Insurance Claims – Get an Advance Payment!

Insurance claim advance payments are not widely known by people who file claims. Often, when an insured has a loss of significant size, such as a flood, tornado, wildfire, hurricane loss or a big water damage loss, an advance payment of a portion of the anticipated settlement is issued by the insurance company. This situation also happens regularly when a business has a loss and needs money up front.

It is a customary and widely accepted practice for the insurance company to issue an advance payment in this type of instance. Be aware that there’s nothing in the standard property insurance policy that deals with advances. It is usually just a courtesy that the insurance company extends to their policyholder.

However, they don’t usually offer to do it. You have to request the advance.

Here’s an example. Joe Smith’s house is hit by lightning, and a fire damages most of the house. Joe’s policy has Building limits of $100,000, Contents limits of $50,000, ALE limits of $20,000. The house can be repaired for $70,000, which is less than the policy limits. However, the adjuster expects that the Contents loss will exceed the policy limits of $50,000, and the ALE loss will be $15,000. The adjuster sends in his first report to the insurance company, and tells them to expect the loss to be approximately $135,000 on these three parts of coverage.

The insurance company could easily issue an initial advance payment of $25,000 to $35,000 for Contents and ALE, and $40,000 to $50,000 for the Dwelling loss.

So, what do you do if your Contents are damaged and you need the most basic things, like a change of clothes and shoes? What if you need to have a contractor secure the building and put tarps on the roof to keep further rain out of the building? Most people do not have tens of thousands of dollars just lying in their bank accounts that could be used to begin repairs, or begin replacing personal property. That’s when the insurance company issues an advance.

It’s best to make your request in writing. Even if it’s just a hand-written letter, it’s best if it’s in writing. Write or type your request, keep a copy for your records, and give the copy to your adjuster. It’s also a good idea to send a duplicate copy to the claims department of your insurance company. Send it by overnight courier or certified mail. NEVER rely on the adjuster to ask for an advance on your behalf. He might get delayed with other work and it could be days before he asks. DO IT YOURSELF.

Take control of your claim, my friend! Make an EARLY request in the claims process for your advance payment!

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Antigua Weather – Best and Worst Months to Go

Antigua has 365 beaches – one for every day of the year – and plenty of good weather to go with each one. But the island has its share of bad weather months, too.

Beside the beaches, Antigua and its companion island of Barbuda are known for good shopping, historical sites and plenty of hotels, resorts and restaurants.

The island has little variation in temperatures throughout the year, but strong peaks and valleys with rain.

Tourists will experience an average high monthly temperature of 85 degrees Fahrenheit, the World Weather Organization says. The average monthly low temperature is 75 degrees.

Antigua weather in June through October reaches average high temperatures of about 87 degrees Fahrenheit. They reach a low of 83 degrees in December, January and February.

Rainfall rates 3.6 inches per month. It reaches a high of 5.5 inches in September, with almost as much rain in October and November. These months have the most storm and hurricane activity of the Caribbean's annual hurricane season, which officially runs from July 1 to November 30. The islands also see higher rainfall in May, although not as much as the fall months.

Antigua weather in February sees rainfall reach a low of 1.5 inches, followed closely by March, January and April, respectively. February through April average about eight rain days per month, while August, October, November and December average 13 days a month.

The best time to visit Antigua is March and April, while the worst time to visit Antigua is September and October, according to the Caribbean Tourism Organization.

A combination of warm temperatures and light rainy make February through April along with June the least risky months for a vacation there. Likewise, Antigua weather in August through November along with May have the highest risk of rain.

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Life Insurance Fraud

Life insurance fraud is a black eye on both life insurance companies and life insurance customers. Both parties have been guilty of life insurance fraud and will be again–especially since, sadly, fraud seems to be on the rise according to most statistical measures.

Research by the non-profit The Coalition Against Insurance Fraud concludes that life insurance fraud committed by all parties costs an average household $1650 per year and increases life insurance premiums by 25%.

Life insurers are most often guilty of insurance fraud in the form of their agents doing “churning”. This is where the agent seeks to cancel your existing life insurance policy and replace it with a new policy that is paid for by the “juice”, or cash value, in your existing policy. Agents do this to earn more commissions for themselves without having to seek new prospects for business. Churning can result in increased premiums for a customer and clearly costs them out of their cash value.

Another insurance fraud practiced by agents, however, is called “windowing”. This is where, being unable to attain a client’s or applicant’s signature on a necessary document but already having that signature elsewhere, the agent holds up a signed document behind the unsigned document, presses it against a window to make the light shine through, and traces over the signature with a pen in order to forge the signature of the client or applicant.

When big name insurance companies have their agents do bad things it makes big headlines, but the fact is that the public is far more guilty of insurance fraud than companies are. And of course making false claims is the thing they do the most, which is why all claims on life insurance death benefit payouts are subject to investigation.

But falsely stating background or financial income information is another form of insurance fraud often engaged in by consumers. They might be embarrassed by their medical history or income, or they may realize that if they tell the truth they will have their coverage diminished or their premiums will be very high. If a life insurance company finds out someone lied on their application they have the right not to pay the claim or not pay the full death benefit depending on the circumstances and the policy.

But there are things that buyers of life insurance can do to protect themselves against insurance fraud, since they don’t have the great investigative resources that life insurance companies do.

Remember, when it comes to life insurance, if it sounds too good to be true, it probably is. There’s no free lunch.

Save all of your life insurance paperwork, including getting receipts for every penny you give your agent, and never ignore any notifications from your life insurance company.

Life insurance is never free and it’s not a pension plan, although certain policies can indeed become self-funding–but they never start off that way.

Never buy any coverage that you feel strongly is unnecessary, never let yourself be pressured, and never borrow to finance life insurance.

Although it can be part of an investment portfolio, life insurance’s number one role is protection against the unforeseen–and most people don’t need life insurance in their later years. It is intended to be temporary.

