By : SHUBH AGGARWAL & RAMANDEEP SINGH
Class – bcom sem4
Meaning of Risk
Risk is the potential that a chosen action or activity (including
the choice of inaction) will lead to a loss (an undesirable
outcome)
OR
Risk is an uncertainty concerning the occurrence of a loss
In insurance industry we define risk to identify the property or
life being insured
“that driver is a poor risk”, “cancer patient is an unacceptable
risk”
Types of Risk
Objective Risk: relative variation of actual loss from expected
loss
For eg: An insurer has 100000 cars insured for a long period of
time, and on the average 10000 cars meet with at least one
accident and claim for damages each year. However, for a
particular year, it is unlikely that there will be exactly 10000
claims. Under certain assumptions, it can be proven that over a
long period of time, the deviation of the number of claim in a
year from 10000 will, on the average be 100.
Thus there is a variation of 100 claims from the expected
number of 10000 or a variation of 1%.
This relative variation of actual loss from expected loss is
known as objective risk
Types of Risk
Subjective Risk-an uncertainty in the individual’s personal
estimate of the chance of loss.
It can vary from one person to another.
For eg-Somebody who has lost a lot of money in the stock
market will probably feel more risk investing in the market
than someone who has profited handsomely.
Subjective risk may alter the behavior of the risk taker if it is an
undesirable risk
Categories of Risks
Pure and Speculative Risks
Fundamental and Particular Risks
Enterprise Risk
Pure Risk & Speculative Risk
Pure risk : there are only the possibilities of loss or no loss
Examples: Damage to property from fire, lightning, flood or
earthquake etc
Speculative risk : either profit or loss is possible
Examples: investment in shares or real estate, betting on horse
race
ONLY Pure Risks are insured but exceptions always exist…..
Like some insurers will insure institutional portfolio
investments
Fundamental & Particular Risks
Fundamental risk affects the entire economy or large number of
persons or groups within the economy – rapid inflation,
cyclical unemployment, war, natural disaster, terrorist attack
Particular Risk affects only individuals and not the entire
community . For e.g.. Car thefts, bank robberies, dwelling fires
Enterprise Risk
Relatively new term that encompass major risks faced by a
business firm
Pure Risk
Speculative Risk
Strategic Risk: uncertainty regarding the firm’s financial goals
and objectives
Operational Risk: results from the firm’s business operations
like a bank that offers new online banking services may incur
losses if hackers break into the bank ‘s computers
A Contract
A contract is an agreement between parties, creating
mutual obligations that are enforceable by law. The
basic elements required for the agreement to be a
legally enforceable contract are: mutual assent,
expressed by a valid offer and acceptance; adequate
consideration; capacity; and legality.
INSURANCE
An insurance is a legal agreement between an insurer
(insurance company) and an insured (individual), in
which an insured receives financial protection from an
insurer for the losses he may suffer under specific
circumstances.
Under an insurance policy, the insured needs to pay
regular amount of premiums to the insurer. The
insurer pays a predetermined sum assured to the
insured if an unfortunate event occurs, such as death
of the life insured, or damage to the insured or his
property.
TYPES OF INSURANCE
GENERAL INSURANCE- General insurance is an
agreement between a policyholder and insurer
wherein the insurance company protects your valuable
assets from fire, theft, burglary, or any other
unfortunate accident.
LIFE INSURANCE- Life Insurance can be defined as a
contract between an insurance policy holder and an
insurance company, where the insurer promises to pay
a sum of money in exchange for a premium, upon the
death of an insured person or after a set period.
Requirements of an Insurance Contract
Offer and acceptance
Consideration
Competent parties
Legal Purpose
Requirements of an Insurance Contract
Offer and Acceptance: Applicant for insurance makes the offer and the
company accepts or rejects the offer
An agent merely solicits the prospective insured to make the offer
In property & Liability insurance especially personal line insurance – auto ,
home insurance , the agents typically have the power to bind the insurer
through the use of binder.
Binder is a temporary contract for insurance
In life insurance, agent does not have the power to bind the insurer
A conditional premium receipt is given to the applicant after filling the
application form
Consideration
Consideration is the value that each party gives to the
other
For Insured: Payment
of first premium plus
an agreement to abide
by the conditions
specified in the policy
For insurer: Promise to
do certain things as
specified in the
contract. For e.g.:
paying for a loss from
the insured peril
Competent Parties
Each party must be legally competent/ must have legal
capacity to enter into a binding contract
Most adults are legally competent to enter into the
insurance contracts but there are some exceptions like
Insane persons, intoxicated persons, minors
Also, insurer must be licensed to sell insurance in that
country
Legal Purpose
An insurance contract that encourages something illegal or
immoral is contrary to the public interest and can not be
enforced
For e.g. policy can not cover seizure of the drugs by the
police
Aleatory Contract
Unilateral Contract
Personal Contract
Conditional Contract
Contract of Adhesion
Distinct Legal Characteristics of
Insurance Contracts
Distinct Legal Characteristics of
Insurance Contracts
Aleatory Contract: where the values exchanged may not be
equal but depend on an uncertain event . For e.g..- ??????????
(Commutative Contract?)
Unilateral Contract: only one party makes a legally
enforceable promise. Only the insurer makes a legally
enforceable promise to pay a claim . After the first premium is
paid, the insured can not be legally forced to pay the premiums
(Bilateral Contract?)
Personal Contract: the contract is between the insured and the
insurer
Distinct Legal Characteristics of
Insurance Contracts
Conditional Contract: Insurer’s obligations to pay a claim
depends on whether the insured has compiled with all policy
conditions
For e.g. In a homeowner’s policy , the insured must give
immediate notice of loss. If the insured delays for an
unreasonable period in reporting the loss, the insurer can refuse
to pay the claim
Contract of Adhesion: means the insured must accept the
entire contract, with all of its terms and conditions
Principles of Insurance
Utmost Good Faith
Insurable Interest
Indemnity
Corollaries of Indemnity
Proximate Cause
Utmost Good Faith
Uberrima fides is a Latin phrase meaning "utmost good faith”
.This means that all parties to an insurance contract must deal
in good faith, making a full declaration of all material facts in
the insurance proposal
A minimum standard that requires both the buyer and seller in a
transaction to act honestly toward each other and to not mislead
or withhold critical information from one another
A positive duty voluntarily to disclose ,accurately and fully, all
facts material to the risk being proposed ,whether requested or
not
Representations
Statements made by the
applicant for insurance
For e.g. If you apply for life
insurance, you may be
asked questions
concerning your age,
weight, height, occupation,
state of health, family
history etc. Your answers to
these questions are the
representations
Representation
(A)Material
(B)False
(C)Relied on by the insurer
Material - If the insurer knew the true facts, the
policy would not have been issued, or it would have
been issued on different terms
False-the statement is not true or misleading
Reliance – the insurer relies on the representation in
issuing the policy at specified premium
Contract is voidable if
the representation is
Examples
Karim applied for life insurance and states in the
application that he has not visited a doctor within the
last five years
However, six months earlier he had surgery for lung
cancer. So, the statement made by him is false,
material and relied on by the insurer
Misrepresentation
If an applicant for insurance states an opinion that
later turns out to be wrong , the insurer must prove
that the applicant spoke fraudulently and intended to
deceive the company
An innocence misrepresentation of a material fact, if
relied on by the insurer , also makes the contract
voidable.