CHAPTER 1 - PRINCIPLES OF LAW
1.1 Sources of Law
1.1.1 Legislation
1.1.2 Common Law
1.2 Principles of General Contract Law
1.2.1 The Essential Requirements of a Binding Contract
1.2.2 Privity of Contract
1.2.3 Terms of the Contract
1.2.4 Interpretation of Ambiguous Terms
1.2.5 Exclusion Clauses and Unfair Terms
1.2.6 Misrepresentation and Non-Disclosure
CHAPTER 2 - THE PARTIES
2.1 The Policyholder
2.2 Insurance Companies
2.2.1 Underwriters
2.2.2 Claims Department
2.3 Lloyd's of London
2.4 Co-Insurers
2.5 Reinsurers
2.6 Insurance Brokers / Intermediaries
2.7 Underwriting Agencies
2.8 The Financial Services Authority (FSA)
2.9 Financial Ombudsman Service (FOS)
2.10 Loss Adjusters
2.11 Loss Assessors
2.12 Lawyers
2.13 Supply Chain
CHAPTER THREE - THE CONTRACT OF INSURANCE
3.1 The Prospectus
3.2 The Proposal Form
3.3 The Schedule of Insurance
3.4 The Policy of Insurance
3.4.1 Preamble
3.4.2 The Insuring Clause
3.4.3 Definitions
3.4.4 Perils and Exclusions
3.4.5 Warranties
3.4.6 Conditions
3.4.7 Endorsements
3.4.8 Survey Requirements / Risk Requirements
3.4.9 Other Terms Of the Contract
3.5 Practical Tips on Dealing with Exclusions and Breaches of Warranty and Condition
3.6 Customer Care and Complaints
CHAPTER FOUR - INSURABLE INTEREST AND INDEMNITY
4.1 The Creation of Insurable Interst as a Statutory Requirement
4.2 The Indemnity Principle
4.3 Legislative History
4.4 Situations Where the Interests of More than One Party are Affected
4.4.1 Joint and Composite Insurance
4.4.2 Bailor / Bailee
4.4.3 Landlord / Tenant
4.4.4 Mortgagor / Mortgagee
4.4.5 Vendor / Purchaser of Land
4.4.6 Buiding Contracts
4.4.7 Rental / Hire Agreements
4.4.8 Hotel Proprietors / Guests
4.4.9 Purchaser / Vendor of Goods
4.5 Indemnity
4.5.1 Loss
4.5.2 Measure of Indemnity
4.5.3 Valued Policies
4.5.4 Unvalued Policies
4.5.5 Unvalued or Valued Policy?
4.5.6 Amount Recoverable - Valued Policy
4.5.7 Amount Recoverable - Unvalued Policy
CHAPTER FIVE - PERILS
5.1 Fire
5.2 Lightning
5.3 Explosion
5.4 Riot
5.5 Malicious Damage
5.6 Escape of Water
5.7 Escape of Fuel Oil
5.8 Storm
5.9 Flood
5.10 Accidental Damage to Underground Services
5.11 Theft
5.12 Accidental Damage
5.13 Subsidence, Heave and Landslip
CHAPTER SIX - PROXIMATE CAUSE
6.1 Statute Law
6.2 Operation of the Doctrine
6.3 Ascertaining the Proximate Cause
6.4 Immediate and Intervening Causes
6.5 Concurrent Causes
6.6 Financial Ombudsman Service
6.7 Summary
CHAPTER SEVEN - UTMOST GOOD FAITH
7.1 The Origins of Utmost Good Faith
7.2 Non-Disclosure and Misrepresentation
7.2.1 Non - Disclosure
7.2.2 Misrepresentation
7.3 Material Facts
7.3.1 Facts Material to the Physical Hazard
7.3.2 Facts Material to the Moral Hazard
7.4 Facts that do not Need to be Disclosed
7.4.1 Express Waiver of Right to Disclosure
7.4.2 Implied Waiver of Right to Disclosure
7.5 Inducement
7.6 Avoidance of the Policy
7.7 Waiver and Estoppel
