4 COMMON CONDITIONS IN INSURANCE CONTRACTS

Condition is the part of an insurance contract that identifies the general requirement of the insurer and the insured on matters relating to the fulfilment of the contractual agreement.

A condition can also be defined as a provision or clause in insurance policies that qualifies or limits the insurer's promise to perform.

Conditions enumerate the duties of both parties to an insurance contract 

Generally, insurance contains the following conditions:

1. Notice and proof of loss: All major insurance policies require that the insured notify the insurer when the insured peril, event or accident occurs.

The period in which the notice must be filed and how it must be filed may differ from one policy to the next.

The insurer is entitled to a timely notice so he can investigate and analyze the circumstances surrounding the covered events.

The homeowner's policy, for example, lists as one of the insured’s duties after loss to “give immediate notice to us or our agent” and to file proof of loss within sixty days.

A typical life insurance policy says that payment will be made “upon receipt…of proof of death of the insured.”

A health policy requires that “written proof of loss must be produced to the company within twelve months of the date the expense was incurred.”

A personal auto policy says, “We must be notified promptly of how, when, and where the accident or loss happened.

In some cases, In some situations, the insurer is relieved of all duty under the contract if the insured fails to file a notice of loss with the insurer within a reasonable time after the loss.

2. Cooperation of the insured: Another condition that can exist in an insurance contract is the cooperation of the insured.

Cooperation on the part of the insured means that the insured must meet certain criteria before the insurer will compensate him for his losses.

For example, all insurance contracts require that the insured cooperate in the investigation of facts surrounding the happening of the insured events.

Cooperation also requires that the insured cooperate with the insurer in the event of a court case.

Cooperation on the part of the insured also means that the insured must meet certain criteria before the insurer will compensate him for his losses.

In some cases, if the insurer can prove that the insured refuses to cooperate with him, the insured may be released of his obligation under the insurance contract.

3. Suspension of coverage: Some insurance policies specify that coverage may be suspended in certain circumstances.

By the suspension of coverage, we mean conditions that may release the insurer from his liability under the insurance contract.

Although suspension of coverage is quite similar to a voidance of coverage, there have some differences.

Suspension of coverage removes coverage for as long as some conditions persist.

Once these conditions are eliminated, the insurance coverage resumes as it was before the suspension, with no need for a new agreement between the parties

A voidance of coverage, on the other hand, occurs when the policy is cancelled and insurance coverage is only reinstated by mutual agreement between the insured and the insurer.

While the suspension of coverage is usually temporary because coverage resumes once the condition is resolved, voidance of coverage may be permanent unless the insurer and insured reach an agreement.

Some life and health insurance contracts include particular clauses that curb coverage for anyone serving in the military during wartime

The suspension is lifted and coverage is reinstated when the conflict ends or the insured no longer serves in the military.

The insured must understand the circumstances that may suspend the insurance contract because their effect is far larger than exclusions.

4. Protection of the property after loss: This condition is most obvious in property insurance, where the insured is usually required to protect the property after a loss

This is to ensure that the loss is reduced as much as possible.

For example, an insured who crashes his or her car is responsible for having it transported to a garage for safekeeping.

To minimize the loss in the event of a fire, the insured is expected to preserve undamaged property from the weather and other perils.

The fact that there is insurance does not mean that the insured should be careless and irresponsible.

Insurance requires that the insured be reasonable and fair.

The purpose of the protection of property clause is to force the insureds to protect their property in the event of loss, just as they would if they didn't have insurance.

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