Definition of Insurance Policy

In insurance, an insurance policy is a contract (generally a model contract) between the insured and the insured, known as the policyholder, that defines the claims that the insurer is required to pay legally. In return for a down payment, known as the insurance premium, the insurance company promises to pay for the loss caused by the risks covered by the policy language.

Insurance contracts are designed to meet specific needs, and therefore have many advantages that are not found in many other types of contracts. Since insurance policies are standard formats, they feature a similar reference language across a wide range of different types of insurance policies.

An insurance policy in general is an integrated contract, which means that it includes all forms associated with the agreement between the insured and the insured: 10 But in some cases supplementary writings such as messages sent after the final agreement can make the insurance policy an incomplete contract: 11 An insurance book states that "Courts generally consider all previous negotiations or agreements ... every contractual term in the policy at the time of delivery, in addition to those that are subsequently written as carriers of documents and endorsement ... with both parties agreeing Is part of the written policy. " [3] The book also states that politics must refer to all papers that are part of politics  Oral agreements are subject to the rule of conditional release evidence, and may not be considered as part of the policy if the contract appears complete. Advertising and circulars are usually not part of a policy  Oral contracts may occur pending the issuance of a written policy.

General features

An insurance contract or agreement is a contract whereby the insurance company promises to pay benefits to the insured or on their behalf to a third party in the event of specific events. Subject to the "principle of chance", the event must be uncertain. Uncertainty can be either about the date of the event (for example in the life insurance policy, the time of the death of the insured is uncertain) or whether it will happen at all (for example in the fire insurance policy, whether or not it will happen Fire at all).]

Insurance contracts are generally considered as adhesion contracts because the insurer prepares the contract and has little or no ability to make substantial changes to it. This is interpreted to mean that the insurance company bears the burden if there is any ambiguity in any terms of the contract. Insurance policies are sold without the policyholder seeing a copy of the contract: 27 In 1970, Robert Keaton suggested that many courts actually applied "reasonable expectations" rather than interpreting ambiguity, which he called "the principle of reasonable expectations". This doctrine was controversial, as some courts adopted it while others explicitly rejected it  In many jurisdictions, including California, Wyoming, and Pennsylvania, the insured is bound by clear and clear terms in the contract even if evidence indicates that the insured has not read or understood it

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Insurance contracts are dependent on chance that the amounts exchanged between the insured and the insured are not equal and depend on future events uncertain By contrast, non-insurance ordinary contracts are preliminary in that the amounts (or values) exchanged are usually intended by the parties to be approximately equal This distinction is especially important in the context of exotic products such as limited risk insurance that includes “substitution” provisions.

Insurance contracts are one-sided, and this means that only the insurer makes promises that are legally enforceable in the contract. The insured is not obligated to pay the insurance premiums, but the insured must pay the benefits under the contract if the insured has paid the insurance premiums and meets some other basic conditions]

Insurance contracts are subject to the principle of maximum goodwill (Oprahima Finds), which requires both parties to the insurance contract to act in good faith, and in particular, imposes on the insured the duty to disclose all material facts that relate to the risks to be covered This contrasts with the legal doctrine covering most other types of contracts, emptying the trash (let the buyer warn). In the United States, an insurer can sue an insurance company damaged for acting in bad faith.

structure

Insurance contracts have been written traditionally on the basis of each type of risk (the risks are very narrowly defined), a separate premium has been calculated and charged for each. Only those individual risks that are expressly described or "scheduled" in the policy are covered; Consequently, these policies are now described as "individual" or "schedule" This system of “dangers is called or “specific risks has demonstrated unsustainable coverage in the context of the Second Industrial Revolution, in that great typical clustering there are dozens of types of risks that must be insured against. For example, in 1926, an insurance industry spokesperson indicated that a bakery would have to purchase a separate policy for each of the following risks: manufacturing operations, elevators, teams, product responsibility, and contractual responsibility (for a catalytic pathway connecting the bakery to nearby railways), and building responsibility ( For a retail store), and the protective responsibility of owners (to neglect contractors who have been assigned to make any modifications to the building

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In 1941, the insurance industry began a transition to the current system where risks covered initially are broadly defined in “all risks or “all amounts an insurance agreement in a policy model (for example, payment All amounts that the insured becomes legally obligated to pay as compensation ... ”), and then are limited by subsequent exclusion clauses (for example,“ This insurance does not apply to ... ”)  if the insured wants to Coverage of risks arising from exclusion in the standard form, the insured can sometimes pay an additional premium to obtain approval for a policy that exceeds exclusion.

