2 Insurance This is protection against something that might happen eg: a road accident, a fire, theft. Insurance is needed to reduce the financial risk when a household is faced with problems caused by damage to property, personal injury or death.
3 Insurance It is an agreement between an individual who is afraid of incurring a loss (insured), and an insurance company (insurer). In return for a fee (called a premium), the insurer will make good to the insured (compensate) if this loss occurs.
4 The Insurer This is the insurance company who sells insurance/assurance The Insured This is the person purchasing insurance/ assurance. They are protecting themselves against possible financial loss.
5 The Premium This is the fee paid by the insured to the insurer to purchase insurance The greater the risk (the more likely it is that the insurance company has to pay out compensation) the higher the premium To Compensate This means to make a payment to make amends/ to make good Compensation is the money paid out if damage or loss occurs
6 Incoming Money Premiums INSURANCE Profits on FUND Investments Compensation Insurance Outgoing Money Investment of Premiums PROFIT FOR THE INSURANCE COMPANY Payment of Expenses Payment of
7 Assurance Assurance means making provision for something which will happen. eg.: death
8 Whole life Assurance This provides an agreed sum of money for your family after your death. Endowment Assurance This pays an agreed sum of money upon reaching a certain age or at your death if it comes first. It can be a useful way of saving money
9 Term/Temporary Assurance This provides cover for an agreed period of time. The Insurance company guarantees to pay an agreed sum of money to the dependents of an insured person if the person dies before a certain age. Once the age has been reached the cover ceases. It is used to cover the period when children are growing up and being educated, or when the mortgage is being paid. It provides for those left behind if the main income earner dies
10 What is the surrender value? The insured stops paying the premiums on an endowment assurance policy and cashes it in for a sum less than the agreed amount
11 Life Assurance and Insurance differ in two ways i. - With insurance there is a possibility of the event occurring - With life assurance there is certainty that the person will die or reach a certain age ii. - Insurance is taken out on an annual basis. - Life Assurance is taken out over a definite number of years
12 What is meant by Adequate Assurance? Adequate assurance should: 1. Cover all possible risks 2. Be enough to cover any loss that might occur eg.: if a house is worth 250,000, it should be insured for 250,000 and no less
13 What is Risk? This is the danger or chance that damage, loss or injury could occur.
14 Insurable Risks These are risks that can be insured against eg.: you can insure your own house as its loss would cause you financial suffering Non Insurable Risks These are risks that cannot be insured against eg.: it s impossible to calculate the risk You cannot insure your neighbours house as it s loss wouldn t cause you financial suffering eg.: competition, new laws, strikes, changes in tastes, increases in costs, etc
15 Not all situations can be covered by insurance. For a risk to be insurable, the following conditions must be present:
16 1. There must be an Insurable Interest (ownership) in the thing or person being insured The Insurable Interest Principle states that the insured must gain from its existence and suffer from its loss. 2. There must be enough other people wanting to take out insurance against a similar risk. 3. Any loss incurred must be accidental and not certain. 4. The possible losses should not be too great as to ruin the insurance company 5. It must be possible to calculate the risk of a loss occurring
17 If any one of the five conditions is missing, the risk is uninsurable
18 Exclusion Clause Most insurance and assurance policies have an exclusion clause, which states the conditions under which certain situations are not covered by insurance eg.: Life assurance policies will not cover death from taking drug, or during a war or riot. Motor insurance will not cover a private car used for speed testing
19 An Insurance Broker This is an agent who sells insurance for several insurance companies. They give advice to people seeking insurance and help people to find a policy that suits their needs and which is has the most competitive premium. You submit your proposal and claim forms to the broker. These act as a medium/middle man between the insured and the insurance company. A small commission, called brokerage, is charged for this service.
