Insurance Act 2015 The Act addresses perceived current imbalance in the law in favour of insurers in the following areas: Disclosure and misrepresentation in business insurance contracts Insurance warranties Insurers remedies for fraudulent acts
33 Insurance Act 2015 Amends the Third Parties (Rights Against Insurers) Act 2010 so it can be brought into force. The 2010 Act simplifies the procedure for third parties to seek compensation from an insurer in circumstances where the insured has become insolvent or ceased to exist.
34 Insurance Act 2015 Correcting defects in the 2010 Act The 2010 Act failed to deal with all categories of insolvent or defunct entitles.
35 Fair Presentation of the Risk The insured has a duty to make a fair presentation of the risk to the insurer. The duty applies to pre-inception disclosure as well as variations of non-consumer insurance contracts.
36 The Duty of Fair Presentation Comprises of Three Elements The insured s duty of disclosure The insured must either: disclose every material circumstance which it knows or ought to know, or failing that, give the insurer sufficient information to put a prudent insurer on notice that it needs to make further enquiries for the purpose of revealing those material circumstances.
37 The First Limb Misrepresentation The duty includes the duty not to make misrepresentations (section 20 of the 1906 Act). The insured is not required to disclose material circumstances which the insurer knows, ought to know or is presumed to know.
38 The First Limb A business insured is taken to know what is known to the insured s senior management and individuals responsible for the insured s insurance. An insured ought to know what would have been revealed by a reasonable search of information available to the insured.
39 The Second Limb Changes the existing law It is intended to address the risk of an insurer taking a passive role in the disclosure process and only asking questions when the insured makes a claim under the policy. Requires the insured to make the disclosure in a manner which would be reasonably clear and accessible to a prudent insurer.
40 Knowledge knows : What is known to the individuals involved in that particular underwriting decision. ought to know : Information which is readily available to the underwriters or is known by an employee or agent of the insurer who ought reasonably to have passed it on. presumed to know : Matters it ought to know in the ordinary course of its business, such as industry knowledge.
41 Proportionate Remedies The new Act provides for a range of proportionate remedies. Unless the breach is deliberate or reckless (in which case the remedy of avoidance is still be available), the onus is on the insurer to show what it would have done had it received a fair presentation of the risk.
42 Proportionate Remedies Insurers will still be entitled to avoid the policy if they can show that had they received a fair presentation of the risk, they would not have entered into the contract. Will Insurers now introduce additional warranties or exclusions which affect the recoverability of claims?
43 Duty of Good Faith The duty of good faith remains as a interpretative principle. A breach of the duty no longer automatically entitles the insurer to avoid the policy and will instead be subject to proportionate remedies.
44 Warranties Under the 1906 Act, a breach of warranty discharges the insurer s liability under the contract in its entirety, even if the breach was trivial or did not relate to the insured s loss.
45 Warranties Under the new Act, a breach of warranty will no longer automatically take the insurer off risk. The Act makes warranties suspensive conditions. The insurer s liability will be suspended while the insured is in breach of a warranty but can be restored if the breach is subsequently remedied.
46 Basis of the Contract Clauses Clauses, which operate to turn the insured s pre-contractual representations (including answers to questions on a proposal form) into warranties are known as basis of contract clauses. These clauses have been abolished.
47 Terms to Reduce Particular Risks An insurer may not rely on the insured s breach of a term to avoid paying a claim if the breach could not have increased the risk of the loss. Applies to breaches of warranties and other terms which tend to reduce risk of loss of a particular kind or at a particular location or time. It does not apply to terms which define the risk as a whole.
48 Insurers Remedies for Fraudulent Claims An insurer: is not be liable to pay fraudulent claims. can elect to terminate the contract and refuse to pay claims relating to losses suffered after the fraud. will remain liable for all legitimate losses suffered before the fraud.
49 Contracting Out Parties to non-consumer insurance contracts may contract out (with the exception of the prohibition on basis of the contract clauses) as long as any disadvantageous term (which puts an insured in a worse position than that under the default regime) meets transparency requirements.
50 Transparency An insurer must take sufficient steps to draw the disadvantageous term to the insured s attention before the contract is entered into or the variation agreed; and the disadvantageous term must be clear and unambiguous as to its effect.
51 Reforming Standard Insurance Market Wordings All Risks CAR Insurance Is not insurance for all risks
52 All Risks Does not explain that all risks are not covered. Does not provide an explanation that all risks cover is not a guarantee of good condition or of good working order.
53 Example of a Standard Exclusion Wear and tear, corrosion and gradual deterioration Normal making good, wear, tear or the cost involved in rectifying normal wasting, wearing away, corrosion or gradual deterioration
54 Wear and Tear, Corrosion and Gradual Deterioration Wear and tear The ordinary and natural deterioration or abrasion that an object experiences by its expected contacts during its natural life expectancy.
55 Defect Exclusions Since 1985 a suite of standard form defect exclusion clauses, drafted by a committee of leading insurers, has been available to the market.
