Reinsurance - M97（Dip级30学分，选修）-《再保险》
往期精选：
（前述章节【Dip系列课程】M97-第七章-合同措辞D11C-D11F）
D11G Occupational disease clauses（职业病条款）
The occupational disease clauses set out the basis on which reinsurers are prepared to provide cover for occupational disease and physical impairment arising under an employers’ liability and/or workers’ compensation policy.
职业病条款规定了再保险人准备为雇主责任险和/或工人赔偿险中的职业病和身体损伤提供保险的依据。
It was recognised that, while the legal liability for occupational disease and physical impairment may arise from a sudden and identifiable event, it may also arise from a gradually operating occupational hazard spread over many years. The clauses, therefore, apply in the latter situation. They define what constitutes an event and the date of the loss occurrence for the purpose of determining the applicable treaty period. The standard clauses are known as the accident circle occupational disease (ACOD) clauses. These are shown in table 7.3.
人们认识到，虽然职业病和身体损伤的法律责任可能来自于一个突然的、可识别的事件，但也可能来自于多年来逐渐产生的职业危害。因此，这些条款适用于后一种情况。为了确定适用的条约期，这些条款规定了什么是事件以及损失发生的日期。标准条款被称为事故循环职业病（ACOD）条款。见表 7.3。
Table 7.3: Accident circle occupational disease (ACOD) clauses（表 7.3：事故圈职业病（ACOD）条款）
ACOD/A: Any one claim by any one employee is considered one event.
ACOD/A：任何一名雇员提出的任何一项索赔都被视为一个事件。
ACOD/B: Any one claim by any one employee is considered one event and,
• if original liability is established on an exposure basis, the claim paid by any one period of reinsurance is reduced in proportion to total length of exposure, and the retention and cover reduced in proportion to the reinsured’s period of exposure to all years;
• if legal liability is not established on an exposure basis, the date of loss occurrence is deemed to be the date the legal liability was established.
ACOD/B：任何一名雇员提出的任何一项索赔均被视为一个事件，并且
• 如果原始责任是根据风险敞口确定的，则任何一期再保险所支付的索赔额将按风险敞口总长度的比例减少，自留额和保障额将按分保人所有年份的风险敞口期的比例减少；
• 如果法律责任未按风险敞口确定，则损失发生日期被视为法律责任确定日期。
ACOD/C: In relation to covers on a ‘claims made’ basis, any one claim by any one employee is considered one event (as ACOD/A), however the date of the loss occurrence is deemed to be the date the original insured is advised of claim following diagnosis.
ACOD/C：对于以 “索赔发生 “为基础的承保，任何一名雇员提出的任何一项索赔都被视为一个事件（如 ACOD/A），但损失发生日期被视为原被保险人在诊断后被告知索赔的日期。
For example, employee, John Smith was awarded £1m having developed an occupational disease following exposure to a particular occupational hazard for the 45-month period between 1 July 2015 and 31 March 2019. For the first 18 months of that period, John Smith worked for a single employer and the original insurer purchased reinsurance cover in excess of £100,000 for each calendar year which incorporated ACOD/B. How much is recoverable from reinsurers?
例如，雇员约翰-史密斯在 2015 年 7 月 1 日至 2019 年 3 月 31 日的 45 个月期间因接触特定职业危害而患上职业病，获赔 100 万英镑。在此期间的前 18 个月，约翰-史密斯为单一雇主工作，原保险人为每个日历年购买了超过 100,000 英镑的再保险，其中包含 ACOD/B。可从再保险公司收回多少？
D11H Change in law clause（法律变更条款）
The change in law clause is designed to protect the reinsurers’ agreement with the reinsured from a change in the law after the commencement of the treaty. If the change is considered to significantly increase reinsurers’ liability, the parties agree to work to revise the terms and conditions of the treaty. However, if that process fails, cover continues as if the law had not changed.
法律变更条款旨在保护再保险人与分保人之间的协议不受条约生效后法律变更的影响。如果法律变化被认为会大大增加再保险人的责任，双方同意努力修改条约的条款和条件。但是，如果这一过程失败，则继续承保，就像法律没有发生变化一样。
The clause is common in casualty excess of loss treaties where, for example, benefits to injured workers may be altered by legislation with retroactive effect.
该条款在意外事故超赔条约中很常见，例如，受伤工人的福利可能会因具有追溯效力的立法而改变。
A typical example is: In the event of any change in the law, whether arising from legislation, decisions of the courts or otherwise, at any time after the Reinsurer has entered into this Agreement by which the Reinsurer’s liability hereunder is materially increased or extended the parties hereto agree to take up for immediate discussion at the request of either party a suitable revision in the terms of this Agreement. Failing agreement on such revision within thirty days after such a request it is agreed that the Reinsurer’s liability hereunder whensoever arising shall be determined as if the said change in law had not taken place.
（条款的）一个典型例子是：在再保险人签订本协议后的任何时候，如果法律发生变化，无论是由立法、法院判决还是其他原因引起，从而导致再保险人在本协议项下的责任大幅增加或扩大，则本协议双方同意应任何一方的要求，立即讨论对本协议条款进行适当修订。如果在提出要求后三十天内未就上述修改达成一致意见，则双方同意，再保险公司在本协议项下的责任，无论何时发生，均应按上述法律变更未发生时的情况确定。
D11I Loss corridor clause（损失走廊条款）
The loss corridor clause describes an additional amount retained by the reinsured, usually on the working layer of a casualty treaty. Under the terms of this clause, the reinsured agrees to retain an additional ‘corridor’ of losses with reinsurers providing cover outside (say, above and below) that corridor.
损失走廊条款描述的是分保人保留的额外金额，通常是在意外险条约的工作层上。根据该条款，分保人同意保留一个额外的损失 “走廊”，由再保险人在该走廊之外（例如，高于或低于该走廊）提供保险。
For example, a reinsured may agree to retain an aggregate amount of paid losses equivalent to 10% of net earned premium income, otherwise recoverable under a particular layer of excess of loss reinsurance. This amount (or percentage) may sit above 35% of net earned premium income such that reinsurers pay losses recoverable under that layer of excess of loss reinsurance up to an aggregate amount equivalent to 35% of net earned premium income and above 45% of net earned premium income, subject to an upper limit.
例如，分保人可能会同意保留一笔等同于净已赚保费收入10%的累计赔付损失，这本来是可以通过某一层次的超额损失再保险得到赔偿的。这笔金额（或比例）可能位于净已赚保费收入的35%以上，因此再保险人将在该层次的超额损失再保险范围内，支付净已赚保费收入35%至45%之间的累计赔付损失，且会受到上限的限制。
感谢阅读，欢迎打赏。
记得分享朋友圈打卡哦！
关注本sir，向更优秀的自己前进！
