Insurance claims in New Zealand / Paul Michalik LLB (Hons) (VUW), BA (VUW), BCL (Oxon), Christopher Boys LLB (VUW), BA (VUW), Dip Ed (CCEd).

Includes bibliographical references and index.

Ch. 1: Overview and general principles of Insurance law -- 1.1. Introduction -- 1.2. The claim -- 1.3. Indemnity -- 1.4. The policy -- 1.5. Utmost good faith -- 1.6. Other special doctrines -- -- Ch. 2: Terminology -- 2.1. The language of insurance -- -- Part 1: Claims -- Ch. 3: Responding to a claim -- 3.1. Considering a claim -- 3.2. Step 1: Discover what happened -- 3.3. Step 2: Find and read the policy -- 3.4. Step 3: Apply the polic wording to the facts to confirm cover -- 3.5. Step 4: Consider the exclusions -- 3.6. Step 5: Consider the policy conditions -- 3.7. Step 6: Consider insurance law beyond the policy -- -- Ch. 4: Proving the loss -- 4.1. Principles of interpretation -- 4.2. Is the loss within the scope of the policy? -- 4.3. Causation for insurance claims -- -- Ch. 5: Indemnity -- 5.1. Introduction -- 5.2. The indemnity principles in historical context -- 5.3. Modern use of the indemnity principle -- 5.4. Market value or cost to reinstate -- 5.5. Partial losses -- 5.6. Total losses - market value -- 5.7. Market value may equal reinstatement cost -- 5.8. Total loss of a building -- 5.9. Reducing the loss -- 5.10. Insurance write-off/constructive total loss -- 5.11. Indemnity versus reinstatement cover -- 5.12. Repairs and improvements to the insured's position -- 5.13. Repairs and additional costs -- 5.14. Time of assessment -- 5.15. The challenges of successive insured losses -- 5.16. Reinstatement of cover -- 5.17. Underinsurance and reinstating cover -- 5.18. Merger -- 5.19. The Ridercrest case -- 5.20. Total reinstatement costs as a cap to the insured's recovery -- 5.21. Separate adjustment of each and every loss -- -- Ch. 6: Loss and damage -- 6.1. The meaning of "loss" -- 6.2. Property going missing -- 6.3. Wider senses of "loss" -- 6.4. Loss by exclusion from possession under lawful authority -- 6.5. Loss by deprivation of use - the need to wait and see -- 6.6. Amount of the claim for loss -- 6.7. Perishable property -- 6.8. Loss and exclusion from premises -- 6.9. Exclusion from time-sensitive premises -- 6.10. Making a claim - damage -- -- Ch. 7: Liability -- 7.1. Liability cover - general principles -- 7.2. Legal liability -- 7.3. Voluntary settlement -- 7.4. Liability to third parties -- 7.5. Legal costs -- 7.6. Conduct of defence and settlement -- 7.7. Damages or compensation -- 7.8. Trade, business or prefession -- 7.9. "Professional capacity" wordings as definitions of the insured business -- 7.10. Fortunity -- 7.11. Dishonesty -- -- Ch. 8: Assessment of claims -- 8.1. Quantum and assessing the claim -- 8.2. The role of the adjuster/assessor -- 8.3. Quantum -- 8.4. Assessing and paying claims -- 8.5. Delay in settling claims -- -- Ch. 9: Avoidance for non-disclosure -- 9.1. Insurance law - good faith -- 9.2. Non-disclosure and mis-disclosure -- 9.3. The Insurance Law Reform Act 1977 - an amelioration -- 9.4. A further amelioration - the inducement requirement -- 9.5. Material facts include moral hazard considerations -- 9.6. Limits to the duty of disclosure -- 9.7. Disclosure and intermediaries -- 9.8. Help with filling out forms -- 9.9. Avoidance and the Contractuals Remedies Act 1979 -- -- Ch. 10: Non-payment of claims -- 10.1. Good faith at claims stage -- 10.2. Fraud -- 10.3. Exclusions -- 10.4. Delay in notification -- 10.5. Conditions and warranties -- 10.6. Claims cooperation clauses -- 10.7. Claims cooperation clauses and ss 9 and 11 of the Insurance Law Reform Act 1977 -- --

