UNITED INDIA INSURANCE COMPANY LIMITED

MISCELLANEOUS INSURANCE MANUAL

MISCELLANEOUS DEPARTMENT
HEAD OFFICE
24, WHITES ROAD, CHENNAI 600 014

CONTENTS
S.N

Particulars

Page
No.

Preface

Miscellaneous insurance

Personal Accident ( Individual & Group )

31

Flight Coupons

54

Students Safety Insurance Scheme

57

Bhagyashree Child Welfare

61

Rajarajeswari Mahila Kalyan Bima Yojana

67

Cradele Care

79

Burglary Insurance ( Business Premises )

85

10

Travelers baggage insurance

94

11

All risk Insurance

98

12

Money in transit Insurance

103

13

Plate Glass Insurance

113

14

Television Insurance

116

15

Pedal Cycle Insurance

118

16

Cycle Rickshaw Insurance

121

17

Gun Insurance

123

18

Golfers Insurance

126

19

Hoarding Insurance

132

20

Special Contingency Policy

134

22

Public Liability ( Non - Industrial )

137

23

Public Liability ( ACT )

176

24

Public Liability ( Industrial )

183

25

Lift Insurance

200

26

Product Liability

206

27

Commercial General Liability

232

28

Media liability Insurance

239

29

Clinical Trials

244

30

Employees workmen Compensation insurance

248

31

Cinema Audience Insurance

272

32

Professional Indemnity Insurance

274

33

Carriers legal Liability Insurance

302

34

Directors & Officers Liability Insurance

306

35

Fidelity Insurance

321

36

Shop Keepers Insurance

327

37

Dukan Mitra policy

331

38

Compact Insurance

356

39

Householders Insurance

407

40

Unicare / Graha Riksha Policy

411

41

Uni Home Insurance Policy

424

42

Wedding bells Insurance

431

43

Film Production ( Cine Mitra )

435

44

Bankers Indemnity Policy

443

45

Jewellers block Insurance

454

46

Liquified Petroleum Gas dealers Combined Policy

464

47

Marga bandhu Policy

473

48

Suhana safari Policy

482

49

Uni Study Care

488

MISCELLANEOUS UNDERWRITING MANUAL

PREFACE

Underwriting is an art. It is the capacity to

1.

Clearly visualise the property or interest to be insured

2.

Estimating the probability of operation of perils to be insured against

3.

Estimating the extent of liability that may arise due to operation of the peril.
It is only then that the underwriter can decide whether or not to accept the risk and,

if accepted, what would be the rates, terms and conditions.

It is a quality that can be acquired through a continuous leading process, proper
exposure and application of mind. The world of the underwriter is a fascinating world,
but only for those who have the insight.
The proposal form provides the window through which the underwriter is able to
visualize the risk. It is an extremely important document. Each proposal is unique and
should never be viewed as a routine document. Properly completed proposal form has
two aspects:a.

It helps to give the Underwriters a clear idea of the risk.

b.

It is a part of contract document. Hence, if you accept a proposal with incomplete

information, it is presumed that you have given up your right to challenge the
contract of insurance on the grounds of non-disclosure of information. It is also
important to note that if some vital and relevant disclosure is not properly taken
cognizance of while issuing the policy, you are supposed to have accepted the risk
in spite of the adverse feature without any special restriction, which is improper

underwriting. Hence, always try to scrutinize every proposal and ask for any
information you feel necessary for getting a clear idea of the risk before accepting
it.
Once the risk is accepted, ensure that the policy is drafted without any ambiguity.
It would be worthwhile to remember that an insurance policy is a legal document and any
ambiguity will always be viewed against the insurance company which has drafted the
policy.
One more aspect of underwriting is rating. The rate to be charged should be
sufficient to take care of the following aspects:a.

To pay claims

b.

To cover management costs

c.

To cover procurement cost like agency commission

d.

To create surplus for building reserves.

e.

To leave a margin of profit.

This should hold true for every class of business. Since the miscellaneous branch
of Insurance has been out of the Market Agreement for several years now, the
Underwriter's Role has become more vital.
The erstwhile Market Agreement can be a guideline for Liability-Product and
Public, Professional Indemnity policies.

In other cases, the guidelines of the company for rating are provided . In case any
deviations are needed, please justify the reasons in writing and get an approval from the
competent authority.

You are aware that the Insurance Regulatory and Development Authority
requires all

existing policies, proposals,

claim

forms, endorsements and rating

guidelines to be filed with them. These have already been filed. Now, if any changes are
to be made in any of the above, it will have to be approved by them. Any new policy or
modifications of an existing policy should also be referred to them for approval. With
the opening up of the insurance sector, great responsibility has been cast upon each one
of us to ensure proper underwriting which should result in growth with profitability
and ensure that our Organisation attains the leading position in the market.

MISCELLANEOUS INSURANCE

INTRODUCTION

Miscellaneous insurance owes its origin and growth to the Industrial Revolution In
the wake of the steam engine and new discoveries of high pressure boilers and vessels,
fast moving automobiles, and aircraft, highly complicated and monstrous machinery,
explosive chemical complexes, Petroleum refineries, and a host of other technological
advancements, sweeping changes have taken place in the socio-economic structure. With
progress, hazards to life and property have also been constantly on the increase. This has
contributed to the ever-increasing growth of miscellaneous insurance, striving to design
tailor-made cover to suit individual and specific needs.
Broadly the Miscellaneous insurance can be classified into five categories based
on the subject matter that is being covered under the policy.
i.

Insurance of persons

ii.

Insurance of Property

iii.

Insurance of Liability

iv.

Insurance of Interest

v.

Package Policies (A combination of more than one of the above)

A.

INSURANCE OF PERSONS:-

These Policies have the following in common:

i.

These insurance are not strict Contracts of Indemnity and are called benefit
policies.

ii.

Contribution and Subrogation do not apply, since these policies are not contracts
of indemnity.

iii.

Compensation is payable according to a set scale of benefits.

iv.

Insurable Interest is a must. The claimant, must be placed in such a position that he
recovers the monetary loss suffered due to death or disability /sickness of the
person insured.
A person has unlimited insurable interest in his own life, and that of his spouse.

Otherwise, if a person has effected Insurance in respect of another person the exact
pecuniary loss which is the extent of insurable interest only is recoverable.
Personal Accident Insurance, Student Safety Insurance policies are some of the
examples of Insurance policies of Persons.

B.

INSURANCE OF PROPERTY
The subject matter of insurance is the policy holders own property or that for

which he is responsible e.g. goods held in trust / as bailee, etc., as in Burglary and All
Risks insurance.
1.

These insurances are essentially Contracts of Indemnity.

2.

Subrogation and Contribution apply.

3.

The limit of insurers liability is the sum insured as stated in the policy.

4.

Insurable interest must exist. This can arise out of

10

a.

Ownership (e.g. owner, joint owner, executor, trustee, mortgage or,

mortgagor)

5.

b.

Lawful possession proprietors for carriers & pawn brokers)

c.

Contract (e.g. Tenancy; lease). (e.g. bailee, hotel guests effects

Settlement of claim may be made by means of cash payment or by

reinstatement, repair or replacement, at the option of the insurer.

6.

As these policies are contracts of Indemnity depreciation or appreciation

must be taken into account in any loss settlement.

Allowance

for

appreciation is, of course, subject to the limits of the sum insured under the
contract.
C.

INSURANCE OF LIABILITY:

Civil Liability Arises out of

-

Law of Torts.

Statutes.

Law of contracts.

Liabilities arising out of law of torts & statutes are covered under the liability
polices. Tort liability is based on negligence, Liability Insurance indemnifies the Insured
towards injury / damage caused to Third Party life and property. The types of policies
underwritten are public Liability, product liability, employers liability and professional
indemnity etc. The special features of liability policies are :
a.

Claims Made basis :- The policy is on claims made basis. This means that the
accident giving rise to the claim shall occur during the period of insurance and
further that the claim shall be first made against the insured during the policy
period.

11

b.

Retroactive Date:- This is the date of commencement of the first claim made
liability policy. This remains unaltered so long as the policy is renewed without a
break and there has been no substantial material alteration of risk.

c.

Period of Insurance:-This is the period commencing from the retroactive date and
terminating on the expiry date of the policy.

d.

Policy Period:- This is the period commencing from midnight on the inception
date and terminating at midnight on the expiry date of the policy.

OCCURRENCE BASIS
The injury or damage which gives raise to claim must occur during the policy
period. This is known as occurrence basis. A claim can arise against the insured even after
the policy has expired. We generally do not issue policies on Occurrence Basis.
D.

INSURANCE OF INTERESTInsurance like Fidelity Guarantee or Court Bonds, Customs Bonds etc. fall under

this Group.
The quantum of loss under a Fidelity Guarantee (F.G) is computed from the
employers books of account. This is payable subject to the limit of Sum Insured.
Subrogation principle holds good.
Contribution:- Under Fidelity Guarantee contribution is not limited to
contribution as between insurers, because sometimes private suretyship is also arranged.
In such circumstances, the private surety may be brought into contribution with the
Insurance Company.
As there may be a considerable gap between the act of defalcation and its
discovery, the coverage under the policy must be clearly defined in this respect. Once a

12

discovery is made in respect of a person (employee) the cover ceases to be operative for
further lapses on the part of the same person.
Package Policies :The necessity to have individual polices for different risks has given birth to the
Package policies where different risks are granted to the Insured under a single policy.
This is a sort of an umbrella cover e.g. shopkeepers, householders, COMPACT policies.

GENERAL CONDITIONS
The essential features of the conditions generally found in all Miscellaneous
Insurance polices are as follows:
NOTICE
Any information given or communication required to be made under the policy
from the Insured to the Company, should be written and addressed to the Policy issuing
office.
For this purpose the DO or BO must make sure that their address is clearly and
prominently mentioned on the policy document.

MIS-DESCRIPTION
As insurance is a contract of Utmost Good Faith, and once the insured is in any
possession of full information about the subject matter of insurance, any
misrepresentation, or non-disclosure of any materials fact will make the policy void ab
initio and no benefit can be obtained under the policy. Also all the premium paid under
the policy will be forfeited.

13

REASONABLE CARE: After taking an Insurance Policy the Insured must continue to take proper care to
prevent loss or damage. He should always act as a prudent uninsured person.
CANCELLATION: The company can cancel the policy by proper written notice. In that event
Proportionate premium for the unexpired period of insurance will be refunded.
The insured may also request cancellation of the policy at any time, but refund of
premium will be subject to short period rates.
Please ensure that a cancellation clause is always present in any policy. No
policy can be issued without a cancellation clause
FRAUD :If fraud is proved no claim shall be payable under the policy.
CLAIMS PROCEDURE :When an event occurs which is likely to give rise to a claim under the policy, the
insured must give immediate notice to the Company. He must give to the Company
particulars of the amount of the loss or damage, and the required evidence and
explanations to substantiate the claim, as may be reasonably required by the Company
within the specified time. The cost of this must be borne by the insured.
Timelines

have

been

specified

for

registering

of

claims

under

the

Personal Accident policies

Registering of claim intimated within one month from the date of accident- Branch
Offices and Divisional Offices

14

 Registering of claim intimated after 30 days from the date of accident up to 6

months-Regional Offices- Region/LCB Head
Registering of claim after 180 days from the date of accident Head Office
The ROs/LCBs should maintain a separate register regarding approvals given for
registering of claims as mentioned above. Half yearly statement of the same will have to
be furnished to HO by the LCbs/RO.
The above regulations will be applicable for :
Individual PA Policies
Group PA Policies
Students Safety Insurance
UniStudy Care policies
Uni Home Care policies
All other package policies where PA extension has been opted for.
METHOD OF INDEMNITY :Instead of paying the claim in cash, the insurance company can choose to reinstate
or repair the property lost or damaged. This can also be done in collaboration with other
insurers who are involved in the loss. The Company does not have to reinstate exactly or
completely but only as circumstances permit. In any case the maximum expenditure to be
borne by the company for reinstatement shall be limited to the cost of reinstatement to the
pre-loss condition of the property. The Sum Insured, is of course, the maximum limit of
such expenses. In practice, this condition is rarely used.
CONDITION OF AVERAGE :If at the time of loss it is found that the value of the property insured is greater than
the Sum Insured, then the insured shall be considered as being his own insurer for the

15

difference and shall bear a ratable proportion of the loss. The claim payable will bear the
same ratio to the loss, as the Sum Insured bears to the total value for the property.
For example,
Let the SUM Insured be

Rs. 1,000/-

Let the total value of the property at the time of loss be

Let the amount of loss sustained be

Rs.1,500/Rs.600/-

Though Rs.600/- is well below the Sum Insured, the entire amount will not be
payable.
The loss will be paid in the same proportion that the Sum Insured bears to the total
value.
That is
Sum Insured

Total value

Claim payable
Loss Sustained.

OR
Claim payable
Total value

Sum Insured x Loss sustained

1000
1500

600

2/3 x 600 = Rs.400/If there is more than one SUM Insured under the policy for various items this
condition is applicable to the property separately to each item covered.

16

ARBITRATION :Once the liability under the policy is admitted, any disagreement with the insured
about the amount of claim to be paid under the policy should be referred to arbitration.
The Arbitrator, a disinterested-person, is to be appointed in writing by the insured and the
Company.
Unless liability has been accepted by the Company no arbitration can be
conducted. No action or suit upon the policy can be brought regarding the amount
payable unless the award by arbitrators or umpire is first obtained.
LIMITATION:
If the Company rejects the liability, the claim must be made subject matter of a suit
in a Court of Law within 12 Calendar months from the date of rejection. Failing this, the
claim will be deemed to be barred by Limitation and will not be recoverable at a later
date.
PREMIUM
In Insurance contracts, Premium is the consideration being paid by the insured to
the insurer.
The premium may be calculated in different ways according to the class of
insurance. It is essential that the insurers should obtain a premium adequate to cover the
risk.
The basic principle of insurance is that the premium contributions of the many
insured's must be pooled to meet the claim of the few who suffer loss. It is essential that
the premium charged be sufficient to ensure that the total premium received will be
adequate to meet all the claims. It follows that premium should be commensurate with
the risk, taking in to account the probability of loss as well as the possible magnitude of

17

the loss. The premium thus calculated should be the "pure risk
premium charged to the insured is suitably loaded to take

premium". The actual

care of initial expenses of

procurement of business, stationery and expenses of management, as well as certain

margin of profit for the Company.
The premium is usually quoted as a rate percent or per mile (thousand) on the
sum insured or limit of liability but there are several other basis for rating.
ADJUSTABLE PREMIUM :Sometimes initial premia are computed on estimates only, where the basis of
premium calculation, i.e. number of persons wages etc. may not be accurately known or
fixed at the beginning of the year. At fixed intervals stated in the policy the insured is
required to give declarations about the actual figure involved. At each expiry, the correct
premium is calculated from these particulars and the necessary premium adjustment is
carried out. If figures are in excess of the estimated, additional premium must be paid. If
they have fallen short of the estimate, refund made to the policy holder, subject to any
minimum premium stipulated.
SHORT PERIOD PREMIUM :Normally all policies are for one year period. Short period policies may be effected
and a special short period scale of rate applied accordingly. The reasons for applying a
higher scale of rates for short period policies are as follows :i.

There are certain charges (e.g. cost of policy forms, stamps charges)
connected with the issue of policies which do not vary with the term
insurance.

ii.

The seasonal factor, short-term policies may be taken only during the period
when exposure to the peril is maximum.

18

iii.

Normal annual premia are computed on the understanding that they will be
received in advance, and this is important when thinking of the total
premium income. If Insurers permitted proposers to remit the premium at
pro-rata annual rates, it would tantamount to receive premium by
installments.

SHORT PERIOD RATES :(Nor Exceeding)

1.

Week

10% of Annual Rate

Month

25% of Annual Rate

Months

35% of Annual Rate

Months

50% of Annual Rate

Months

60% of Annual Rate

Months

75% of Annual Rate

Months

85% of Annual Rate

Exceeding 8 Months

Annual Rate.

PLEASE NOTE THAT ALL THE PREMIUM RATES THAT ARE MENTIONED
IN THE MANUAL ARE ONLY GUIDELINE RATES.

