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Practical Guide to the Insurance Act 2015

Page 175

Index

Index
  • basis clauses 1.15–16, 6.1–2; abolition of 6.3; contracting out of Act and 8.5; permissible alternative 6.4
  • beneficiaries, third-party: deliberate or reckless breach 5.11; fair representation, duty of 3.7, 3.8, 3.10, 9.13
  • British Insurance Law Association (BILA) 1.8, 3.15
  • brokers 3.17, 3.26, 3.27, 5.44; commission 5.17–18; confidential information 4.13–19; contracting out of Act: transparency 8.13, 8.15, 8.16, 8.17, 8.23; knowledge 3.11, 4.10–11, 4.13–19, 4.27, 4.29, 4.34; neither deliberate nor reckless breach 5.13; subscription risks 5.44, 5.46
  • burden of proof: deliberate or reckless breach 5.7; exclusion clauses 7.22
  • captive insurance company: reasonable search 4.28
  • causation test 7.4, 7.5, 7.6–10, 7.12–13, 7.16, 7.26, 7.28, 7.30, 7.31
  • change in circumstances or in law: excuses for breach of warranty 6.41
  • charitable trusts: knowledge of insured 4.4, 4.5–11
  • claims already paid: avoidance 5.15; deliberate or reckless breach 5.10; proportionate reduction of 5.26; termination from date of variation 5.31; varying terms of contract, remedy of 5.23–4
  • co-insurance in subscription market: LMA standard clause 5.49
  • commencement 2.1–5
  • commission: brokers 5.17–18
  • companies see corporations
  • composite policy with two or more insureds 3.6, 3.7; avoidance and premium repayable 5.16, 5.20; deliberate or reckless breach 5.12; proportionate reduction of claim 5.27; varying terms of contract, remedy of 5.27
  • conditions 7.23; precedent 6.5, 6.9, 6.32, 6.36–40, 7.19, 7.23, 11.6
  • confidential information 4.12–19, 4.56–7
  • confidentiality: breach of warranty of 6.28
  • consent: confidential information 4.18
  • consortium leaders 5.45

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    consumer insurance: contracting out 8.1, 8.3, 8.4, 8.24, 9.6; fraudulent claims 9.1, 9.6; meaning 2.16, 3.2; non-consumer vs 2.15–21; pre-contractual duties 3.1–2, 8.4; remedies 5.1
  • consumer vs non-consumer insurance: application of Act 2.15–21; business, trade or profession 2.18; case law in other areas 2.19; mixed use 2.16, 2.20; objective assessment 2.17
  • contracting out of Act 8.1–2;
  • commencement 2.1; consumer insurance 8.1, 8.3, 8.4, 8.24, 9.6; disadvantageous terms 8.2, 8.7–8; entire agreement clauses 8.6; exceptions: non-consumer insurance 8.5–6; flexibility 8.10, 8.11; fraudulent claims 9.6; group insurance 8.24; meaning of consumer insurance 8.3; small businesses 8.1, 8.10, 8.12, 8.14; sufficient steps to draw term to insured’s attention 8.9, 8.10, 8.11–17, 8.23, 8.24; term must be clear and unambiguous as to effect 8.9, 8.10, 8.18–23; transparency 8.1, 8.2, 8.6, 8.7, 8.9–23, 8.24
  • conveyancing 4.29
  • corporations: deliberate breach 5.9; directing mind and will 3.22, 4.7; fraudulent claims 9.11, 9.12; groups 3.7, 3.10, 4.28; knowledge of insured 4.4, 4.5–11, 4.28, 5.9; representation of expectation or belief 3.22, 3.23
  • coverholders 5.45
  • criminal convictions 3.17, 6.32; directors’ and officers’ liability (D&O) policies 6.4, 7.19; employees of insured 3.25, 6.4, 7.19
  • damages 5.28, 5.29, 11.4; fraudulent claims 9.2
