What is an ensuing loss clause?
Ensuing Loss Clause — an exception to an exclusion in a first-party property policy that applies in a special type of fact pattern where the damage caused by an excluded peril operates as a link in the “chain of events” that enables a covered peril to damage other property.
What is the reinstatement provision in a health insurance policy?
A reinstatement clause is an insurance policy clause that states when coverage terms are reset after the insured individual or business files a claim due to previous loss or damage. Reinstatement clauses don’t usually reset a policy’s terms, but they do allow the policy to restart coverage for future claims.
What is the meaning of contribution in insurance?
Contribution — the principle holding that two or more insurers each liable for a covered loss should participate in the payment of that loss.
Which of the following is an agreement between an insured and an insurer where the insurer agrees to indemnify the insured for specific losses in exchange for a premium?
Insurance contract: An agreement between a policyowner (often an insured) and an insurer, where the insurer agrees, for a consideration, to indemnify the insured for loss caused by specific events.
What is definition of continuous and repeated seepage or leakage?
Seepage, meaning continuous or repeated seepage or leakage of water over a period of weeks, months, or years. This can happen in many places around your home, such as under your sink, plumbing in walls, in the pipes in your foundation slab, and more.
Is consequential loss recoverable?
By definition, therefore, consequential losses are exceptional and often not recoverable. Direct loss is the natural result of the breach in the usual course of things. Most foreseeable kinds of loss are direct, including financial losses such as loss of profits and loss of business or goodwill.
When a health policy is reinstated insured losses are covered immediately if?
Under a health policy’s reinstatement terms, insured losses from accidental injuries and sickness are covered immediately after reinstatement. Under a health insurance policy’s reinstatement terms, insured losses from sickness will not be covered unless they occur at least 10 days after reinstatement.
What is automatic reinstatement of loss clause?
Automatic reinstatement is an insurance policy provision that states that the policy limit will be restored after a claim is paid out. In other words, it reinstates the original policy limit after the insurer pays for a covered loss. Automatic reinstatement may also be known as maximum aggregate limit of indemnity.
What is average clause in insurance?
Definition of average clause 1 : a clause in an insurance policy that restricts the amount payable to a sum not to exceed the value of the property destroyed and that bears the same proportion to the loss as the face of the policy does to the value of the property insured — compare coinsurance.
What is proximate clause in insurance?
Proximate cause is concerned with how the actual loss or damage happened to the insured party and whether it resulted from an insured peril. It looks for is the reason behind the loss; it is an insured peril or not.
What is insurance indemnification?
What Is Indemnity? In an insurance context, an indemnity refers to a contractual obligation for one party to provide compensation in the event of losses on the part of another party.
What is an ensuing loss clause in an insurance policy?
Some exclusions may include “ensuing loss” clauses. An ensuing loss clause limits the scope of what is otherwise excluded under the policy. An ensuing loss clause may read as follows: of part or all of any property on or off an insured premises.
What is “ensuing loss”?
The idea of “ensuing loss” sounds so simple. It is a loss that ensues from an earlier loss. In first party property insurance contracts, the “ensuing loss” concept comes into play when the initial loss is excluded, such as in the case of mold, water damage, or when a defective design causes the loss.
What is the difference between an “ensuing loss” and an excluded loss?
If the latter portion of the definition is used, however, the “ensuing loss” is covered only if happens as a direct result of the excluded loss. Of course, the case law utilizes neither of these rather straightforward approaches.
What is an ensuing loss in a civil case?
Courts around the country have adopted two different ways of defining an ensuing loss. One school of thought is that an ensuing loss is simply something which occurs as a consequence or follows an initial loss. [2]