CASUALTY INSURANC

E

Reporter:

Regine Joy L. Magabo

DEFINITION:

- covers LOSS or LIABILITY arising from ACCIDENT or MISHAP, excluding certain types of loss which by law or custom are considered as falling exclusively within the scope of other types of insurance such as marine, fire, suretyship and life.

COVERAGE:- presumed to include any loss or

damage when an accident is the cause of the loss.

(casualty = accident)

a. Employer’s liability insuranceb. Workmen’s compensation insurancec. Public liability insuranced. Motor vehicle liability insurancee. Plate glass insurancef. Burglary and theft insuranceg. Personal accident and health insurance

as written by non-life companies

WHAT GOVERNS?

- except Compulsory Motor vehicle Insurance

- the terms of the contract which are not violative of the laws and by the general provisions applicable to all types of insurance

GENERAL DIVISIONS:which affect the person and/or property of the insured:

which give rise to third-party liability on the part of the insured:

• plate glass insurance• burglary and theft insurance• personal accident and health insurance as written by non-life companies

• employer’s liability insurance• workmen’s compensation insurance• public liability insurance• motor vehicle liability insurance

COMPARISON OF THE DIVISIONS:

Third party liability Person or property of the insured

1. Insurable interest

- The insured has interest in the safety of persons who may maintain, or in the freedom from damage of property which may become the basis of suits against him in case of their injury or destruction.

- The insured has interest on his own life (section 10) and on his property (section 13).

2. When payable?

-Attaches when the liability of the insured to the injured 3rd party attaches, regardless of actual loss at that time.

- Action against the insurer lie only when there is an actual loss sustained by the insured.

Third party liability Person or property of the

insured

3. Right of injured person to sue insurer of party at fault

- 3rd persons to whom the insured is liable, can sue directly the insurer upon the occurrence of the injury or event upon which the liability depends.

- 3rd persons cannot proceed against the insurer. Their recourse is limited to the insured alone.

4. Basis of insurer’s liability

- Based on contract - Based on contract

5. Extent of insurer’s liability

- Extent of policy - Extent of policy

ACCIDENT AND HEALTH INSURANCE

Accident Insurance- reimburses the insured for

pecuniary loss suffered as a result of injuries sustained in an accident

Health Insurance- reimburses the insured for

pecuniary loss arising out of disease-related illness.

RULE AS TO DEATH OR INJURY RESULTING FROM ACCIDENT:

GENERAL RULE:

Death or injury does NOT result from accident if it is the NATURAL RESULT of the insured’s voluntary act, unaccompanied by anything unforeseen except the death or injury.

EXCEPTION:

If the death or injury is NOT THE NATURAL RESULT of the insured’s voluntary act or if something UNFORESEEN OCCURS in the doing of the act which produces the injury, the resulting death is within the protection of the insurance policy.

ACCIDENT VS. INTENTIONAL

ACCIDENT – happens by chance, fortuitously, without intention, design, and which is unexpected, unusual, and unforeseen.

INTENTIONAL – which implies the use of reasoning faculties, consciousness, and volition.

FORMULA:

cause + result of the death or injury = accidental RECOVERY

cause is intentional NO RECOVERY