Miscellaneous - Insurance by Ravish Ji
Miscellaneous - Insurance by Ravish Ji
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Personal Accident Insurance
• Permanent total Disablement.
• Permanent partial disablement.
• Temporary total disablement.
• 100% or 50% of CSI is paid according to the disability
suffered for the permanent total disablement
• Insurer is not liable for compensation under more
than one of the sub clauses in respect of the same
period of disablement.
• Once a claim is settled under one of the sub clauses
for permanent total disablement/death the policy
becomes inoperative.
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Special features
• The cover is for 24 hours and on a worldwide
basis.
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Personal Accident policy
• Cumulative bonus-benefits increased by 5% max
upto 50%.
• Carriage of dead body-2% of CSI or Rs 2500
whichever is less
• In the case of temporary total disability 1% of CSI
subject to maximum Rs 5000/- (revised ) per week up
to max 100 weeks are payable.
• Education fund
– For 1 dependent child below 25 years age-10%
of CSI s.t. max Rs 5000
– For more than 1 dependent child below 25
years age-10% of CSI s.t. max 10000
– The benefit is available for only on CSI and not
on cumulative bonus
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Personal Accident-exclusions
• Compensation in respect of death,injury or
disablement arising from:
• Intentional self-injury, attempted/suicide
• Influence of intoxicating liquor or drugs
• Engaging in aviation
• Any breach of law with criminal intent
• Service in armed forces
• War & nuclear perils
• From child birth or pregnancy
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Classification of risk
• Risk group I-accountants,doctors,lawyers
engaged in administrative functions
• Risk group II-contractors, builders,
drivers,athletes,woodworking Machinists
• Risk group III-circus personnel,working in
mines with explosives- electrical installation
with high tension supply or racing on
horseback
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Group personal accident policy
• Some common relationship among the persons to be
insured and a central point for administration of the
policy scheme
• No insured person has an independent right of action
against the insurer
• Cumulative bonus & education grant is not applicable
• Medical expenses & war risk extensions are available
• SI can be linked to emoluments payable to the
insured
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Group personal accident policy
• Premium-dependent on profession,activity involved
in
• On duty covers -75% of applicable premium
• Off duty covers-50% of applicable premium
• Exclusion of death cover-allowed when group life
policy exists
• Group discount-say where more than 100 persons are
covered
• Any physical infirmity or defect/disability prior to the
commencement of cover –or any cumulative effect as
a result of such disability stand excluded
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Flight insurance coupons
• Passenger Flight Coupon provides cover for
accidental bodily injury while embarking /
disembarking from or traveling in any aircraft
operated by a regular airline over a scheduled route
as a passenger during the flight specified
• The cover can be for specific flight or for specific
period of time
• Declaration policies can be issued to individuals or
companies for frequent fliers
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Student safety insurance
• Available to schools,colleges or other educational
institutes
• Benefits the registered students
• All students to be covered -additions allowed but
deletions are not
• Maintenance of attendance register
• Claim amount payable to the parent/guardian as recorded
in the school register Policy is issued in the name of the
educational institution
• Compensation limit
– Per student-10000/
– Per accident-500000/
– Per policy period-1000000/
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Burglary Policy
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Burglary is defined as
• Theft of property from the premises described
following upon felonious entry of the said premises
by violent & forcible means
• Theft by a person in the premises who subsequently
breaks out by violent and forcible means provided
there shall be visible marks at the place of such entry
or exit by tools,explosives electricity or chemicals
• The use of force & violence need not be against
property only-it can be against any individual also.
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Burglary Policy
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Property covered
• Stock in Trade
• Goods in trust or on commission for which
the insured is responsible
• Cash & currencies locked in safe
• Fixtures & fittings ,tools of trade
• Loss or damage to any part of the building
caused by burglary or any attempt
therefore is also covered
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Key clause
• The loss of cash from the safe following the
use of the key to the said safe or any
duplicate thereof belonging to the insured
is not covered unless such key has been
obtained by violence or threat or through
means of force
• The key clause cannot be deleted even by
payment of extra premium
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Key clause
• A complete record of cash kept in the safe
should be kept secured in some place
other than the safe and the liability of the
insured is limited to the amount actually
shown by such records
• The keys of the safe or strong room shall
not be left on the premises after business
hours.