20 A Proposal Form This is an application form for an insurance company. It gives the insurer essential details needed to assess the risk and calculate the premium
21 On receiving the completed proposal form, the insurer can then: 1. Accept/reject the proposal 2. Calculate the premium to be charged It must be completed truthfully and accurately, as the principle of Utmost Good Faith applies
22 Two important principles of insurance are relevant when applying for insurance: i. Utmost good faith ii. Insurable interest
23 Principle of Utmost Good Faith This states that you must give all information on the proposal form which could influence the insurer s decision to give you insurance cover The proposal form must be answer accurately and truthfully, and all relevant information must be provided eg.: that your home has a thatched roof
24 If lies are told and a claim arises, the insurer will not pay any compensation because the principle of utmost good faith will have been broken. The insured agrees to this principle when signing the proposal form
25 Insurable Interest Principle This states that the person seeking insurance must gain from the existence and suffer from the loss of the person or item being insured
26 The proposal form requires the following details: 1. The persons name and address 2. The type of cover required
27 3. It will also require some of the following information: CAR INSURANCE LIFE ASSURANCE HOUSE CONTENTS Age & Gender of Driver Age of Person Value of House Occupation Occupation Value of Contents Type of Licence Hobbies Alarm Systems Details of Car No Claims Bonus Medical Condition Drinker or Smoker
28 An Actuary This is the insurance official who calculates the appropriate premium to charge each client The calculation of the premium depends on: 1. The number of people seeking insurance 2. The risk involved, 3. The amount to be covered 4. The number of claims being made
29 Loadings These increase the premium being paid. The increased premium is a result of the increased financial risk attached to the item(s)/asset(s)/person(s) being insured. eg.: a young male driver seeking car insurance pays a higher premium eg.: a house having a thatched roof increases the premium eg.: a smoker wishing to take out a life assurance policy
30 Deductions These reduce the amount of premium being paid. The reduced premium is a result of the reduced financial risk attached to the item(s)/asset(s)/person(s) being insured. eg.: a burglar alarm installed on a house eg.: having a no-claims bonus
31 CAR LIFE PROPERTY Loadings Loadings Loadings First insurance Dangerous occupation Type of construction Under 25 years old Dangerous hobby Nature of business Provisional Licence Use of car for business purposes Medical Condition Travelling abroad Deductions Deductions Deductions No claims bonus Non-smoker Fire alarms Non-drinker Non-drinker Burglar alarms Member of Neighbourhood watch
32 A Cover Note This is issued by the insurers when it is not possible to issue a policy immediately. This is mainly used in the motor insurance industry It acts as proof that the person has insurance cover. With car insurance, an insurance disk must be displayed on the window screen to show that the car is insured
33 A No Claims Bonus This is a reward individuals get for not claiming compensation from the insurer. This bonus usually results in a lower premium.
34 Insurance Policy This is an insurance document that gives full details of the cover being given A Policy Excess Clause This states that a certain amount of the loss must be paid for by the insured eg.: the first 200 or 10%. This stops small claims being made
35 Types of Insurance There are 5 main types if insurance 1. Personal Insurance 2. Property Insurance 3. Life Assurance 4. Motor Vehicle Insurance & 5. Insurance for Businesses
36 1 Personal Insurance i. Personal Accident Insurance is when people receive compensation because they are injured and unable to work ii. Medical Insurance covers the cost of doctors, hospitals and other expenses in times of illness. The V.H.I., Quinn, an Vivas are the main medical insurers
37 1 Personal Insurance iii. Salary Protection Insurance gives extra protection to someone who has to go out on early retirement with a small pension iv. PRSI (Pay Related Social Insurance) is a state or social insurance which covers people who are out of work through illness, disability, maternity leave, unemployment, etc.
38 1 Personal Insurance v. Travel Insurance gives compensation in the event of a trip being cancelled, a person becoming ill or having an accident whilst away. It can cover goods being stolen whilst away, lost baggage, etc
39 2 Property Insurance i. House Insurance covers the house if its damaged by fire or during a break in. ii. House Contents Insurance gives compensation if household contents are stolen or damaged eg.: furniture, clothes, etc
40 2 Property Insurance iii. All Risks Insurance covers any accidental loss or damage to household property. It covers loss or damage to selected items anywhere in Ireland or Europe. Each item must be named when taking out the insurance cover. eg.: a valuable painting or necklace
41 3 Life Assurance i. Whole Life Protection for those left behind ii. Term Protection for those left behind iii. Endowment Savings or retirement
42 4 Motor Vehicle Insurance By law any person who drives a car must have insurance for any claims made by third parties i.e. hence the name third party insurance. Third party covers damage to all people and property other than the driver of the car and the car they were driving
43 4 Motor Vehicle Insurance Motorists can also take out the following: ii. Fire and theft Insurance compensates the insured in the case of the car going on fire or being stolen. It also provides third party cover. iii. Comprehensive Insurance which gives third party, fire and theft cover as well as accidental damage cover (for damage to the car driver and the motorist s own car)
44 5. Insurance for Businesses 1. Motor Insurance protects against damage or injury caused by their motor vehicles Third party insurance is compulsory on all motor vehicle owned by a business 2. Fire Insurance covers damage to property, stock, etc due to fire 3. Burglary Insurance insures against the theft of stock, cash, equipment, etc. 4. Key Person Insurance provides life assurance policies for key members of staff eg.: managing director, key sales person
45 5. Insurance for Businesses 5. Employers Liability Insurance protects employers against claims made by employees who are injured at work. 6. Public Liability Insurance protects businesses against claims made by members of the public who were injured on the businesses premises 7. Product Liability Insurance protects businesses against claims made by members of the public who are injured using a business s product
46 5. Insurance for Businesses 8. Goods in Transit insures against any loss, damage or theft of goods being transported. 9. Fidelity Guarantee protects against any theft by employees 10. Consequential Loss covers the business against loss of profits and temporary closure due to a flood or fire say. 11. Bad Debts protects against any losses due to customers not paying their debts.
