Full Text Transcript
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INSURANCE&RISKMANAGEMENt
20il:
(IRM) EXAMINATION. MAY
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R011 No
11-2-Tecb.:icalAspectsof Inauranae;
Total No. of Questions-9] [Total No. of Printed Pages- 7
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Time Allowed-3 Hours Maximum Marks-1~0
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Answer all questions.
Marks
1. State whethe~ the following statements are True/False: 10
1. The basis of insurance is sharing of losses of many amongst few.
2. There is no agency commission or brokerage payable in respect of motor third
party insurance business in India.
3. The Principle of Utmost good faith imposes duty of disclosure on the insurance
agent, insured and the company authorities.
4.
In liability insurance, it is not possible ~opredetermine the extent of insurable
interest.
5. Under the No-fault liability provision of the Motor Vehicle Act, the negligence
of the owner or user of the vehicle is not relevant to decide the question of
liability.
6. Adverse selection refers to a situation where the insurance applicant presents
a possibility of loss that is lower than the average expected from a random
sample of all applicants. .
7. A 'slip' like 'cover note' serves as an acceptance to the proposal by the Insurance
underwriter.
8. Deductibl,es are application in life insurance contracts too, as dE;ath of an
insured is always a total loss.
9. Endowment plans promise protection from risk in the event of death of the
insured only during the policy term.
10. While determining proximate cause, the sequence of events according to their
time of occurrence is irrelevant.
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2. Choose the accurate or near E\6C~qte-Ja,;qs,,~:r.;>.*f~.~.~~~l!?~~ng statements:
1. Transfer of the rights available to the insured under a contract of insurance
to another person with the consent of t~e insurer is known as
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(a) Assignment
(b) Nomination
(c) Appraisal
(d) None of the above.
2.
:permanent ~ife Insurance policies acquire paid-up value, if the prenllums
under the policy are paid for at least
(a) Two years
(b) Three years
(cl One year
(d) None of the above.
3. Annuity whose payments are not contingent on the annuitant being alive is
known as
(a) Pure life annuity
(b) Pensions
(c) Annuity certain
(d) None of the above.
4. The process of selection and classification of policyholders after thorough
evaluation of hazards is known as
(a) Rate marking
(b) Loss adjusting
(c) Underwriting
(d) None of the above.
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5.
AllY.ambiguity in the contract language that is construed strictly in favour of
the insured is known as the 'doctrine' of
(a) Contra proferentum
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(b) Lapse
. (c) Experience judgement
(d) None of the above.
6. Causes of loss or perils that are listed in the insurance policies are c:alled as
(a) Pure risks
(b) Nan1ed perils
(c) Open perils
(d) None of the above.
. - 7. Owner's funds in mutual insurance entities are termed as
r (a) . Reserve Fund
(b) Policyholders surplus
(c) Shareholders surplus
(d) Solatium fund.
8.
A legal instrument in which a surety ensures the performance of a contract
by the principal or the obligator is called as
(a) Certificate
(b) Notice
(c) Bond
(d) All the above.
9. 'ForcefuL entry' is a prerequisite for a
(a) Burglary
(b) Theft insurance
(c) Fire insurance
(d) All the above.
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10. Amount payable to persons for recovering property from sea under a marine
insurance policy is called as
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(a) Sue and Labour charges
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(b) Particular charges
(c) Commission
(d) Salvage charges.
3. Gro~p insurance. generally costs less than individual insurance. Why? 5
4. Discuss the implications of post settlement actions and recoveries with respect to 6
settlement of general insurance claims.
5. Discuss the rationale for solvency surveillance in Insurance industry. 6
6. How do the Insurance contracts satisfy the provisions of Indian Contract Act 8
of 1872 ?
7. Decide the admissibility of claims in the following cases:
(i) Mr. Harsha insured his car, with his son as a 'named driver'. Unfortunately,
his car was stolen from a supermarket car park. During the investigation
proceedings of Mr. Harsha's theft claim, the insurers discovered that the car
was, in fact, registered in the name of the son, and the son was' also responsible
for the financing arrangement. The insurer refused to meet the claim and
cancelled the policy from its start date. Mr. Harsha further admitted that he
had taken out the policy in order to :ceduce the premihm by using his 'no
claims discount', but he argued that his son was the' main user of the car.
Are the insurers right in denying the claims? 6
(ii) In December, 2002Mrs. Debjani Mukerjee had applied to GoodHealth Insurance
Company Ltd. for a life assurance cover of Rs. 5,00,000 and for Rs. 2,00,000
critical illness cover. Two years later she was diagnosed with breast cancer.