19

PROPOSAL FORMS
In accident Insurance a completed proposal form is the basis of the contract and hence a
proposal must invariably be obtained for all insurances, in the standard forms in use. In
practice, it is often found that the proposer does not realise the need for utmost care in the
completion of the form. It is advisable, wherever possible, to assist the proposer when he
personally completes the form. If this is not feasible (for reasons such as the proposer not
being familiar with the language), then the

questions and answers should be read to

him and in particular, the declaration signed by him.

In the different kinds of proposal forms in use, certain features are common.
1. NAME OF PROPOSER

The full name with aliases should be given

2. ADDRESS OF PROPOSER

Full postal address required for the purpose of

communication as well as identification. Also,
the address may put insurers on inquiry in some
classes of insurance. Address of premises where
the risk is expected to be covered, if different
from the above, must also be noted carefully.

3. OCCUPATION

Occupation or profession of proposer.

4. INSURANCE HISTORY

Existing or part policies, and earlier declinature,

cancellation renewal or more stringent terms

These are necessary from the underwriting point

of view, especially as they may shed some light
on the moral hazard, a factor which is generally
very difficult to assess.

20

5. CLAIMS EXPERIENCE

This enquiry is fundamental to underwriting. The

experience is a sure guide to the assessment of
the physical hazards and it may also reveal
unfavourable moral hazard. A number of small
losses may indicate carelessness.

Proposer sometimes fails to answer questions on

proposal form, inserting merely a dash or a tick.
In no circumstances can this be passed over, and
the form must be returned for proper completion.

6. DECLARATION

A declaration is another feature common to all

proposal forms. It must be dated and signed.
The declaration is important for the following
reasons:i) This

changes the normal duty of utmost

good faith into a contractual duty of utmost good

faith and is expressed in the form of a warranty
that the statements made are true and complete
and that there has been no concealment of
material facts.

1.

The proposal form, with the declaration is specifically deemed to be the basis of
the contract and is incorporated as forming part of the policy.

21

2.

Email id also will have to be obtained

THE DETAILS OF THE PROPOSER WILL HAVE TO BE OBTAINED AS PER

THE KYC (KNOW YOUR CUSTOMER) NORMS.

DATE AND SIGNATURE :

It is always necessary to make sure that the proposal form has been signed, for
experience shows that this is at times left out inadvertently. Whatever the reason, the fact
remains that an unsigned form entirely fails in its main objective.

22

COVER NOTES

It is not always possible to complete an insurance and prepare a policy

immediately whenever cover is requested. The insurers may require further particulars of
risk. Also an inspection may be necessary.
The following details should be embodied in any letter granting cover or where
separate cover note is issued.
i.

Name of proposer (and, of course, name of the Insurer)

ii.

Date

iii.

The subject matter of the insurance, with the Sum Insured or limit of
indemnity as the case may be.

iv.

The period of the interim protection, with a provision for cancellation at the
insurer's option.

v.

The risks insured and a statement that the cover is granted subject to

the

terms and conditions of the insurees ordinary policy of the class concerned. If
however, any special conditions are imposed, such conditions must be stated.
vi.

Reference to the premium received.

NOTE:-

It should be noted that inspectors are not authorised to issue cover

notes for Miscellaneous Accident insurance Policies, except for Motor.

23

POLICY FORMS
The policy is not a contract, but is an evidence of the Contract.
A Schedule policy is one where the whole of the typewritten matter is to be
found in the schedule.
The policy is a legal document and for this reason alone every word of a policy is
important. The following are the principal rules of construction.
The intention of the Parties must prevail.
1.

This intention must, be gathered from the policy 'itself, because it is in the words
of the policy that the parties have chosen to express their intention.

2.

If there is any contradiction between the written and printed parts of the policy, the
written section overrides the printed portion, since it is deemed to show more
clearly the intention of the parties. However, as far as possible, the printed and
written portions must not be rejected unless, it is inconsistent with the written
section.

3.

As the policies are prepared in standard form, the effect of a particular

construction upon other cases is not overlooked; a policy must not be considered
for purposes of a particular insurance only.

4.

It is essential that the whole of the policy be regarded and not a particular clause
only. As a consequence, the same words usually bear the same meaning
throughout the document, but at the same time due consideration must be given to
the object of any special clause found in the policy.

5.

Any express term in the policy is held to override any implied terms, if the two are
inconsistent.

24

6.

The ordinary rules of grammar must be followed in policy construction; but the
intention of the parties should prevail.

7.

The wordings must be construed in their plain, ordinary and popular sense.
Technical terms must, however, be given their strict legal meaning, unless
there is an obvious intention to the contrary.

8.

The significance of any particular word must be obtained by reference to context.

The ejusdem generis rule means that where some specific things are mentioned
before using a general term, the meaning of the general terms is confined to things
of the same type and will not include things of a different sort. For example, if
one says, "Storm, tempest and other perils" a cyclone may fall within the other
perils, but "other perils" a cyclone may fall within the other perils, but "other
perils" would not include some peril unrelated to storm and tempest, for example
burglary.
Section 46 of the Insurance Act states that if there is any dispute concerning the

policy the Courts of law in India to whom the dispute may be referred shall decide the
dispute in accordance with the law of the land not withstanding
contrary

which

the

policy

anything

to

the

of insurance may contain. Thus section 46 has an

overriding effect over any policy term which is not consistent or in consonance with the
law of the land.
KINDLY NOTE
For policies like the Jewellers Block, Householders policy, Shopkeepers policy,
Burglary policy etc, the proposers address and the location covered may be different.
Please ensure that if this is the case, the LOCATION OF THE RISK is clearly mentioned
in the policy.

25

In a single location, if more than one Insured is covered, then the same should be
brought to the notice of the Regional Office / Head office to control accumulation of risk
and to take adequate protection
EXCEPTIONS
There are certain kinds of property and certain types of perils, which cannot be
covered under most of the policies.
A.

LOSS OR DAMAGE TO ITEMS WHICH ARE COVERED BY A

MORE

SPECIFIC INSURANCE:
B.

PROPERTY NOT COVERED UNLESS SPECIFICALLY MENTIONED :

Goods held in trust or Commission, valuables,

manuscripts, curios, rare

books, patterns, moulds, designs, deeds, bonds, bills of exchange, promissory notes,
money or securities for money, stamps or stamp

collection, unless specifically

mentioned and insured.

C.

WAR GROUP OF PERILS :

Any direct or indirect loss arising from or a consequence of war or warlike

activities is excluded. They exclude invasion, act of foreign enemy, hostilities (whether
war be declared or not) civil war, mutiny, rebellion, revolution, insurrection, military or
usurped power or Civil Commotion or loot or

pillage

in connection with these.

Confiscation or detention by the order of any Government or Public Authority is also an

exception. These war group of perils cannot be covered on risks situated on land even on
payment of extra premium.
D.

NUCLEAR RISKS :

Any loss expenses, consequential loss or legal liability, if directly or indirectly caused by
or even contributed to by nuclear perils, is not covered. The nuclear perils include

26

ionizing radiation, or contamination by radio activity from any nuclear fuel or from any
nuclear weapons material.
E.

DEPRECIATION, DELAY, LOSS OF MARKET :

INHERENT DEFECT or vice including damage by insects moth vermin,

mildew, mould damp, wear and tear, deterioration, spontaneous combustion or
decay of perishable goods.

SETTLEMENT OF CLAIMS
According to the policy conditions, the insured is required to inform the
occurrence of a claim or an event, likely to give rise to a claim, immediately. Procedural
matters as outlined in the procedural manual must be attended to. In order to help with
technical matters of claim settlement, the following steps have to be taken.
On the day of receipt of information regarding occurrence of a loss.
1.

The date and time of receipt of intimation has to be recorded on the letter or
telegram or other paper carrying the intimation.. In case the information is verbal
or through telephone, the message should be recorded in writing, noting date and
time of receipt. If the insured or his representative gets in touch personally, as
much details as possible, especially regarding probable quantum of the loss; where
the loss occurred, and how should be obtained. The insured should also be advised
to inform the police immediately, where necessary.

2.

If there has been a delay in intimation of loss, the reason must be thoroughly
investigated.

3.

The claim is to be entered in claims intimation register.

4.

Claim number to be noted on policy copy (office copy). If policy is issued by some
other office, they are to be contacted immediately for giving information

27

regarding claim, as well as requesting for a policy copy

to

be forwarded

immediately to the dealing office.

5.

A claim form should be sent to the insured simultaneously asking for all
information / documents which the known facts of the case indicate as being
necessary. The party should be alerted in this letter itself to lodge a police
complaint where necessary, and also to preserve recovery rights.

6.

A surveyor must be deputed for the assessment of the loss wherever necessary.

7.

Reinsurance Department, Regional office/Head Office (where necessary) must be

kept informed.

8.

If business has come through a Development officer, he must be fully involved in

obtaining the documents and complying with other requirements. A copy of the
letter to party detailing the requirements may be sent to the Development Officer
for follow up. When some of -the requirements are fulfilled, a letter
acknowledging receipt of documents sent, and reminding the insured of the
remaining requirements. The papers already received should be studied for any
additional documents or requirements, which may also be called for at this stage.

On receipt of completed claim form along with all other documents,

1.

A surveyor if not already appointed should be deputed.

2.

The work of surveyor must be followed up to see that it is finalised as early as

possible. In case of expected delay in issuing the final report, the surveyor must
submit a preliminary report, and status report must also be called for periodically.
After the Surveyor's report is received and all requirements fulfilled, the same
should be scrutinised carefully.

28

An interim reply may be sent to be insured stating that the claim is under
consideration.
1.

If claim is admissible under the policy, a claim note should be prepared

immediately indicating clearly the calculation of amount payable.
a.

If the claim falls within the powers of the concerned DO/BO for settlement,
the signature of the appropriate authority should be obtained on the note.

b.

If the claim is to be passed by a higher authority, the Claim note in the

appropriate form with the dealing officer's recommendation, should be sent
to the controlling office along with the relevant claim documents, and
copies of the proposal and policy together with any relevant
correspondence, for their attention.

2.

If claim is not admissible under the policy, the claim note recording the grounds
for refusal should be signed by a person having claim settling authority one step
above that is required for settling the claim.
The insured should be advised .immediately by registered A/D post that the claim
is not payable. The repudiation of the claim must be noted immediately in the
claim register, and policy copy (office copy).

3.

Where admissibility of claim it not clear, further information should be called for,
if necessary.
If such claim is to be referred to the Controlling office, the claim note should be
completed in all details and should convey clearly the position of the dealing
office with regard to the admissibility or otherwise of the claim.
After a claim note has been passed in an admissible claim, a discharge voucher
must be sent to the insured for completion and return as an advance receipt for

29

claim. Where necessary, letter of indemnity / subrogation must also be sent for
completion.
Meanwhile, any recoveries possible from third parties should be pursued be
handing over to the lawyers and filing a suit where necessary. Letter of
subrogation must be obtained. Disposal of Salvage must be attended to, as detailed
in the manual for disposal of salvage.
NOTE :- For very large claims and claims occurring soon after (within 5 days) of
acceptance of risk, RO and HO guidance should be sought immediately. The
procedural Manual may be referred for further details

30

claims

PERSONAL ACCIDENT INSURANCE

(INDIVIDUAL & GROUP)
SELECTION OF RISKS :
This Insurance is intended to provide for the payment of compensation in the event
of the insured sustaining death or disablement by bodily injury, resulting solely and
directly from accident caused by external, violent and visible means.
Personal Accident Insurance was under tariff with effect from 01.01.1977. It has
been withdrawn from the Tariff with effect from 01.04.94 (both individual and group
below 500). However the Tariff rates are treated as guideline rates from that date and
these are applicable to all types of Personal Accident Insurance underwritten in India
except the following cases :a.

Janata Personal Accident Policies;

b.

Extension of Motor Policies to cover P.A. to Third Party / Passenger.

c.

Policy issued by aviation Department.

d.

School children P.A. Group Policies.

Under composite package policies such as householders, Shopkeepers, Golfers

Policies, Gun Policies etc. Where P.A. is covered, the P.A. cover should be granted as per
the Guideline rate except where the Scheme provides otherwise. The cover provided by
the policy is world-wide. Payment of claim, however, can be made only in India in Indian
Rupees.

31

UNDERWRITING CONSIDERATIONS:
STANDARD PROPOSAL FORM :
Insurers should obtain from each individual a standard proposal form.

For

renewals, instead of asking for a fresh proposal form, a mere declaration of good health
would suffice for two renewals. After two renewals, fresh proposal form should be
insisted upon. A duly completed proposal from would indicate, besides details about the
insured person, the details of his income and particulars regarding physical defects,
chronic diseases and disability.
Personal Accident Insurance is a benefit policy and not strictly a contract of
indemnity. The amount of Insurance must be regulated by the financial position of the
proposer. It is undesirable to grant cover for benefits, which will place the Insured in a
better financial position when he is disabled than, when he is following his normal
profession or occupation. This may lead to a temptation to prolong the incapacity unduly.
Hence it is important to consider the proposers net income and the resultant loss of
earning capacity, due to the accident. A reasonable margin may be allowed for extra
expenses, which may have to be incurred in the event of disablement. As a general rule,
the compensation in respect of Temporary Total disablement must be limited to his
income per week.
Moral hazard is very important in connection with this class of Insurance
Acceptance must be limited to persons of good health, sound physical and mental
condition. The duly completed proposal form must be carefully examined to ensure that
the proposer is a healthy, sober and temperate person without any physical defeat or
infirmity. In particular, the proposer must not be unduly light or heavy in relation to his
height. In case the proposer had already lost or seriously impaired the sight of one eye or
lost a limb or part of the limb or other member of the body or is suffering from Diabetes,
defective hearing or deafness, fits, gout, heart trouble, hernia, paralysis, rheumatic
complaint, rupture, varicose veins etc, the consequences of accident tend to

32

be more

serious. Under these circumstances such proposals will have to be specially examined.
In any event it is desirable that such proposals are approved by the controlling office.
No proposal can generally be considered from persons below 12 years of age.
However, there is a provision in the guidelines which allows Insurers to use their
discretion to cover persons below 12 hears and above 70 years but the rate should be
higher than those applicable to persons between 12 and 70 years of age (the age group for
which rates have been prescribed). However Insurance to persons below 12 years may be
discouraged. The limit has since been revised to 80 years. When proposals from persons
above 70 years are received, the premium should be loaded by 10%. This should be done
only once between the age of 70-80 years. No medical examination need be insisted upon
either for renewal or fresh cover.
Documents to be called for to verify the income are:
A)

Salary Certificate (if the insured is a salaried person).

B)

Income Tax returns (to verify the income from gainful employment and not
from fixed assets).

SUM INSURED :
The capital sum insured should be fixed at the commencement of the policy. No
change in capital sum insured in permissible during the currency of the policy.
MINIMUM PREMIUM
The minimum premium chargeable under individual policy is Rs.50/-.

33

Fixation of Capital Sum Insured Under Personal Accident Policies.

In order to fix a reasonable capital sum insured under various tables for personal
Accident Proposals our HO has given certain instructions. It is absolutely necessary to
follow them :
1.

The policy issuing office should indicate separate sums insured under different
Tables. This will enable us to fix Higher Sum Insured for Tables I, II & III a lower
Sum Insured for Table IV commensurate with the insureds net income per week.

2.

The policy issuing office should satisfy itself that the CSI is commensurate with
the income of the Insured person. The insureds reported income as incorporated in
the proposal form is to be substantiated at the proposal stage itself by verification
of Income Tax Returns and / or other records and if necessary supporting
document have to be obtained and kept along with the Proposal Form.

3.

Within the Acceptance Limits of the Operating Office at different levels,

4.

They may accept maximum CSI under PA policy per person as follows :

4a.

Table

I- 48 - 60 months salary /income

Table

II & III -48-60months salary income

Table

IV - 24 months salary / income

The policy issuing office should verify even the existing P.A. polices so as to
ensure that the Maximum Sum Insured as above under different Tables is not
exceeded. If however, for any valid reason, the CSI has been fixed for higher sums
insured in Table I or II and 24 months for Table IV, such cases should be referred
to HO for approval.

34

5.