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Difference Between Employers’ Liability Insurance (ELI) and Workers Compensation Insurance (WCI)

Employers’ Liability Insurance (ELI) and Workers Compensation Insurance (WCI) are two important insurance covers to protect the interests of employees, as well as employers. There are, however, certain differences between the two. Due to these differences, it may result in wrongful litigation and consequently anxiety to parties involved. The differences between ELI and WCI are relating to where they apply and what they cover. We will discuss about them here briefly.

Where they apply

Employers’ liability insurance

As an employer, it is mandatory for you in UK to purchase employers’ liability insurance. Not purchasing attracts penalty under law. In certain situations your employees may feel that you are liable for job related illness/injury which they may sustain and they sue for this. If it is really a case, it may bring in expenses such as hospitalization, financial compensation and the like. ELI helps you under such circumstances.

While it is mandatory for you as an employer to have ELI, your employees need to prove that the job related injury/illness is because of your negligence. Imagine yours is a lumber business. While working, your employees should have the necessary equipment, training and skills to operate them. If you employ them without teaching the safety norms, imparting the training and checking the fitness, and they sustain injuries, it will amount to your negligence as per rules framed under Employers’ Liability Insurance Act and employees are likely to feel appropriate to sue you, because you are liable.

Workers compensation insurance

On the other hand, workers compensation insurance is a cover for the welfare of the employees. It depends on the circumstances that are the tone of relation between employer and employees. Thus, if you are more concerned about employees’ health and safety, you need to purchase this insurance. It does not matter whether it was your fault or your employees’ fault that resulted illness, accident or death, this insurance comes to your help.

Coverage

Employers’ liability insurance

As an employer, you have to go to court of law if the affected employee sues you. You need to pay financial compensation and bear the hospitalization and medication. ELI covers all these expenses.

Likewise, for employees ELI covers the permanent and temporary disability, injury and wrongful death at workplace. It covers the cost of litigation as well.

Workers compensation insurance

For employers, WCI is a Good Samaritan. In most cases, it ensures that your employees do not resort to litigation. However, in such unfortunate event, WCI covers the expenses because of litigation. It covers the financial expenses to be given to the affected employee for work-related injury, illness or even death.

Employees when inured at workplace, under WCI, are guaranteed to get compensation from the employer to cover medical and hospitalization expenses and certain portion of wages. In most cases, it is two-thirds or more. WCI covers the expenses on litigation, by the employee. In general, WCI takes care of the situation and makes sure that litigation on the part of employees is avoided.

WCI covers compensation (wages) in case of a temporary disability for the period of absence. If the individual got permanent disability, and not fit for employment in current occupation, WCI covers the expenses of vocational training and rehabilitation and cost of searching a job, if he wants.

Despite both ELI and WCI are meant to protect the interests of employees and employers, there are differences in the way they apply. You need to understand them and purchase a cover according to the need of your business.

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Twelve Secrets and Tricks to Buying Life Insurance

Secret #1: Don’t spend too much time on a life insurance quote.

Do not be fooled by the low price quotes you get online – they don’t apply to you unless you are extremely healthy. Statistically only 10% of people who apply actually get the lowest priced policy. The premium you end up paying has nothing to do with the initial quote you get online or from an agent. It is amazing to me how often I see people getting duped by an agent who quotes company X at a lower price than another agent.

Life insurance policies are the same price no matter who you buy from! One agent or website quoting a lower premium means nothing. Prices for any given policy is based on your age and health. There are a few exceptions to this but that is beyond the breadth of this article.

Most life insurance companies have 10-20 different health/price ratings and no agent or website can assure you the quote they give you is accurate. You have to apply, do a health check, and then go through underwriting (meaning you complete a mini-exam with a nurse in your home and then the company checks you doctor records and reviews and ‘rates’ your health) to get the real price of the policy. Remember that a health rating also factors in your family history, driving record, and the type of occupation you have. Only use quotes to help narrow down your choices to the top companies. You may want to consider a no load or low policy. The more that you save on commissions the more money builds up in your policy. You can even buy term insurance no load, and save a lot on premiums. You will not get the help of an agent, which may be worth something if they are very good.

The most important factor determining price is matching your particular health history with the company best suited for that niche. For instance company X might be best for smokers, company Y for cancer survivors, Company Z for people with high blood pressure, etc.

Secret #2: Ignore the hype on term versus cash value permanent insurance.

You can go crazy reading what everyone has to say on buying term insurance versus a whole or universal life policy. Big name websites give advice that I think borders on fraudulent. Simply put there is NO simple answer on whether you should buy permanent cash value policies or term insurance.

But I do think there is a simple rule of thumb – buy term for your temporary insurance needs and cash value insurance for your permanent needs. I have read in various journals and run mathematical equations myself which basically show that if you have a need for insurance beyond 20 years that you should consider some amount of permanent insurance. This is due to the tax advantage of the growth of the cash value within in a permanent policy. I am divorced and have taken care of my children should I die. I probably no longer need as much insurance as I now have. I have earned a great return on my policies and have paid no taxes. I no longer pay the premiums, because there is so much cash in the policies. I let the policies pay themselves. I would not call most life insurance a good investment. Because I bought my policies correctly, and paid almost no sales commissions my policies are probably my best investments. I no longer own them, so when I die my beneficiaries will get the money both tax free, and estate tax free.

Since most people have short term needs like a mortgage or kids at home they should get some term. Additionally most people want some life insurance in place for their whole life to pay for burial, help with unpaid medical bills and estate taxes and so a permanent policy should be purchased along with the term policy.

Secret #3: Consider applying with two companies at once.

Life insurance companies really don’t like this “trick” because it gives them competition and increases their underwriting costs.

Secret #4: Avoid captive life insurance agents.

Look for a life insurance agent who represents at least fifty life insurance companies and ask them for a multi company quote showing the best prices side by side. Some people try to cut the agent out and just apply online. Just remember that you don’t save any money that way because the commissions normally earned by the agent are just kept by the insurance company or the website insurance company without having your premium lowered.

Plus a good agent can help you maneuver through some of the complexities of filling out the application, setting up your beneficiaries, avoiding mistakes on selecting who should be the owner, the best way to pay your premium, and also will be there to deliver the check and assist your loved ones if the life insurance is ever used.

Secret #5: Consider refinancing old life policies.

