Reinsurance - M97（Dip级30学分，选修）-《再保险》
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（前述章节【Dip系列课程】M97-第八章-再保险相关的法律问题Intro-A1A）
A1B Fair presentation（公平陈述）
For reinsurance contracts, the basic rule is that the reinsured has a statutory duty to make a fair presentation of the risk to the reinsurer before the contract is entered into.
对于再保险合同，基本规则是再保险人有法定义务在合同签订前向再保险接受人公平陈述风险。
Obligation（义务）
Under the Insurance Act 2015: 3(3) A fair presentation of the risk is one:
a. which makes the disclosure required by subsection (4) of the Act (see below);
b. which makes that disclosure in a manner which would be reasonably clear and accessible to a prudent insurer; and
c. in which every material representation as to a matter of fact is substantially correct, and every material representation as to a matter of expectation or belief is made in good faith.
根据《2015 年保险法》：3(3) 风险的公平表述如下：
a. 该法案规定了该法案第 (4) 款所要求的披露（见下文）；
b. 以审慎的保险公司相当清楚且易于理解的方式进行披露；和
c. 其中，关于事实的每项材料陈述基本上都是正确的，并且关于期望或信念的每项材料陈述都是善意的。
Disclosure（披露）
There are two aspects to this duty of disclosure as follows: 3(4) The disclosure required is as follows, except as provided in subsection (5):
a. disclosure of every material circumstance which the insured knows or ought to know; or
b. failing that, disclosure which gives the insurer sufficient information to put a prudent insurer on notice that it needs to make further enquiries for the purpose of revealing those material circumstances.
该披露义务有以下两个方面：3(4) 要求的披露如下，但第 (5) 款规定的情况除外：
a. 披露被保险人知道或应当知道的所有重大情况；或者
b. 如果不能做到这一点，则应向保险人提供足够的信息，使谨慎的保险人注意到它需要为揭示这些重要情况而进行进一步的查询。
The first aspect (a.) requires the ‘disclosure of every material circumstance which the (re)insured knows or ought to know’.
第一个方面 (a.) 要求“披露（再）被保险人知道或应该知道的所有重大情况”。
Section 7(3) states that ‘a circumstance or representation is material if it would influence the judgment of a prudent insurer in determining whether to take the risk and, if so, on what terms’. The section continues with examples of things which may be material circumstances, that is, special or unusual facts relating to the risk, and any particular concerns which led the insured to seek insurance cover for the risk.
第 7(3) 条规定，“如果某种情况或陈述会影响审慎的保险公司在决定是否承担风险以及如果承担风险的条件时的判断，则该情况或陈述是重大的”。本节继续举例说明可能是重大情况的事情，即与风险有关的特殊或不寻常的事实，以及导致被保险人寻求风险保障的任何特殊问题。
By way of general illustration, the following facts have been held to be material by the courts in reinsurance cases:
• Nature of the risks underwritten. – In WISE (Underwriting Agency) Limited v. Grupo Nacional Provincial (2004), the high value watches used in a shipment to be reinsured were mistranslated as ‘clocks’ in the original Spanish policy. This was held to be a breach of the duty of disclosure. – Similarly, in Aneco Reinsurance Underwriting v. Johnson & Higgins (2002) the broker described the underlying risk as a proportional quota share contract, when it was in fact a facultative obligatory treaty. This was judged as being a material misrepresentation.
• Arbitrage underwriting. – In Sphere Drake Insurance v. Euro International Underwriting Ltd (2003), reinsurance was sought for a US workers’ compensation ‘carve-out’ business in the expectation that it would be loss making on a gross basis, but profitable on a net basis. The court considered that, while this practice was disapproved of by many, it was neither objectively nor subjectively dishonest but should have been disclosed.
作为一般说明，法院在再保险案件中认为以下事实是重要的：
• 承保风险的性质。 – 在 WISE (Underwriting Agency) Limited v. Grupo Nacional Province (2004) 案中，再保险货物中使用的高价值手表在西班牙原始保单中被误译为“时钟” 。这被认为违反了披露义务。– 同样，在 Aneco Reinsurance Underwriting v. Johnson & Higgins (2002) 案中，经纪人将潜在风险描述为比例成数分保合同，而实际上它是一项临时强制性条约。这被判定为重大失实陈述。
• 套利承保。 – 在 Sphere Drake Insurance 诉 Euro International Underwriting Ltd（2003 年）一案中，有人为一项美国工人赔偿 “分割 “业务寻求再保险，预期该业务在毛额基础上会亏损，但在净额基础上会盈利。法院认为，虽然许多人不赞成这种做法，但客观上或主观上都不诚实，而是应该予以披露。
The reinsured who is not an individual knows only what is known to one or more individuals who are in senior management at the reinsured, or responsible for the reinsured’s reinsurance (e.g. the risk manager or broker). As to what the reinsured ought to know, it is that which ‘should reasonably have been revealed by a reasonable search of information available to the (re)insured’. This includes information held within the reinsured’s organisation or by any other person, for instance, the reinsured’s agent.
非个人的分保人只知道分保人的高级管理人员或负责分保人的再保险的一个或多个个人（如风险经理或经纪人）所知道的事情。至于分保人应该知道的信息，是指 “通过合理搜索（再）被保险人可获得的信息而应该知道的信息”。这包括分保人组织内部或任何其他人（如分保人的代理人）掌握的信息。
The second aspect to the duty of disclosure (b. in our quote from the Act) is a fallback position in the event that the reinsured fails to fulfil the primary duty of disclosure. The reinsured must give the reinsurer ‘sufficient information to put a prudent (re)insurer on notice that it needs to make further enquiries for the purpose of revealing those material circumstances’.
披露义务的第二个方面（引自《保险法》中的 b.部分）是在分保人未能履行主要披露义务的情况下的一种退路。分保人必须向再保险人提供 “足够的信息，使审慎的（再）保险人注意到它需要为揭示这些重要情况而进一步查询”。
So, the duty of disclosure may be positively satisfied by the reinsured giving less than full disclosure of all material information, provided what has been disclosed is enough to put the reinsurer on notice that it needs to ask further questions. Being unduly cryptic in referring to a material matter, for example, may not satisfy the duty on the basis that ‘sufficient information’ had not been provided to put the reinsurer on notice to make further enquiries.
因此，如果分保人没有充分披露所有重要信息，只要所披露的信息足以让再保险人注意到它需要进一步询问，那么分保人就可以积极履行披露义务。例如，在提及某一重要事项时过于隐晦，可能不符合披露义务，因为所提供的 “足够信息 “不足以让再保险人注意到需要进一步询问。
It remains to be seen how the courts will deal with any deliberate failures to disclose information, even when sufficient ‘signposts’ have been left to put the reinsurer on notice. As the reinsurance contract remains one of utmost good faith, it may be that such conduct will be held to amount to deliberate breach of the over-arching duty to make a fair presentation.
法院将如何处理任何故意不披露信息的行为，即使已经留下足够的 “路标 “让再保险人注意到这一点，仍有待观察。由于再保险合同仍然是最大诚信的合同，这种行为可能会被认定为故意违反公平陈述的总体责任。
Excluded from the disclosure obligation are circumstances which diminish the risk, which are known, ought to be known or presumed to be known by the reinsurer, and facts waived by the reinsurer, all in the absence of enquiry.
不在披露义务范围内的情况包括：再保险人已知、应知或推定已知的减少风险的情况，以及再保险人在未进行调查的情况下放弃的事实。
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