47 Risks a business cannot insure against (what are these risks called?) a. Losses due to poor management b. Goods going out of date or no longer needed c. Legal changes affecting the business eg.: loss of profits due to smoking ban
48 By law PRSI and third party insurance must be paid
49 Making a Claim In the event of a loss, an injured person can claim compensation from the insurer. This compensation can come in the form of money or replacement of the item insured. A Claim When an insured person suffers an injury or loss, they have a right make a demand/to call for compensation.
50 An Assessor This is an insurance official who inspects the damage or loss and recommends the amount of compensation to be paid
51 How to make a claim 1. Inform the insurer (and Gardai of the loss) 2. Obtain estimates to repair or replace what is lost 3. Complete a claims form truthfully 4. The assessor inspects the damage or loss and estimates the compensation (taking in mind the estimate 5. Compensation is agreed and payment or replacement is made
52 Claim Form This must be completed when compensation for a loss/damage is sought. It must be completed fully and truthfully. Questions vary, but will include: Name and address, policy number, details of claim, replacement costs, etc This form is then used to determine: if the loss was accidental/deliberate, if the proximate clause policy applies and the amount off compensation to be paid
53 The Proximate Clause Policy The cause of the loss must be what was insured against eg.: fire as opposed to theft
54 Certain principles apply when making a claim and calculating the compensation to be paid 1. Indemnity 2. Contribution 3. Subrogation 4. Average Clause
55 The Principle of Indemnity This states that the insured cannot gain/make profit from making an insurance claim. Because of this principle there is no point of insuring something for more than it is worth.
56 The Principle of Indemnity Example A house valued at 300,000 which is insured for 450,000 burns down. The insurer will only pay 300,000 because the loss incurred was only 300,000. If 450,000 compensation is paid then the insured would gain 150,000 from the house burning down.
57 The Principle of Contribution This states that if a risk is insured by two or more insurance companies, any compensation payable will be shared between the companies. Each company pays compensation in relation to the amount of risk it covered Compensation paid by each insurance company is calculated by the following formula Sum insured with individual company Total sum insured X Loss
58 The Principle of Contribution Example A person insures a house valued at 300,000 with two insurance companies for 300,000 each. The person will only receive 300,000 if the house burns down. Each insurer will only contribute 150,000 each. If each paid 300,000, then the individual would gain from the house burning down; this goes against what principle?
59 The Principle of Contribution Example A house is worth 300,000 It is insured with Company A for 125,000 It is insured with Company B for 175,000 The house is damaged by fire and the damage amounts to 42,000 Company A would pay 17,500 compensation 125,000 X 42,000 = 17, ,000 Company B would pay 24,500 compensation 175,000 X 42,000 = 24, ,000
60 The Principle of Subrogation This passes on the legal right to recover any loss suffered from the insured over to the insurer When the insurer pays out compensation, the insurer can claim from someone else who might have caused the loss. After paying compensation for a loss suffered, the insurance company is entitled to take over any property.
61 The Principle of Subrogation Example An insurance company pays compensation to a business whose stock is destroyed by a fire caused by a negligent electrician. The insurance company can sue the electrician for the amount of compensation it had to pay out. The insurance company can sell any remaining stock to recover some of its compensation
62 Under-insurance (Average Clause) This means to insure an item for less than it s worth and can be used to keep premiums down. If an item is not insured for its full value, then the amount of compensation paid, in the case of partial loss, will be reduced. The formula for calculating the compensation when an item is underinsured is Sum Insured X Loss incurred Market Value
63 Under-insurance (Average Clause) example A house is worth 300,000 It is only insured for 150,000 i.e. ½ of its value If fire destroys the house, the most one could receive in is 150,000 (i.e. ½ of its value)
64 Under-insurance (Average Clause) example A house is worth 300,000 It is only insured for 225,000 i.e. ¾ of its value If fire caused 100,000 worth of damage, the most one could receive in compensation is 75,000 (i.e. ¾ of 100,000)
65 Over-insurance The principle of indemnity prevents one from over-insuring. WHY? i.e. for insuring something for more than it is worth.
66 Why have insurance costs increased? Insurance companies point to higher costs and increased spending as the main reason for increasing their prices. eg.: more compensation paid out, government taxes, etc Prices of cars, houses, etc have risen in recent years, these items are worth more and need to be insured for a larger amount. This increases the cost of insurance.
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