Insurance companies have been criticized in some quarters for developing sophisticated policies with layers of interactions between coverage terms, conditions, exceptions and exceptions to exceptions. In the case of the interpretation of one ancestor of the hadith clause "Done Operations Dangerous Products" the California Supreme Court

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Parts of the insurance contract

Announcements - Determine who is the insured, the address of the insured, the insured company, the risks or properties covered, policy limits (insurance amount), any applicable discounts, policy period, and amount of premiums It is usually provided in a form to be filled out by the insurance company at the request of the insured and attached at the top of the first pages of the policy or included in it.

Definitions - define important terms used in the rest of the policy]

Insurance Agreement - Describes covered risks, assumed risks, or the nature of the coverage. This is where the insurance company makes one or more express promises to compensate the insured.]

Exceptions - the coverage of the insurance agreement is nullified by describing the property, risks, risks or losses arising from specific reasons not covered by the policy.

Conditions - These are specific provisions, rules of conduct, duties and obligations that the insured must adhere to in order to cover coverage or must remain bound to it in order to keep the coverage in effect. If the terms of the policy are not met, the insurance company can reject the claim]

Policy Model - Definitions, insured insurance, exceptions and conditions are usually merged into one integrated document called the Policy Model, Coverage Model, or Coverage Part. When multiple coverage models are aggregated into one policy, the declarations will be announced to the same extent, after which there may be additional advertisements for each coverage pattern. Traditionally, policy paradigms have been so strictly standardized that they do not have empty spaces to fill. Instead, they always refer explicitly to the terms or amounts stated in the declarations. If the policy needs to be allocated beyond what is possible with advertisements, then the insurer will attach recommendations or riders.

Approvals - Additional forms attached to the policy that somehow amend them, either without restriction or condition, having some conditions Ratifications can make policies difficult to read for non-lawyers; They may review, expand or delete items previously contained on many pages in one or more coverage forms, or even modify each other. Since it is extremely dangerous to allow non-lawyer subscribers to directly rewrite policy models using word processors, faithful believers are usually directed to amend them by attaching pre-approved approvals by attorneys to make several common adjustments.

Riders - The cyclist is used to transfer the terms of a policy amendment and thus the amendment becomes part of the policy. The riders are historians and digitists so that both the insurer and the document holder can determine the provisions and the level of benefit. Riders involved in group medical plans include name change, change to eligible employee categories, change the level of benefits, or add managed care arrangement like a health maintenance organization or a preferred provider organization (PPO).]

Jackets - The term has several distinct and confusing meanings. In general, it refers to a set of standard standard provisions that accompany all policies at the time of delivery. Some insurance companies refer to a set of standard documents shared across a whole family of policies as a "jacket". Some insurance companies extend this to include policy models, so that only parts of the document that are not part of the jacket are ads, endorsements, and riders. Other insurance companies use the term "jacket" in a manner closer to its ordinary meaning: a cover, cover, or presentation folder with pockets in which the policy may be delivered, or the cover sheet to which policy forms are stapled or stapled above the policy. The provisions of the standard plate are then printed on the wrapping itself

Industry standard models

In the United States, property and accident insurance companies usually use a similar or even identical language in their standard insurance policies, which are formulated by consulting organizations such as the Office of Insurance Services and the American Insurance Services Association  This reduces the regulatory burden for insurance companies as countries must agree to policy models; It also allows consumers to compare policies more easily, albeit at the expense of consumer choice  Additionally, when policy models are reviewed by courts, interpretations become more predictable when courts explain the interpretation of the same terms in the same policy models, rather than different policies from different insurance companies]

However, in recent years, insurance companies have increasingly modified standard models in company-specific ways or refrained from adopting changes [32] to standard models. For example, a review of home insurance policies found significant differences in various provisions In some areas, such as managers and employees, liability insuranceand the personal insurance umbrella [35] have little uniformity at the 

industry level.

Manuscript policies and support

For the vast majority of insurance policies, the only page written specifically for the needs of the insured is the ads page. All other pages are standard templates that refer to terms defined in ads as needed. However, certain types of insurance, such as media insurance, are written as manuscript policies, which are custom formulated from scratch or written from a mixture of standard and nonstandard models By analogy, policy approvals that are not written in standard forms or whose language is written specifically to suit the special circumstances of the believer are known as manuscript approvals