  • damages for late payment 1.3, 1.18–19, 10.1–3; causation 10.13; commencement 2.2; contracting out 8.5, 8.6, 8.7, 8.16, 8.21, 8.22, 10.21; implied term 10.2; limitation period 10.20; parliamentary passage of Insurance Bill 1.21, 1.23; reasonable grounds for disputing claim 10.8–10; reasonable time 10.4–7; reinsurance 10.15–19; remedies 10.11–14; small businesses 10.14
  • data-dumping 1.12, 1.13, 3.29, 3.31; reckless or deliberate breach 5.7
  • databases, subscription: knowledge of insurer 4.41, 4.42, 4.45, 4.47
  • date contract entered into 2.7–12, 3.26
  • date of inception 2.7
  • deceit 3.12, 5.28, 11.4
  • definitions: circumstance 3.14; consumer insurance contract 2.16, 2.20, 8.3; contract of insurance 2.1; senior management 4.5
  • deliberate or reckless breach 5.7–12, 5.31; duty to pay claims within reasonable time and 8.5, 8.6, 8.21; neither 5.13–14, 5.32, 5.35
  • directors’ and officers’ liability (D&O) policies 6.4, 7.19
  • disclosure of documents in civil proceedings 4.29
  • disclosure, duty of 3.1–4, 3.13–17, 3.22; disclosure putting insurer on notice 3.33–7; knowledge see separate entry; matters not required to be disclosed 3.41; misrepresentation and non-disclosure 3.24–5; reasonably clear and accessible 3.29–32, 3.36; timing and content of presentation 3.26–7; what must be disclosed 3.38–40
  • entire agreement clauses 8.6
  • estoppel 6.9; fraudulent claims 9.5
  • excess insurance 5.43, 5.50–1
  • exclusion clauses: terms not relevant to actual loss 7.20–2, 7.23
  • expert evidence: matters not required to be disclosed 3.41; reasonable search 4.29; varying terms of contract: remedy for breach of fair presentation duty 5.22
  • Explanatory Notes 1.28; duty of fair presentation 3.9; knowledge 4.1, 4.8–9, 4.11, 4.29, 4.36, 4.46, 4.55, 4.63; remedies for breach of fair presentation duty 5.8; terms not relevant to actual loss 7.20, 7.25–6; contracting out 8.13; fraudulent claims 9.3, 9.7
  • extent of application of Act 2.14
  • facts 3.17, 3.39; opinion or belief 3.39
  • facultative reinsurance: confidential information 4.19; date contract entered into 2.11
  • facultative/obligatory (fac/oblig) contracts: date contract entered into 2.10
  • fair presentation, duty of 1.3, 6.4, 9.13, 11.1, 11.5; commencement 2.1, 2.3, 2.4, 2.5; disclosed, what must be 3.38–40; disclosure, duty of 3.13–17; disclosure putting insurer on notice 3.33–7; disclosure reasonably clear and accessible 3.29–32, 3.36; fac/oblig open cover 2.10; fraud unravels all 3.36; knowledge see separate entry; matters not required to be disclosed 3.41; misrepresent, duty not to 3.18–23; misrepresentation and non-disclosure 3.24–5; owed by insured 3.5–12; pre-contractual duties 3.1–4; remedies see remedies for breach of fair presentation duty; timing and content of presentation 3.26–8; variations, contractual 2.4, 5.30

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    fiduciary relationships 5.45
  • Financial Conduct Authority (FCA) 10.6
  • financial institution crime insurance: disclosure putting insurer on notice 3.35
  • floating policies: date contract entered into 2.9
  • fraud against principal by agent: matters deemed not to be known 4.61–3
  • fraud unravels all 3.36
  • fraudulent claims 1.17, 9.1–4, 11.1; attribution of fraudulent intent 9.11–12; collateral lie 9.6, 9.9; commencement 2.1, 2.5; contracting out of Act 9.6; fraudulent act 9.6; group insurance 9.13; old law 9.2; relevant event giving rise to claim 9.7; remedies 9.4–10; right to terminate 9.4, 9.5–10; waivers 9.5, 9.9