Most companies won’t tell you but the price you pay on your old policies has probably come down dramatically if you are in good health. In the last few years life insurance companies have updated their predictions on how long people will live. Since we are living longer they are reducing their rates rather dramatically. Beware the agent may be doing this to obtain a new commission, so make sure it really makes sense.

I really am amazed at how often we find that our client’s old policies are twice as expensive as a new one. If you need new life insurance consider “refinancing” your old policies and using the savings on the old policies to pay for the new policy – that way there is no extra out-of-pocket costs. We like to think of this process as “refinancing your life insurance” – just like you refinance your mortgage.

Secret #6: Realize life insurance companies have target niches that constantly change.

One day company ‘X’ is giving good rates to people who are a little overweight and the next month they are super strict. Company ‘Y’ might be lenient on people with diabetes because they don’t have many diabetics on the books – meaning they will give good rates to diabetics. At the same time company ‘W’ might be very strict on diabetics because they are insuring lots of diabetics and are afraid they have too big of a risk in that area – meaning they will give a bad rate to new diabetics who apply.

Unfortunately when you are applying a life insurance company will not tell you, “Hey, we just raised our rates in diabetics.” They will just happily take your money if you were not smart enough to shop around. This is the number one area a smart agent can come in handy. Since a good multi-company agent is constantly applying with multiple companies he or she will have a good handle on who is currently the most lenient on underwriting for you particular situation. The problem is that this is hard work and many agents are either too busy or not set up to efficiently shop around directly to different underwriters and see who would make you the best offer. This is a lot harder than just running you a quote online.

Secret #7: Don’t forget customer service.

Most people shopping for insurance focus on companies with the lowest price and the best financial rating. Unfortunately I know of some A+ rated companies with low rates who I would not touch with a ten foot pole simply because it’s easier to give birth to a porcupine backwards then it is to get customer service from them.

Before I understood this I used a life insurance company that gave a client a great rate but 2 years later the client called me and said, “I have mailed in all my payments on time but just got a notice saying my policy lapsed.” It turned out the company had been making lots of back office mistakes and had lost the premium payment!

We were able to fix it because we caught the problem so early. But if the client happened to have died during the short period the policy had lapsed, his family might have had a hard time proving that the premium had been paid on time and they might not have received the life insurance money – a loss of hundreds of thousands of dollars in that case.

Secret #8: Apply 3-6 months ahead of the time you need the insurance if possible.

Don’t be in a hurry to get a policy if you already have some coverage in force. But go ahead and apply right away knowing that you might need months to shop around if the first company does not give you a good rate. Even though the life insurance industry is getting more automated your application will still often be held up for weeks or months while the insurance company waits on your doctor’s office to mail them a copy of you medical records.

If you are in a hurry and buy a quickie ‘no-underwriting’ policy without going through the full health checks and underwriting that a mainstream life insurance company requires, you will end up paying 20%-50% more because the insurance company will automatically charge you higher rates because they don’t know whether you are healthy or about to die the next day.

Secret #9: Avoid buying extra life insurance through work if you are healthy.

I am sure there are exceptions to this “trick” but I have rarely found one. By all means keep the free life insurance your employer provides. But if you are healthy and you are paying for supplemental life insurance through payroll deduction you are almost certainly paying too much. What is happening is that your ‘overpayments’ ends up subsidizing the unhealthy people in your company who are buying life insurance through payroll deduction.

Usually the life insurance company has cut a deal with your employer and will waive the required health exam for all employees – instead they just average the price for all the employees and offer one or two rates for males or females at any given age. Life insurance companies know they will pick up lots of unhealthy clients this way so they jack up the price on everyone so that the healthy people end up overpaying so that the unhealthy employees get a cheaper policy. Also, unlike the guaranteed term policies which we recommend, most life insurance you buy through work will get more expensive as you get older.

Also group life insurance is generally not portable when you retire or change jobs meaning that when you retire or change jobs you might have to apply all over again even though you will be older and probably not as healthy and risk being turned down for a policy. If the group plan does allow portability they generally limit your conversion choices and force you to go into expensive cash value plans.

I remember helping someone evaluate his supplemental life insurance. He was sure it was a better deal than any policy I could find him. Little did he know that the price of his group plan would go up every year? By the time he retired his premium would have risen to over $10,000/year. I found him a policy for around $1000/year that would never go up. Also, unlike his old group life policy, he could take the individual policy with him when he changed jobs or retired.

Secret #10: Do a trial application on a COD payment basis.

Only send money with the application if you need the life insurance coverage right away. Sending a check with the application is a traditional practice agents used to do – I think mostly because it got them their commissions faster. If you send money with an application you usually get temporary coverage immediately but if you already have plenty of coverage and are just trying to get better rates ask your agent to do a trial application on a COD basis so you only pay once the policy is approved. If you do not send money, and you die before paying for the policy there is no coverage.

Secret #11: Wear your shoes when the nurse measures your height.

When the insurance company sends out the nurse to do your health check try to be as tall as possible if you are overweight? In most states you are allowed to wear shoes and if you are a little overweight your taller height/weight ratio will look a little better to the underwriter who is determining your health rating and policy price. Also do your exam early in the morning with no food in you – this will make your cholesterol count and various health ratios look the best.

Secret #12: Be careful with extra perks and riders.

Most policies come with options like accidental death benefit, child riders, disability riders, return of premium etc. If you do the math on most of these “extras” they usually don’t make smart financial sense. Life insurance companies are out to make money and these riders are usually profitable because they either cover something that rarely happens or they are so stringent that the benefit never gets paid out. Keep things simple and focus mainly on getting a life policy to cover your life without many strings attached. Again a good agent can help you weigh the benefits of the extra riders. But be wary of an agent who tries to tack on every possible extra rider.

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Real Estate Agents – Strengths and Weaknesses in Listing Commercial Property Today

In this commercial property market there are some real pressures and challenges that confront a lot of property owners when they want to sell or lease their property. They need the help of top agents that really understand the local area, to help in moving the property.

Contrary to popular belief, it is in markets like this that good agents can make a lot of commission. It all comes down to the way in which they package their services and help their clients.