7.8 Continuation of the Duty of Disclosure after the Polcy Incepts
7.9 Approach of the FSa and FOS to Utmost Good Faith
7.9.1 The Financial Services Authority
7.9.2 The Financial Ombudsman Service
CHAPTER EIGHT - FRAUD
8.1 What is Fraud
8.2 Burden of Proof
8.3 Categories of Fraudulent Claim
8.4 The Effect of Fraud
8.5 Joint and Composite Policies
8.6 The FOS
8.7 Fraud Indicators and their Investigation
CHAPTER NINE - MEASURES OF SETTLEMENT
9.1 Policy Limits and Excesses
9.2 Basis of Settlement Provisions
9.3 The Cost of Establishing the Extent of Loss
9.4 Buildings - Measure of Settlement
9.5 Provisional Sums and Prime Cost items
9.6 Public Authorities Clause
9.7 Debris Removal
9.8 Insurers' Right to Reinstate
9.9 Building Repair Networks
9.10 Non - Buildings - Measure of Settlement
9.11 Extended Warranties
9.12 Salvage
9.13 Costs of Mitigation
9.14 Underinsurance
9.15 Day One Basis
9.16 Index Linking
9.17 Penalties for Underinsurance
9.18 Practical Guidance for Calculating the value at risk
CHAPTER TEN - DOUBLE INSURANCE AND CONTRIBUTION
10.1 Double Insurance
10.2 Where Double Insurance can Arise
10.2.1 Same Subject Matter
10.2.2 Same Insured in Respect of the Same Interest
10.2.3 Same Risk / Peril
10.3 Restrictions / Limitations on Double Insurance
10.4 Contribution
10.4.1 Where the Right to Contribution Arises
10.4.2 Payment as a Volunteer
10.5 Determining the Amount of Contribution
10.5.1 Maximum Liability Basis
10.5.2 Independent Liability Basis
10.6 Authority for Method
10.6.1 Average in cases of Concurrent Double Insurance
10.6.2 Average in Cases of Non - concurrent Double Insurance
10.7 ABI Rules on Contribution
CHAPTER ELEVEN - SUBROGATION AND DISTRIBUTION OF RECOVERIES
11.1 Subrogation
11.1.1 The Policyholder cannot Profit from their Insurance Claim
11.1.2 Right to Take Action Policyholder's Name
11.1.3 Insurers' Position against the Third Party
11.1.4 Loss Adjusters' Role in Subrogation
11.2 Distribution of recoveries
CHAPTER TWELVE - FINANCIAL OMBUDSMAN SERVICE
12.1 Authority of the Financial Ombudsman Service
12.2 Who is Entitled to Make a Complaint to the FOS
12.3 Complaint Handling Rules
12.4 Time Limits
12.5 Adjudication
12.6 The Loss Adjuster's Role in FOS Investigations
12.7 Decisions Made by the FOS
12.8 Awards
12.9 Compliance with Awards and Settlements
12.10 General Services Provideed by the FOS
CHAPTER THIRTEEN - THE FINANCIAL SERVICES AUTHORITY
13.1 Role of the FSA
13.2 Regulation of Insurers
13.3 Regulation of Loss Assessors
13.4 Consumer Rights
13.5 Insurance: Conduct of Business Sourcebook
CHAPTER FOURTEEN - REFORM OF INSURANCE LAW
14.1 Background
14.2 Consumer Insurance ( Disclosure and Representations ) Bill 2009
14.3 Implementation and Future Reform
CHAPTER FIFTEEN - HEALTH AND SAFETY AND CONSTRUCTION ( DESIGN AND MANAGEMENT ) REGULATIONS 2007
15.1 Health and Safety at Work etc Act 1974
15.2 Management of Health and Safety at Work Regulations 1999