  • fraudulent misrepresentation 5.28
  • freedom of contract 8.1
  • good faith: representation of expectation or belief 3.17, 3.18, 3.22–3; utmost see separate entry
  • group companies: fair presentation, duty of 3.7, 3.10; reasonable search 4.28
  • group insurance: contracting out of Act 8.24; fraudulent claims 9.13
  • history of insurance law reform 1.6–8
  • hold harmless fiction 1.19
  • implied representation 5.46; conveyancing 4.29
  • implied term about payment of claims see damages for late payment
  • implied warranties 6.8, 6.9, 6.18
  • inception date 2.7
  • inducement 5.3–5; subscription risks 5.47
  • inequality of arms 1.14
  • insolvency 3.17
  • Insurance Conduct of Business Sourcebook (ICOBS) 10.6
  • interest: compound 10.11, 10.14; damages for late payment 10.11, 10.14; hold harmless fiction 1.19; premium repaid 5.19
  • internet: knowledge of insurer 4.41, 4.51
  • interpretation: aids 1.24–8; utmost good faith 11.5–6, 11.7
  • intranet: knowledge of insurer 4.41
  • jurisdiction clause 2.13
  • knowledge 1.4, 3.4, 3.14, 3.22, 4.1–4; commencement 2.4; confidential information 4.12–19, 4.56–7; contracting out of Act: disadvantageous term 8.7; deemed not to be known 4.61–3; deemed to be known 3.23, 4.3, 4.58–60; deliberate breach and 5.9; fraudulent claims 9.11; of insured 4.1, 4.2–34, 4.58–63, 5.9, 8.7; of insurer 3.41, 4.1, 4.35–63; non-disclosure and 3.24; senior management 4.5–9, 5.9; those responsible for insured’s insurance 4.10–11, 5.9
  • knowledge of insured 4.1, 4.2–3; brokers 3.11, 4.10–11, 4.13–19, 4.27, 4.29, 4.34; confidential information 4.12–19; contracting out of Act: disadvantageous term 8.7; deemed not to be known 4.61–3; deemed to be known 3.23, 4.3, 4.58–60; deliberate breach and 5.9; differences between old and new law 4.31–4; forgotten matters 4.3; not an individual 4.4; (senior management) 4.5–9, 5.9; (those individuals responsible for insured’s insurance) 4.10–11, 5.9; partnerships 4.4; reasonable search 4.3, 4.4, 4.6, 4.9, 4.20–30, 4.32, 4.34, 8.8; timing of exposure to information 4.3
  • knowledge of insurer 3.41, 4.1, 4.35–57; confidential information 4.57; deemed not to be known 4.61–3; deemed to be known 4.58–60; ought to know 3.41, 4.39–47; presumed to know 3.41, 4.48–55
  • liability policies: exclusions clauses 7.21, 7.22; fraudulent claims 9.8
  • limitation period 1.19; damages for late payment 10.20
  • limited liability partnerships: knowledge of insured 4.4, 4.5–11
  • lineslip 5.45
  • Lloyd’s Market Association (LMA) 3.19, 4.4, 5.18; co-insurance: standard clause 5.49; definition of “insured’s organisation”: standard clause 4.28; definition of “senior management”: standard clause 4.9; rely on effect of legal advice without waiving privilege: standard clause 10.9; standard clauses contracting out of ss. 10 & 13A Insurance Act 8.16–8, 8.20–2; standard clause contracting out of s.11 Insurance Act 8.19–20
  • Lloyd’s Minimum Standards for Conduct Risk 10.6

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    long-tail contracts: date contract entered into 2.12
  • loss adjusters 9.12
  • loss experience, disclosure of existing 3.17
  • managing general agents 5.45