Where the CSI per person exceeds Rs.50 lacs in respect of any one Table, all such
cases should be referred to HO prior to acceptance.
The ceiling for different tables indicated above is only the maximum and the

Operating Offices should take all precautions to ensure that not only this ceiling is not
exceeded, but also the CSI is fixed at a reasonable level taking into account all the
relevant factors. The above limits will also apply for each individual who may avail of
more than one policy.
There have been several requests for increase in sum insured during the
currency of the policy and or at renewal. The request can be considered after
obtaining the relevant proof of income and necessary IT returns for the preceding
three years. It is always advisable to obtain a proposal form every two years in any
case under PA policy as also a letter from the parent organisation/employer for
change in Capital Sum Insured, as the case may be.
For the purpose underwriting risks are classified into three groups :
Risk Group I :
Accountants, Doctors, Lawyers, Architects, Consulting, Engineers,

Teachers,

Bankers, Persons engaged in Administrative functions, Persons primarily engaged

in occupations of similar hazard.
Risk Group II :
Builders, Contractors and Engineers engaged in superintending functions only,
Veterinary Doctors, Paid drivers of Motor cars and Light Motor Vehicles and persons
engaged in occupations of similar hazard and not engaged in manual labour.
All persons engaged in Manual labour (except those falling under Group III) Cash
carrying employees, Garage and Motor Mechanics, Machine Operators, Drivers of truck

35

or Lorries and other Heavy vehicles, Professional athletes and Sportsman, woodworking
machinists and persons engaged in occupations of similar hazard.
Risk Group III :
Persons working in underground mines, explosives, magazines, workers involved
in electrical installation with high tension supply, jockeys, circus personnel, persons
engaged in activities like racing on wheels or horseback, big game hunting,
mountaineering, winter sports, skiing, ice hockey, ballooning, hand gliding, river rafting,
polo and persons engaged in occupations/activities of similar hazard.
The rates of premium and the Table of Benefits are as below :
Rate of Premium per mile (in Rupees) 206

Table

Risk Group

Risk Group

II

0.45

0.60

0.65

0.90

I.

Death only

II.

Death,
Permanent
Disablement

III.

Death, PTD & Permanent

Partial Disablement

0.95

1.25

IV.

Death, PTD, PPD &

Temporary Total Disablement

1.50

2.00

Total

36

Weekly Compensation Under Table - IV

(a)

TTD at 1% of Capital Sum Insured per week upto Maximum 100 weeks Maximum weekly benefit not to exceed Rs.5,000/- in any case not exceeding 25%
of the actual monthly earning / salary.

(b)

For Chief Executives of corporate clients - 1% of Sum Insured per week subject to
a Maximum of Rs.10,000/- in any case not exceeding 25% of the monthly salary.

SCOPE OF COVER:
The Company undertakes to pay the Insured or his legal personal representative,
the following sums in the event of: 1.

If at any time during the currency of the policy the Insured sustains any bodily
injury resulting solely and directly from accident caused by external violent and
visible means.
a.

If such injury, within 12 calendar months of its occurrence, be the sole and
direct cause of the death of the insured, the capital sum insured as stated in
the Schedule.

b.

If such injury within 12 calendar months of its occurrence be the sole and
direct cause of the total and irrecoverable loss of :i.

Sight of both eyes or of actual loss by physical separation of the two

entire hands or two entire feet or one entire hand and one entire foot
or loss of sight of one eye and loss of one entire foot or one entire
hand-the capital sum insured, stated in the policy.

ii.

Loss of two hands or two feet or one hand and one foot, or of loss of
sight of one eye and loss of use of one hand or one foot-the capital
sum insured stated in Schedule.

37

c.

If such injury within 12 calendar months of its occurrence be the sole and
direct cause of the total and irrecoverable loss of
i.

Sight of one eye or actual loss by physical separation of one entire

hand or one entire foot, -50% of the capital sum insured stated in the
policy.

ii.

Total and irrecoverable loss of use of a hand or a foot without

physical separation-50% of the capital sum insured.

d.

If such injury shall as a direct consequence permanently, totally and

absolutely disable the Insured from engaging in any employment or
occupation of any description whatsoever, then-lump sum equal to 100% of
the capital sum insured.

The benefits under items b, c and d are known as permanent total

disablement benefits.
e.

If such injury shall within 12 calendar months of its occurrence be the sole
and direct cause of the total and irrecoverable loss of use of or the actual
loss by physical separation of the following, then the percentage of the
capital sum insured as indicated below shall be payable. This benefit is
called permanent partial disablement benefit.
Percentage of
Capital Sum Insured

i.

Loss of toes - all

20

Great - both phalanges

Great - one phalanx

Other than great, if more than one toe lost each

38

ii.

Loss of hearing - both ears

50

iii.

Loss of hearing - one ear

15

iv.

Loss of four fingers & thumb of the hand

v.

Loss of four fingers

35

vi.

Loss of thumb - both phalanges

25

Loss of thumb - one phalanx

10

vii.

viii.

ix.

x.

xi.

xii.

40

Loss of index finger

- Three phalanges

10

- Two phalanges

- one phalanx

Loss of middle finger

- Three phalanges

- Two phalanges

- one phalanx

Loss of ring finger

- Three phalanges

- Two phalanges

- one phalanx

Loss of little finger

- Three phalanges

- Two phalanges

- one phalanx

Loss of metacarpals
- first or second (additional)

- third, fourth of fifth (additional)

Any other partial disablement

% as assessed by the Doctor

39

f.

If such injury shall be the sole and direct cause of temporary total disablement,
then so long as the Insured shall be totally disabled from engaging in any
employment or occupation of any description whatsoever, a sum at the rate of one
percent of Capital Sum Insured per week but not exceeding Rs.5000/- per week in
all and in any case not exceeding 25% of the actual monthly earning / salary. This
benefit is known as temporary total disablement benefit. Compensation can be
paid proportionately for part of a week also. The compensation payable under
foregoing sub-clause (f) shall not be payable for more than 100 weeks in respect of
any one injury calculated from the date of commencement of disablement and
shall not exceed the capital sum insured. Payment under this sub-clause (f) shall
not be made until the total amount of Compensation is ascertained and agreed.
Effective from 10.04.98, a new clause called Childrens

Education

Fund has been incorporated under the P.A. Policy.

Under this clause. :
a)

If the Insured person has one dependent child below the age of 23 years, an
amount equal to 10-% of the CSI subject to a maximum of Rs.5,000/.

b)

If the Insured person has more than one dependent child below the age of 23 years,
an amount equal to 10% of the CSI subject to a maximum of Rs.10,000/-.
The payment as above will be made along with the CSI to the same person/s who

is/are entitled to receive the CSI.

An undertaking from the person receiving the amount that the same will be spent
solely for the education of the child / children of the deceased should be obtained before
settlement. This is an in built cover and no additional premium need be charged.

40

Note :
1.

The benefit under this extension will be available on the basis of the original CSI
only and not on the cumulative Bonus.

2.

The age limit of 23 years shall apply on the date of accident and not at the
beginning of the policy year. Provided that there be any other subsisting PA
Insurance in the name of the insured and benefits under this Regulation becoming
payable under all such policies the total amount so payable shall be limited to a
maximum of Rs.5000/- in case there is one dependent child and Rs.10,000/- in
case there are more than one dependent child.

The amount so payable shall be

borne by all the policies in proportion to the original sum insured.

3.

The following Endorsement must be used :It is hereby agreed and declared that not withstanding anything contained to the
contrary in the within policy this insurance is extended to provide compensation
towards Education Fund for the dependent children of the Insured as follows in the
event of death or Permanent. Total Disablement of the Insured due to accident.

a)

If the insured person has one dependent child below the age of 23 years, an
amount equal to 10% off the CSI subject to a maximum of Rs.5,000/.

b)

If the Insured person has more than one dependent child below the age of 23 years,
an amount equal to 10% off the CSI subject to a maximum of Rs.10,000/-.
The payment will be made along with the CSI to the same person/ s who is / are

entitled to receive the CSI.

Provided that the benefit under this extension will be available on the basis of the
original CSI only and not on the cumulative Bonus.

41

Also provided that the age limit of 23 years shall apply on the date of accident and
not at the beginning of the policy year.
Further provided that if there be any other subsisting P.A. Insurance/s in the name
of the Insured and benefits under this Regulation becoming payable under all such
policies, the total amount so payable shall be limited to a maximum or Rs.5,000/If there is only one dependent child and Rs.10,000/- if there are more than one
dependent child. The company shall not be liable to pay or contribute more than its
ratable proportion of such loss or damage.

FROSTBITE:
Frostbite will be treated as an accident for the purpose of claim.
There are increasing instances where the proposals are for PTD and no cover is
required for Death. In such cases, the complete details of the persons covered will have to
be obtained and certainly in case of individual policies. The premium rate will have to
higher than in the case of death.

EXCLUSIONS
The company shall not be liable under the policy for
1.

Compensation under more than one of foregoing sub-clauses in respect of the

same period of disablement.

2.

Any other payment after a claim under one of the sub-clauses (a), (b), (c) or (d)
has been admitted and becomes payable.

42

3.

Any payment in case of more than one claim under the Policy during any one
period of insurance by which the maximum liability of the Company in that period
would exceed the sum payable under sub-clause (a) of this policy.

4.

Payment of weekly compensation until the total amount shall have been
ascertained and agreed.

5.

Payment of weekly compensation in respect of Death, Injury or Disablement of the

Insured :a.

From intentional self-injury, suicide or attempted suicide.

b.

Whilst engaging in Aviation or ballooning or whilst mounting into, or

dismounting from or travelling in any balloon or aircraft other than as a
passenger (fare paying or otherwise) in any duly licensed type of aircraft
anywhere in the world.

c.

Directly or indirectly caused by general diseases or insanity.

d.

Arising or resulting from the Insured committing any breach of law with
criminal intent.

6.

Payment of compensation in respect of Death, Injury of Disablement of the

Insured due to or arising out of or directly or indirectly connected with or traceable
to: war, Invasion, act of foreign enemy, hostilities (whether war be declared or
not), Civil War, Rebellion, Revolution, Insurrection, Mutiny, Military or Usurped
Power, Seizure, Capture, Arrests, Restraints and Detainment of all kings, princes
and people of whatever nation condition or quality.

7.

Payment of compensation in respect of death of or bodily injury or any disease or

illness to the insured :-

43

a.

Directly or indirectly caused by or contributed to by or arising from

ionizing radiations or contamination by radioactivity from any nuclear fuel
or from any nuclear waste from the combustion of nuclear fuel. For the
purpose of this exception, combustion

shall include any self-sustaining

process of nuclear fission.

b.

Directly or indirectly caused by or contributed to by or arising from nuclear

weapons material.

Provided also that the due observance and fulfillment of the terms and conditions
of this policy (which conditions and all endorsements hereon are to be read as part of this
Policy) shall so far as they relate to anything to be done or not to be done by the Insured
be a condition precedent to any liability of the Company under this policy.
8.

PREGNANCY EXCLUSION CLAUSE:

The Insured under this policy shall not extend to cover death or disablement

resulting directly or indirectly caused by, contributed to or aggravated or prolonged by

childbirth or pregnancy or any consequence thereof.

STAMP DUTY :
Stamp duty on annual policies would be borne by the Insurer whereas the Insured
has to bear it in the case of shout period insurance. In case of group PA policies stamp
duty is payable on the basis of maximum amount for which any one employee is insured.

STAMP DUTY :

Rate upto 2.50%.

0.10 p (per Rs. 1000/- SI.)

Rate exceeding 2.50%.

0.10 p (per Rs.1000/- SI. part or thereof)

44

In respect of both individual and Group P.A. Policies for Indian personnel /
Experts working in foreign countries on CIVILIAN DUTIES, it is permissible on
payment of following additional premium to delete exception No.6 :
P.A. Policies issued during

50% extra over the rate.

peace time / normal period.

Deletion of Exception No.6 from
P.A. policies during abnormal /

150% extra over the rate.

apprehensive period.

INDIVIDUAL PERSONAL ACCIDENT INSURANCE

CUMULATIVE BONUS
Compensation payable under clause 1, a, b, c and of the policy, Viz., death, loss of
limb(s) or sight and permanent total disablement arising out of accidental injuries shall be
increased by 5% in respect of each completed year, during which the policy is in force,
prior to the occurrence of an accident for which the capital sum becomes payable.
However, the amount of such increase shall not exceed 50% of the capital sum insured
stated in the policy. The earned cumulative bonus will be lost if the policy is not renewed
within 90 days. If the claim lodged is for Temporary Total Disablement Cumulative
Bonus need not be withdrawn.
MEDICAL EXPENSES
The policy may be extended to include payment of medical expenses upto 10% of
the sum insured or 50% of the admissible claim amount or the actual expenses incurred
towards medical expenses (whichever is lower) by

45

charging 20%

extra on

the

premium.

The medical expenses are in addition to the benefits provided under the

policy.
EXPENSES OF CARRIAGE OF DEAD BODY
The policy will cover the actual expenses incurred for the carriage of the dead
body of the insured to the place of residence subject to a maximum of 2% of C.S.I. or
Rs.2,500/- whichever is less.
FAMILY PACKAGE COVER :
(i)

For Earning Member (person insured) and Spouse (if earning) - 100% if
C.S.I. for each

(ii)

Spouse (if not an earning member) - 50% of C.S.I. or Rs. 1 lakh whichever
is lower

(iii)

Children (between 5 yrs and 19 yrs) - 25% of C.S.I. or Rs.50,000 whichever

is lower per child.

Conditions in case of claim:

In case of death, written notice must be given before interment / cremation unless
reasonable cause is shown. In the event of loss of sight, amputation of limbs,
written notice must be given within one month of loss
In case of death or PTD, the claim will be paid only on delivery of policy for
cancellation and discharge and in the case of Temporary Total Disablement, upon
termination of such disablement. For permanent partial disablement claim will be
paid on submission of the policy for reduction of the CSI by the amount of claim.
Any medical official or other agent of the Company shall be allowed to examine
the person in case of alleged injury or disablement.

46

Notes :
(i)

For children the cover should be limited to Death and Permanent

Disablement (total and partial) Premium payable will be as applicable to
Table II benefits and corresponding rates.

(ii)

Premium payable for husband and wife will be on the total sum insured for
Table III benefits and corresponding rates.

(iii)

A discount of 5% may be granted on gross premium under Family Package

cover if only 2 persons are covered and 10% for more than 2 persons.

Any deviation in cover/extra benefits under the PA policy will have to be referred
only after consultation with the Regional Office/Head Office.

GROUP PERSONAL ACCIDENT INSURANCE :

The following two types of policies can be issued.
Type A :

Covering employees of a firm /company / Association or Club (i.e. with

employer - employee relationship)

These are further divided into two types :i.

Named employees and

ii .

Unnamed employees

Type B :

Covering members of an Institution / Society /Association / Club (i.e. with

no employer - employee relationship.)

This group can also be bifurcated into :i.

Groups where members could be named and identified.

47

ii.

Others.

Rates of premium in respect of A (i) and B (i) would be charged as per the
classification under which the employees / members would fall. In respect of A (ii) the
employer may declare the number of employees in each classification on the basis of
records maintained by his various offices. In case the employer is unable to give classwise information, all the employees should be treated as Group I excluding those who
can be classified under Group II or III and their number should be declared.
With regard to B (ii), where it is neither possible to categorizes individual risks,
nor to classify a group of people under any one classification, the following procedure
should be followed :
1.

Group like societies, associations and clubs, where the membership offered is of a
general nature Into restricted to any particular trade, occupation or profession)
may be insured as Group I with the provision that all members of the Group
must be included in the policy.
If only selected members of such a group want to insure themselves, they must

declare their occupation in the proposal form. This will then become a named group and
the risk can be classified according to occupation.
It may, however be noted that :1.

The number of persons and the sum insured in each Group should be specified
when the cover is taken.

2.

Only members of an Institution / Association / Club / Society etc., (where the

Group is well defined and a register of membership is maintained and it is possible
to find out the number of members at any given time) can be covered.

48

3.

The employees working at such Institution / Association / Club / Society are to be

covered separately at appropriate rates.

4.

Issue of Group policies for public places like hostel, cinema, swimming pools or
for specified short duration for covering visitors at exhibition, conference, sports
event etc, is not permissible; (Public Liability policies should be issued for such
covers);

5.