56 DE Clauses The clauses, labelled DE1 to DE5 by the original drafting committee, provide five different levels of cover thought to adequately define the various degrees of cover that insurers were prepared to offer.
57 LEG 1 to LEG 3 A similar suite of standard form defect exclusions clauses was introduced in 1996 by a consultative group of engineering insurers known as the London Engineering Group ( LEG ) for engineering class risk.
58 DE5 This policy excludes: The cost necessary to replace, repair or rectify any Property insured which is defective in design plan specification materials or workmanship; Loss or damage to the Property insured caused to enable replacement, repair or rectification of such defective Property insured. But should damage to the Property insured (other than damage as defined in (ii) above) result from such a defect, this Exclusion shall be limited to the costs of additional work resulting from and the additional costs of improvement to the original design plan specification materials or workmanship
59 The Issues The DE clauses use different terms without explanation So that they exclude the cost of repairing or replacing property which is lost or damaged due to defective design plan specification materials or workmanship (DE1) or in defective condition due to a defect in design plan specification materials or workmanship (DE2, DE3) or is defective in design plan specification materials or workmanship (DE4, DE5).
60 DE 1 Lack of Clarity An outright exclusion for damage caused by a defect Is defective workmanship limited to defective workmanship built into the insured property, as would be defective design? Was the intention to exclude damage to the building inflicted directly by a mistake in the method of working?
61 DE 1 Anomalous It is phrased so as to apply only where the damage is caused by ( due to ) a defect. It is anomalous that the other DE clauses contain no such requirement.
62 DE 2 Inconsistent Interpretation JCT requires the minimum level of cover that must be obtained in an all risks policy with a defects exclusion clause akin to DE2. However the minimum level of cover does not fully correspond to DE2 in one important respect. Requires cover where a defective part, and any structure supported by it, is damaged by a peril other than the defect itself, the standard DE2 wording exclude cover in this situation.
63 DE 3 May not provide wider cover than DE1 To apply the Insurers does not have to show a causal link between defect and damage as required by DE1, but merely that the property is in defective condition Provided the insurer can show that the property was in a defective condition the exclusion applies
64 DE 3 Requires Divisibility The exclusion hinges on the distinction between Property which is in defective condition and other Property insured which is free of the defective condition. Blackwell v Gerling, [t]his suggests, and indeed requires, divisibility.
65 Dividing the Indivisible No clear indication as to how to distinguish between defective and non-defective parts. Possible tests for property in defective condition whether the material or item in question is rendered less useful or valuable by reason of the defect. whether the item was likely to be damaged if the defect materialised. whether the item is distinct in commercial or construction terms from the defect.
66 DE 3 Dividing the Indivisible Tuckey L.J. in Blackwell (Contractors) Ltd v Gerling the property insured excluded by the clause must be restricted to that part of the works which has suffered damage. If that part is wholly or partly defective the exclusion applies. But the assured can only claim an indemnity for loss or damage so the real question is how the works should notionally be divided into parts for these purposes.
67 DE 3 Dividing the Indivisible Moore-Bick L.J. in Seele v Tokio Marine considered that the clause was intended to preserve cover in respect of parts of the work which in commercial terms are to be regarded as separate and distinct from that part in which the defect exists It appears that one asks the question: is the defect contained within an area which the participants would treat as being a distinct package, or stage, of the works
68 DE 4 Defective Part Exclusion Like DE3, it distinguishes between defective and non-defective parts of the insured property, but identifies the excluded property with the narrower phrase component part or individual item. But what constitutes the component part?
69 DE 5 Design Improvement Exclusion DE5 preserves the most generous scope of cover for consequential damage. If the defect causes damage to the property over and above the defect itself, the assured is entitled to the costs of re-instating all of the damaged property, including to the defective part, less the additional costs (if any) of improving the original design, materials etc.
70 DE 5 Design Improvement Exclusion The basic exclusion for the cost of remedying the defective property applies whether or not the damage is caused by the defect. The write-back for loss of or damage to the defective property is limited to the situation where damage result[s] from such a defect. Accordingly, at least if the clause is to be read literally, it has the opposite effect to DE1.
71 DE 5 Design Improvement Exclusion The policy will indemnify for damage to defective property where it is damaged as a result of the defect, but not where damage to the defective property is caused by an unrelated peril.
72 DE 5 Design improvement exclusion It would have been possible to make a distinction in DE5 between improvements to the original design of the Property insured which is carried out voluntarily and betterment that is the unavoidable consequence of carrying out remedial works.
73 DE Clauses: General It has been held that the Report of the Insurance Institute of London, which describes the background market developments is: [I]nstructive about the purpose of defect exclusion clauses and how they have evolved [b]ut... cannot be used as an aid to construction of the clause in question which must be construed according to its terms.
74 Reform There is a natural tension in using standard wording in bespoke policies. Exclusion clauses ought to be capable of being easily understood and applied. There is no rational basis for not using simple plain English and to provide accompanying guidance notes.
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