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Property excluded-
unless specifically mentioned
• Gold or silver articles
• Watches or jewellery or precious stones or
Deeds, Bonds, Bills of exchange, promissory
notes, cash, treasury notes and Bank notes,
Cheques, securities for money, stamps,
stamp collection, books of account,
• Documents of any kind, manuscripts,
medals and coins
• Motor vehicles and accessories or live stock
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Definitions
• THEFT: Dishonestly taking away movable property
out of the possession of any person without consent
of that person (Section 378 of IPC)
• BURGLARY: Taking and carrying of property from
premises: a) Following felonious entry/exit by use of
violent and forcible means.
b) The presence of visible marks at the place of entry or
exit.
• ROBBERY: Voluntarily causing to any person Death or
hurt or wrongful restraint or fear of instant death or
hurt or wrongful restraint in order to commit a theft
(Section 390 of IPC)
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Definition
• HOUSEBREAKING: Committing House trespass by
effecting entrance into the house or already being in
house for purpose of committing an offence or having
committed an offence effecting forcible exit (Section 445
of IPC.)
• DACOITY: When five or more persons armed or otherwise
jointly commit or attempt to commit a robbery.
• LARCENY: Theft committed by a person who has got a
right to be in the premises.
• HOLD UP:Theft accompanied by assault or violence or or
the threat of it to the insured/employees irrespective of
whether there is a forcible entry
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Perils Covered
• Burglary or House-breaking of
property following upon felonious
entry of the premises by violent and
forcible means.
• Theft by a person in the premises
who subsequently breaks-out by
violent and forcible means.
• Damage to the Premises by the
burglars failing to be made good by
Insured.
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Exclusions-loss or damage where
• Any inmate or insured’s family member or
business staff is involved as principal or accessory.
• By acts of persons lawfully on the premises
(larceny)
• Consequent upon fire or explosion
• Loss of cash from the safe following the use of key
or duplicate (unless such key is obtained by
threats or violence)-KEY CLAUSE
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Exclusions-loss or damage where
• Earthquake and other natural perils
• Riot strike and civil commotion
• War and kindred perils,nuclear risks
• Premises left uninhabited by day and night for
seven or more consecutive days and nights
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CONDITIONS
• INDEMNITY:
a) Extent of intrinsic value of property lost, subject to
sum insured.
b) Repair damage to property or premises insured.
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Reinstatement of Sum Insured
• Immediately upon the happening of any loss or
damage as described in the policy, the total SI
under the various descriptions of property
which have been Lost or damaged, shall be
reduced by the amount of loss or damage and
such reduced S.I shall be the limit of the
insurer’s liability in respect of any further loss or
damage occurring during the current period of
Insurance unless the insurer consents, upon
payment of additional premium to reinstate the
full sum-Insured.
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Special Feature
• This Policy contains the usual “Average
Clause”
• Insurance must be effected for the full value
of property to be insured unless first loss basis
is underwritten
• The probable highest amount at risk at any
one time should be declared.
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Rating
• It is a non-tariff business.
• Premium rates depend upon the client,
• Situation of the risk
• Property to be covered,
• Precautions for protection,
• Previous claims experience
• Higher or lower rates may be charged and
protective measures imposed, if felt necessary,
considering the hazard involved.
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Rating
• Reduce rate for stocks in bulk with large Sum Insured
• Increase rate where chances of major loss in single
incidence.
• Cash/Valuables in Burglar-proof safe
• First loss- 90%-50% of the premium is charged
depending on percentage of SI opted
• Declaration Policy- Minimum retention of 35% at
expiry as per Fire Tariff.
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Underwriting considerations
• Moral hazard of proposer
• Survey of risk
• Maintaining of books of accounts
• Regular stock taking and audit once a year
• Avoiding/Loading premium for small articles with
high values eg. Jewellery etc.
• Correct description of goods
• Separate S/I for stock, cash,goods-in-trust
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Underwriting considerations
• Details of safe-weight, size, make etc., if
proposal for cash in safe.
• Separate Fire Ins.of property a must.
• Cover restricted to cash/money in safe and
not in steel almirah/cash box.
• All endorsements/warranties to be attached.
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Types of policies
• Full value policy-Insurance must be
effected for the full value of the property to
be insured
• Policy contains usual “average” clause
• First Loss Insurance-policies may be issued
for an amount less than the total value of
the property with the stipulation that the
company will pay the whole amount of loss
upto the limit of S/I. insured.
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First Loss Policy
• Acceptance should be considered in case of large
warehouse and stores where value of stock is very
considerable and of substantial and bulky
nature(normally not less than Rs.10
lacs)rendering total loss a remote possibility
e.g.Baled goods, Machinery etc.
• Damage to the premises must be excluded in such
policies
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Declaration Policies
• These policies may be considered where large
stocks which fluctuate considerably during the
year are involved along the same lines as Fire
Declaration Policies.