In simple terms, top agents and experienced agents can do very well today providing them work the local area and their database. A good database will always get you through any market conditions and frustrations. In saying, that I am a big believer that a salesperson's database should not be delegated to the office administrative staff to control.

Every salesperson should take ownership of their database; In this way they will get good activities from it. In this market you need leads that you can do something with. When a database is passed over to the administrative staff to control, the inevitable result is inaccurate and old data. The database soon becomes redundant. The salesperson does not keep it up to date.

Become Change Agents

So we are the 'agents of change' when it comes to helping our property clients an owners get results in this market. We should know how to attract the right people to every property listing that we take on. Exclusive listings are more important in today than ever before. Some top agents will not take on 'open listings' for the very reason that they are a waste of time and effort.

When you know the drawbacks of the industry and the listings today, you can offer the clients that you serve some solid solutions. So what are the drawbacks? Here is a list of some of the larger ones:

  1. The time that it takes to sell or lease a property can be longer today. Every client has to be conditioned for the best price or rent so the time on market is not lengthened. The first few weeks of every marketing effort are the most important. Position the property correctly to get the best inquiry in this time.
  2. High prices and high rents will achieve nothing. The price or rent for the property should be optimized for inquiry. You have to do more with less when it comes to marketing and inspecting of properties.
  3. A larger number of competitive properties can frustrate your marketing efforts and time on market. Check out these properties before you do anything with your listing.
  4. Buyers and tenants are slower to inquire, inspect the property, and then make a decision. Your skills with each stage of the listing should be optimized. Hone your skills accordingly.
  5. Limited finance can put some 'brakes' on the larger deals. Find out where your prospects can get finance from and what the criteria of approval may be.

Whilst these may be drawbacks in the market, they are also opportunities for agents that can get focused and organized. Every problem is an opportunity in disguise.

Are you a solution provider in this commercial real estate market? Top agents are just that. You can be too.

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5 Fundamental Principles of Insurance

Insurance is a contract, a risk transfer mechanism whereby a company (Underwriter) promised to compensate or indemnify another party (Policyholder) upon the payment of reasonable premium to the insurance company to cover the subject-matter of insurance. If you are well conversant with these principles, you will be in a better position in negotiating you insurance needs.

1. Insurable interest. This is the financial or monetary interest that the owner or possessor of property has in the subject-matter of insurance. The mere fact that it might be detrimental to him should a loss occurred because of his financial stake in that assets gives him the ability to insure the property. Castellin Vs Preston 1886.

2. Umberima fadei. It means utmost good faith, this principle stated that the parties to insurance contract must disclose accurately and fully all the facts material to the risk being proposed. That is to say that the insured must make known to the insurer all facts regarding the risk to be insured (Looker Vs Law Union and Rock 1928). Likewise, the underwriter must highlight and explain the terms, conditions and exceptions of the insurance policy. And the policy must be void of ‘small prints’.

3. Indemnity. It stated that following a loss, the insurer should ensure that they placed the insured in the exact financial position he enjoyed prior to the loss (Leppard Vs Excess 1930).

4. Contribution. In a situation where two or more insurers is covering a particular risk, if a loss occurred, the insurers must contribute towards the settlement of the claim in accordance with their rateable proportion.

5. Subrogation. It has often been said that contribution and subrogation are corollary of indemnity, which means that these two principles operates so that indemnity does not fail. Subrogation operates mainly on motor insurance. When an accident occurred involving two or more vehicles, there must be tortfeasor(s) who is responsible for accident. On this basis, the insurer covering the policyholder who was not at fault can recover their outlay from the underwriter of the policyholder who is responsible for the incidence.

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The “Contents Pack-out” Trap and How to Escape It

“Contents Pack-out” is a term used by water and fire restoration contractors, and insurance companies. It is the process in which the contractor sends trucks, boxes and workers to your home. They pack up all of the damaged personal property in your home or business and transport it back to their warehouse. Once the personal property is at the warehouse, the contractor begins the cleaning and restoration process.

Insurance companies do not like to replace personal property. They would rather clean or repair it and give it back to you. That drastically slashes their claims cost, which makes them happy.

I’ve been an insurance adjuster for over 16 years, and in the insurance business for over 35 years. I’ve seen very few instances where seriously damaged personal property can be just cleaned or repaired successfully. Most fires burn or infuse toxic chemicals into personal property, like wood or textiles. Same goes for a flood loss. My personal opinion is that replacement of damaged personal property is better than repair or cleaning.

So, what is the trap?

Insurance adjusters like to swoop in with their favorite approved restoration contractor and do a “pack-out.” But your insurance policy has a limit on Personal Property. All of the money that the insurance adjuster authorizes to have your contents cleaned is paid against the policy limit. So, if the restoration contractor cleans a bunch of your damaged property, but you reject it as damaged, the contractor still gets paid. But you have less money now to replace your damaged personal property.

The trap is that a pack-out can penalize you when you are submitting your insurance claim!

Here’s the Escape Strategy

1. You own the personal property…not the insurance company and not the restoration contractor. It is YOUR DECISION what gets repaired and what gets replaced, not the adjuster.

2. Call in your own restoration contractor for a second opinion. It shouldn’t cost you anything, but even if it did, it would be money well spent.

3. Make sure every single item that gets removed from your home is listed on an inventory sheet.

4. Based upon your contractor’s opinion, negotiate the replacements with the adjuster and settle the claim.

If you have experienced a property loss, whether fire, wind, flood or other, you need to know winning insurance claim strategies. The insurance company will not tell you the claims process, but I will. I will show you how to take control of your insurance claim, and add hundreds or even thousands more dollars to your claim settlement. For more information, go to the website listed below.

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Benefits of International Travel

International travel can be a great experience; it allows you to witness many new cultures and lifestyles. International travel has many benefits which make it better than your traditional domestic vacation. Depending on your destination, traveling abroad can also save you money because of the current exchange rate. These rates change and may not be available in the future. A good exchange rate or activity that you would like to see may not be available if you put off planning the vacation. Another benefit of planning an international trip today is the current technology, which makes booking a trip easy. Technology can help eliminate the hassle of finding the best prices and locations based on your budget.