  • marine, aviation or transport insurance 1.8
  • marine insurance: exclusion clauses 7.21; term defining risk as a whole 7.18, 7.23; territorial limits 7.18; warranties 6.14, 7.33
  • materiality 1.6, 1.16, 3.2; disclosure, duty of 3.13, 3.15–17; misrepresent, duty not to 3.20
  • misrepresentation 1.6, 1.13, 1.14, 3.12, 3.34; co-insurers in subscription market 5.49; corrected before insurance underwritten 3.28; damages 5.28, 5.29, 11.4; duty not to misrepresent 3.18–23; fraudulent 5.28; knowledge of insurer 4.35; negligent 5.28, 5.29; non-disclosure and 3.24–5
  • mistakes: corrected before insurance underwritten 3.28
  • moral hazard 7.19, 9.3
  • multiple persons insured under same policy: deliberate or reckless breach 5.12; fair representation, duty of 3.5–12
  • negligent misrepresentation 5.28, 5.29
  • New Zealand 7.6, 7.18
  • non-consumer insurance: basis clauses 6.1, 8.5; consumer vs 2.15–21; contracting out of Act 8.1, 8.3, 8.5–6, 8.10, 8.13, 8.24; fair representation, duty of see separate entry; fraudulent claims 9.1
  • non-executive directors 4.8
  • Northern Ireland 2.14
  • notification clause 7.19
  • obligatory/obligatory (oblig/oblig) contracts: date contract entered into 2.9
  • official secrets 4.12
  • open cover insurance: date contract entered into 2.8, 2.9, 2.10
  • opinions: duty of disclosure 3.17, 3.39
  • overview 1.1–5
  • P&I Clubs 8.1
  • parliamentary passage of Insurance Bill 1.20–3; Special Public Bill Committee 4.8–11, 4.26, 4.32, 7.14
  • partnerships: knowledge of insured 4.4
  • placing brokers 3.26; knowledge 3.11, 4.11; neither deliberate nor reckless breach 5.13
  • pre-contractual duties 3.1–4; fair
  • presentation, duty of see separate entry
  • premium 5.21, 6.28; avoidance 5.15, 5.16–20; brokers’ commission and 5.17; composite policy with more than one insured 5.16, 5.20; damages 5.29; deliberate or reckless breach 5.10, 5.31; example of operation of remedies 5.39–42; fraudulent claims 9.4, 9.9; MIA 1906 s84 and new remedies 5.37; negligent misrepresentation 5.29; payment warranties 6.13, 6.18, 6.20, 6.21, 7.19; proportionate reduction of claim 5.25–7, 5.32, 5.35, 5.36, 5.42; variations and remedies 5.31, 5.32, 5.35; varying terms of contract, remedy of 5.21, 5.24
  • problem of old law 1.11
  • professional indemnity insurance: ‘claims made’ policy 9.7; fraudulent claims 9.7, 9.10; premium payment warranty 6.13
  • proportionality: reasonable search 4.29
  • proportionate reduction of claim: breach of duty of fair presentation 5.25–7, 5.29, 5.35, 5.43; example 5.39–42; excess insurance 5.51; subscription risks 5.48
  • public authorities: knowledge of insured 4.4, 4.5–11
  • qualifying breach 5.6; deliberate or reckless breach 5.7–12, 5.31; neither deliberate nor reckless breach 5.13–14, 5.32, 5.35; subscription risks 5.48
  • reasonable search 4.3, 4.4, 4.6, 4.9, 4.20–30, 4.32, 4.34, 8.8; groups of companies 4.28; scope of search 4.27; timing 4.30
  • reckless see deliberate or reckless breach
  • records: retention of written 7.19
  • regulatory oversight 10.6
  • reinsurance contracts 2.6, 2.13, 10.2; confidential information 4.19; damages for late payment 10.15–19; date contract entered into 2.8, 2.9