The Company refused to meet her claim. It said this was because she had not
disclosed that for most of the early 1990s she had been suffering from, and
received treatment for, back pain following childbirth. Insurance company
considered this fact as she had not revealed this information to be. reckless
non -disclosure.
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Mrs. Debjani told the Insurance Company that she had not thought she
needed to disclose this information. She had thought the question on the
firm's application form referred only to illnesses that had resulted in her .
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taking time off work during the previous five years. It was more than five-
years since she had suffered from the back pain and she had never needed
to take time off work because of it. In response, the company pointed out
that it had asked whether she had 'ever suffered' from 'bad or spinal
trouble'. Mrs. Debjani said she did not believe that back pain due to childbirth
was 'bach or spinal trouble';
Was the denial by the Insurance Company justified? 6
(iii) A ship was. carrying a shipment of lumber carried from Canada to Saudi
Arabia, some of which was loaded on deck and some of which under deck.
During the voyage the vessel suffered engine failure and had to be towed
to Piraeus, Greece for repairs. The shipment was insured under an open
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cargo policy. Some of the cargo was damaged before the engine problems
were repaired. Initially, believing the cause of the damage was the failure
to properly ventilate the holds, a covered peril, underwriters agreed to
advance the assured approximately US$3,50,000. But later on the
underwriters advanced only approximately US$2,60,000. After the cargo
arrived in Saudi Arabia, it was surveyed by a surveyor appointed by
underwriters. The essence of that surveyor's opinion was found to be that
the damage to the cargo was caused by delay although other factors
contributed. Later, the Underwriters denied the claim ~n the basis of
exclusion for 'delay' in the Timber Trade Federation Clauses. The
underwriters argued that this clause excluded all damages caused by delay
even if, delay was only a contributing cause. -
Discuss the admissibility of the claim. 8
8. (i) In January, 2009, there was a serious fire at Mrs. Kapoor's bakery shop,
which was insured with ABC General Insurance Company under a commercial
policy. The fire brigade thought the fire might have been caused -by an
electrical fault. Initially, the firm made an interim payment to Mrs. Kapoor
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c5fRs. 1,00,000 and appointed loss adjusters. During the course of their
investigations the loss adjusters discovered that Mr. Kapoor's business
owned its suppliers Rs. 70,000. Mrs. Kapoor had borrowed almost ~
Rs. 1,00,000 from her bank over the previous two years and had made"
incorrect statements when applying for the bank loans. The loss adjusters'
also discovered that, in her original insurance application, Mrs. Kapoor
had failed to disclose that the ground floor of her shop unit was unoccupied
and was not properly secured. The firm told Mrs. Kapoor that it was
treating her policy as void.
Is the company right in treating the policy as 'void' ? 8
(ii) Mr. Mahender Singh's home was broken into in October, 2009. The burglars
had kicked in a panel in his back door and stolen many of his possessions.
After accepting his claim for the stolen contents, his insurance company arranged
for one of its approved contractors to replace the back door, even though the
municipality owned the property and was responsible for repairing tpe damage.
Early the following year, shortly before Mr. Singh's policy was due to expire,
the insurance company sent him a renewal questionnaire. This asked for
details of his current security arrangements. Mr. Singh completed the form,
confirming that his external doors had (a mortise deadlock and security bolts
or a key-operated locl?-ingsystem'. The firm renewed the policy, but within a
month Mr. Singh's property was broken into a second time. Again, the thieves
had kicked in the rear door panel. When the firm discovered that the back
door did not, in fact, have security bolts or a key-operated locking system, it
refused to meet Mr. Singh's. claim. .
(a) Is Mr. Singh's claim reasonable? 6
(b) In case of a dispute for repudiated claims, what provisions are 6
made by IRDA ?
9. Fill in the blanks with appropriate word: 10x1.1
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1. Non-disclosure of a material fact renders a contract at the =15
option of the insurer.
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2. Brokers are ,.. of the proposer.
3. ,'Payment of compensation to victims of 'Hit and Run' accidents is made from
the ...........................
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4. Insurance act as arbitrator to facilitate redressal of customer
disputes relating to insurance.
5.
""""""""""""'" refers to the contractual relationship by virtue of which risks
of insurers are shared with another insurer.
6.
""""""""""""'" results are an indication of the effectiveness of the Company's
underwriting policy.
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7. The payment made in the event of loss under a value policy
is the cost of reinstating the same kind of property by a new one.
8. Compensation awarded through judiciary procedures in liability claims is
called as ...........................
9. """"""""""""'" Average refers to the loss incurred by the sacrifice made.
during extreme circumstances for the safety of the vessel and th~ cargo in a
marine transit.
10. A life insurance policy that is discontinued within the financial year of issue
is called a duration lapse.
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