Traveling, whether for a long weekend away to a nearby country, or clear across the globe, is invigorating, refreshing and expands so much in one’s life that it is something that more people should do. Traveling abroad can greatly change your life for the better because there are many cultures and lifestyles to experience. These cultures can provide you with an entirely new perspective on life. Once you begin experiencing the beauty of the world, you may even begin planning yearly international vacations.

Currency rates fluctuate regularly and, as stated before, this may be a good reason to plan an international vacation today. Money is necessary if you are planning to travel and see the sights the country has to offer. If your currency can be exchanged at a reasonable rate, this can greatly improve your vacation experience. This is an important reason for traveling internationally now since you can get the most out of your trip. If you put the trip off the exchange rate may change for the worse and you can lose money after arriving at your destination.

Practical reasons

However, let us get down to the more practical reasons for traveling internationally. Frankly, it is understandable why most people would be hesitant to travel now. The economy appears to be in bad shape and many people are trying to save money. However, in some instances, this can be beneficial for travel, the airlines may lower their prices in order to get your business and this can save you money. Airline prices also fluctuate between airlines and by looking around you may find a special promotional vacation package that may not be available in the future.

Vacations are meant to be fun and enjoyable and this is another reason for traveling abroad today. There are many locations to visit from the beaches of the Caribbean to the beautiful and exquisite city of Paris, France. Experiencing something new is always the best way to live and an international vacation provides just that. This can spice up your life by allowing you to find things that you would not normally consider trying.

In fact, these days traveling is so much easier, more efficient and less time consuming than it used to be. We can travel across the globe faster and it requires much less energy than was required years ago. It is also possible watch TV, movies or listening to music while traveling. On some airlines, you can even follow the path of your airplane via satellite!

Technology and travel

Due to the technology available, planning a vacation can be stress-free as well. By using the internet to purchase your international flight tickets, you can plan your trip, get travel advice, and shop around for great deals. Technology has come a long way especially for finding the best travel packages. You can book your hotel, car, flight, and even your entertainment all on one website. If you are unsure of your destination, you can browse through the millions of videos and pictures of different locations to find which location best suits you. Planning an international trip can be an enjoyable experience when compared to the hassle involved years ago.

It is highly recommended to travel abroad at least once in your life and there are many benefits to planning your trip now. Saving money is the main reason for planning your trip today. When traveling abroad, you may have to exchange your money for the local currency. Currency exchange rates change frequently and this can have a large impact on your vacation. Since you do not know what the rates are going to be in the future, it is best to plan your trip while a good rate is available. You should also consider planning a trip because of the cultural value. Experiencing new cultures and lifestyles can help provide much value to your life. It may even change your life completely because you may find something new that you like. If you are planning an international trip, you should consider these suggestions because they can help you get the most out of your trip.

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Insurance In Tort Laws

INTRODUCTION

This project has been an eye opener for me. It is extremely relevant to the modern times and as the future of India we should understand that it is the common mass that runs the country. Consumer protection rights are an important issue in modern days. The law can be effectively used to stop any abuse of the common people especially illiterate masses who do not understand the rules and regulations which is to be followed while buying particular item. It is law, the controller of the entire society which can stop this abuse from taking place. It can place effective standards guiding a product’s genuinity and the proper verification of its price. No extra taxes should be issued according to the seller’s wish. I have proceeded by referring to the books written by Avtar Singh, Venkat Rao and others. It has been a wonderful and educational delight in going about this topic and making a project which is of greatest importance in the present day scenario.

DEFINITION OF CONSUMER

The words “consumer”, “consumed”, “consumption” is all cognate, and when one is defined, the contents of the definition go into all of them wherever they occur in the same act.

Section 2 of the act wherein ‘consumer’ is defined. According to him, the definition of the consumer will not take a client who engaged the advocate for professional services.

Consumer means any person who-

– Buys any goods for a consideration which has been paid or promised or partly paid and partly promised or under any system or deferred payment and includes any user of such goods other than the person who buys such goods for consideration paid or promised or partly promised or under any system of deferred payment when such use is made with the approval of the person, but does not include a person who obtains such goods for resale or for any commercial purpose

– Hires or avails of any services for a consideration which has been paid or promised or partly paid or partly promised or under any system of deferred payment and includes any beneficiary of such services other than the person who hires or avails of the services for the consideration paid or promised or partly paid or partly promised or under any system of deferred payment when such services are availed of with the approval of the first mentioned person but does not include a person who avails of such services for any commercial support

In Black’s Law Dictionary it is to mean:

One who consumes. Individuals who purchase, use, maintain or dispose of products and services. A member of that broad class of people who are influenced by pricing policies, financing practices, quality of goods and services, credit reporting debt collection and other trade practices for which the state and federal consumer laws are enacted.

OBJECTVES OF THE ACT

The act is dedicated, as its preamble shows, to provide for better protection of rights of consumers and for that purpose to make provisions for the establishment of consumer councils and other authorities for settlement of consumer disputes and for other connected matters. In the statement of objects, reasons it is said that and the act seeks to provide speedy and simple redressal to consumer disputes. Quasi judicial body machinery has been set up at the district, state and central levels. These quasi judicial bodies have to observe the principle of natural justice and have been empowered to give relief to a specific nature and to award, wherever appropriate, compensation to consumers. Penalties for non compliance of orders given by quasi judicial bodies have also been provided.

The object and purpose of rendering the act is to render simple, inexpensive and speedy remedy to consumers with complaints against defective goods and deficient services and for that quasi judicial machinery has been sought to be set up at the district, state and national levels. These quasi judicial bodies are required to apply the principle of natural justice and have been empowered to give relief of specific nature and appoint wherever necessary, compensation to consumers.

INSURANCE

An operational definition of insurance is that it is

– the benefit provided by a particular kind of indemnity contract, called an insurance policy;

– that is issued by one of several kinds of legal entities (stock company, mutual company, reciprocal, or Lloyd’s syndicate, for example), any of which may be called an insurer;

– in which the insurer promises to pay on behalf of or to indemnify another party, called a policyholder or insured;

– That protects the insured against loss caused by those perils subject to the indemnity in exchange for consideration known as an insurance premium.