15.3 Risk Assessment
15.3.1 Types of Hazards
15.4 Construction Projects Subject to the Regulations
15.5 When Duties Arise and Upon Whom
15.6 Duties on a Client
15.7 Duties on a Designer
15.8 Contractor Competency
15.9 Health and Safety Executive ( HSE )
CHAPTER SIXTEEN - PRACTICAL HINTS AND TIPS
16.1 Reporting to Insurers
16.2 Waiver, Estoppel and Reservation of Rights
16.3 Repudiations
16.4 Mitigation of Loss
16.5 Dealing with Policyholders' Claims
16.6 Who should the Settlement Monies be paid to ?
16.7 Forms of Discharge / Settlement Agreements
16.8 Investigations
16.9 Witness Statements
16.10 Status of Correspondence - Privilege, Without Prejudice and Confidential Communications
16.10.1 Privileged Communications
16.10.2 Status of Loss Adjusters' Reports
16.10.3 Without Predjudice Communications
16.10.4 Confidential Communications
CHAPTER SEVENTEEN - CHECKLIST FOR HANDLING INSURANCE CLAIMS
APPENDICES
Appendix 1 The Chartered Institute of Loss Adjusters Charter
Appendix 2 Supplier Network Guidance Note
Appendix 3 Section 1 - ABI Blue Book - Suggested Practice for the Conduct of Material Damage and Business Interruption Insurance in Great Britain and Northern Ireland
Appendix 4 Section 2 - ABI Blue Book - Material Damage and Business Interruption Insurance, Suggested Wordings
Appendix 5 Section 3 - ABI Blue Book - Best Practice Guide to Procedures for Collective Policies
Appendix 6 Section 4 - ABI Blue Book - Claims Management
Apeendix 7 Section 5 - ABI Blue Book - The Role of the Insurance Industry in Dealing with Civil Emergencies
Appendix 8 Section 7 - ABI Blue Book - Recommended Practice for the Disclosure of Claims History
READING LIST
LIST OF CASES
Aegis Electrical and Gas International Services Co Ltd v Continental Casualty Co [2007] EWHC 1762 (Comm)
Agapitos v Agnew (2003) [2002] EWHC 1558 (Comm)
Amey Properties Ltd v Cornhill Insurance plc (1996) [1996] LRLR 259
Anderson v Norwich Union Fire Insurance Society (1977) [1977] 1 Lloyd's Rep 253
Ansari v New India Assurance Ltd (2009) [2009] EWCA Civ 93
Aspen Insurance UK Ltd and Others v Pectel Ltd (2008) [2008] EWHC 2804 (Comm)
Austin v Drew (1815) 171 ER 115
AXA v Gottlieb (2005) [2005] EWCA Civ 112
Baghbadrani v Commercial Union Assurance Co plc (2000) [2000] Lloyd's Rep IR 94
Bank of Nova Scotia v Hellenic Mutual War Risk Association (Bermuda) Ltd ( the 'Good Luck' ) (1992 [1991] 2 WLR 1279
Bankers Insurance Co Ltd v South (2004) [2003] EWHC 380 (QB)
Bedfordshire Police Authority v Constable (2009) [2009] EWCA Civ 64
Boag v Economic Insurance Co Ltd (1954) [1954] 2 Lloyd's Re3p 581
Carter v Boehm (1766) 97 ER 1162
Castellain v Preston (1883) [1882 - 83 ] LR 11 QBD 380
Commercial Union Assurance Co v Hayden (1977) [1977] QB 804
Commonwealth Smelting Ltd v Guardian Royal Exchange Assurance (1984) [1984] 2 Lloyd's Rep 608
Co-operative Retail Services Ltd v Taylor Young Patnership and Others (2002) [2002] UKHL 17