A declaration policy can be issued whereby addition / alteration could be effected

by charging additional premium (or allowing a refund), a pro-rata premium for the
unexpired period of insurance. However the refund will be allowed only if there is
no claim in respect of the particular insured person. But no alteration is permitted
in the group discount.

DEFINITION OF GROUP AS PER IRDA IS GIVEN BELOW:

1.

A group should consist of persons who assemble together with a commonality of

purpose or engaging in a common economic activity like employees of a company.
Non employer employee groups like employee welfare associations, holders of
credit cards issued by a specific company, customers of a particular business
where insurance is offered as an add on benefit, borrowers of a bank, professional
associations or societies may also be treated as a group provided the president /
secretary / manager / group organizer in his capacity as a organizer of the group
has an authority from majority of the members of the group to arrange insurance
on their behalf or is doing so as part of a necessary security for other matters such
as a bank on the life of borrowers. For employer employee groups the scheme
may be either contributory or non contributory and there will be no limit to
employer contribution. Where an insurer is not clear whether a particular group
insurance proposal can qualify as per these guidelines, the insurer may refer the
matter to IRDA with facts of the case for clarification

49

2. No group should be formed with main purpose of availing insurance. There

should be a clearly evident relationship between the member and the group
manager for services other than insurance.

Where a homogeneous group of

persons may decide to buy a group insurance policy to achieve saving in cost, a
person negotiating group rates and then going round finding, members to insure
will be considered as a legitimate group.
3. While it is not proposed to prescribe the minimum size of a group through these
guidelines, it is expected that insurers will exercise prudence in requiring a
minimum group size. However, different criteria may apply to micro-insurance
groups.
4. Though entry into or exit from the group may go on continuously, entry into the
group insurance policy for individual members will be either from a well defined
date such as the next anniversary of the policy or from the first of the following
month or from a clearly identifiable event other than merely joining the group,
such as date of commencement of employment or date of sanction of a loan etc.,
subject to payment of premium in time. Insurance will, however cease, as soon as
a member leaves the group except where it is agreed in advance to continue the
benefit even after the member leaves the group, such as in case of an employee
who retires. In case of travel related insurance, insurance may attach from the date
of the travel subsequent to acceptance of risk and receipt of the premium.
FOR FURTHER DETAILS YOU MAY REFER THE IRDA CIRCULAR REF. NO:
015/IRDA/LIFE/CIRCULAR/GI GUIDELINES /2005 DATED 14-07-2005.
STANDARD POLICY FORM
All group P.A. policies shall be issued only in the standard policy form.

50

SUM INSURED :
a.

Where sum insured is linked to emoluments payable to insured person, the

basis of calculating emoluments must be defined in the policy.

b.

The premium on the policy must be adjusted at the end of the policy year
based on the declaration of emoluments in the policy year.

c.

Where more than one category of employees are covered, the sum Insured
for each category should be determined at the inception of the policy.

d.

Sum insured under the policy can be increased with proportionate increase
in premium.

e.

Cumulative Bonus will not apply to group policies.

MINIMUM PREMIUM
Minimum premium chargeable for a Group Policy is Rs.100/-.
ON DUTY COVERS :
If P.A. cover is required only for the restricted hours of duty (and not for 24 hours)
a reduced premium equivalent to 75% of the appropriate premium should be charged. The
cover is meant for employees, taken out by employer for accident to employees arising
out of and in the course of employment.
OFF DUTY COVERS :
If cover is required for only for the restricted hours when the employee is not at
work and / or not on official duty a reduced premium of 50% the appropriate premium
can be charged. A suitable endorsement may be incorporated with policy.

51

GROUP DISCOUNTS :
Group policies may be issued covering more than 1 person. However, group
discount as per the following scale can be granted only if the number of insured persons
in a group exceed 100.
No. of Persons

Discount (%)

upto 500

NIL

501

- 2000

2000 - 5000

10

5001 & above

15

Note :
1.

The Group Discount should not be reviewed during the currency of the insurance.

2.

Any other discount / bonus other than specified (like total abstainers bonus,
renewal bonus, life policy holders bonus or double benefit etc.,) are not
admissible.

MEDICAL EXPENSES
The policy may be extended to include payment of medical expenses up to 10% of
the sum insured or 50% of the admissible claim amount or the actual expenses incurred
towards medical expenses whichever is lower by charging 20% extra premium. The
medical benefits are in addition to benefits provided under the policy.

52

CLAIMS:
Fatal Claims Claim form, original policy (for cancellation), Investigation report, Death
certificate, Postmortem report

(Coroners report/inquest report-, Where ever

necessary-FIR/Police report)
Payment is to be made to the assignee of the policy. If there is no assignee,
payment

is

to

be

made

to

the

legal

representatives

identified-

Will/Probate/Succession certificate
Disability/education Grant/Medical Expenses claims
Claim form, report of attending doctor, diagnostic reports (X rays, reports
confirming injury), FIR/Police report wherever necessary) Certificate of Proof of
Age (Education Grant Claims), Medical Bills

53

FLIGHT COUPONS

SCOPE OF COVER :
PASSENGERS flight Insurance Coupon covers death and / or permanent
disability and any bodily injury caused by violent, accidental, external or visible means
whilst travelling in or entering into or descending from any aircraft owned and / or
operated by a regular airline over a scheduled route by which the insured is travelling as a
passenger during flights specified. The age of the Insured should be between 12 and 70.

RATE OF PREMIUM
Rs.5/- per Rs.50,000/- for a flight of not more than 24 hours duration. However,
the minimum premium would be Rs.5/- net.

BENEFITS :
The following are the extent of compensation payable :
Clause 1 :

Should such injury, within three calendar months from the occurrence

thereof, solely and directly :

a.

Cause the death of the Insured (or)

b.

Cause or necessarily result in the loss by physical separation of the whole of

i.

Both hands or feet

ii.

One hand and one foot

iii.

One hand or foot and the complete THE CAPITAL SUM

54

and irrecoverable loss of sight in

INSURED

one eye

C. Cause or necessarily result in the complete

and irrecoverable loss of sight in both eyes.

Clause 2:

Should such injury, within

THE CAPITAL
SUM INSURED

50% OF THE

months from the occurrence thereof, solely

CAPITAL SUM

and directly cause or necessarily result in:

INSURED

a.

The loss by physical separation of the whole of one hand or one foot.

b.

The complete and irrecoverable loss of sight of one eye.

Clause 3

Should such injury, solely directly and totally 1% OF THE

disable and prevent the insured from attending CAPITAL
to his business or occupation for the period of SUM
such total disablement with a maximum of 100 INSURER
weeks from the date of the accident. Maximum PER WEEK
weekly benefit not to exceed 1% of the C.S.I.
subject to a maximum of Rs.5000

Clause 4:

Should such injury solely directly and totally 0.15%

disable the insured and prevent him from THE
attending to a substantial portion of his business CAPITAL
or occupation, compensation for the period of SUM
such partial disablement with a maximum of 52 INSURED
weeks from the date of the accident

55

PER WEEK

OF

Exclusions :

1.

War and allied perils

2.

Injury / death whilst under the influence of intoxicants or is suffering from lunacy
or insanity if these are the direct / indirect causes.

3.

Injury / death arising from disobedience of instructions of aircraft crew / owners /

operators or their agents or servants.

4.

Accidental death of the insured shall not be presumed by reason of his

disappearance.

56

STUDENTS SAFETY INSURANCE SCHEME

1.

The policy is intended to be issued to the Schools / Colleges or any other

educational institution for the benefit of the students studying therein.

2.

SCOPE OF COVER :
The students will be covered against death, total loss of two limbs or two eyes,

total loss or one limb and one eye, total loss of one limb or one eye and Permanent total
and partial disablement.
3.

BENEFITS UNDER THIS SCHEME PER STUDENT :

1.

Death (Capital Benefit) : Rs.10,000/-

2.

Loss of two limbs, two eyes or one limb and one eye : Rs.10,000/-

3.

Loss of one limb or one eye : Rs. 5,000/-

4.

Permanent total disablement from injuries other than those mentioned above :
Rs.10,000/-

5.

Permanent partial disablement (percentage of benefits as given below on the

capital benefit of Rs.10,000/Sl.
No.

Percentage capital
Benefit

Parts Lost in

i.

Loss of toes
- Great both phalange
- Great-one phalanx
- Other than Great, if more than
one toe lost each

ii.

Loss of Hearing

- both ears

50

iii.

Loss of Hearing

- one ear

15

iv.

Loss of 4 fingers and thumb of one

hand

40

v.

Loss of 4 fingers

35

57

all

Compensation
20
5
2
1

vi.

Loss of thumb one Phalanx

- both phalanges

25

vii. Loss of index finger

- three phalanges
-Two phalanges
-one phalanx

10
8
4

viii. Loss of middle finger

- three phalanges
-Two phalanges
-one phalanx

5
4
2

ix.

Loss of ring finger

- three phalanges
-Two phalanges
-one phalanx

5
4
2

x.

Loss of little finger

- three phalanges
-one phalanx

4
2

xi.

Loss of metacarpals

- First or second
(additional)
-third, fourth or fifth
(additional)

HOSPITALIZATION EXPENSES :
In addition to the above the policy will provide for reimbursement of medical
expenses, subject to a limit of Rs. 500/- per student per year incurred by the student for
treatment to him in a hospital or nursing home, as an in-patient for any injury sustained in
an accident
4.
A.

Compensation limits :
a.

Per one student

Rs. 10,000/-

b.

Per any one accident

Rs. 5,00,000/-

58

c.

Per any one policy year

Rs.10,00,000/-

P.S. The limits under b & c can be suitably altered to suit the requirements on individual
cases in consultation with RO / HO.
B.

Medical expenses for hospitalisation treatment mentioned above Maximum of

Rs.500/- for any one student for any one year.

5.

PREMIUM Rs.6/- per student per annum for the above limits.

6.

PROCEDURE FOR ISSUING THE COVER :

The School / College / Educational Institution will give a letter of request

furnishing the following particulars and pay the premium.

1.

Name of Institution:

2.

No. of students as on the date of proposal :

3.

Limit of compensation selected for any one year.

4.

Declaration from the school authorities that a proper attendance register giving the
names of all students is maintained throughout the year which must be available
for inspection, if necessary by the Insurance Authorities.
Additional inclusions of the students in the middle of the policy period may be

allowed on request subject to payment of Rs.1/- for each student. No refund for deletion
will be allowed.
The policy will be issued in the name of the Institution on the life and for the
benefit of total number of students as given in the declaration.

59

CLAIMS PROCEDURE :
In the event of any accident to a student resulting in a claim under the policy the
following procedure is to be complied with.
a.

Immediate notice in writing to be given to the Insurance Company.

b.

Claim form and other certificates as required by the Insurance Company should be
furnished.
For the purpose of convenience and proper processing and disposal of the claim,

the claim papers will have to be routed through the authorities of the school. It will be
expected that the Institution will render proper guidance and assistance to the concerned
in the matter of preferring the claim and follow up.
Claim will be payable to the parent or guardian of the student as recorded in the
school register and as certified by the School Authorities. The policy is subject to usual
exclusions applicable for P.A. cover and the agency commission payable is 5%.

60

+BHAGYASHREE CHILD WELFARE INSURANCE POLICY

UNDERWRITING INSTRUCTIONS:
1. INSURED: This scheme will be applicable to the girl children in the age group
of 0 to 18 years, whose parents age does not exceed 60 years. This scheme is
intended to provide insurance cover only to ONE girl child in a family.
2. PREMIUM: Rs. 15/- per girl child per year.
3. GROUP DISCOUNT:
NO. OF PERSONS
250-1,000
1.001-10,000
10,001-1 LAC
ABOVE 1LAC-2.5 LACS
ABOVE 2.5 LACS-5 LACS
ABOVE 5 LACS-10 LACS
ABOVE 10 LACS

4. AGENCY COMMISSION

% AGE OF DISCOUNT
5
10
15
30
35
40
45

: 15%

5. STAMP DUTY

: As applicable

6. FINANCIAL INSTITUTION

61

BHAGYASHREE CHILD WELFARE INSURANCE POLICY

(For girl child in the age group 0-18 years whose parents age does not exceed 60 years)
The Insurance cover would be available on 24 hour risk basis. In case of death of
either or both parent/s resulting solely and directly from Accident caused by outward,
violent and visible means, and if such accident shall within 6 calendar months of its
occurrence lead to death then a sum of Rs.25000/- shall be deposited in the name of the
girl child with a financial institution .The financial institution shall make following
disbursements from Corpus created out of the deposit amount for the benefit of the girl
child to the living parent or to the nominated guardian or the girl child .
Age of the
girl child
1-5 years

Amount
disbursement
Rs.1,200 per annum

6-11 years

Rs.1,200 per annum

12-17
years

Rs.2,400 per annum

18 years

Balance amount to
the credit of the girl
child

Payable to
Surviving parent or guardian for looking
after the needs of the child.
Surviving parent or guardian provided the
girl child is admitted in a school and
expenditure is incurred on her education.
Surviving parent or guardian provided the
girl child is admitted in a school and
expenditure is incurred on her education.
To the Girl Child

In case of discontinuation of studies by the girl child the disbursement for

education will not be paid but on completion of 18 years balance amount to her credit
will be paid as a lump sum.

62

In case of death of the girl child before attaining the age of 18 years balance
amount standing to the credit of the girl child would be paid to the surviving parent or
guardian.
Definition / Explanation:
Death by accident caused by outward, violent and visible means would include
death arising out of or traceable to slipping and / or falling from the mountainous terrain;
biting by insects, snakes and / or animals, drowning, washing away in floods, landslides,
rock slides, earthquake, cyclone and other convulsions of nature and / or calamities; rape,
murder and terrorist activities. It also includes death caused by surgical operations such
as sterilisation, caesarian, hysterectomy, i.e. removal of uterus and removal of breast/s
due to cancer operations, death at the time of child birth provided that such death occurs
during the surgical operation in hospital / nursing home or whilst being in the hospital /
nursing home after such surgery / convalescence, however not beyond a period of seven
days from the date of surgical operations.
EXCLUSIONS
1.

Intentional self injury, suicide or attempted suicide

2.

Whilst under the influence of intoxicating liquor or drugs

3.

Whilst racing on wheel, Hunting Big game shooting, Mountaineering, or whilst

engaged in winter sports, skiing & Ice Hockey

4.

Directly or indirectly caused by insanity

5.

Arising or resulting from the Insured committing any breach of law with criminal
intent

6.

Directly or indirectly connected with or traceable to War, invasion, act of foreign

enemy, hostilities or warlike operations (whether war be declared or not) Civil
war, rebellion, revolution, insurrection, Mutiny, Military or usurped power, seizure
capture, arrests restraints and detrainments of all kings, princess and people of
whatever nation, condition or quality whatsoever

63

7.

Directly or indirectly caused by or contributed to by or arising from or traceable to

ionising radiation or contamination by radio activity from any source whatsoever
or from nuclear weapons material.

Renewal of the Policy after expiry:

It will be necessary for the Insured to contact the nearest Office of the Company
and obtain a fresh Insurance Cover after the expiry of the Policy as renewal notice or
intimation of renewal WILL NOT be sent by the Office.

64

BHAGYASHREE CHILD WELFARE INSURANCE POLICY

SCHEDULE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

Policy No. code

Agency Code:
Dev.:
Officer :
Annual Premium
: Rs.
Name of the girl child to be :
insured
Age of the child
:
Names of the parents
: Shri.
Smt.
Address of the parents
:
Name of the guardian nominated :
Address of the guardian
:
Period of Insurance
: From__________ at_______ AM/ PM
To ___________________ (Midnight)
Proposal Dated
:
Name and address of the :
financial Institution : managing
the fund

IN WITNESS WHEREOF, the undersigned being duly authorized has hereunto set his /
her hand at __________________ this ____________ day of ______________ 20.
Policy Issuing Office
Duly Constituted Attorney

65

CLAIM FORM - BHAGYASHREE CHILD WELFARE POLICY

1.

a) Name of insured :
b) Address

c) Name of other persons having

an Interest in the property
2.

DETAILS OF INSURANCE
Policy No. (s)

Sum
Insured
Rs.

Period
From

N.B. If Insurance is effected with other

Companies, copies of such policies to be
attached.