The influence of insurance on the law of torts has been significant, both on theoretical level and on practice. Insurance has undermined one of the two main functions of awarding of damages, and it has in cast doubt on the value judgements made by the courts in determining which particular test of liability is appropriate in the given circumstances.

Regardless of whether in the particular circumstances the appropriate principle of liability is intention is malice, fault or strict liability, the purpose of common law damages remains the same. The primary purpose of an award of damages is to compensate the victim for his loss, with view to restoring him as near as possible to the position he would have been in but for the tort of the wrongdoer. But damages have another: by making the wrongdoer responsible for meeting an award of damages, the courts are trying to deter others from committing similar tortuous wrongs.

Insurance vitiates the secondary purpose of damages, at the same time incidentally ensuring that the primary purpose is more often achieved.

It can scarcely be realistically asserted that insured defendants are deterred by the prospect of losing no-claims bonus or by increasing of premium on renewal of their policies. Once it is conceded that insurance renders compensation for the sole purpose of damages but then the tort action itself becomes vulnerable to attack, for there are many ways-some perhaps fairer and administratively cheaper than tort- of compensating a victim for a loss he has suffered.

Prima facie, where a person suffers loss of recognized kind as the result of another’s act, then the latter should have to make good that loss. But for valid reasons, the courts have held that, in certain circumstances, the actor will have to compensate his victim only if he is at fault. The victim’s right to compensation is, therefore curtailed in an attempt to be fair to both the parties. The courts have made a policy decision that, in the circumstances, it is right to reward a defendant who has been careful by protecting him from liability for the consequences of his actions and that, as a corollary the plaintiff must forego his compensation. The policy decision is made on the supposition that the wrongdoer would himself have to pay for the damages but for this protection; it by no means follows that the same decision would be made if there were no risk of the wrongdoer having to provide the compensation.

It is difficult to judge the victim’s right to compensation should be curtailed when that curtailment is not justified by a corresponding benefit to the wrongdoer. The requirement of fault ceases to play its role as the leveler between the victim’s legitimate expectations and the wrongdoer’s legitimate expectations, and becomes simply a hurdle to the victim’s progress to compensation. If it is accepted that no one can insure against liability for harm caused by intentionally to another , then similar arguments can be made by the inappropriateness of the victim’s having, in certain circumstances to prove an intention to do him wrong or harm, when it is irrelevant to the wrongdoer whether he had such an intention or not.

Again the victim’s right to compensation is being curtailed without any corresponding benefit to the wrongdoer.

However, insurance has influenced the law of tort on a much more practical level as well. While the fact of insurance is not of itself a reason for imposing liability , there can be no doubt that it does add “a little extra tensile strength” to the chain which a wrongdoer to his responsibilities.

As well it has given new horizon to damages ; it is true that traditionally it was considered to inform the court that a defendant was insured , but “those days are long past” and now it is frequently openly recognized that the defendant would be insured.

The policy of insurance constitutes a contract of insurance between Life Insurance Corporation or a subsidiary of General Insurance Company of India, as the case may be, such services such has been undertaken to render under the contract of insurance. However as a rule, occasion to render services arise only when insured surrenders his policy, or the policy matures for payment or the insured dies or any other contingency which gives rise to render service occurs.

Breach of contract of insurance may give rise to a cause of action to file a civil suit, but such breach of contract may itself constitute deficiency in service, so as to give a cause of action to file a complaint under the consumer protection act for one such more relieves awardable hereunder.

Section 13(4) of the act vests in a redressal agency powers of the Civil Court, while trying a suit in respect of such matters as examination of witnesses on oath and production of documents. Declining to exercise jurisdiction in a case before it only because it involves examination and cross examination of facts, witnesses and production and consideration of documents would amount to abdication of its jurisdiction.

Such discretion can be exercised only when the gives rise to several issues and necessities taking of voluminous oral and documentary evidence, or otherwise involve complex questions of fact and law which cannot be decided in time bound proceedings under the consumer protection act.

MOTOR VEHICLE INSURANCE

Where the sale of a vehicle is complete, the title therein passes to the purchaser notwithstanding that his name has not been recorded in the R.C.Book. Such owner is entitled to get his vehicle insured and also to maintain a claim on the basis of such insurance. The earlier owner, who has lost insurable insurance on the sold vehicle, cannot advance a claim on the basis of policy of the said vehicle, earlier taken by him, on the ground that he is still the recorded owner of the said vehicle.

Section 157 of the motor vehicles act is only in respect of third party risks and provides that the certificate of insurance described therein shall be deemed to have been transferred in favour of the person to whom the motor vehicle is being transferred. It does not apply to other risks, if any, covered by the policy. If the transferee wants to avail the benefits of other risks covered by it, he has to enter into an agreement thereof with the investor.

FRAUD BY INSURER

If it is established that the discharge voucher was obtained by fraud, misrepresentation, undue influence or coercive bargaining or compelled by circumstances, the authority of the consumer forum may be justified in granting relief. Mere execution of the discharge voucher would not deprive the consumer of his claim in deficiency of service.

DELAY IN SETTLEMENT OF CLAIM

In Sarveshwar Rao v. National Insurance Company Ltd. , it was held that the delay of two or more years in settling the insurance claim would result in inadequacy in the quality, nature and manner of the service which the insurance company has undertaken to render, and amounts to deficiency in service.

In Delkon India Pvt. Ltd. V. The Oriental Insurance Company Ltd. . The National Commission has held that it was a deficiency of service to have delayed the claim by two years on the ground that the final police report was not coming.

INTERPRETATION OF TERMS

In Skandia Insurance Company v. Kokilaben Chandravadan , the honorable Supreme Court ruled that the exclusion terms of the insurance must be read with so as to serve the main purpose of the policy, which is to indemnify the damages caused to the vehicle.