• Probable highest sum insured at any one time
during the period is taken as the sum insured
of the policy and 100% premium on the same
is to be collected as deposit at full value rate
• A minimum of 35% of the annual premium on
the sum insured will be retained by the
company.
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Floating policies
• Cover goods in more than one location under
one sum insured
• The subject matter of insurance has to be
identical in all locations
• Policies issued when separate sum insured is
not available
• They are issued only to well known clients
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Risks to be avoided
• Risks situated in the interior
• Jewellers
• Dealers in precious stones, curious and antiques
• Watch makers and Dealers
• Gold and Silver-smiths
• Furriers
• Money lenders and Pawn Brokers
• Athletic clubs and sport Pavilions
• Stamp Dealers &Tailoring Establishments
• Launderers
• This list is not exhaustive but indicative of the type
of risks to be avoided.
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Documents required for claim
procedure
• Duly completed claim form
• Copy of first information report (Police FIR)
• Survey/investigation report
• Copy of final investigation report issued by the
police authorities/magisterial order.
• Letter of undertaking/subrogation form obtained
from the insured.
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FIDELITY GUARANTEE
• This policy covers the employer towards
direct financial loss from employee
dishonesty.
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FIDELITY GUARANTEE
• Direct pecuniary loss sustained due to
fraud/dishonesty committed by the employee during
the uninterrupted continuance of employment.
• The limit of compensation is the specified sum
insured
• Loss due to bad accountancy is not covered, as also
omissions
• Act should be committed in the course of duties
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Time limit for discovery of
losses
• Acts insured against should not be discovered
later than 12 months after resignation,
dismissal,retirement or death of the employee
or not later than 12 months after the
termination of the policy
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FIDELITY GUARANTEE
• Application of precautions and control measures and
supervision of the employee
• Advise insurers regarding change in the nature of
duties so that premium chargeable can be
reconsidered.
• Immediate notice of the claim
• Subsequent to the loss the policy stands cancelled in
respect of the defaulting employee
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FIDELITY GUARANTEE
• Subrogation-after settlement of the claim the insurers
can exercise all rights of action against the employee
in the name of the employer but at the cost of the
insurer themselves
• Contribution-pay pro-rata with any other policy
• Termination of policy
• Arbitration
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FIDELITY GUARANTEE
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CASH IN TRANSIT INSURANCE
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CASH IN TRANSIT INSURANCE
• Two amounts are specified
– LIMIT OF INSURER’S LIABILITY FOR ANY ONE LOSS
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EXCLUSIONS
• Shortage due to error or omission
• Loss of money entrusted to any person other than
insured or his authorized employees
• Losses due to the fraud,dishonesty of an employee of
the insured( to be discovered within 48 hours)
• Loss occurring on the premises after business hours
unless money is in a locked safe or strong room
• Loss by riot/strike & terrorist activity
• Theft of money from unattended vehicles
• Loss from safe by use of its key unless the key is
obtained by use of threat or violence-key clause
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EXTENSIONS UNDER THE POLICY
• DISBURSEMENT RISK-Loss arising whilst
disbursing the wages is covered at additional
premium provided the loss is occasioned by any
of the insured perils
• INFIDELITY OF EMPLOYEES-Act of dishonesty by
the employees entrusted with the carrying of the
property e.g. staging a robbery or concealing and
raising false alarm of snatching are covered at an
additional premium
• TERRORISM-Can be covered if asked for
specifically
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House owners insurance policy-
Single policy taking care of various
contingencies
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Sections-of the package policy
• Section I A-Fire & Allied Peril-building
• Section I B-Fire & Allied Peril-contents
• Section II-Burglary (same SI as in Sec I B)
• Section III-All Risk
• Section IV-Plate Glass
• Section V-Breakdown of Domestic Appliances
• Section VI- TV & VCR/ DVD
• Section VII -Pedal Cycle
• Section VIII-Baggage :anywhere in India
• Section IX -Personal Accident
• Section X-Public Liability-25000/ per event WC as per WC
act
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Section 1-Fire & Allied Peril
• Covers building & contents(excluding money &
valuables) against
• Fire Lightning explosion
• Bursting and overflowing of water tanks
• Aircraft or articles dropped there from
• Riot strike & malicious acts
• Earthquake landslide subsidence
• Flood storm tempest hurricane
• Impact damage by any rail/road vehicle or animals
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Extended benefits
• Household contents temporarily housed elsewhere
due to operation of an insured peril
• Replacement and installation cost for external locks &
key
• Reimbursement of Alternative Accommodation
expenses or loss of rent if covered specifically
• Medical reimbursement for accident hospitalization
to the insured and spouse (65 yrs old & below) due to
an accident occurred within the apartment
• Worldwide personal liability for entire family
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Breakdown of domestic appliances
• Unforeseen & sudden physical damages due to
mechanical or electrical breakdowns of domestic
appliances whilst contained in the insured premises
• Satellite dishes are also covered if specifically asked
for
• Damage to the appliance due to water or oil escaping
from washing machine,dishwasher,or fixed water or
heating system is not covered
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ADDITIONAL COVERS
• Loss or damage to wedding gifts in the house
by an insured peril for the period 1 month
before & after the wedding day of any
member of the family
• Spoilage of frozen food due to
– Contamination by fumes from
refrigerator / freezer
– A rise or fall in temperature incl.