I/We hereby declare that the statement made by us in the claim form are true to the best
of our knowledge and belief and that I / We have to withheld any material information
which has bearing upon the claim.
Place:
Date:

Signature of the Claimant

(The Issue of this form does not constitute admission of liability)

66

RAJRAJESHWARI MAHILA KALYAN BIMA YOJANA

PROPOSAL FORM
[IMPORTANT : The company will not be on risk until the Proposal has been accepted by
the Company and the premium paid in full.]
1.

Name of the proposer:

2.

Address :

3.

Age [Completed years]

4.

Occupation :

5.

Marital status
Name and age of the husband (if applicable)

6.

Cover required
(Please specify whether basic or basic with extended
cover)

7.

Nomination details: Name

Address
Relationship with proposer

8.

Policy Period (1 Year to 5 Years)

9.

Period of Insurance

10.

Witness to nomination
Name & Address with signature
Name & Address with signature
From

To

DECLARATIONS
I declare that I have explained the question s to the Proposer, that the Proposer s

an s w e r s thereto have been recorded by me and that he / she ha s affix e d his / her sign
a t u r e thumb impression after satisfying himself / herself that the answers have been
correctly recorded.
Signature of person writing the answers
Date :

67

EXISTING DISABILITY: I hereby declare that I do / do not suffer from loss /

disablement / incapacity of and I understand that the Company shall not pay for the same
in the event of any accidental injury.
I declare that the questions were explained to me fully by Shri/Smt./ Kumari and that the
answers thereto have been recorded by him/her under my dictation and that I have affixed
my signature/ thumb impression after satisfying myself that they have been correctly
recorded.
Date:
Signature / Thumb Impression of Proposer:
I / We, hereby declare that the information furnished above are true and correct to my/our
knowledge and belief
Place :
Date:

Signature of the Proposer

PROHIBITION OF REBATES:
The following is an extract of Section 41 of Insurance Act 1938
No person shall allow or offer to allow either directly or indirectly as an
inducement to any person to take out or renew or continue an insurance in respect of any
kind of risk relating to lives or property in India any rebate of the whole or part of the
commission payable or any rebate of the premium shown on the policy nor shall any
person taking out or renewing or continuing a policy accept any rebate except such rebate
as may be allowed in accordance with the published prospectuses or tables of the
Insurers.
Any person making default in complying with the provisions of this Section shall
be punishable with fine, which may extend to five hundred rupees.

68

NOTE :
Maximum amount receivable:
Attention is drawn to Condition No.6 above when the insured is having more than
one Rajarajeshwari Mahila Kalyan Bima Yojana in force at the time of the accident or
injury.
Renewal of the Policy after expiry:
It will be necessary for the Insured to contact the nearest Office and obtain a fresh
insurance after the expiry of the Policy as renewal notice or intimation will not be sent by
the Office

69

RAJRAJESHWARI MAHILA KALYAN BIMA YOJANA (NEW)

SCHEDULE
Policy No.:

Agency
Code:

Premium
Basic Cover
Extended Cover

Rs.
Rs.

Total Premium

Rs.

Name of the insured

Address of the Insured

Age of the insured (Completed years)

Occupation of the Insured

Dev. Officer
code

Name and Age of the Husband (if :

applicable)
Period of Insurance

From:___ at _____ AM / PM
To______________(Midnight

:
Nomination details
Name

Address

Relationship

Proposal and Declaration Dated

IN WITNESS WHEREOF, the undersigned being duly authorized has hereunto set
his / her hand at ____________ this ____________ day of ______________ 200.
Policy issuing Office.
Duly Constituted Attorney

70

RAJ RAJESHWARI MAHILA KALYAN YOJANA

This Insurance policy is for women of all strata of society falling within the ages
of 10 and 75.
The Insurance cover would be available on 24-hour risk basis. If the Insured
sustains any bodily injury resulting solely and directly from Accident caused by outward,
violent and visible means, and if such injury shall within 6 calendar months (unless
otherwise specified) of its occurrence lead to disablement as specified below, then the
Company shall pay to the Insured the sums as mentioned hereunder:
Permanent Total Disablement

Rs. 25,000/-

Loss of one limb and one eye or loss of

both eyes and./or loss of both limbs

Rs. 25,000/-

Loss of one limb / sight in one eye

Rs.12, 500/-

In the case of unmarried woman the Policy will be extended to cover death due to
accident as defined in the Policy in which event the compensation will be payable to the
nominee or legal heir. The compensation shall be RS.25,000/-.
In the case of married woman the Policy will be extended to cover the death of the
Insureds husband arising out of accidental death caused by external violent and visible
means in which event the compensation will be payable to the wife (Insured) only. The
compensation shall be Rs.25,000/-. In the event of wife (Insured) predeceasing the
husband or in the event of simultaneous death of both the husband and Insured wife no
compensation shall arise under this extension.

71

Permanent Total Disablement means such disablement of a permanent nature,

incapacitating an Insured for all work, which she was capable of performing at the time
of the accident resulting in such disablement.
Death or disability by accident ca u s e d by external, violent and visible means
includes Death and or Permanent Total Disablement arising out of or traceable to slipping
and / or falling from the mountainous terrain; biting by in sects, snakes and / or animals;
drowning, washing away in floods, landslides, rock slides, earth quake, cyclone and other
convulsions of nature and/or calamities, murder and terrorist activities.
In the case of woman it also include s Death and or Permanent Total Disablement
cause d by rape surgical operations such as sterilization, caesarian, hysterectomy, i.e.
removal of uterus and removal of breast/s due to cancer operations, death at the time of
child birth provided that such death occurs during the surgical operation in hospital /
nursing ho m e or whilst being in the hospital / nursing home after such surgery
convalescence, however not beyond a period of seven days from the date of surgical
operations.
The policy can be extended to cover risks of legal case of divorce as also loss of
house hold goods in calamity on payment of additional premium.
The coverage is as follows:
Sl.

Risk covered

Compensation

No.

payable
Temporary total disablement

arising out of an

Rs.500/- per

accident-define d herein above and resulting in month subject

hospitalization as an inpatient resulting in total to a maximum
disability to engage in any occupation or work or

of Rs.1,500/-

employment
Legal Divorce: Actual legal expenses necessarily

72

Actuals not

incurred for legal divorce proceedings initiated

exceeding

during the currency of the Policy and incurred during

Rs.2,000/-

the currency of the Policy or during renewal of the

Policy but only once in life time of the Insured and
provided the expenses shall be reimbursed only on
obtaining divorce decree.
Loss and or damage to household goods / personal

Upto a limit

effects whilst contained in house / dwelling arising

of Rs.2,000/-

out of fire, lightning, riots, terrorism, storm, typhoon,

flood cyclone and earthquake.

EXCLUSIONS
Compensation under more than one of the sub clauses (a), (b), (c) and (d) in respect of
disablement and or death.
Payment or compensation in respect of death, injury or disablement directly or indirectly
arising out of or contributed to by or traceable to any disability already existing on the
date of commencement of this Policy;
Death injury or disablements arising from or traceable to :
Intentional self injury, suicide or attempted suicide;
Whilst under the influence of intoxication, liquor or drugs;
Directly or indirectly caused by insanity;
Arising or resulting from the insured commiting any breach of law with criminal intent:

73

Death, injury or disablements of the insured and loss or damage to property arising out of
ionizing radiation or contamination by radio activity from any source what so ever:
Death, injury or disablements of the insured and loss or damage to property directly or
indirectly caused by or arising from or in consequence of or contributed to by nuclear
weapons material;
Death, injury or disablements of the Insured and any loss or damage to property
occasioned by or through or in consequence directly or indirectly of any of the following
occurrence namely,
War, invasion, act of foreign enemy, hostilities or warlike operations (whether war be
declared or not) civil war;
Mutiny, civil commotion assuming the proportions of or amounting to a popular rising,
military rising, insurrection, rebellion, revolution, military or usurped power;
Loss or damage to property occasioned by its own fermentation, natural heating or
spontaneous combustion or by its undergoing any heating or drying process;
Loss or damage to property occasioned by or through or in consequence of:
The burning of property by order of any Public Authority;
Subterranean Fire;
Volcanic eruption or other convulsions of nature;
Loss or damage to property such as:
Goods held in trust or on commission;
Bullion or unset precious stones;
Any curios or work of art;
Manuscripts, plans, drawings or designs, patterns, models or moulds;
Securities, obligation or documents of any kind, stamps, coins or paper money,
cheques, books of accounts or other business books, computer system records;

74

Explosives;
Any payment in excess of the sum insured under this Policy during any one year
of Insurance, for any one Insured Person.
UNDERWRITING INSTRUCTIONS:
INSURED: This policy can be issued to cover all cross sections of women in the
age group of 10-75 years irrespective of their income, occupation or vocation. The Policy
is intended to benefit housewives, students, domestic labour, skilled or unskilled labour
and other women engaged themselves in similar or other types of activities in rural, semiurban areas.
PREMIUM : Basic cover premium would be charged at the rate of Rs.15/- per
woman per year.
Basic cover with extended cover premium would be charged at the rate of Rs.23/per woman per year.
GROUP DISCOUNT
NO. OF PERSONS

% AGE OF
DISCOUNT

101 - 1,000

10

1.001 - 10,000

15

10,001 - 1 LAC

20

ABOVE 1 LAC - 2.5 LACS

30

ABOVE 2.5 LAC - 5 LACS

40

ABOVE 5 LAC - 10 LACS

50

ABOVE 10 LACS

60

75

LONG TERM PERIOD DISCOUNTS : Insurance cover can also be taken for
longer period up to 5 years. Such long term policies would attract discount on premium
as under:

TERM OF THE POLICY (YEARS)

DISCOUNT %

NIL

10

15

20

AGENCY COMMISSION

15%

STAMP DUTY

As applicable

DEPARTMENT

Non-Traditinoal

76

RAJARAJESWARI MAHILA KALYAN BIMA YOJANA - CLAIM FORM

(The issue of this form does not constitute admission of liability. Please return this
form duly completed together with Death Certificate from the Hospital or the Medical
Attendant, Post Mortem Certificate, and Police Panchanama, if any; should there be delay
in obtaining any forms, kindly return this claim form first to the office which issued the
policy)
Claim No.

Policy No.

1.

Name of claimant (in full) (if more than one, state names of all) Full
Postal Address
Relationship of Claimant with the deceased

2.

State nature of title under which Claimant is claiming the amount

a)
b)
c)

Particulars of the insured person who met with accident / died in the accident
3.

Name (in full)

Last full Postal Address
Last Occupation
Age at the time of the accident

a)
b)
c)
d)

4.

When did the accident happen? (give date and exact time)
Where did the accident happen?
Give full description of the accident, its cause and injuries sustained
State date, time and place of death

a)
b)
c)
d)

5.

On what date did the claimant receive information in regard to the

accident and from whom?

6.

Give the names and addresses of two persons who witnessed the
accident

7.

Was the deceased free from infirmity at the time of accident? If not,
give particulars
Was the deceased under the influence of drugs or drink at the time of
accident?
Is the Claimant satisfied that the death was directly due to the
accident?
Give the names and address of
The Hospital, Clinic or Nursing Home where the deceased was
treated after the accident
The Physician / Surgeon who attended on the deceased after the

77

a)
b)
c)
d)
i)
ii)

accident
iii) His regular Physician, if any
e) i) Has the accident resulted in any permanent total disablement?
ii) If so, give the details of disablement?
8.

Did the deceased have any other Rajajashwari Mahila Kalyana Bima
Yojana? If so, state the name of the insurer and amount claimed.

9.

if temporary total disablement is covered:

Has the Insured been an in-patient in the hospital?
Period of hospitalisation

10
.

If legal divorce is covered

Name of the court where petition is field?
Name of the advocate handling the case.
Has divorce decree been obtained? If so, please attach a certified copy
thereof.
Actual expenses incurred for obtaining the decree along with
documentary evidences.
Has the insured persons claimed for such expenses earlier and if so,
the details of Policy No. and expenses claimed and reimbursed,

11. If damage to house-hold goods / personal effects ifs covered

Time and date of loss / event
Cause of loss / event
Description of items lost / damaged
Describe in detail the total event giving rise to the claim
Has the fire / event loss been reported to Fire Brigade / Police or other
Authorities?
Extent of loss

iii)
(i)
(ii)

a)
b) from
to
a)
b)
c)
d)
e)

a)
b)
c)
d)
e)
f)

I / we hereby affirm and declare that the answers to all the above questions are full and
true in every respect.
Place :
Date :

Signature of Claimant

Witnesses
1.

Signature
Name
Address

2.

Signature
Name
Address

78

CRADLE CARE INSURANCE POLICY

PROPOSAL FORM FOR CRADLE-CARE POLICY

1.

a) Name of the Proposer

b) Name of the insured person
c) Relation between the proposer and the Insured

2.
3.
4.

5.
6.

person
Residential Address / Permanent Address:
Address for Correspondence:
a) Have you ever proposed for Cradle-Care Insurance
b) If so, give name of each company and amount of
Insurance
c) Has any company
i. Declined to issued a policy to you?
ii. Declined to continue your insurance
iii. not invited the renewal of your policy?
iv. Imposed any restriction or special conditions?
If so, give names and address of each company in respect i)
Name of Co.-of i, ii, iii and iv above.
ii)
Sum insured
iii)
Policy No.--Please indicate
a) Capital Sum Insured
a) Rs. ---------------------------------------b) Period of insurance
b) From ----------------- To --------------I declare that the above answers are true to the best of my knowledge and belief, that I have
disclosed all particulars affecting assessment of the risk. I agree that this proposal and
declaration shall be the basis of the contract me and this Company.
Place :

Proposers Signature

Date :

Signature of the person to be insured

ASSIGNMENT:
I ------------------------- do hereby assign the monies payable by the --------------------------in the event of my death to ----------------------- (Name & Relationship to the Insured) and I
further declare that his / her receipt shall be sufficient discharge to the Company.

79

Dead this -------------------------- day of ------------------- 200 at -------------------------WITNESS:

Name & Address :

Signature/s

Signature of the policy holder

PROHIBITION OF REBATES
The following is the copy of section 41 of the Insurance Act, 1938.
1. No person shall allow or offer to allow either directly or indirectly as an inducement to
any person to take out or renew or continue an insurance in respect of any kind of risk
relating to lives or property in India any rebate of the whole or part or commission
payable or any rebate or the premium-shown on the policy nor shall any person taking
out or renewing continuing a policy except any rebate as may be allowed in accordance
with the published prospectuses or tables of the insurer.
2. Any person making default in complying with the provisions of this sections shall be
punishable with fine which may extend to five hundred rupees.
CRADLE CARE INSURANCE POLICY
The policy covers the event of the expectant mother (who is the Insured under this Policy)
delivering a child with defect, deformity / malformation congenital abnormality of any kind
whatsoever.
The policy pays the said amount mentioned in the Schedule if such disorder/deformity manifests
itself within 200 days of the date of delivery of the child or before the date of expiry of this
Policy,
whichever
is
earlier,
provided
however
that
the
said
disorder/deformity/defect/malformation is of congenital nature and such origin.
The compensation as above would not be payable if the defect / deformity /disorder /
malformation be due to any post-delivery complication of whatsoever nature.
The compensation as above would be payable to the Insured or, in case of the death of the
Insured, to her surviving spouse or if such surviving spouse dies before a valid claim under this
Policy becomes payable to the legal heir of the Insured / her legal representative, as the case
may be.

80

EXCLUSIONS:
No compensation under this Policy would be payable in any event in respect of the following: -

Still-born child-whether with deformity or not;

Death of the mother (the Insured)
Miscarriage, Infanticide
Any defect/deformity/disorder/malformation which is not congenital in nature;
Malfunctioning of any organ internal or external as against malformation (for which
alone compensation is payable under this Policy)
Any defect/deformity/malformation/disorder which manifests itself after 200 days of the
delivery of the child or after expiry of the policy period.