CONDUCT OF THE INSURER

In Oriental Insurance Co. Ltd. V. Mayur Restaurant and bar , the conduct of the insurer was under question. The commission held that deficiency of the service was established on the part of the opposite party on two counts i)delay in settlement of claims and ii) unreasonable and un maintainable reasons for repudiating the claim of the complainant, and the compensation with the interest and cost was awarded.

SUICIDE BY THE ASSURED

In Life Insurance Corporation v Dharma Vir Anand, the national commission refused to hold the insurance commission liable as the insured committed suicide before the expiry of three years from the date of the policy.

BREACH OF TERMS

In B.V.Nagarjuna v Oriental Insurance Company Ltd., the terms of insurance contract permitted the insured vehicle to carry six passengers at a time but the driver allowed two more persons to get in. It was held that merely adding two more persons without the knowledge of the driver did not amount to indemnification by the insurance company.

NOMINEE’S RIGHTS

In Jagdish Prakash Dagar v. Life Insurance Corporation , it was held that a nominee under a policy of life insurance will be a consumer within the meaning of section 2(1) (d) of the Consumer Protection Act. The commission held that the nominee could legislatively maintain an action against deficiency raised in service by the arbitrary decision of the insurer.

REPUDIATION

Repudiation is defined as the renunciation of a contract (which holds a repudiator liable to be sued for breach of contract, and entitles the repudiatee on accepting the repudiation to treat the contract as at an end

This concept of repudiation is needed in the concept of insurance. The concept of repudiation will be dealt hereto a number of times and to provide beneficiary evidence, the definition has been given.

Unilateral repudiation of its liability, under the contact of by the life insurance corporation or an insurance company does not, by itself oust the jurisdiction of a redressal agency, to go into the sustainability of such repudiation, on facts and in law and to decide and to adjudicate if, in the facts of the case, it amounts to deficiency in service or unfair trade practice, and if so, to award to the aggrieved person, such relief or reliefs under Section 14(1) of the said Act as he or she is entitled to. The fact that before such repudiation it obtained a report from a surveyor or surveyors also does not oust the jurisdiction of a redressal agents to into the merits of such repudiation, for otherwise in each case the corporation or such company, and deprived the aggrieved person of the cheap and expeditious remedy under the consumer protection act.

Where, however the corporation or the company conducts thorough investigations into the facts which have given rise to claim and other associated facts, and repudiates the claims in good faith after exercise with due care and proper application of mind, the redressal agency should decline to go into the merits of such repudiation and leave the aggrieved person to resort to the regular remedy of a suit in a civil court.

The law does not require the life insurance corporation or an insurance company to accept every claim good or bad, true or false, but it does require the corporation or the company to make a thorough investigation into such claim and to take decisions on it, in good faith, after exercise of due care and proper application of mind and where it does so it renders the service required by it and cannot be charged with deficiencies in service, even if, in the ultimate analysis, such decisions is wrong on the facts and in law and the redressal agency would be disinclined to substitute its own judgement in the place of the judgement of the corporation or insurance company.

The question as to whether repudiation of its liability does or does not amount to deficiency in service would depend upon the facts of each case.

Where a cheque sent towards a premium is dishonoured by the drawee bank and consequently the policy is cancelled or it lapses or the injured dies before the proposal is accepted and contract of insurance results, no claim can be founded in such a policy, which was cancelled or has since lapsed, or a contract of insurance, which did not materialize at all. Repudiation of such claim can never amount to deficiency in service.

Insurance agent is not entitled to collect premium on behalf of the corporation. Where an insured issues a bearer cheque towards premium and hands it over the insurance agent who encashes it, but does not deposit the premium with the corporation event till the expiry of the grace period and consequently the policy lapses and meanwhile the insured also dies, his nominee has to blame himself or herself for the indiscretion of the insured and cannot blame or fault the corporation.

BASIC PRINCIPLES OF INSURANCE

There are some basic principles concerning the topic of Consumer Protection Law and Insurance.

– Settlement of insurance claim is service, default or negligence therein is deficiency of that service

In the case of Shri Umedilal Agarwal v. United India Assurance Co. Ltd, the National Commission observed as under:

“We find no merit in the contention put forward by the insurance company that a complaint relating to the failure on the part of the insurer to the settle the claim of the insured within a reasonable time and the prayer for the grant of compensation in respect of such delay will not within the jurisdiction of the redressal forums constituted under the consumer protection act.

The provision of facilities in connection with insurance has been specifically included within the scope of the expression “service” by the definition of the said word contained in section 2(i) (o) of the act. Our attention was invited by Mr. Malhotra, learned counsel for the insurance company to the decision of the Queen’s Bench in national transit co. ltd. V. customs and central excise commissioners . The observations contained in the said judgement relating to the scope of the expression insurance occurring in the schedule of the enactment referred to therein are of no assistance to all of us in this case because the context in which that expression is used in the English enactment considered in that case is completely different. Having regard to the philosophy of the consumer protection act and its avowed object of providing cheap and speedy redressal to customers affected by the failure on the part of persons providing service for a consideration, we do not find it possible to hold that the settlement of insurance claims will not be covered by the expression insurance occurring in section 2(1)(d).Whenever there is a fault of negligence that will constitute a deficiency in the service on the part of the insurance company and it will perfectly open to the concerned aggrieved customer to approach the Redressal Forums under the act seeking appropriate relief.”

– L.I.C. Agent has no authority in collecting the premium

The supreme court held that under regulation 8(4) of life insurance corporation of India (agents) regulation, 1972 which had acquired the status of life insurance corporation agents rules with effect from January 31, 1981, which were also published in the gazette, LIC agents were specifically prohibited from collecting premium on behalf of LIC and that in view thereof an inference of implied authority cannot also be raised.

– Rejection of claim as false after full investigation

The national commission held as follows:

” from the facts disclosed by the record and particularly averments contained in the consumer affidavit filed by the first respondent it is seen that the insurance company had fully investigated into the claims put forward by the complainant that his claim was rejected. Thus it is not a case where the insurance company did not take a prompt and immediate option for deciding the claims against the insurance company. Having regards to the facts and circumstances of this case and the nature of the controversy between the parties we consider that this is a matter that should be adjudicated before a civil court where the complainant as well as the respondent will have ample opportunities to examine witnesses at length, take out the commission for local inspections etc. and have an elaborate trial of the case.”

