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A1B上)
A1B Fair presentation(公平陈述)
Presentation(呈现)
The manner of the presentation of the risk is also prescribed by the Insurance Act. Disclosure must be made in a manner that is ‘reasonably clear and accessible to a prudent (re)insurer’. It is not acceptable, for example, to ‘data-dump’ a vast amount of unordered, indigestible data in an attempt to avoid inadvertent non-disclosures.
保险法也规定了风险的呈现方式。披露的方式必须“对审慎的(再)保险公司来说相当清晰且易于理解”。例如,为了避免无意的泄露而“转储”大量无序、难以消化的数据是不可接受的。
Under the Act, a material representation is fair if as to a matter of:
• fact, it is substantially correct; and
• expectation or belief, it is made in good faith.
根据该法案,如果涉及以下问题,实质性陈述是公平的:
• 事实上,它基本上是正确的;和
• 期望或信念,它是出于善意而做出的。
For example, in Pan Atlantic v. Pine Top (1994), a broker made available full loss information to an underwriter but, at the same time, showed summary loss statistics which were inaccurate. The House of Lords held that this was not a fair presentation.
例如,在 Pan Atlantic 诉 Pine Top(1994 年)一案中,经纪人向承销商提供了全部损失信息,但同时呈现了不准确的损失统计摘要。上议院认为这不是一个公平的陈述。
Remedy(补救)
The remedy for breach of the obligation to make a fair presentation depends on the reinsurer being able to demonstrate that, but for the breach, it would not have entered into the contract at all, or would have done so only on different terms.
对违反公平陈述义务的补救措施取决于再保险公司是否能够证明,如果没有违约行为,它根本不会签订合同,或者只会按照不同的条款签订合同。
Avoidance remains a remedy for a deliberate or reckless breach of the duty. Otherwise, the remedy depends upon what the reinsurer would have done had the risk been fairly presented (for example, varying the terms of the policy, increasing premium or avoiding the policy).
回避(即撤销保单)仍然是对故意或鲁莽违反义务的一种补救措施。否则,补救措施取决于再保险公司在公平呈现风险的情况下会采取的措施(例如,改变保单条款、增加保费或规避保单)。
Contracting out(外包)
In order to successfully contract out of the changes brought in by the Insurance Act, reinsurers will need to satisfy certain transparency requirements. They must ensure that any terms which would put the reinsured in a worse position than before the Act are clear and unambiguous as to their effect, and sufficiently drawn to the reinsured’s attention before the policy is entered into. In determining whether this requirement has been met, the reinsured’s characteristics and the circumstances of the transaction will be taken into account.
为了成功地摆脱《保险法》带来的变化,再保险公司将需要满足某些透明度要求。他们必须确保任何会使分保人处于比该法案之前更糟糕的境地的条款,其效果是清晰明确的,并在保单签订之前充分引起分保人的注意。在确定是否满足这一要求时,将考虑分保人的特征和交易情况。
At the time of writing, the main focus of contracting-out provisions appearing in the marketplace is the duty of fair presentation and, in particular, the remedy for failures that are neither deliberate nor reckless, as insurers reserve the right to pay additional premium rather than have their claims reduced proportionately.
在撰写本文时,市场上出现的外包条款的主要焦点是公平陈述的义务,特别是对既不是故意也不是鲁莽的失败的补救措施,因为保险公司保留支付额外保费的权利,而不是按比例减少他们的索赔。
A1C Indemnity(弥偿)
All reinsurance contracts are contracts of indemnity. Indeed, indemnity has been said to be the ‘controlling principle in insurance law’ (Castellain v. Preston (1883)) and will be implied if not expressly provided for in the reinsurance contract. Simply, the reinsured may recover from reinsurers the amount of its actual loss, provided that the loss falls within the original insurance contract and within the relevant reinsurance contract.
所有再保险合同都是弥偿合同。事实上,弥偿被认为是“保险法中的控制原则”(Castelllain v. Preston (1883)),如果再保险合同中没有明确规定,弥偿将是默示的。简单来说,分保人可以向再保险人索赔其实际损失金额(而不能超出),前提是该损失属于原保险合同和相关再保险合同的范围。
A1D Insurable interest(保险利益)
Broadly, in this context, the rule is that the insurer must have a reinsurable interest in the subject matter of the reinsurance contract. This interest depends on the original insured having an insurable interest in the original risk and the insurer being liable, under the terms of the original policy, to indemnify the original insured against loss arising out of that risk.
从广义上讲,在这种情况下,规则是保险人必须对再保险合同的标的物拥有可再保险利益。该利益取决于原被保险人对原风险具有保险利益,并且保险人根据原保单条款有责任赔偿原被保险人因该风险而造成的损失。
Classically, the requirement is for the original insured to have an interest in the subject matter of the (re)insurance contract, so ‘as to have a benefit from its existence, prejudice from its destruction’ (Lucena v. Crawford (1806)).
传统上,要求原始被保险人对(再)保险合同的标的物具有利益,以便“从其存在中受益,从其毁灭中受益”(Lucena v. Crawford (1806)) 。
The rule has, however, been complicated by the Gambling Act 2005. Before the Act, wagers were unenforceable and what distinguished (re)insurance from a wager was insurable interest. Now, the Act may not require an insurable interest but, as the indemnity principle remains at the time a claim is made, its impact is rendered largely academic.
然而,2005 年《赌博法》使该规则变得更加复杂。在该法案出台之前,投注是不可执行的,(再)保险与投注的区别在于可保利益。现在,该法案可能不要求可保利益,但由于弥偿原则在提出索赔时仍然存在,因此其影响主要是学术性的。
A1E Form(形式)
There is no general requirement that a reinsurance contract takes any particular form to be valid, or even that it is in writing. There are, however, specific requirements in relation to life and marine reinsurances, ensuring that these contracts are written, not oral. Section 2 of the Life Assurance Act 1774 requires that the person with the insurable interest be named in the policy, and s.22 of the Marine Insurance Act 1906 provides that a contract of marine insurance shall be inadmissible in evidence unless embodied in a marine policy in accordance with the Act.
对于再保险合同是否有效,甚至是否采用书面形式,没有任何一般要求。但对人寿和海上再保险有具体要求,确保这些合同是书面的,而不是口头的。1774 年《人寿保险法》第 2 条要求在保单中列明拥有可保利益的人的姓名,而 1906 年《海事保险法》第 22 条规定,除非按照该法在海事保单中体现,否则海事保险合同不得作为证据。
Noted: In practice, reinsurance contracts are without exception written, avoiding the likely and significant evidential difficulties associated with reconstructing the terms of an oral contract in the event of a dispute. As to their written form, in addition to the traditional slip, contracts are also concluded via fax, email or other electronic means.
请注意: 在实践中,再保险合同无一例外都是书面形式的,这样就避免了在发生争议时重构口头合同条款可能带来的重大举证困难。至于书面形式,除了传统的单据外,合同还通过传真、电子邮件或其他电子手段签订。
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