GENERAL EXCLUSIONS:

The Company shall not be liable in respect of:

1. Any claim due to deliberate act of the Insured/Spouse or any member of the family /
household of the Insured.
2. Any claim arising out of non-compliance or violation of Medical Advice tendered.
3. Any claim attributable to consumption, intake, inhalation of intoxicating liquor or drug or
anti-depression medication, unless taken under medical advice and supervision
4. Any claim due to any self-injury, suicide attempted suicide.
5. Any claim arising out of Riot, Strike & Civil Commotion.
6. Any claim, whether direct or indirect, occasioned by, happening through or arising from
any consequence of war, invasion, act of foreign enemy, hostilities (whether war be
declared or not) , civil war; rebellion insurrection, revolution, military or usurped power,
or civil commotion in connection therewith
7. Any claim arising out of any contractual liability / consequential loss of any kind or
description
8. Any claim whatsoever directly or indirectly resulting from ionising radiation or
contamination by radio activity by any nuclear fuel or any nuclear waste from the
combustion of nuclear fuel or from any nuclear weapons materials.

81

CRADLE CARE INSURANCE POLICY

SCHEDULE

AGENCY:
Issuing Office:

Policy No:
Date of proposal and Declaration
Statistical code:

PERIOD OF
INS
URA
NCE
From:

INSURED:
Name:
Address :

To:

Name & Address of the Hospital / Nursing

Home / Midwife
SUM INSURED

PREMIUM

Rs.

Rs.
Subject otherwise to the terms, provisions and conditions of the Policy.

IN WITNESS WHEREOF signed by and on behalf of the Company at

this
day of
20

Prepared by:
Examined by:
Authorised Signatory.

82

CLAIM FORM
CRADLE - CARE INSURANCE
(The issue of this form does not constitute admission of liability. Please return this form duly
completed along with necessary certificates.)
POLICY No.
1.
A)
B)
C)

CLAIM NO.

Name of the Insured:

Address:
Occupation:

2. A) Name and address of the mother:

B) Age:
C) Height / Weight:
3.

a)
b)
c)
d)
e)
f)
g)

Date / Year of marriage

Treatment particulars if any during pregnancy to delivery:
Date of delivery:
Place of delivery:
Name and address of the Hospital / Nursing Home:
Name and address of midwife:
Name of the Physician / Surgeon / Gynaecologist
who attended at the time of delivery:

4.

a)
b)
c)
d)

State of health of the mother prior to delivery:

State of health of the mother after delivery:
Health condition of the child after birth:
Nature of the defect / deformity / malformation of the child:

5. a) Was the defect present and observed at the time of delivery itself?
If so give details.
b) If the deformity was, however, not observed at the time of
delivery, please specify following details:
i) When was it first noticed:
ii) Where? (Hospital / Home)
iii) By Whom (Parents / Doctor / any other)
iv) Circumstances under which noticed e.g., at the time of
Medical check-up, treatment for any ailments, after
any accident.

83

6.Date of the earlier advice to the Company about the defect /deformity

I / We hereby declare that the information furnished above is correct in all aspects.

PLACE:

SIGNATURE OF THE INSURED

DATE:

84

PROPERTY INSURANCE

BURGLARY INSURANCE (BUSINESS PREMISES)

SELECTION OF RISKS
This insurance is intended to cover contents of business premises against loss or
damage by burglary and / or house breaking. It also covers damage to premises, caused
by burglars, during the burglary or any attempt thereat if the insured is responsible for
such repairs. The term burglary and / or house breaking are defined in the policy as
theft, involving entry into or exit from the Insured premises by forcible and violent
means. The entry could also follow assault or violence or threat of the same, to the
insured or to his employees or members of his family.
Normally the policy does not cover loss due to theft or shoplifting which in most
trades, is inevitable and must be regarded as not payable. The policy does not cover loss
or damage due to burglary, in which any member of the Insureds family of staff is
concerned as principal or accessory. Any act committed by any person lawfully present in
the premises is also not insured.
Whenever possible, the property to be insured will have to be itemised according
to its nature. The value of the items will have to be inserted in the schedule of the policy
separately. For example :a.

Stocks belonging to the insured and held in trust or on commission for which the
insured is responsible.

b.

Furniture, fixtures and fittings.

c.

Cash, currency or valuables kept in locked standard safe or cash box in locked
steel cupboard.

d.

Other items to be specified.

85

It is desirable for an inspection to be made as to whether the safeguards to prevent

entry into the premises by burglars are satisfactory. If not, further precautions must be
taken. Normally, it is necessary to arrange for completion of an inspection report after
obtaining necessary information. Particular attention must be paid to the following :
a.

Cellar and basement windows and doors.

b.

Glass panelled doors.

c.

Rear ground floor windows and doors.

d.

Windows on other floors which may be accessible from out-houses and adjoining
buildings.
In the case of a change of address during the currency of the policy, it is necessary

for a survey of the new premises to be made in the same way. Subject to security
arrangements being satisfactory, the policy can be endorsed to cover property at the new
address.
There is a general tendency among proposers when effecting burglary insurance to
propose not for the full value but for a reduced value with an idea that burglars are never
likely to steal everything. This of course is generally true. However, in order to obtain
adequate consideration for the risk undertaken by the company, the equitable way is to
insure for to total value of the property at risk. The policy contains the usual condition of
average for each item.
When the insurance includes an amount in respect of cash and/or valuables in safe,
it is necessary to ensure that the insured safe

is

burglar

resistant. When covering

valuables in safe, it is desirable to limit the sum insured in respect of any one article to
5% of the total sum insured or Rs.5000/- whichever is higher. It is also desirable that a
responsible person be in charge of the premises at all times. A watchman should patrol
the premises at night. The policy does not cover loss of contents from the safe caused by
the use of the key to the safe or its duplicate, belonging to the insured unless such key to
the safe or its duplicate, is obtained by violence or threat to use-violence. Further a

86

complete list of the contents in the safe should be kept/maintained. The liability of the
Company is limited to the amount shown by such a record. This should not exceed the
sum insured. All keys and duplicates should be removed from the premises at night and
all other times when the premises are closed for business.
It is essential that the stocks and sales books are kept upto date so that the insured
may be in a position to prove the quantum of loss if a claim should arise.
It is possible to consider extending this insurance to cover theft risks in
exceptional cases on payment of additional premium. This extension will however be
subject to a deductible/ excess. Moreover, granting this extension would require prior
approval of the controlling office.
SCOPE OF THE POLICY:
The policy covers the contents contained within the premises mentioned in the
policy schedule against loss or damage by burglary and/or house breaking. It extends to
cover any damage to the said premised by the risks insured that should be made good by
the insurer. The burglary policy can be extended to cover theft on payment of additional
premium.
EXCLUSIONS :
The policy does not cover loss or damage to or arising from or occasioned by:
a.

War, warlike operation etc. Civil War, Mutiny, Rebellion, Revolution, Insurance,
Riot, Strike, Civil Commotion or Loot, confiscation or Detention by the order of
any Government or Public Authorities, Flood, Hurricane, Subterranean Fire,
Earthquake and other similar convulsions of Nature and atmospheric disturbance.

b.

By any of the insureds family or employees or any person lawfully in the

premises. Or where such loss or damage has been expedited or in any way assisted

87

or brought about by any inmate or member of such household staff as principal or

accessory.
c.

Losses that the recoverable under fire or plate glass insurance policy.

d.

Goods held in trust or on commission or gold or silver articles, watches, jewellery,

precious stones, medals, coins, curios, furs, sculptures, manuscripts, rare books,
plans, patterns, models, moulds, designs, deeds, bonds, bills of exchange,
promissory notes, money or securities for money, stamps or stamp collections,
documents of title to property or business books unless specifically insured.

e.

Loss of money and / or other property abstracted from safe following use of the
key to the said safe or any duplicate thereof belonging to the insured unless such
key has been obtained by assault or violence or any threat.

f.
g.

Nuclear risks.
i.

If there be any material alterations in the premises where by the

risk is increased.

ii.

If the interest of the insured in the property is passed on to others, otherwise

than by will or operation of law.

h.

Loss arising from ioinsing radiation or contamination by radio activity from any
source or any consequential loss / legal liability arising out of it.
i.

If the premises is left unoccupied for more than seven days consecutively.

CONDITIONS:
1.

REINSTATEMENT OF

SUM

INSURED:

No

provision

for

automatic

reinstatement of sum insured following payment of claim. The reduced sum

insured may be reinstated at Insureds option and with the consent of the Insurer.

88

2.

Maintenance of Books and Keys: The Insured shall keep a daily record of the
amount of cash contained in the strong room/safe and such record shall be
deposited in a secure place and produced as documentary evidence in support of a
claim under this policy. The keys of the strong room/safe shall not be left on the
office premises out of business hours unless the premises are occupied by the
Insured
CONDITION OF AVERAGE: Condition of average for full value policies and

condition of partial average for first loss policies

UNDERWRITING CONSIDERATIONS :
While underwriting proposals for burglary insurance, special attention will have to
be paid to two factors which make the premises vulnerable to burglars :
1.

Nature of property i.e. whether it is valuable in relation to its bulk or whether it

may be disposed off easily.

2.

Ease with which the property can be removed i.e. whether the premises are well
protected with locks; bolts and other security measurers, and whether the premises
are always patrolled by watchman.

3.

Whether the risk is a locked out /closed premises or silent risk

4.

Material of construction of building

5.

Security arrangements at premises

Full investigation must be made in all cases where there is a history of previous

entry into the premises by burglars, in addition to ascertaining the method of entry. It is
necessary to ascertain what precautions have been taken with a view to preventing
recurrence. It may be necessary to impose terms depending upon individual
circumstances.

89

PREMIUM RATE :
The following are some of the important factors which weigh while rating
proposals under this category :
1.

Whether in respect of cash / or valuable in locked deposit vaults / strong

rooms of banks, extension is required to cover cash in till and / or counter.

2.

Whether security arrangement including a watchman are available on a 24

hours basis.

3.

The nature of construction of the building in which the contents proposed

for insurance are kept. Similarly risks in a secluded area, risks in an interior
place, risks in the open with fencing only, risks in an unoccupied building,
risks in a locality prone to burglary etc. will call for suitable loading in the
premium. Extension of insurance cover to include theft risks is to be
considered carefully with suitable additional premium and excess.

4.

In the event of settlement of a claim the sum insured will be reduced to the
extent of the settlement unless reinstated.

1.

TYPES OF POLICIES :Policies for standard cover with the amount of insurance specified for different

items proposed for insurance, poses no problem and can be issued in the Companys
printed policy form with the amounts specified against each item.
2.

FIRST LOSS POLICY :In case where bulk and heavier stocks are to be covered insurance on full value

basis need not be arranged.

Here a First Loss Policy may be issued. Under this policy,

the sum insured may not be less than 10% of the total amount. This may be reduced in
individual cases. The condition of average is modified, as applicable to the percentage

90

chosen of the amount at risk. This amount is the maximum liability of the Company. The
premium for this insurance will be the basic premium for the first loss amount, plus an
additional premium based on a percentage of the premium rate so charged. This
additional premium will be calculated on the balance of the aggregate amount.
3.

DECLARATION POLICY :In case of insurance of fluctuating stocks, a declaration policy can be suggested on

similar lines as in the case of corresponding fire policies. The declaration policies will
have to be approved by Regional Offices. Deposit premium of 100% of the annual has to
be submitted before the inception of risk.
DETERMINATION OF VALUES TO BE INSURED:
Full value Insurance:
The sum insured should be fixed on current market prices for stocks. For other
items such as furniture, fixtures, equipment etc, the SI can either be on the market value
(New replacement cost less depreciation) or on reinstatement value basis. To cover
fluctuating stocks at one place or at many places or variations due to seasonality, Floater
Declaration policies can be issued.
Rating Schedule - Burglary (Business Premises) Policy
Taking into account the relevant factors, the suggested premium rates for first class
proposals in major cities may be indicated as under :Stock in trade or goods in custody of Insured :
a)

Cash/Valuables kept in locked deposit vaults/strong rooms of banks/

safe deposits

b)

0.125%

Vulnerable goods like curios, liquors, metals, motor vehicle parts, pens, radios,
readymade garments, Electronic gadgets, wrist watches etc.,

91

0.30%

c)

Other general goods

0.15%

d)

Heavy stock like machinery and other bulky goods 0.05%

Heterogeneous stock will have only one overall rate applied, keeping in mind the

proportion of the various types of goods constituting the mix.

B)

Furniture Fixtures Fittings, utensils and appliances of trade.

a)

More portable and valuable appliances of trade etc.,0.10%

b)

Goods of general type 0.05% Intention is not to apply different rates for the same
insured, but to rate according to preponderance of bulky or portable items.

C)

Cash and / or Valuables

In locked deposit vaults / strong room in Banks.

0.125%

Locked standard Burglar resistance safes.

0.15%

Locked cash book is locked cup - board.

0.15%

Minimum Premium for Burglary Policy is Rs.50/Large Risks : If Sum Insured exceeds Rs.10 Lakhs in any one locations or for one
client the rates may be scaled down on merits up to 25%. If probability of loss of entire
property is very low, First Loss policy may be suggested.
One watchman on 24 hours, basis would merit a scaling down of rates upto 10%
Inferior risks : Rates suggested can be increased by up to 50% for inferior risks
like buildings of poor construction, risks in secluded area, unoccupied buildings, locality
prone to burglary, lack of watchman, etc.,
Risk in open compound : Load premium by 50%. Excess not below 0.25% of Sum
Insured to be imposed.

92

LIMITS OF ACCEPTANCE :
The Branches and Divisions are authorised to accept recommended proposals upto
Rs. 125 lakhs and 250 lakhs respectively. In respect of a single location if the S.I. exceeds
Rs. 125 lakhs / Rs. 250 lakhs respectively BO / DO should send LR advice to RUC. RO.
Proposals for furriers, jewelers, watch makers and dealers, Gold and Silversmiths,
Dealers in precious stones, Curios, antiques, money lenders, pawnbrokers should not be
considered under any circumstances without reference to HO.

CLAIMS PROCEDURES
Claim

form,

FIR,

Final

Police

Investigation report, Legal Opinion (if required)

93

Report,

Survey

Report,

Internal

TRAVELLERS BAGGAGE INSURANCE

SELECTION OF RISKS
This insurance is intended to cover accompanied baggage (not dealers stock or
travellers samples) during a specified journey (including Air travel by recognised
Airlines), undertaken by the insured. The baggage is covered whilst in transit with
passenger under his ticket. It can also be covered as luggage under that ticket. However,
luggage sent separately under a Bill of lading, Air Way bill, Railway Receipt, Lorry
Receipt or other Consignment Note, is excluded. Further the insurance will not be
extended to any article which did not form part of the contents of the packages when the
journey started unless such an article is specifically declared and insured. The full
description of the accompanied baggage will have to be obtained (i.e.) travelling suitcase,
dressing bag and trunk, hold all etc. Where articles of special value like jewellery or
ornaments are required to be covered, full particulars will have to be obtained, as in the
case of All Risks insurance. The contents of each bag must be described. All the items the
traveller carries during the journey, except those that are specifically excluded, will have
to be insured. The property belonging not only to the proposer but also to the family
members travelling with him can be insured. Items left unattended cannot be covered
under the policy.
Only the contents of baggage are covered. If the container, namely, the suitcase is
to be covered, its value is to be declared and included in the sum insured. Otherwise,
when the entire contents of the baggage including the suitcase is lost, the claim can not be
paid for the suitcase.
The proposal form must be recommended, after scrutiny for acceptance by the
concerned Development Officer.

94

The proposer is required to declare the mode of transport, route and places he
intends visiting. The insurance does not extend to cover cash, securities, travel tickets,
loose articles like umbrellas and other properties

in actual use or worn by the persons

during the journey.

This insurance is also subject to the usual condition of Average for each item.
SCOPE OF COVER :
The policy provides cover against loss of or damage to accompanied personal
baggage of the Insured or Insureds family members due to

fire, riot and strike,

terrorist activity or theft or accident during the course of journey including stoppages en
route anywhere in India.
EXCLUSIONS
The policy does not cover loss or damage to or arising from or occasioned by
a.

Routine travel

b.

War, warlike operation etc., or civil commotion or loot, confiscation or detention

by the order of any Government or Public Authority.

c.

Cracking, scratching or breakage of the glass, crockery, cameras, binoculars,

lenses, sculptures, curios, pictures, musical instruments, sports gears, or other
similar articles of brittle or fragile nature, unless such losses or damages arise from
accident to vessel, vehicle or air craft by which the property is conveyed.

d.

Depreciation, wear and tear, moth, vermin or any process of cleaning, dyeing,
repairing or restoring to which the property is subjected.

e.

Loss or damage caused to any electrical machine or fittings.

f.