– Unilateral reduction in the insurance amount.

The national commission held that the insurance company is not entitled to make a unilateral reduction of Rs. 4, 29,771 from Rs. 30, 12,549 at which its own surveyor assessed the loss.

– Mere repudiation does not render the complaint not maintainable.

The national commission overruled the objection of the insurance company that merely because the insurer had totally repudiated its liability in respect of the claim, no proceedings could validly be initiated by the insured under the consumer protection act.

– Mere unilateral repudiation does not oust the jurisdiction.

The national commission held that merely because the insurer has repudiated the insurance claim under the policy unilaterally, it is difficult to hold that the various redressal forums constituted under the consumer protection act, 1986 will have no jurisdiction to deal with the matter that if such a contention of the insurance company can get a report from the surveyors, repudiate the claim and oust the jurisdiction of the redressal forums, that the redressal forums are, therefore, bound to see whether or not the repudiation was made in good faith on valid and justifiable grounds that if the surveyor or surveyors choose to submit the wrong report and the insurance company repudiates the claims without applying its mind then the repudiation cannot be said to be justified that the report of the surveyor will show that the investigations have been proper, fair and thorough and that it has to be remembered that the surveyors bread comes from the employer.

– Mere unilateral repudiation no ground to oust jurisdiction.

The national commission repelled the objection and observed as under:

“Ordinarily a remedy is available to a consumer in Civil Court but mere repudiation of claim arising out of policy of insurance under section 45 of the insurance act, 1938, cannot take away the jurisdiction of the redressal forum constituted under the act. The avowed object of the act is to provide cheap, speedy and efficacious remedy to the consumers and it is with this object that section 3 of the act lies down as follows:

3. Act not in derogation of the provisions of any other law: – the provisions of this act shall be in addition to and not in derogation of the provisions of any other law for the time being in force.”

The national commission overruled the objection in the view of repudiation of contract of insurance by the corporation; the redressal agencies under the act cannot entertain the claim of the insured and reiterated the law laid down by it in the Divisional Manager, Life insurance Corporation of India, Andhra Pradesh v. Shri Bhavnam Srinivas Reddy.

– Removal of insured goods on attachment no theft.

It was ruled in the stated case that attachment of certain items of insured Machinery and goods by the bailiff of a civil court, though later found to be illegal and consequent removal did not amount to theft and or house breaking by force so as to entitle the insured to prefer a claim under the policy.

– When repudiation amounts to deficiency and when it does not?

The national has held:

In M/s Rajdeep Leasing and Finance and others v. New India Assurance Company Limited and others –

That rejection of the claim by the insurance company after examining and considering the two separate survey reports from qualified surveyors and three legal opinions from different oriental counsels could not be said to constitute a deficiency in service so as to give a rise in the cause of action for a complaint under the consumer protection act.

In Oriental Insurance Co. Ltd. V Modern Industries Ltd. , the national commission has held that where the cover note inter alia mentions that the risk is subject to the usual terms and conditions of the standard policy, it is equally the responsibility of the complainant to call for these terms and conditions even if they are not sent by the insurance company, as alleged, to understand the extent of risk covered under the policy and associated aspects.

In Life Insurance Corporation of India v. Dr. Sampooran Singh

The complainant had taken out an insurance policy of 40,000 rupees in 1982, for the purpose of payment of estate duty on his only residential house in chandigarh in the event of his death and paid 5 premia, but with the abolition of estate duty on one residential house owner in 1985, the policy became inoperative due to the act of the state and not due to any deficiency on the part of the corporation any dispute between the parties as to the amount payable there under cannot be construed as deficiency in service on part of the corporation.

In LIC of India v M/s Kanchan Murlidhar Akkalwar

The complainant applied to the opposite party for housing loan, and on the advice of the latter, she took two LIC policies, one for Rs. 90000 and the other for Rs. 20000 entered into an agreement for the purchase of the house with the house with the owner on the advice of the opposite party obtained a fire policy for Rs. 2 lakhs. The opposite party advised the complainant to obtain a release deed from the zilla parishad co operative society in respect of the she proposed to purchase with a certificate that the said plot is not mortgaged therein. The complainant got a certificate from the Maharashtra government that the vendor had re paid the housing loan and interest thereon due to Zilla Parishad Krishi Karmachari Sehakari Gribe Narman Sanstha and that there was nothing outstanding from him towards loan amount or interest. Still the opposite party did not release the loan. On these facts the national commission by its majority judgement observed that:

“We have carefully gone through the records and heard the counsel. Clause 1 (c) of the loan offer letter clearly states that the advance of the loan is subject to the property being free from encumbrances to the satisfaction of the insurance company and a good and marketable title. At the same time it appears that the respondent-complainant had to go through a number of steps, although necessary, having financial implications and causing mental and physical stress to her and at the end of all of which she was told that no dues certificate given by the maharashtra government in respect of the prospective seller of the property in question, was not “release of mortgage” certificate that was obtained. The respondent complainant perhaps also had in her mind the case of Mr. Vaishempayam who got the loan under similar circumstances. Thus the evasion petition is disposed of as above.”

CONCLUSION

This project topic is increasingly beneficial in the modern times with the consumer protection rights being redressed with due care. It is being advertised in the mass media in our country. The slogan which our consumer is using is: “JAGO GRAHAK JAGO”. The time has come to realize the ideal market situation in which the buyers are not persuaded or coerced falsely into buying items which are of no use to them at all. Besides the relationship between buyer and seller should not be damaged at any cost. The relationship between the buyer and seller is said to be a fiduciary relationship and the trust between them should remain intact. A time has come in which the customer should get his proper position in the market conditions. He has to have proper knowledge about what is going on in the market and the concerned prices and the supply and the different other practices referred to.

Insurance is a very sensitive issue in the modern times. People are being hoodwinked into signing up in companies which are turning out to be frauds in the true sense of the term. This project has been an eye opener to me and I have come to realize the importance of the consumer protection act and insurance.

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