보험법
보험 계약, 공정 진술 의무, 보험금 청구 및 규제 체계.
소개
Insurance law in England & Wales governs the formation, interpretation, and performance of insurance contracts. The Insurance Act 2015 reformed the law of insurance, replacing the duty of utmost good faith (uberrimae fidei) with a duty of fair presentation for commercial insurance. The Consumer Insurance (Disclosure and Representations) Act 2012 governs consumer insurance. The FCA and PRA regulate insurers. Key principles include insurable interest, indemnity, subrogation, and contribution.
핵심 원칙
Duty of Fair Presentation — Before a commercial insurance contract is made, the insured must make a fair presentation of the risk to the insurer, disclosing every material circumstance known or which ought to be known (Insurance Act 2015, s.3).
Consumer Disclosure — For consumer insurance, the insured must take reasonable care not to make a misrepresentation (Consumer Insurance Act 2012). The insurer cannot avoid the contract unless the misrepresentation was deliberate or reckless.
Insurable Interest — The insured must have a legally recognised interest in the subject matter of the insurance at the time of loss.
Indemnity — Insurance is a contract of indemnity: the insurer undertakes to compensate the insured for actual loss, not to provide a windfall. Exceptions: life and personal accident insurance.
Subrogation — Once an insurer indemnifies the insured, it is subrogated to the insured's rights against third parties responsible for the loss.
Proximate Cause — The insurer is liable only if the loss was proximately caused by an insured peril. If multiple causes exist, the court determines which is the dominant or effective cause.
Warranties and Conditions — Under the Insurance Act 2015, breach of warranty suspends the insurer's liability rather than discharging it entirely. The insurer's liability is restored when the breach is remedied.
Late Payment — The Insurance Act 2015 (as amended by the Enterprise Act 2016) implies a term that insurers must pay valid claims within a reasonable time. Breach gives rise to a claim for damages.
핵심 법령
Insurance Act 2015
Consumer Insurance (Disclosure and Representations) Act 2012
주요 판례
Carter v Boehm
(1766) 3 Burr 1905
Versloot Dredging v HDI Gerling
[2016] UKSC 45
일반적인 시나리오
Insurer refuses to pay a valid claim
Under the Insurance Act 2015 (as amended), insurers must pay valid claims within a reasonable time. If they fail, the policyholder can claim damages for late payment, including consequential losses flowing from the delay.
Non-disclosure on a home insurance application
For consumer insurance, the Consumer Insurance Act 2012 applies. The insurer's remedy depends on whether the misrepresentation was deliberate/reckless (contract can be avoided) or careless (proportionate remedy based on what the insurer would have done).