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31. Mar 2023
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  1. By : SHUBH AGGARWAL & RAMANDEEP SINGH Class – bcom sem4
  2. 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”
  3. 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
  4. 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
  5. Categories of Risks  Pure and Speculative Risks  Fundamental and Particular Risks  Enterprise Risk
  6. 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
  7. 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
  8. 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
  9. 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. 
  10. 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.
  11. 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.
  12. Requirements of an Insurance Contract  Offer and acceptance  Consideration  Competent parties  Legal Purpose
  13. 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
  14. 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
  15. 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
  16. 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
  17.  Aleatory Contract  Unilateral Contract  Personal Contract  Conditional Contract  Contract of Adhesion Distinct Legal Characteristics of Insurance Contracts
  18. 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
  19. 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
  20. Principles of Insurance  Utmost Good Faith  Insurable Interest  Indemnity  Corollaries of Indemnity  Proximate Cause
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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.
  26. THANKYOU……
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