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Claims Notes

This is a sample of our (approximately) 4 page long Claims notes, which we sell as part of the Insurance Law Notes collection, a Distinction package written at Multiple Institutions in 2013 that contains (approximately) 51 pages of notes across 14 different documents.

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Claims Revision

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Claims What is an Insurance Claim?
'Insurance Claim': A claim is essentially derivative of an insured loss that falls within the subject matter of the insurance policy. You cannot claim for a loss unless a loss has been suffered - when an insured suffers an insured loss it has claim against insurers clear link - when you interpret policy conditions in connection with claims, the conditions must be interpreted in the context of the particular loss to which they relate. The following must precede an insurance claim: (i) (ii) (iii)

Tangible property - Total or partial loss. Intangible property - Loss of a contractual right. Liability - Determination of liability and of quantum. But also must bring to UWs' attention circumstances likely to give rise to a claim, as soon as they come to the insured's attention
- notify.

------------------------------------------------------------------------------------------------------------------------------------Notification Requirements Implied at Law?
No positive duty on an insured at law to keep an UW advised / notify them of a claim. In the absence of an express contractual term the insured only has to prove loss and comply with CPRs, after bringing loss to insurer's attention.
------------------------------------------------------------------------------------------------------------------------------------Contractual Terms as to Notification of Claims Policy Terms: Actual obligation on an insured as to the notification of a claim to UWs is determined by policy terms. These constitute a trigger for the claim obligation in first place, shape and dictate form / content of the obligation to notify and set out the effect of the breach. Triggers for Claim Obligation: Important as this sets off the start of the period: 1) Bring to UWs' attention circumstances 'likely to give rise to a claim' - Must be notified as soon as they come to the attention of the insured. Refers to circumstances which may occur prior to loss. Important in context of liability insurance where loss is not ascertained until liability is proved, but UWs will want to know before that. 'Likely' implies must be more than a 50% chance; i.e. more likely than not circumstances will result in claim.
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Jacobs v. Coster; Customer injured - made no complaint so owner believed injuries minor and no basis for a claim so did not notify their insurer until he received a solicitor's letter 7 months later. Held no breach. So not a 50% chance.

2) Insurer must be notified 'as soon as possible after the occurrence of an event' - Contextual/subjective interpretation: looked at from the perspective of the party who has to provide the notice. Means 'as soon as possible to them' in the circumstances.

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