The contract of personal insurance - Civil law

Personal Insurance Contract

Under this agreement, one party (the insurer) undertakes to pay a fee (insurance premium) paid by the other party (the insured), at a time or to pay periodically the amount (the insurance sum) stipulated by the contract in case of causing harm to the life or health of the insured or another citizen (the insured person), the achievement of a certain age or the occurrence in his life of another event specified by the treaty, i.e. Insured event.

The right to receive the insured amount belongs to the person in whose favor the contract is concluded. In the event of the death of the insured person, if the contractor does not specify in the contract for another beneficiary, the heirs of the insured person are recognized as beneficiaries.

The insurance contract is only in writing. Its non-compliance usually entails the invalidity of the contract. The agreement is concluded by drawing up one document or handing insurance policy (certificate, certificate, receipt) signed by the insurer to the insurer to the insurer.

For certain types of insurance, insurers can apply the standard forms of the insurance policy developed by them or by the association of insurers, which essentially turns an insurance contract into an contract of accession (Article 428 of the Civil Code ). Systematic insurance of different lots of homogeneous goods or goods under similar conditions for a certain period can be carried out by mutual consent of the insured and the insurer on the basis of one insurance contract, called general policy.

GK will give a list of material terms contracts for both property and personal insurance. In paragraph 1 of Art. 942 ГК the characteristic of object of the contract of property insurance is given. The insurer and the insurer must reach an agreement on certain property or other property interest that is an object of insurance. In addition, the Civil Code names three other significant conditions relating to: a) the nature of the event, in the event of occurrence of which insurance is carried out (ie, the insured event); b) the amount of the sum insured; c) the term of the contract.

When concluding a personal insurance contract between the insured and the insurer, an agreement must be reached: about the insured person, the nature of the insured event, the amount of the insurance amount and the term of the contract. Thus, the essential conditions of contracts of property and personal insurance differ only in the objects of insurance. In this case, the terms of the insurance contract can be defined in standard insurance rules of the appropriate type, accepted, approved or approved by the insurer or association of insurers. The adoption by the insured of the rules of insurance essentially turns the insurance contract into a typical contract of accession in accordance with art. 428 GK.

Specificity of the insurance contract is in the peculiar duties and rights of the parties. Thus, the insured is obliged to conclude the contract with informing the insurer of the circumstances known to him, which are essential for determining the probability of occurrence of the insured event and the amount of possible losses from its occurrence (insurance risk), if these circumstances are not known and should not be known to the insurer, for example, about hidden shortcomings of insured property or the state of health of the insured citizen.

The insurer is also obliged to observe the insurance secret. He has no right to disclose information about the insured, the insured person and the beneficiary, their health status, and on the property status of these persons.

Simultaneously, the insurer, concluding the contract, has the right to inspect the insured property, and if necessary, to appoint an expert examination in order to establish its real value. If the insurer, who did not take advantage of the right to assess the insurance risk before the conclusion of the contract, was deliberately misled about this cost, he has the right to challenge the insurance value of the property specified in the contract. If the insured amount specified in the contract exceeds the insured value, the contract is insignificant in the part that exceeds the insured value. At the conclusion of the contract of personal insurance, the insurer has the right to conduct an examination of the insured person to assess the actual state of his health.

Important issues related to the stage of performance of the insurance contract - the beginning of its operation, early termination, the consequences of an increase in insurance risk during the validity period, the transfer of rights to the insured property to another person, the insurer's notification of the occurrence of the insured event, including reduction of losses from an insured event (item 957-962 ГК).

As a general rule, the insurance contract comes into force at the time of payment of the insurance premium or its first installment (clause 1, article 957 of the Civil Code), i.e. > The contract can be terminated prematurely due to the failure of the very possibility of the occurrence of an insured event due to, for example, the termination of entrepreneurial activity by a person who insured an entrepreneurial risk (Clause 1, Article 958 GK). At increase of insurance risk the insurer has the right to demand changes of conditions of the contract or payment of the additional insurance premium (item 2 of item 959 GK). When transferring the rights to the insured property to another person, as a rule, the rights and obligations under the insurance contract also pass (part 1, article 960 of the Civil Code).

The insured but the contract of property insurance is obliged to immediately notify about the insured event of the insurer or one hundred representative. This applies to the insured under the contract of personal insurance, if the insured event is the death of the insured or causing harm to his health (Article 961 GK). In the event of an insured event stipulated in the property insurance contract, the policyholder must take reasonable and accessible measures to reduce possible losses (Clause 1, Article 962 of the Civil Code). The insurer is usually released from payment of the insurance compensation or the insured amount, if the insured event occurred as a result of the intent of the insured, the beneficiary or the insured person (Article 963 GK).

In practical terms, the consequences of the occurrence of an insured event through the fault of the insured, the beneficiary or the insured person are very important. They are expressed in the release of the general rule of the insurer from the payment of insurance compensation or insurance amount. Similar consequences in cases stipulated by law may also lead to gross negligence of the insured or the beneficiary (paragraph 1 of article 963).

No less important are the grounds for the release of the insurer from the payment of insurance compensation and the insured amount. Usually, the insurer is released from their payment in cases when the insured event occurs due to events of an emergency nature (the effects of a nuclear explosion, military actions, maneuvers, civil war, etc.), as well as the occurrence of losses under the property insurance contract due to confiscation, requisition , arrest or destruction of the insured property by order of state bodies (Article 964 of the Civil Code).

One of the rules first included in the Civil Code under the name subrogations, is the transfer to the insurer of the insured's rights to compensation for damage. As a general rule, the insurer who has paid the insurance indemnity shall transfer the right of claim within the amount paid out, which the policyholder (beneficiary) has to the person responsible for losses compensated as a result of insurance (Clause 1, Article 965 of the Civil Code). Subrogation is a kind of a cession.

Types of insurance

The Civil Code provides for the possibility of incomplete (item 949), additional (item 950), double (item 4 item 951) property insurance, and also property insurance and enterprise risk from different insurance risks (item 952). Of types of insurance allocated by the number of insurers, insurance and membership-based insurance, it is necessary to note such types as coinsurance, reinsurance and mutual insurance.

Coinsurance recognizes the insurance of the object under one contract jointly by several insurers (Article 953 GK). As a general rule, if such a contract does not define the rights and obligations of each of the insurers, they are jointly and severally liable to the insurer (the beneficiary) for payment of the insurance compensation or the insured amount.

Reinsurance aims to insure the risk of paying the insurance indemnity or the insured amount under the contract with another insurer-reinsurer (clause 1, Article 967 GK). In this case, the insurer under the main insurance contract that has concluded the reinsurance contract in this last contract is already an insured. Since the reinsurance contract can be concluded jointly by several insurers, it is possible to talk about coinsurance reinsurance. In addition, after payment by several reinsurers of the insurance indemnity, the right of claim passes, which the insurer (the main insurer or the main insurers under coinsurance) would have to the person responsible for damages reimbursed as a result of reinsurance. In other words, subrogation with coinsurance reinsurance is possible.

Mutual insurance is carried out by citizens and legal entities on a reciprocal basis by combining in the mutual insurance societies necessary for this purpose. This insurance occurs, as a rule, directly on the basis of membership. Mutual insurance companies are non-profit organizations operating in accordance with the Civil Code and the law on mutual insurance (Article 968 GK).

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