  • remedies for breach of fair presentation duty 5.1–2; affirmation 5.10, 5.38; avoidance see separate entry; commencement 2.3, 2.4; contracting out of Act: disadvantageous term 8.7; damages 5.28, 5.29; deliberate or reckless breach 5.7–12, 5.31; example of operation of 5.39–42; excess insurance 5.43, 5.50–1; inducement 5.3–5, 5.47; MIA 1906 s84 and 5.37; neither deliberate nor reckless breach 5.13–14, 5.32, 5.35; proportionate reduction of claim 5.25–7, 5.29, 5.35, 5.36, 5.42, 5.43, 5.48, 5.51; qualifying breach 5.6; subscription risks 5.43, 5.44–9; variations and 5.30–6; varying terms of contract 5.21–4, 5.41, 5.47, 5.51; waivers 5.38

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    remedies for fraudulent claims see fraudulent claims
  • representation of expectation or belief 3.22–2
  • representation of fact: compared with nondisclosure 3.24–5; substantially correct 3.18, 3.21
  • rescission 11.4
  • restitutio in integrum 5.10, 5.15, 5.19
  • retention of written records 7.19
  • retrocession contracts 2.6, 2.13
  • retrospective effect: fraudulent claim and right to terminate 9.5; varying terms of contract: remedy for breach of fair presentation duty 5.23–4
  • rumours 3.39
  • Scotland 1.19, 2.14, 10.1
  • senior management: definition of 4.5; deliberate breach 5.9; fraudulent claims 9.12; knowledge of 4.5–9, 4.37, 5.9
  • several liability 5.44
  • social media 4.51
  • solicitor: premium payment warranty 6.13; professional indemnity insurance 6.13, 9.10
  • statutory bodies: knowledge of insured 4.4, 4.5–11
  • subscription risks 5.43, 5.44–9
  • Terms of Business Agreements (ToBAs): avoidance and premium 5.18
  • terms not relevant to actual loss 1.4, 1.15–16, 7.19, 7.23; 1980 Law Commission proposals 7.3–5; 2006/7 Law Commissions’ proposals 7.6–9; 2012 and 2014 proposals 7.10–13; 2014 (7 Nov) proposal of Law Commissions 7.14–16; causation test 7.4, 7.5, 7.6–10, 7.12–13, 7.16, 7.26, 7.28, 7.30, 7.31; condition precedent 7.19, 7.23; contracting out of Act: disadvantageous term 8.7; effect of section 11 7.25–7; examples 7.28–32; exclusion clauses 7.20–2, 7.23; historical background 7.2; interaction between sections 10 and 11 7.33; mischief 7.1, 7.23, 7.31; not applicable to terms defining risk as a whole 7.17–19, 7.20, 7.23; parliamentary passage of Insurance Bill 1.21–3; risk mitigation terms 7.17, 7.23–4
  • third-party beneficiaries: deliberate or reckless breach 5.11; fair representation, duty of 3.7, 3.8, 3.10, 9.13
  • time-specific warranties 6.17, 6.18, 6.19–27; examples of 6.24–7; risk becomes essentially same as originally contemplated 6.20, 6.21, 6.22–3; risk to which warranty relates 6.20–1
  • trade sanctions 10.5
  • transparency: contracting out of Act 8.1, 8.2, 8.6, 8.7, 8.9–23, 8.24; examples 8.12, 8.14–17; sufficient steps to draw term to insured’s attention 8.9, 8.10, 8.11–17, 8.23, 8.24; term must be clear and unambiguous as to effect 8.9, 8.10, 8.18–23
  • variations, contractual 5.30; commencement 2.4, 2.5; deliberate or reckless breach 5.31; fair representation, duty of 2.4, 5.30; neither deliberate nor reckless breach 5.32; proportionate reduction of claim 5.35, 5.36; remedies for breach of fair presentation duty 5.30–6; termination from date of variation 5.31
  • varying terms of contract: remedy for breach of fair presentation duty 5.21–4; example 5.39–41; excess insurance 5.51; subscription risks 5.47

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