風(fēng)險管理與保險第4章ppt課件

1、第一部分 風(fēng)險管理和保險根底 第1章 風(fēng)險 第2章 風(fēng)險管理 第3章 保險第4章 影響保險合同的根本要素 第5章 保險合同的內(nèi)容及其分析.第4章 影響保險合同的根本要素.4.1 Agency Law代理法The law of agency deals basically with the legal consequences of people acting on behalf of other people or organizations.代理關(guān)系涉及到三方：principal委托人、 agent 代理人和a third party第三方。.The principal(insurer) c

2、reates an agency relationship with a second party(agent) by authorizing him or her to make contracts with third parties(policyholders) on the principals behalf. So the source of the agents authority is the principal.Expressed or Implied Authority明示權(quán)限與默示權(quán)限明示權(quán)限When an agent is appointed, the principal

3、 expressly indicates the extent of his or her authority.默示權(quán)限By entering into the relationship, the principal implies that the agent has the authority to fulfill the principals responsibilities.Binding Authority約束權(quán)限A binder(暫保單)：the agreement that exists before a contract is issued. 在正式保險合同發(fā)出之前的協(xié)議。 主

4、要用于財富責(zé)任保單。人壽安康保險代理人普通只能發(fā)出conditional binder(有條件的暫保單). A conditional binder implies that coverage exists only if the underwriter ultimately accepts (or would have accepted) the application for insurance.Waiver and Estoppel棄權(quán)與制止反言Waiver is the intentional relinquishment of a known right.棄權(quán)意味著有意放棄知的權(quán)益。

5、為了棄權(quán)，一個人必需知道他享有這種權(quán)益并有意放棄它。Estoppel occurs when the insurer or its agent has led the insured into believing that coverage exists.當(dāng)保險公司或代理人讓被保險人置信保險關(guān)系曾經(jīng)建立起來的時候，制止反言原那么開場生效。.Agency by Estoppel制止反言的代理關(guān)系A(chǔ)n agency relationship may created when the conduct of the principal implies that an agency exists-an

6、agency by estoppel.如保險人暫停一個代理人的任務(wù)，但仍留有一些blank policies空白保單在代理人手中；或被停頓任務(wù)的代理人把一些業(yè)務(wù)送給保險人而保險人接受了這些業(yè)務(wù)時。.4.2 Requirements of a Contract合同的根本要件保險合同又稱保險契約，它是保險關(guān)系雙方之間訂立的一種在法律上具有約束力的協(xié)議。根據(jù)當(dāng)事人的雙方商定，一方支付保險費(fèi)于對方，另一方在保險標(biāo)的發(fā)生商定事故時承當(dāng)經(jīng)濟(jì)補(bǔ)償責(zé)任或者當(dāng)商定事故出現(xiàn)時履行給付義務(wù)的一種法律行為。.任何一份協(xié)議要具有法律效能，必需滿足以下根本條件：1、There must be an offer and a

7、n acceptance.2、There must be consideration.3、The parties to the contract must be competent.4、Its purpose must be legal.5、The contract must be in legal form.4.3Distinguishing Characteristics of Insurance Contracts保險合同的特征 1、based on utmost good faith 最大誠信. Potential insureds are held to the highest st

8、andards of truthfulness and honesty in providing information for the underwriter.最大誠信 (1)representations陳說 When you are negotiating with an insurer for coverage, you make statements concerning the exposure. These statements are called representations. (2)concealment隱瞞You must also reveal those mater

9、ial facts about the exposure that only you know and that you should realize are relevant.Material Fact重要現(xiàn)實Material Fact: the insurer must prove that the information was so important that if the truth had been known, the underwriter would not have made the contract or would have done so only on diffe

10、rent terms. 2、contracts of adhesion 附和性合同. Most insurance contracts are prepared by the insurer and then accepted or rejected by the buyer. .Expectations Principle預(yù)期原那么The objectively reasonable expectations of applicants and intended beneficiaries regarding the terms of insurance contracts will be

11、honored even though painstaking study of the policy provisions would have negated those expectations.投保人和未來的受害人有關(guān)保險合同的客觀的合理預(yù)期是該當(dāng)被滿足的，即使煞費(fèi)苦心解讀出來的保單條款能夠否認(rèn)他們的預(yù)期。. 因此，現(xiàn)代方法在解釋附和性保險合同時 1.to favor the insured when terms of the contract drafted by the insurer are ambiguous. 當(dāng)合同條款出現(xiàn)歧義時作有利于被保險人的判決。2.to read t

12、he contract as an insured would. 從被保險人的角度來解讀合同。3.to determine the coverage on the basis of reasonable expectations of the insured. 在被保險人的合理預(yù)期根底上理賠。. 3、contracts of indemnity 補(bǔ)償性.That means the insurer agrees to pay no more( and no less) than the actual loss suffered by the insured.The purpose of the

13、 insurance contract is to restore you to the same economic position you had before the loss, not to improve your situation. (1)Insurable Interest可保利益a. A person not subject to loss does not have an insurable interest.b. When insurable interest must exist: in property insurance, the interest must exi

14、st at the time of the loss;life insurance requires an insurable interest only at the inception of the contract.c. Extent insurable interest limits payment.the insured or the subject: the person whose death requires the insurer to pay the proceeds of a life insurance policy.the beneficiary: the perso

15、n or other entity entitled to the proceeds of the policy upon the death of the subject.the owner of the policy: the person or other entity who has the authority to exercise all the prematurity rights of the policy, such as designating the beneficiary, taking a policy loan and so on. (2)Subrogation代位

16、追償 This right gives the insurer whatever claim against third parties the insured may have as a result of the loss for which the insurer paid. 在第三方給被保險人呵斥了損失，而保險人賠償了這個損失后，被保險人將向第三方索賠的權(quán)益轉(zhuǎn)給保險人。. (3)Actual Cash Value Provision 實踐現(xiàn)金價值the replacement cost at the time of the loss, less physical depreciatio

17、n including obsolescence. 損失發(fā)生時的重置本錢減去折舊。或fair market value公平市價 the amount a willing buyer would pay a willing seller. (4)Other Insurance Provision 反復(fù)保險條款The purpose of other insurance provision in insurance contracts is to prevent insureds from making a profit by collecting from more than one insurance policy for the same loss. 4、Personal 個人性.Insurance contracts insure against loss to a person, not to the persons property.問題討論1、Mic