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- covers LOSS or LIABILITY arising from
ACCIDENT or MISHAP, excluding certain types
of loss which by law or custom are
considered as falling exclusively within the
scope of other types of insurance such as
marine, fire, suretyship and life.
- presumed to include any loss or damage
     when an accident is the cause of the loss.
                (casualty = accident)

a.    Employer’s liability insurance
b.    Workmen’s compensation insurance
c.    Public liability insurance
d.    Motor vehicle liability insurance
e.    Plate glass insurance
f.    Burglary and theft insurance
g.    Personal accident and health insurance as
      written by non-life companies
- except     Compulsory    Motor   vehicle
Insurance

     - the terms of the contract which are not
violative of the laws and by the general
provisions applicable to all types of insurance
which affect the person which give rise to third-
and/or property of the party liability on the
insured:                part of the insured:


• plate glass insurance   • employer’s liability
• burglary and theft      insurance
insurance                 • workmen’s
• personal accident and   compensation insurance
health insurance as       • public liability insurance
written by non-life       • motor vehicle liability
companies                 insurance
Third party liability          Person or property of
                                                     the insured

1. Insurable   - The insured has interest      - The insured has interest
interest       in the safety of persons        on his own life (section 10)
               who may maintain, or in         and on his property (section
               the freedom from damage         13).
               of property which may
               become the basis of suits
               against him in case of their
               injury or destruction.

2. When        -Attaches      when       the   - Action against the insurer
payable?       liability of the insured to     lie only when there is an
               the injured 3rd party           actual loss sustained by the
               attaches, regardless of         insured.
               actual loss at that time.
Third party liability      Person or property
                                                of the insured

3. Right of      - 3rd persons to whom the    - 3rd persons cannot
injured person   insured is liable, can sue   proceed against the
to sue insurer   directly the insurer upon    insurer. Their recourse
                 the occurrence of the        is limited to the
of party at
                 injury or event upon which   insured alone.
fault
                 the liability depends.

4. Basis of      - Based on contract          - Based on contract
insurer’s
liability

5. Extent of     - Extent of policy           - Extent of policy
insurer’s
liability
 Accident Insurance
      - reimburses the insured for pecuniary
 loss suffered as a result of injuries sustained
 in an accident

 Health Insurance
      - reimburses the insured for pecuniary
 loss arising out of disease-related illness.
GENERAL RULE:

     Death or injury does NOT result from
 accident if it is the NATURAL RESULT of the
 insured’s voluntary act, unaccompanied by
 anything unforeseen except the death or
 injury.
EXCEPTION:

     If the death or injury is NOT THE
 NATURAL RESULT of the insured’s voluntary
 act or if something UNFORESEEN OCCURS in
 the doing of the act which produces the
 injury, the resulting death is within the
 protection of the insurance policy.
 ACCIDENT       –        happens         by
 chance,        fortuitously,        without
 intention,   design,    and     which     is
 unexpected, unusual, and unforeseen.

 INTENTIONAL  – which implies the use of
 reasoning   faculties, consciousness, and
 volition.
FORMULA:

     cause + result of the death or injury =
          accidental          RECOVERY

  cause   is intentional       NO RECOVERY

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Philippine Casualty Insurance

  • 2. - covers LOSS or LIABILITY arising from ACCIDENT or MISHAP, excluding certain types of loss which by law or custom are considered as falling exclusively within the scope of other types of insurance such as marine, fire, suretyship and life.
  • 3. - presumed to include any loss or damage when an accident is the cause of the loss. (casualty = accident) a. Employer’s liability insurance b. Workmen’s compensation insurance c. Public liability insurance d. Motor vehicle liability insurance e. Plate glass insurance f. Burglary and theft insurance g. Personal accident and health insurance as written by non-life companies
  • 4. - except Compulsory Motor vehicle Insurance - the terms of the contract which are not violative of the laws and by the general provisions applicable to all types of insurance
  • 5. which affect the person which give rise to third- and/or property of the party liability on the insured: part of the insured: • plate glass insurance • employer’s liability • burglary and theft insurance insurance • workmen’s • personal accident and compensation insurance health insurance as • public liability insurance written by non-life • motor vehicle liability companies insurance
  • 6. Third party liability Person or property of the insured 1. Insurable - The insured has interest - The insured has interest interest in the safety of persons on his own life (section 10) who may maintain, or in and on his property (section the freedom from damage 13). of property which may become the basis of suits against him in case of their injury or destruction. 2. When -Attaches when the - Action against the insurer payable? liability of the insured to lie only when there is an the injured 3rd party actual loss sustained by the attaches, regardless of insured. actual loss at that time.
  • 7. Third party liability Person or property of the insured 3. Right of - 3rd persons to whom the - 3rd persons cannot injured person insured is liable, can sue proceed against the to sue insurer directly the insurer upon insurer. Their recourse the occurrence of the is limited to the of party at injury or event upon which insured alone. fault the liability depends. 4. Basis of - Based on contract - Based on contract insurer’s liability 5. Extent of - Extent of policy - Extent of policy insurer’s liability
  • 8.  Accident Insurance - reimburses the insured for pecuniary loss suffered as a result of injuries sustained in an accident  Health Insurance - reimburses the insured for pecuniary loss arising out of disease-related illness.
  • 9. GENERAL RULE: Death or injury does NOT result from accident if it is the NATURAL RESULT of the insured’s voluntary act, unaccompanied by anything unforeseen except the death or injury.
  • 10. EXCEPTION: If the death or injury is NOT THE NATURAL RESULT of the insured’s voluntary act or if something UNFORESEEN OCCURS in the doing of the act which produces the injury, the resulting death is within the protection of the insurance policy.
  • 11.  ACCIDENT – happens by chance, fortuitously, without intention, design, and which is unexpected, unusual, and unforeseen.  INTENTIONAL – which implies the use of reasoning faculties, consciousness, and volition.
  • 12. FORMULA:  cause + result of the death or injury = accidental RECOVERY  cause is intentional NO RECOVERY