Mechanical derangement or over winding of watches.

95

g.

Money, securities, manuscripts, business books or documents, jewellery, watches,

furs, precious metals precious

stones, gold and silver ornaments. Pair and set

clause (See All Risks)

h.

Theft from car except from car of fully enclosed saloon type having all the doors,
windows and other openings securely locked and properly fastened.

i.

Consequential loss or legal liability of any kind or description.

j.

Articles which did not form part of the contents of any of the packages, when
the

journey

commenced,

unless specifically declared and accepted by the

Company.
k.

Articles of consumable nature.

l.

Any property whilst being conveyed by any carrier under contract of affreighment.

m.

Nuclear risks.

UNDERWRITING CONSIDERATIONS :
This policy also, like the All Risks Policy, provides very wide coverage. Hence the
moral hazard aspect has to be carefully gone into before acceptance. This cover should be
given only on an accommodation basis, provided the client gives substantial profitable
business in other departments.
Travellers Samples, Testing Equipment and Dealers stock can be included subject
to conditions
PREMIUM RATE :
The following aspects will have to be looked into before quoting a rate.

96

1.

Whether the, baggage included jewellery and valuables. If so, such items are to be
specifically declared for insurance.

2.

Whether the journey extends out of India.

3.

The period of journey.

Suggested rates are :

Journey upto 1 month

0.20%

Journey upto 1 1/2month -

0.25%

Journey 3 months

0.35%

Journey upto 6 months

0.60%

Journey upto 12 months

0.75%

Minimum premium Rs.30/CARE OF PROPERTY INSURED :

It is necessary to specifically draw the insureds attention to the condition of the
policy under which he is required to take all reasonable care to safeguard the property.
LIMITS OF ACCEPTANCE :
The Acceptance limit for Branch Office in nil. The level of acceptance for D.O.
is Rs. 10 lacs. All proposals are to be referred to respective D.O/s by Branches for rating
and acceptance. Any proposal exceeding 10 lakhs should be advised to RO. RUC by
sending large risk Advice.

97

ALL RISKS INSURANCE (JEWELLERY & VALUABLES)

SELECTION OF RISKS
This insurance is intended to cover Gold and Silver ornaments, cameras, watches,
personal jewellery, Cell Phones, Laptops, Calculators and other such valuables. They are
covered whilst at any location within the geographical limits specified in the policy,
against loss or damage by fire, accident, theft or misfortune. The cover provided by the
policy is wide enough to include losses about which the company may have to rely to a
large extent on the insured himself. Therefore, the moral hazard is of utmost importance.
Proposals will have to be entertained from persons who are known to, or who have been
reliably recommended to the company, or whose bonafides are beyond any doubt.
All valuables proposed for insurance will have to be individually described in the
proposal form to permit identification and the sum insured against each item stated. The
cover is normally restricted to India only. But if cover outside India is necessary, it should
be indicated in the proposal form.
The jewellery items should have been recently examined and valued by an
approved valuer and a copy of the valuation certificate should be attached to the proposal
form. It is desirable to obtain from the insured, proof of the value stated (purchase receipt
or jewellers valuations). However, please advise the client that the sum insured so stated,
is not to be regarded as the agreed amount payable in the event of total loss. This is
because in such an event, the amount payable will not be more than the proportionate
value of the particular part damaged or lost. The special value that such articles may have
as, part of such pair or set cannot be considered. So far as clothing, personal

and

household effects are concerned, no article other than furniture will be admitted to be of
greater value than 5% of the sum insured unless otherwise specified.
This insurance is also subject to the usual condition of average for each item..

98

SCOPE OF THE POLICY :

The policy covers the property in the house, office, hotel, road or elsewhere within
the geographical limits specified in the policy.
EXCLUSIONS
The policy does not cover loss or damage to or arising from
a.

War, warlike operation etc. or civil commotion or loot or confiscation or

detention by order of any Government or Public Authority.

b.

Cracking, scratching or breakage of glass and other articles of brittle or

fragile nature unless such loss or damage arises from accident to vessel,
train, vehicle or aircraft by which such property is being conveyed.

c.

Depreciation, wear and tear, moth, mildew, vermin or any process of

cleaning, dyeing, repairing or restoring to which the property is subjected.

d.

To any electrical machine or to any portion of electrical installation arising

from or occasioned by overrunning etc.

e.

Mechanical derangement or over-winding of watches and clocks.

f.

Money, securities, manuscripts, business books or documents.

g.

Theft from car except from car of fully enclosed saloon type, having all the
doors, windows and other openings securely locked and properly fastened.

h.
i.
j.

Consequential loss or legal liability of any kind or description.

Articles of consumable nature.
Loss of or damage to any property whilst being conveyed by any carrier
under contract.

k.

Nuclear risks.

99

UNDERWRITING CONSIDERATIONS
The policy in view of its wide coverage should be given only to valued clients who
have all their other classes of business placed with us. The Underwriting Office should
exercise great care in accepting such proposals. The aspect of moral hazard must be fully
examined. Proposals from unknown persons, dealers of stock, moneylenders,
pawnbrokers etc. should not be accepted for All Risks Cover. They may be referred to the
Controlling Office.
Rating for this insurance would depend on the amount proposed for insurance and
whether the geographical limits require extension beyond the insureds country of
residence. It may be noted that riot and strike risks are covered in the basic cover. No
extra need be charged. The suggested rate is one percent.
CARE OF PROPERTY INSURED
In view of the type of articles insured under the policy, it is necessary to advise the
insured to take all reason able care to safeguard the items. Where jewellery is concerned,
the insured is expected to have the items examined at reasonable intervals by competent
jewellers. He should have all attachments, fastenings and stone settings, attended to as
advised by the jeweller.
Items suggested against coverage
China and glassware
Musical Instruments
Apparel/Gloves/scarves
Tennis/badminton Racquet/Cricket bats/sports goods/Golf clubs/Fishing rods
Cameras used by Press/cinematograph, professional photographers/ videographers

100

PAIR AND SET CLAUSE :

Valuables are often bough as a pair or set and the loss or damage to one item may make
it difficult to replace in such a way as to match the undamaged part of the pair or set. The
insured may like to replace the pair or set entirely, but the liability of the insurer is only
for the lost or damaged item, limited to a proportionate part of the insured value of the
pair or set.

LIMITS OF ACCEPTANCE :
The Branches and Divisions are authorised to accept recommended proposals up
to the following limits.
Branch Nil
Division Rs. 10 Lakhs.
In case the proposal exceeds these limits, it is necessary to secure approval from
the controlling office before intimating acceptance.
Rate: It is usual to quote a rate of 1 % for Section A of the cover.
In respect of jewellery and valuables which are in Bank lockers, we can grant a
reduced rate not below 0.25%.
In respect of valuables like cameras, binoculars etc., a slightly reduced rate, not
below 0.80% may be charged. Works of art, curios, antiques etc., would call for a
minimum rate of 1%.

101

CLAIMS PROCEDURE AND DOCUMENTS REQUIRED IN SUPPORT OF

CLAIMS:1.

The loss should have been reported to the nearest Police Station. F.I.R. has
to be obtained.

2.

Claims up to Rs.2,500/- may be settled on the basis of the completed claim

form provided the settling authority is satisfied about the genuineness of the
Claim.

3.

Claims exceeding Rs.2,500/- should be settled on the basis of a final investigation

report from the Police.

102

MONEY - IN - TRANSIT INSURANCE

SELECTION OF RISK :
This Insurance is intended for industrial, manufacturing and business concerns that
periodically draw from banks or other sources large sums of money for payment of
salaries and for other day-to-day transactions. This cover provides an indemnity in
respect of loss of money carried by authorised messengers while in transit from one place
to another, specified in the policy. The Insurance is intended to cover the money in actual
transit i.e. from the time the money is taken out at one place until it is delivered at the
other place. When money drawn for any reason is not paid on the day it is drawn, the
risks can be covered against Burglary and/or House Breaking Risks, robbery or hold up
provided it is retained in a locked standard burglar resistant safe or strong room in the
insureds premises.
The premium is charged on the basis of estimated total carryings during the period
of Insurance. The sum insured should represent the estimated annual turnover, which
should not be lesser than the previous years turnover of money in transit plus 15%. The
Insured has the option of increasing the sum insured as and when required during the
currency of the policy. If at the time of loss, it is found that the actual money in transit has
exceeded the sum insured under the policy, no liability can attach. However, this does not
apply to cash kept in the premises during business hours.
The Insurance under the policy can also be extended to cover money collected by
employees from the time of collection during rounds, until it is delivered at the insureds
premises or at the premises of any of their bankers on the day of collection. It is also
possible to extend the Insurance against burglary and/or house breaking risks, while the
money is retained overnight by such employees in any locked steel cupboard at their
residence. This may happen if employees are unable to deliver the money at the insureds
premises or bank on the day of collection. Authority from the controlling office is
necessary before confirming this extension.

103

It is possible to extend the cover when money is carried by persons other than the
insureds employees namely Insured/Proprietor himself or Partners/Directors of the
Insured Firm by charging an additional premium of 10%. When more than one Firm
operates from one premises, there is a possibility of one firm being engaged for carrying
cash belonging to other firms between the office premises and the Bank. If the cover for
such contingency is required such extension can be granted by attaching necessary
endorsement at a further premium of 10%. It is made clear that the insured should
maintain proper records of all such transactions.
The money in transit policy covers specified transits for specific purposes only.
The transits could be for wages, salaries disbursements, or any money transited for
specific purposes only.
In case cover is sought for transits other that those specified in the printed policy
schedule, these have to be specifically included in the schedule clearly mentioning the
transits covered. If necessary, additional premium may be charged depending on the
nature of transit eg collection of cash from all collection centres as this involves
additional risks.
SCOPE OF POLICY
The policy indemnifies the insured in the event of the money carried by the
Insured or by the insureds authorised employees, being lost by robbery or theft or any
other fortuitous cause whilst in transit. It also extends to cover the money while it is
retained in a safe or strong room in the premises against burglary and / or house breaking,
Robbery or hold up.
The term money shall mean and include cash, bank drafts, currency notes,
cheques, postal orders and money orders and current postal stamps.
The Development Officer has to give his recommendations for acceptance of the
proposal.

104

The cash is covered under Section I as detailed below :SECTION I :

A.

Money for the payment of wages, salaries etc or for petty cash
in direct transit from the bank to the Insureds premises from
the time the Cash is received at the bank by the Insured or
the authorised employees of the Insured until delivered at the
premises or other place of disbursement and whilst there until
paid out provided that out of business hours, such Cash shall
be secured in locked Safe or locked strong room on the
premises. Cheques drawn by the Insured to provide for such
Cash and covered in transit from the premises to the bank.

B.

Money other than described in A. above in the personal

custody of the Insured or the authorised employee/s of the
Insured whilst in direct transit between the premises and the
bank or post office.

C.

Money other than described in A and B above collected by

and in the personal custody of the Insured or the authorised
employee/s of the Insured whilst in transit to the premises or
bank within a period not exceeding 48 hours from the time of
collection.

SECTION II :

Cash

(other

than

described

in

Section

(IA) above

whilst in the premises during business hours or whilst secured

in locked safe or locked strong room in the Insureds premises
out of business hours against the risk of burglary, house
breaking and hold - up.

105

EXCLUSIONS :

The Company shall not be liable in respect of :

1.

Shortage due to error or omission.

2.

Loss of money entrusted to any person other than the

Insured or anauthorised employee of the Insured.

3.

Loss of money where the Insured or his employee is

involved as principal or accessory, except loss due to
fraud or dishonesty of the cash carrying employee of
the Insured, occurring whilst in transit and discovered
within 48 hours.

4.

Loss occurring on the premises, after business hours,

unless the money is in a locked safe or strong room.

5.

Loss occasioned by Riot, Strike and Terrorist Activity.

6.

Money carried under contract of affreightment and

theft of money from unattended vehicle.

7.

Loss of money from safe or strong room following use

of the key to the safe or strong room or any duplicate
thereof belonging to the Insured, unless this has been
obtained by threat or by violence.

8.

Loss or damage whether direct or indirect arising from

War, Warlike operation, Act of Foreign enemy,
Hostilities (whether War be declared or not) Civil War,
Rebellion, Insurrection, Civil Commotion, Military or
Usurped Power, Seizure, Capture, Confiscation, Arrest,
Restraints and Detainment by the order of any

106

Government or any other authority. In any action suit

or other proceedings where the Company alleges that
by reason of the above reasons any loss or damage is
not covered by this insurance, the burden of proving
that such loss or damage is covered, shall be upon the
Insured.
a)

Any Loss, destruction or damage, to any property

whatsoever or any loss or expenses whatsoever,
resulting or arising there from or any consequential
loss, and, any legal liability of whatsoever nature,
directly or indirectly caused by or contributed, by or
arising from ionising radiation or contamination by
radioactivity, from any cause whatsoever.

b)

Any Loss, destruction, damage or legal liability directly

or indirectly cause by or contributed to, by arising
from Nuclear Weapons material.

9.

Consequential loss or legal liability of any kind.

10.

Loss or damage due to or contributed to by the Insured

having caused or suffered anything to be done whereby
the risks hereby insured against were unnecessarily
increased.

107

UNDERWRITING CONSIDERATIONS:
Here, the moral hazard is important. The proposals will therefore, have to be
considered from business firms of repute only. The Development Officer has to give his
recommendations for acceptance of the proposal. Proposal from firms or individuals of
unsound financial position, transit involving long distance through uninhabited localities,
unusually large limits per sending as compared with total annual carryings, money
lenders and pawn brokers are not considered satisfactory risks. Hence they should be
referred to the Controlling Office before intimation of acceptance.
The Completed proposal form has to be examined to arrive at a proper assessment
of the physical hazard involved with particular reference to :
a.

Maximum distance between the two places of transit and the nature of
routes to be followed.

b.

Character of the neighbourhood.

c.

Manner in which the money is carried - whether one or more messengers,

whether on foot or public conveyance or in insureds own motorised
transport, whether accompanied by armed guards carrying fire arm, length
of service of messengers entrusted with the carryings.

d.

Maximum amount carried at any one time.

e.

Total estimated annual carryings.

108

PREMIUM RATE :
RATING SCHEDULE
The underwriter must use his skill and discretion to rate money policies. As a
guideline, we may say that for a standard risk, the minimum rates could be as follows:
Basic premium to be calculated on estimated total annual carryings at 0.15%
subject to a minimum premium of Rs.30/- for a single carrying limit (sum insured) not
exceeding Rs.50,000/Suitable adjustments can be made as under:
a)

Where armed guards carrying firm arms accompany carryings above

Rs.10,000/- the rate may be scaled, down by 20%.

b.

Where (single carrying limit) sum insured exceeds Rs.50,000/- the rate is to
be increased by 5% for every Rs.50,000/- or part thereof. For carrying
limits above Rs.5,00,000/-, refer Regional Office and for carrying limits
exceeding Rs.25,00,000/-, refer Head Office.

c.

For carryings on foot or by non-motorised transport, load by 20%.

d.

For carryings by insureds own motorised transport, scale down by 10%.

e.

For large annual carryings say Rs.500 lakhs and over, special rates may be
quoted by Head Office.

f.

For increased sum insured on specific dates, 0.01 (per mille) should be
charged per day. In no case shall the total number of such days when
increased sum insured operates, exceed 30 days in a year.

g.

For extension to infidelity of messengers carrying, cash rate to be increase

by 10%.

h)

Overnight keeping of cash in excess of 48 hrs. Rate to be increased by 10%

in case of Burglar proof safes, and 20% in other cases.

109

i)

Money in till and or counter during working hours - rate to be increased by

100%.

j)

Extension of Riot & Strike risk - rate to be increased by 20%.

The basic rate will have to be adjusted in respect of the following features
1.

Provision of armed guards accompanying the carrying. The rate could be

scaled down if such provision is available.

2.

The particulars of transit, whether it is within two cities / towns within the
same district, all cities / towns within the same district, all cities / towns
within the same state or all cities / towns in the country. A percentage
loading on a graded scale may have to be made depending on the distance
involved.

3.

If the limit per carrying is large, an increase in the rating could be called for.

4.

The mode of transit whether on foot or non-motorised transport will call for
an increase in the rate.

5.

The cover under the Insurance policy can be extended in respect of the
following additional risks:
a.