Ch. 11: Join and Composite Insurance - insuring multiple interests -- 11.1. Joint and composite insurance -- 11.2. Third parties under and insurance policy -- -- Ch. 12: Subrogation -- 12.1. The two rules of subrogation -- 12.2. Recovery actions -- 12.3. Refraining from pursuit of subrogated recovery rights -- 12.4. Subrogated recovery actions and using the property of another -- 12.5. Proceeds of subogated recovery actions -- 12.6. Limit to subogated recovery - Property Law Act 2007 and leases -- 12.7. Property Law Act 2007 - exoneration and indemnity and residential tenancies -- 12.8. Indemnity and subrogation where subsequent events reduce the loss -- 12.9. Subrogation occurs where an indemnity insurer has paid the indemnity -- -- Ch. 13: Double Insurance -- 13.1. The indemnity principle -- 13.2. Contribution between insurers -- 13.3. Double indemnity clauses -- 13.4. Double Insurance - cover must coincide -- -- Ch. 14: Average -- 14.1. Underinsurance and the risk pool -- 14.2. Average makes the underinsured a contributing co-insurer -- 14.3. Average inapplicable in the case of a total loss -- 14.4. Average under ss 15 and 16 of the Insurance Law Reform Act 1985 -- 14.5. Average clauses uncommon in the New Zealand Market -- -- Ch. 15: Insurance intermediaries - agents and brokers -- 15.1. Insurance intermediaries -- 15.2. Agents -- 15.3. Liability for fraudulent or negligent acts of an agent -- 15.4. Affimation of a agent's unauthorised acts -- 15.5. Loss adjesters and claims advocates -- 15.6. Intermediaries and non-disclosure - Insurance Law Reform Act 1977, s 10 -- 15.7. Agent's incorrect representations regarding cover -- 15.8. Help with filling out forms -- 15.9. Brokers -- 15.10. Circumstances where the broker is the insurer's agent -- 15.11. Cover notes -- 15.12. Binder policies -- 15.13. When the broker is the agent of a third party -- 15.14. Receipt of money -- 15.15. Cancellation for non-payment in broker-arranged policies -- -- Ch. 16: Issues in particular contracts of insurance -- 16.1. Life and health policies -- 16.2. Issues of definition -- 16.3. Disability insurance -- 16.4. Income protection insurance -- 16.5. Critical illness/trauma insurance -- 16.6. Health insurance -- 16.7. Evidence in life and health insurances -- 16.8. Professional indemnity insurance -- 16.9. Liability insurance -- 16.10. The charge created by s 9 of the Law Reform Act 1936 -- 16.11. Directors and officers insurance -- 16.12. Employment practices insurance -- 16.13. Business interruption insurance -- -- Part 2: Dispute Resolution -- Ch. 17: Complaints Resolution schemes -- 17.1. Inception of complaints resolution schemes -- 17.2. Functions of the schemes -- -- Ch. 18: The Courts -- 18.1. Dispute resolution through the courts -- 18.2. The Earthquake List -- -- Part 3: Special Insurance Issues -- Ch. 19: The Earthquake Commission Act 1993 -- 19.1. The Earthquake Commission -- 19.2. The cover -- 19.3. Section 18 of the Earthquake Commission Act 1993 -- 19.4. Section 19 of the Earthquake Commission Act 1993 -- 19.5. Dispute resolution -- 19.6. The Earthquake Commission's performance -- -- Ch. 20: The Accident Compensation Act 2001 -- 20.1. The ACC scheme -- 20.2. The interaction between ACC entitlements and insurance benefits.