reasonable cost of hiring a temporary
alternative freezer space
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Insured’s duties in the event of the
claim
• Notice of loss • Cancellation within 7
• Police report days
• Preservation of • Principle of indemnity
property • Subrogation
• Inventory & inspection • Contribution
• Proof of loss • Arbitration
• Surveyors appraisal
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Common exclusions
• War & allied perils
• Wear & tear corrosion and depreciation
• Damage to solid floors caused by the material
beneath the floor being compacted-to prevent claims
resulting from inadequate foundations
• Consequential loss
• Nuclear perils
• Damage caused by faulty design, materials,
workmanship or demolition,structural repairs or
alterations
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Shop owner's package policy
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Shopkeepers Insurance
• Section I A-Fire & Allied Peril-building
• Section I B-Fire & Allied Peril-contents
• Section II-Burglary (same SI as in Sec I B)
• Section III-Money in transit(50000/ p/c limit)
• Section IV-Pedal cycle
• Section V- Plate Glass
• Section VI- Neon and glow sign
• Section VII –Baggage:traveling anywhere in India
• Section VIII-Personal Accident
• Section IX –Fidelity Guarantee
• Section X-Liability
• Section XI-Business Interruption
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Conditions- Loss or damage to
• Valuables/money whilst in a locked safe-2% SI
under section IA or 10000/ whichever is less
• Money in cashier’s till or counter-1% SI under
Section IA or 5000/ whichever is less
• Plate glass-10%SI under Section IA or 50000/
whichever is less
• Neon sign-2% SI under Sec IA or 10000/
whichever is less
• Personal baggage-2% SI or 10000/ whichever is
less
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Conditions
• Fidelity guarantee-10% SI under Sec IA or 50000/
whichever is less
• TPL-5% SI under Sec IA or 25000 whichever is less
• Business interruption-the building under sec IA has
to be of class A construction
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Conditions for all the above policies
• Contribution
• Subrogation
• Cancellation
• Arbitration
• 12 calendar months time limit for filing civil
suits incase of any disputes
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UNITED INDIA INSURANCE CO. LTD.
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Baggage Insurance-exclusions
• Loss,destruction or damage due to
– Acts or omissions of servants or agents
– Wear & tear,depreciation,deterioration
– Any process of cleaning,repairing,restoring,
– War and allied perils and Nuclear exclusions
– Any consequential loss
– Leakage,spilling or exuding of liquids,oils
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Baggage Insurance-exclusions
• Loss of articles like sticks,umbrellas
• Property in use on the voyage or journey
• Articles or clothes whilst being worn or carried
loose
• Cash,coin,notes,securities,travel documents,
precious stones,deeds, negotiable instruments
of any kind
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Excluded-unless specifically covered
• Fragile articles i.e. plate glass,vacuum flasks
Camera, Chinaware, glass items, Musical
instrument
• Precious metal items, jewelleries
• Clocks,works of art and antiques
• Perishable goods,
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Plate Glass insurance
• Insured should merit special consideration for
accepting such risk
• Scope of cover includes loss/breakage to the plate
glass fixed on the display windows or show cases of
commercial establishments
• The maximum indemnity is value of the glass at the
time of loss or S.I. Whichever is less
• Unless mentioned the cover does not include
embossing,silvering,lettering or ornamental
work,bent or any special type of glass
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Plate Glass insurance-exclusions
• Fire Gas heat or explosion
• Convulsions of nature-earthquake, volcanic
eruptions, flood cyclone, hurricane ,tornado
• War & allied perils, nuclear reactions,Riot strike
civil commotion
• Loss or damage to window frames & fittings
• Cracked or imperfect glass or scratches on the
glass
• Breakage during removal,alterations or repairs
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Exclusions under the Plate Glass policy
• Consequential loss-interruption of insured’s business
during restoration of the loss
• Willfully caused by insured or his/her agent
• Cost of removal,replacement of any fitting/fixtures
necessitated for removal of broken glass
• Superficial damage-scratching,disfiguration,
discolouration,fracture not extending through the
entire thickness of the glass
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Underwriting guidelines for Plate Glass
policy
• Pre-acceptance inspections should necessarily be
carried out for verifying any earlier damages if any