Coven SpA V Hong Kong Chinese Insurance Co Ltd (1999) [1999] CLC 223
Darrell v Tibbitts (1880) [1879-80] LR 5 QBD 560
Derry v Peek (1889) [1889] LR 14 App Cas 337
Direct Line Insurance plc v Fox (2009) [2009] EWHC 386 (QB)
Doheny v New India Assurance Co Ltd (2005) [2004] EWCA Civ 1705
Drake v Harbour (2008) [2008] EWCA Civ 25
Drake Insurance plc v Provident Insurance plc (2004) [2003] EWCA Civ 1834
Eagle Star Insurance Co Ltd v Games Video Co (GVC) SA ( the 'Game Boy') (2004) [2004] EWHC 15 (Comm)
Elcock v Thompson (1949) [1949] 2 KB 755
Fenwick v Schmalz (1868) [1868] LR 3 CP 313
Fleming v Hislop (1886) LR 11 App Cas 686
Fosse Motor Engineers v Conde Nast Magazine Distributors (2008) [2008] EWHC 2037 (TCC)
Harris v Poland (1941) [1941] 1 KB 462
Glasgow Training Group (Motor Trade) Ltd v Lombard Continental plc (1989) (cited as 4 November 1988) [1989] SC 30
Global Process Systems Inc and Another v Syarikat Takaful Malaysia Berhad (The 'Cendor Mopu') (2009) [2009] EWCA Civ 1398
Hamilton Fraser & Co v Pandorf (1887) ([887] LR 12 App Cas 518
Hepburn v A Tomlinson (Hauliers) Ltd (1966) [1966] AC 451
HIH Casualty and General Insurance Ltd v New Hampshire Insurance Co (2001) [2001] EWCA Civ 735
Hornal v Neuberger Products Ltd (1957) [1956] 3 WLR 1034
Insurance Corporation of the Channel Islands v Royal Hotel (1998) [1998] Lloyd's Rep IR 151
Investors Compensation Scheme Ltd v West Bromwich Buiding Society (1998 ) [1998] 1 WLR 896
iONIDES V pENDER (1874) [1873-74] LR 9 QB 531
James v CGU Insurance plc (2002) [2002] Lloyds Rep IR 206
Kausar v Eagle Star Insurance Co Ltd (2000) [1997] CLC129
Knight of St Michael [1898] p 30
Kosmar Villa Holidays plc v The Trustees of Syndicate 1243 (2007 & 2008) [2007] EWCA Civ 1003; and [2007] EWHC 458 (Comm)
Kyzuna Investments Ltd v Ocean Marine Mutual Insurance Association (Europe) Ltd (The 'Solveig') (2000) [2000] 1 All ER (Comm) 557
Laker Vent Engineering Ltd v Templeton Insurance Ltd (2009) [2009] EWCA 62
Legal and General Assurance Society Ltd v Drake Insurance Co Ltd 1992 [1991] 2 Lloyd's Rep 36
Leppard v Excess Insurance (1979) [1979] 1 WLR 512
Lewis v Norwich Union Healthcare Ltd (2009) [2010] Lloyd's Rep IR 198
Lonsdale & Thompson Ltd v Black Arrow Group plc(1993) [1993] ch
361
Mark Rowlands Ltd v Berni Inns Ltd (1986) [1985] 3 WLR 964
Martini Investments v McGinn (2001) [2000] 2 Lloyd's Rep 313
Matalan Discount (Cash & Cash) Ltd v Tokenspire Prperties (North Western) Ltd (2001) QBD (Technology & Construction Court). 18 May 2001 unreported
Midland Mainline Ltd v Eagle Star Co Ltd (2004) [2004} EWCA Civ 1042
Moore v Evans (1918) [1918] AC 185
Napier and Ettrick v R F Kershaw Ltd and Others (1), Napier and Ettrick v Hunter (1993) [1993] AC 713
National Employers Mutual General Insurance Association Ltd v Haydon (1980) [1980] 2 Lloyd's Rep 149
