Many proponents feel that filling up of the proposal form is a boring and tiresome job and the agent of the insurance company should take care of that. But actually, that should not be the case. The proposer himself is s
CS Professional · Insurance - Law & Practice · PYQS · June 2023
Many proponents feel that filling up of the proposal form is a boring and tiresome job and the agent of the insurance company should take care of that. But actually, that should not be the case. The proposer himself is supposed to fill up the same on his own. Despite that, many prefer the agent to do the job and most of the times the agents do it without asking for any details of the health status of the proponent. This innocent act may run into a nightmare, if the policyholder dies within two years from the date of commencement of the policy. In such a situation, mandatory investigations are carried out before passing such claims and the insurer may reject the claim, if the probe reveals that the policyholder had withheld some information which was material information for the purpose of underwriting by the insurer. It is the responsibility of the proponent to fill up the proposal form while the agent may only help him. Regulations too do not allow an agent to go beyond this." Thus, an insurance policy is a contract, and it must, therefore, conform to the rules of general contract law. Through a contract of insurance, the insurer agrees to make good any loss on the insured property or loss of life that may occur in course of time in consideration for a small premium to be paid by the insured. The business of insurance aims to protect the economic value of assets or economic value of life of a person. On the basis of the above facts, answer the following questions: (e) "It is therefore the duty of the proposer to disclose, clearly and accurately, all material facts relating to the proposed insurance." Discuss the facts that are to be disclosed by the proponent as well as the facts that are not need not be.
Answer & Explanation:
The duty of disclosure must be observed throughout the negotiations and continues until they are completed and the contract is operative. The contract is deemed to be operative when the proposal is accepted by the insurer. This is called the "condition of continued insurability" which operates front the date of the proposal and the date of its acceptance. Material facts, which are to be disclosed, include the following: Facts, which show that a risk represents a greater exposure than would be expected from its nature e.g., the fact that a part of the building is being used for storage of inflammable materials. External factors that make the risk greater than normal e.g. the building is located next to a warehouse storing explosive material. Facts, which would make the amount of loss greater than that normally expected e.g. there is no segregation of hazardous goods from non-hazardous goods in the storage facility. History of Insurance (a) Details of previous losses and claims (b) if any other Insurance Company has earlier declined to insure the property and the special condition imposed by the other insurers; if any. The existence of other insurances. Full facts relating to the description of the subject matter of Insurance In the absence of an enquiry, the following facts need not be disclosed. Consequently, they have no effect on the validity of the contract: Facts which lessen the risk proposed for insurance Facts which could or should be inferred by the insurer in the wake of the particulars being actually disclosed. Facts of public knowledge, such as the existence of a state of war, or facts which should be known to the insurer in the ordinary course of his business. Matters of law. Facts with the possibility of discovery where the insurer has been given enough information to provoke enquiry on his part. The details furnished by the proposer in such circumstances must be adequate to fulfil his duty of disclosure. Facts which can be reasonably concluded are a matter of indifference to the insurer, or regarding which he has waived information. e.g. if the proposer inserts a disk in an answer to a proposal form question and the insurer makes no further enquiry. Facts which are superfluous to disclose by reason of a warranty in the proposed insurance. Any fact as to which information is waived by the insurer.
Topics: Insurance Contracts
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