and also for proper size and identification of Plate
Glass
• Proposal form must contain the full description of
the risk and the measurement of the plate glass
• Newly fitted glass is undesirable risk mainly because
of shrinking,warping of the wood work which takes
time to settle and damage the glass-else deferred
cover can be considered
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Underwriting guidelines for Plate Glass
policy
• Locality factor should be taken into account viz,
street corners,slum area,disturbed localities,narrow
thoroughfare with heavy traffic
• Vacant premises provide greater hazard as damage
may be affected easily without detection
• Possibility of damage in smash and grab raids-public
houses,showrooms,garages
• Type of glass
• Previous claim experience
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Condition for coverage for Plate Glass
Policy
• The coverage under the policy applies only so
long as the glass is fixed Glasses fixed on
doors,windows should be declined
• Insurance cover will cease if any alterations
are carried out
• Insurance cover will cease if the occupancy is
changed as the exposure to risk may increase
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Claim settlement
• Description of the situation of the glass
• Size and the value of the glass plate broken
• Cause of breakage and intimation to the police and
the insurer
• Narration of any witness ,if any
• Survey is done for heavy breakage
• For minor losses it is settled on the basis of in house
survey and claim form
• Insurer can reinstate or pay the intrinsic value of the
broken glass
• Salvage should be recovered wherever possible by
cutting the glass
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Television Insurance Policy
• Non-tariff business
• Loss or damage to TV including aerial fittings
• Liability of the insured towards third party injury or
property damage arising out of the accidents caused
by the apparatus sub to specified limit declared
including legal cost and expenses
• Loss or damage to the property belonging to or in
the custody of the insured by breakage of or collapse
of the TV antennae fittings subject to specified limit
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Perils covered
• Fire, lightning,explosion
• Bursting and overflowing of water tanks
• Accidental external means
• Aircraft or articles dropped there from
• Short-circuiting,specifically if so desired
• Flood, hurricane,inundation, storm, tempest, cyclone
• Earthquake,fire & shock
• Mechanical or electrical breakdown
• Burglary,housebreaking,theft,riot,strike,malicious act
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Exclusions under the TV policy
• External antennae or fittings by theft unless the TV
set is stolen at the same time.
• Consequential loss,
• Contractual liability
• Wear and tear and Depreciation
• Failure or damage caused by normal atmospheric
conditions
• Loss arising from erection,repairing or dismantling of
the apparatus
• War and allied perils and Nuclear radiation or
ionization
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Exclusions under the TV policy
• Burning out of valves or coils I/c
• Mechanical derangement
• Mechanical or electrical breakdown unless caused by
any of the insured perils
• Defects existing before the inception of the policy
• Costs incurred for normal maintenance
• Willful act or gross negligence on the part of the
insured
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Neon sign insurance
• Loss or damage to the neon sign installation by
accidental external means,fire,lightning,external
explosion and theft
• Third party liability caused due to the loss of Neon
Sign
• The neon sign should be examined regularly by the
competent person and report maintained
• Safety measures to be adopted for the prevention of
loss a result of collapse of the Sign
• The physical characteristics of the property on which
the sign is erected or attached and the features of the
surroundings are important
• Whether the area is prone to windstorms,gale
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Exclusions under Neon Sign
• Fusing or burning out of bulbs,tubes
• Repair cleaning removal or erection,wear and tear
• Overrunning,overheating
• Atmospheric conditions
• Consequential loss
• War & kindred perils
• Strike & riot unless specifically asked for
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Pedal Cycle Insurance
• Loss or damage to the pedal cycle by fire, lightning,
explosion,burglary, housebreaking, theft or accidental
external means subject to certain compulsory excess
• Insured’s legal liability for bodily injury to the public
or property damage subject to max. say Rs 15000
• Loss or damage to tyres,lamps,tools accessories are
covered only if the cycle is also damaged
simultaneously
• Wear & tear,mechanical breakdown,war allied
perils,nuclear radiation,convulsions of nature are
excluded
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