Insurance claims in New Zealand /
Paul Michalik LLB (Hons) (VUW), BA (VUW), BCL (Oxon), Christopher Boys LLB (VUW), BA (VUW), Dip Ed (CCEd).
- xxviii, 313 pages 24 cm.
Includes bibliographical references and index.
Overview and general principles of Insurance law -- Introduction -- The claim -- Indemnity -- The policy -- Utmost good faith -- Other special doctrines -- -- Terminology -- The language of insurance -- -- Claims -- Responding to a claim -- Considering a claim -- Step 1: Discover what happened -- Step 2: Find and read the policy -- Step 3: Apply the polic wording to the facts to confirm cover -- Step 4: Consider the exclusions -- Step 5: Consider the policy conditions -- Step 6: Consider insurance law beyond the policy -- -- Proving the loss -- Principles of interpretation -- Is the loss within the scope of the policy? -- Causation for insurance claims -- -- Indemnity -- Introduction -- The indemnity principles in historical context -- Modern use of the indemnity principle -- Market value or cost to reinstate -- Partial losses -- Total losses - market value -- Market value may equal reinstatement cost -- Total loss of a building -- Reducing the loss -- Insurance write-off/constructive total loss -- Indemnity versus reinstatement cover -- Repairs and improvements to the insured's position -- Repairs and additional costs -- Time of assessment -- The challenges of successive insured losses -- Reinstatement of cover -- Underinsurance and reinstating cover -- Merger -- The Ridercrest case -- Total reinstatement costs as a cap to the insured's recovery -- Separate adjustment of each and every loss -- -- Loss and damage -- The meaning of "loss" -- Property going missing -- Wider senses of "loss" -- Loss by exclusion from possession under lawful authority -- Loss by deprivation of use - the need to wait and see -- Amount of the claim for loss -- Perishable property -- Loss and exclusion from premises -- Exclusion from time-sensitive premises -- Making a claim - damage -- -- Liability -- Liability cover - general principles -- Legal liability -- Voluntary settlement -- Liability to third parties -- Legal costs -- Conduct of defence and settlement -- Damages or compensation -- Trade, business or prefession -- "Professional capacity" wordings as definitions of the insured business -- Fortunity -- Dishonesty -- -- Assessment of claims -- Quantum and assessing the claim -- The role of the adjuster/assessor -- Quantum -- Assessing and paying claims -- Delay in settling claims -- -- Avoidance for non-disclosure -- Insurance law - good faith -- Non-disclosure and mis-disclosure -- The Insurance Law Reform Act 1977 - an amelioration -- A further amelioration - the inducement requirement -- Material facts include moral hazard considerations -- Limits to the duty of disclosure -- Disclosure and intermediaries -- Help with filling out forms -- Avoidance and the Contractuals Remedies Act 1979 -- -- Non-payment of claims -- Good faith at claims stage -- Fraud -- Exclusions -- Delay in notification -- Conditions and warranties -- Claims cooperation clauses -- Claims cooperation clauses and ss 9 and 11 of the Insurance Law Reform Act 1977 -- -- Ch. 1: 1.1. 1.2. 1.3. 1.4. 1.5. 1.6. Ch. 2: 2.1. Part 1: Ch. 3: 3.1. 3.2. 3.3. 3.4. 3.5. 3.6. 3.7. Ch. 4: 4.1. 4.2. 4.3. Ch. 5: 5.1. 5.2. 5.3. 5.4. 5.5. 5.6. 5.7. 5.8. 5.9. 5.10. 5.11. 5.12. 5.13. 5.14. 5.15. 5.16. 5.17. 5.18. 5.19. 5.20. 5.21. Ch. 6: 6.1. 6.2. 6.3. 6.4. 6.5. 6.6. 6.7. 6.8. 