National Farmers Union Mutual Insurance Society Ltd v HSBC Insurance (UK) Ltd (2010) [2010] EWHC 773 (Comm)
Nobel's Explosives Co Ltd v British Dominions General Insurance Co (No1) (1918) [1918] SC 373
North British and Mercantile Insurance Co v London Liverpool and Globe Insurance Co (1877) [1877] LR 5 Ch D 569
North Star Shipping Ltd v Sphere Drake Insurance plc (2006) [2006] EWCA Civ 378
Nsubuga v Commercial Union (1998) [1998] 2 Lloyd's Rep 682
Oddy v Phoenix Assurance (1966) [1966] 1 Lloyd's Rep 134 Orakpo v Barclays Insurance Services Ltd (1995) [1995] LRLR 443
Pan Atlantic Insurance Co Ltd v Pine Top Insurance Co Ltd (1994) [1994] 3 WLR 677
Pawsey v Scottish Union and National (1908) [1908] Times, 17 October 1908
Quorum AS v Schramm (2002) [2002] 2All ER (Comm) 147
Ramco (UK) Ltd v International Insurance Co of Hanover (2004) [2004] EWCA Civ 675
R v Ghosh ((19820 [1982] QB 1053
Re Highgrade Traders Ltd (1984) [1984] BCLC 151
Reynolds v Phoenix Assurance Co Ltd (1978) [1978] 2 Lloyd's Rep 440
Rhesa Shipping Co SA v Edmunds (The 'Popi M') (1985) [1985] 1 WLR 948
Roberts v Avon Insurance (1956) [1956] 2 Lloyd's Rep 240 Rohan Investments Ltd v Cunningham (1998) [1999] Lloyd's Rep IR 190
S&M Hotels v Legal and General Assurance Society (1972) { 1972] 1 Lloyd's Rep 157
Scott v The Copenhagen Reinsurance Co Ltd (2003) [2003] EWCA Civ 688
Scottish and Newcastle plc v G D Construction (St Albans) Ltd (2003) [2003] EWCA Civ 16
Shanklin Pier Ltd v Detel Products Ltd (1951) [1951] 2 KB 854
Shinedean Ltd v Alldown Demolition (London) Ltd (2006) [2006] EWCA Civ 939
Sirius International Insurance v Friends Provident Life & Pensions Ltd
(2005) [2005] EWCA Civ 601
Siu Yin Kwan and Another v Eastern Insurance Co Ltd (1994) [1994] 2 AC 199
Sofi v Prudential Assurance Co Ltd (1993) [1993] 2 Lloyd's Rep 559
Stockton v Mason (1978) [1978] 2 Lloyd's Rep 430
Stowers v GA Bonus plc (2003) [2003 Lloyd's Rep IR 402
Structural Polymer Systems Ltd v Brown (2000) [1999] CLC 268
Tanner v Bennett(1825) 171 ER 987; [1825] Ry & M 182
Tate Gallery (Trustees) v Duffy Construction Ltd (2007) 1 [2007] EWHC 19 (Comm)
Tempus Shipping Co v Louis Dreyfus & Co (1931) [1931] AC 726
Thor Navigation Inc v Ingosstrakh Insurance Co Ltd (2005) [2005] EWHC 19 (Comm)
Tonkin v UK Insurance (2007) [2006] EWHC 1120 (TCC)
Tootal Broadhurst Lee Co Ltd v London Lancashire Fire Insurance Co (1908) The Times 21 May 1908
Wayne Tank and Pump Co Ltd v Employers' Liability Insurance Corporation Ltd (1973) [1973] 3 WLR 483
Weddell v Road Traffic and General Insurance Co (1932) [1932] 2 kb 563
Winicofsky v Army & Nvy General Insurance Association Ltd (1919) [1919] 88 LKJB1111
WISE (Underwriting Agency) Limited and Others v Grupo Nacional Provincial SA (2004) [2004] EWCA Civ 962
Woolcott v Sun Alliance (1978) [1978] 1 WLR 493
Young v Sun Alliance (1976) [1976] 3 All ER 561
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