6.9. 6.10. Ch. 7: 7.1. 7.2. 7.3. 7.4. 7.5. 7.6. 7.7. 7.8. 7.9. 7.10. 7.11. Ch. 8: 8.1. 8.2. 8.3. 8.4. 8.5. Ch. 9: 9.1. 9.2. 9.3. 9.4. 9.5. 9.6. 9.7. 9.8. 9.9. Ch. 10: 10.1. 10.2. 10.3. 10.4. 10.5. 10.6. 10.7. Join and Composite Insurance - insuring multiple interests -- Joint and composite insurance -- Third parties under and insurance policy -- -- Subrogation -- The two rules of subrogation -- Recovery actions -- Refraining from pursuit of subrogated recovery rights -- Subrogated recovery actions and using the property of another -- Proceeds of subogated recovery actions -- Limit to subogated recovery - Property Law Act 2007 and leases -- Property Law Act 2007 - exoneration and indemnity and residential tenancies -- Indemnity and subrogation where subsequent events reduce the loss -- Subrogation occurs where an indemnity insurer has paid the indemnity -- -- Double Insurance -- The indemnity principle -- Contribution between insurers -- Double indemnity clauses -- Double Insurance - cover must coincide -- -- Average -- Underinsurance and the risk pool -- Average makes the underinsured a contributing co-insurer -- Average inapplicable in the case of a total loss -- Average under ss 15 and 16 of the Insurance Law Reform Act 1985 -- Average clauses uncommon in the New Zealand Market -- -- Insurance intermediaries - agents and brokers -- Insurance intermediaries -- Agents -- Liability for fraudulent or negligent acts of an agent -- Affimation of a agent's unauthorised acts -- Loss adjesters and claims advocates -- Intermediaries and non-disclosure - Insurance Law Reform Act 1977, s 10 -- Agent's incorrect representations regarding cover -- Help with filling out forms -- Brokers -- Circumstances where the broker is the insurer's agent -- Cover notes -- Binder policies -- When the broker is the agent of a third party -- Receipt of money -- Cancellation for non-payment in broker-arranged policies -- -- Issues in particular contracts of insurance -- Life and health policies -- Issues of definition -- Disability insurance -- Income protection insurance -- Critical illness/trauma insurance -- Health insurance -- Evidence in life and health insurances -- Professional indemnity insurance -- Liability insurance -- The charge created by s 9 of the Law Reform Act 1936 -- Directors and officers insurance -- Employment practices insurance -- Business interruption insurance -- -- Dispute Resolution -- Complaints Resolution schemes -- Inception of complaints resolution schemes -- Functions of the schemes -- -- The Courts -- Dispute resolution through the courts -- The Earthquake List -- -- Special Insurance Issues -- The Earthquake Commission Act 1993 -- The Earthquake Commission -- The cover -- Section 18 of the Earthquake Commission Act 1993 -- Section 19 of the Earthquake Commission Act 1993 -- Dispute resolution -- The Earthquake Commission's performance -- -- The Accident Compensation Act 2001 -- The ACC scheme -- The interaction between ACC entitlements and insurance benefits. Ch. 11: 11.1. 11.2. Ch. 12: 12.1. 12.2. 12.3. 12.4. 12.5. 12.6. 12.7. 12.8. 12.9. Ch. 13: 13.1. 13.2. 13.3. 13.4. Ch. 14: 14.1. 14.2. 14.3. 14.4. 14.5. Ch. 15: 15.1. 15.2. 15.3. 15.4. 15.5. 15.6. 15.7. 15.8. 15.9. 15.10. 15.11. 15.12. 15.13. 15.14. 15.15. Ch. 16: 16.1. 16.2. 16.3. 16.4. 16.5. 16.6. 16.7. 16.8. 16.9. 16.10. 16.11. 16.12. 16.13. Part 2: Ch. 17: 17.1. 17.2. Ch. 18: 18.1. 18.2. Part 3: Ch. 19: 19.1. 19.2. 19.3. 19.4. 19.5. 19.6. Ch. 20: 20.1. 20.2.