Infidelity of the messenger carrying cash.

b.

Strike and riot risks.

c.

Overnight keeping of monies in the premises in locked standard

burglar - resistance safe in excess of 48 hours.

Each of the above additional perils will call for a loading on the basic rate.

110

Where the Insured is carrying the money in connection with his business, the cover
can be granted by charging an additional premium of 10% of the basic premium.

The

policy has to be suitably endorsed.

Additional premium for covering the risk of terrorism will be at 0.05 per mille.
This rate shall be charged on single carrying limit. In the event of a claim sum insured
has to be reinstated charging the above rate on pro-rata sum insured basis.
OCCASIONAL LARGE CARRYINGS: Where the insured requires cover for huge amounts for short periods much in
excess of the limit per carrying under a regular policy, the following procedure is to be
adopted :The following extra premium may be charged :Upto Rs. 10 lakhs

0.10%

Next Rs. 5 lakhs

0.11%

Next Rs. 10 lakhs

0.12%

Next Rs. 25 lakhs

0.13%

The above rates will have to be charged for maximum period of 3 days on the
amount carried in excess of the basic limit given in the policy. If the cover is required for
more than 3 days, 35% of these rates can be charged for each days accumulation.
LIMIT OF ACCEPTANCE :
The Branches / DOs respectively are authorised to accept recommended proposals
with the limit of Rs.31.25/62.5 lakhs in respect of any one carrying.

Proposals

exceeding the above limits or wider transit will have to be referred to the controlling
office before acceptance. LR. Advice has to be sent for risks having limit per sending in
excess of the limits indicated above.

111

CLAIMS PROCEDURE :
1.

The loss should have been reported to the nearest Police Station. FIR has to
be obtained.

2.

Claims up to Rs.2,500/- may be settled on the basis of the completed claim

form provided the settling authority is satisfied about the genuineness of the
Claim.

3.

Claims exceeding Rs.2,500/- should be settled on the basis of a final

investigation report from the Police.

4.

Where necessary an independent investigator may be appointed.

5.

Subrogation / Indemnity letter from the insured has to be obtained.

6.

The settlement should be reported to the Police with a request for

reimbursement of any recovery made to us.

Note : Where the Final Report from police is delayed for long time, it may be waived
where surveyor / investigator has not raised any doubt as to the cause and quantity of
loss.

112

PLATE GLASS INSURANCE

SELECTION OF RISKS :
Today most of the new buildings have huge plate glass in place of walls, glass
doors, windows etc and also huge display windows made of glass.
This insurance is intended to cover fixed plate glass generally in business
premises, against loss or damage by breakage. The Company will pay or make good the
value of such glass up to the value specified in the schedule of the policy. The insurance
cannot be extended for glass that is not fixed i.e. which might be loose or movable in the
premises.
The word breakage will not include disfiguration or damage other than fracture
extending through the entire thickness of the glass if the glass proposed for insurance is
not plain or of ordinary glazing, special mention will have to be in the proposal form. For
example, embossing, silvering, lettering, bending, curve or ornamental work of any kind
should be mentioned.
SCOPE OF POLICY :
The policy indemnities the insured in respect of breakage of the glass by any cause
specified in the schedule.
EXCLUSIONS:
The policy does not cover loss or damage arising from or occasioned by
a.

Fire, explosion, gas heat, war, war-like operations, riot and strike, loot, pillage,
flood, storm, earthquake and kindred perils.

b.

During removal or alteration or repairs on or about the building where the glass is
situated.

113

c.

Breakage of lettering unaccompanied by breakage or damage of glass.

d.

Breakage of or damage to frames or frame work of any description unless

specifically declared.

e.

Disfiguration or scratching or damage of glass, other than fracture extending

through the entire thickness of glass.

f.

Embossed silvered, lettered, ornamental curve or any glass whatsoever, other than
plain and/or ordinary glass quality unless specially declared.

g.

Breakage of glass not completely and securely fixed.

h.

Consequential loss

i.

Nuclear Risks.

UNDERWRITING CONSIDERATIONS:
While rating proposals for this insurance, the following aspects will have to be
considered: 1.

The placement and the position of the glass - whether the premises is in a
corner- which will expose the glass to more frequent damage. What is the
height of the building? If the glass is forming part of the first second third
floors of the building, it is more prone to accidents following riot strike etc.
If the glass is situated at higher level, it is much safer to insure this risk.
However, Glass at these heights is prone to weather related perils also.

2.

Whether the glass is ornamental or plain.

3.

Whether the glass is a sign plate.

4.

Glasses fixed in cinema theatres and such other public buildings, will attract
a higher rate.

114

CARE OF PROPERTY INSURED :

It is desirable to specifically draw the insureds attention to the condition of the
policy under which he is required to afford all reasonable protection to safeguard the
glass.
LIMITS :
The Branches and Divisions are authorised to accept recommended proposals up
to the following limits:BRANCHES / DIVISIONS
Rs.5,00,000/- per risk / 10,00,000 per risk
Proposals from empty shops, greenhouses, conservatories, unprotected glass, risks
in notoriously trouble prone areas or poor class districts, glass fixed in the premises in
course of construction or alteration must be submitted to the controlling office before
intimating acceptance.

Conditions:
Reasonable care: Insured shall take ordinary and reasonable precautions for the
safety of the property insured
Condition of Average: If the actual value of the Insured property at the time of loss
is found to be greater than the sum insured, then the claim will be reduced
proportionately

115

TELEVISION INSURANCE
SELECTION OF RISKS
This insurance covers Television Apparatus against accidental loss or damage
including fire, flood, short circuiting and hurricane, bursting and over-flowing of water
tanks, theft, riot and strike, earthquake (fire and shock risks), terrorism burglary etc. This
covers, sums for which the insured may become liable to pay in respect of liability from
accidents caused by or through such apparatus subject to a limit of Rs.25,000/-, The
Company will in addition reimburse all costs and expenses incurred with its written
consent for defending such claims for compensation. This insurance also indemnifies the
Insured for breakage or collapse of aerial fittings or mast of the apparatus (so far as such
property is not otherwise Insured) subject to a limit of Rs.2,000/-

SCOPE OF POLICY :
The Company will pay the Insured the value at the time of happening of such a
loss, or the amount of liability incurred, subject to limits indicated.
EXCLUSIONS :
The policy does not cover loss or damage arising from or occasioned by
a.

War, Warlike operation, civil commotion or loot or pillage in connection

with or detention by the order of any Government or Public Authority.

b.

Theft of parts or Antennae unless the apparatus itself is stolen at the same
time.

c.

Erection, repairing or dismantling of the apparatus.

116

d.

Consequential loss, depreciation, wear and tear failure or breakage or

damage caused by normal atmospheric condition.

e.

Liability assumed by the Insured by agreement unless such liability would

have attached to the insured not withstanding such agreement.

f.

Nuclear Risks.

The premium rate suggested is 1 % for the normal use of the apparatus for
personal purpose. VCRs used in the household also can be covered under the policy,
charging the same rate. However full description of the VCR should be given in the
Schedule. The loss or damage to the cassettes is specifically excluded under the policy.
When TV/VCR are given for hire or reward the rate of premium applicable will be
2% and the policy will be subject to an excess of Rs.1000/- for each and every loss.
For the TV/VCR s given for hire or reward the policy will cover the

loss or

damage to the Apparatus whilst in transit from the premises of the Insured to the place of
the customer and vice-versa. However if the transit is under contract of affreighment, it is
not deemed to be covered under the policy.
Minimum Premium - Rs.50/-.
Documents for claim settlement:
Claim form, Bills, FIR, survey report, legal opinion

117

PEDAL CYCLE INSURANCE

SELECTION OF RISKS :
This insurance is intended to cover Pedal Cycle against loss or damage by
accidental means, Fire, Theft. Insureds legal liability or bodily injury or damage to
property of third parties is also covered. The Company will, in addition, reimburse all
costs and expenses incurred with its written consent, in resisting Third Party liability
claims.
SCOPE OF POLICY
1.

The Company will indemnify against

a.

Insureds legal liability for bodily injury to any person;

b.

Damage to property.

In both cases the third party must not be a member of the insureds family or
employee. He should not also be riding the pedal cycle as a pillion passenger. The cover
operates in India. The Insured will be
indemnified for a maximum sum of Rs.10,000/-. This is for any one accident or series of
accidents arising out of one event.
2.

Loss or damage to any such Pedal cycle while in India by

a.

Accidental external means.

b.

Fire, lightning or external explosion.

c.

Burglary, housebreaking or theft.

d.

Riot, Strike and Malicious act.

The Company will in addition, pay all reasonable expenses incurred with its
consent where legal proceedings have been defended for which the Insured may liable.

118

EXCLUSIONS :
The policy does not cover loss or damage to or arising from or occasioned by:
a.

War, Warlike operations etc. Civil Commotion, Loot, Pillage in connection

therewith, Confiscation or detention by the order of any Government or
Public Authority, Earthquake, volcanic eruption, Flood, Storm, Tempest,
Typhoon, Hurricane, Tornado, Cyclone and other similar convulsions of
nature and atmospheric disturbances.

b.

Damage caused by overloading or strain or mechanical breakdown.

c.

Theft of accessories unless the Pedal Cycle itself is stolen at the same time.

d.

If the Pedal Cycle is used for hire or reward or outside India or for racing or
pace making.

e.

Consequential loss, Wear and Tear.

f.

Nuclear Risks.

UNDERWRITING CONSIDERATIONS
It is not advisable to grant comprehensive cover in respect of old vehicles i.e.,
more than 5 years old. A deductible excess ofRs.15/-will be applicable in respect of the
accidental damage portion of the comprehensive cover. It will be a condition of the
Insurance that the cycle will be secured with proper pad lock and chain when left
unattended or not in use.
PREMIUM RATES :
The rate of premium will depend on whether the Insurance is required on
Comprehensive terms or only to cover liability to Public and total loss due to fire & Theft
risks only.
The suggested rates are as follows:

119

For the own damage portion to cover the cycle Minimum 7.5% of the value of the
cycle (Sum Insured)
For third party risks Rs.10/-For theft and third party risks-5% of the value of
the cycle (Sum Insured)
It is permissible to allow a fleet discount for number of cycles insured.

120

CYCLE RICKSHAW INSURANCE

SELECTION OF RISKS :
This is intended to cover cycle rickshaws against loss or damage by accidental
external means, fire, theft and also legal liability for bodily injury or damage to property
of third party and passengers and their goods.
Comprehensive cover cannot be granted in respect of vehicles more than 5 years
old.
SCOPE OF COVER:
Loss or damage to the vehicle against
1.

a.

Accidental external means.

b.

Fire, lightning or external explosion.

c.

Burglary, house breaking and theft

d.

Malicious damage, riot and strike.

Insureds legal liability for bodily injury to any person or damage to

property - limit Rs.10,000/- per any one accident or series of accidents
arising out of one event.

3.

Legal liability for injury or death of passengers or loss or damage to

property- limit Rs.10,000/- for 2 passengers at Rs.5,000/- each.

4.
5.

Rs.500/- for damage to the goods.

Cost of legal expense incurred with the companys consent will
also be reimbursed.

121

EXCLUSIONS :
1.

First Rs.25/- in respect of accidental damage portion.

2.

Loss or damage by overloading, strain or mechanical breakdown.

3.

Theft of accessories unless the vehicle itself is stolen.

4.

Consequential losses, wear and tear, depreciation.

5.

Any loss or damage when the vehicle is used for speed testing or racing or
pace making.

6.

War perils and nuclear perils.

7.

Storm, tempest, flood, hurricane earthquake and similar perils of nature.

CONDITIONS :
The insured should act with due diligence in the event of a claim. The vehicle
should be maintained in satisfactory condition at all times. The vehicle should be secured
with proper padlock and chain when left unattended and also while not in use.
PREMIUM :
For full cover Rs.40/- up to a value of Rs.1,000/- plus l0%on the excess value
beyond Rs.1,000/For total loss only due to fire, burglary, house breaking, theft and other accidental
damage - 2 1/2%. Motor policy form may be used with suitable alterations.
DISCOUNT :
10% discount is allowed if passenger liability is not required.

122

GUN INSURANCE POLICY

The Gun Insurance Policy seeks to cover the following :Section 1.

All risks cover for the gun and accessories against fire, burglary,
housebreaking, theft, or any other accident or misfortune, anywhere in
India.

Section 2.

Cover against the liability of the Insured for accidents caused by him whilst
using the gun. He may be indemnified for loss or damage caused to the
members of the public or damage to the property of the Public. However,
the liability under this section will be restricted to Rs.50,000/- for any one
accident or any one period of Insurance. This limit may be increased to
Rs.1,00,000/- if required.

Section 3.

Cover against workmens compensation liability for one domestic servant

as per the provisions of the Workmens Compensation Act.

Section 4.

Personal accident benefits for the Insured, Insureds spouse and children
aged between 16 and 65 years, permanently residing with the Insured with a
limit not exceeding Rs.10,000/-capital Sum Insured per person and
Rs.50,000/- in all.

Section 5.

Loss or damage to the Insureds property or contents arising out of the use
of the gun up to Rs.5,000/-.

EXCLUSIONS :
The policy has certain special exceptions for the covers under different sections
and also general exceptions as under :

123

SPECIAL EXCEPTIONS
SECTION - 1
The company shall not be liable in respect of:
a.

Loss or damage by burglary or house-breaking or theft or any thereat where

the employees of the assured or members of the Insureds family is
concerned as principal or accessory.

b.

Loss or damage caused by cleaning or repairing or by depreciation, were

and tear.

SECTION 2 & 3 :
The company shall not be liable for claims arising through intentional
injury/ death / damage.
SECTION 4 :
The company shall not be liable for death or disablement of any Insured person
caused by or traceable to
i

Any physical defect or infirmity or disease which existed prior to happening

of any accident;

ii.

Suicide or insanity or intentional self injury or committing an unlawful act:

iii.

The Insured person being under the influence of intoxicating liquor

or drug.

SECTION 5 :
The company shall not be liable in respect of loss or damage caused intentionally.

124

GENERAL EXCEPTIONS :
The Company shall not be liable in respect of
1.

Loss or damage, whether direct or indirect, occasioned by or happening through or

arising from any consequence of war, invasion, act of foreign enemy, hostilities (Whether
war be declared or not), civil war, riot and strike, rebellion, revolution, insurrection,
military or usurped power or civil commotion in connection therewith.

2.

Any claim arising out of any contractual liability

3.

Consequential loss of any kind or description.

4.

a. Loss, destruction of or damage to any property whatsoever or any lossorexpense

whatsoever resulting or arising there from or any consequential loss.
b.

Any legal liability of whatsoever nature directly or indirectly caused by or

contributed to by or arising from ionising radiation or contamination by
radioactivity from any nuclear weapons or material.

PREMIUM RATES:
Section I

1%of the sum insured

Section II

For limit of Rs.50,000/- Rs. 15/For limit of Rs.1,00,000/- Rs. 25/-

Section III

Rs. 10/- per employee

Section IV

As per PA guidelines

Section V

Rs. 10/-.

Note :Section I and II under the policy are compulsory. However if the insured takes all sections
under the policy a discount of 10% may be allowed. Riot and strike cover can be extended by
charging an additional premium of 10%. All proposals to be referred to RO for acceptance.

125

GOLFERS INSURANCE POLICY

SELECTION OF RISKS :
The individual golf players or members of the Golf Club are indemnified under this

policy against liability to public involving their death or disablement. Also covered is
breakage of Golf clubs and loss or damage to golf clubs, bags, equipment and
accessories.
SCOPE OF POLICY :
Section (1) of the policy provides cover for loss or damage to Golfing equipment
(including breakage of club) whilst at any Golf course or in transit in India and to Golf
balls not exceeding a Sum Insured of Rs.1,00,000/- The premium rate to be charged is
1% of the Sum Insured.
Section (2) of the Policy provides cover for Personal Effects (money and
jewellery excluded) against loss or damage by Fire or Theft whilst in or at any Golf
Course in India, with a Sum Insured not exceeding Rs.10,000/-. The premium rate is 1%
of the sum Insured.
Section (3) of the Policy provides indemnity against legal liability arising out of
claims made on the insured in respect of any accidents caused by him whilst playing or
practising Golf on any recognised Golf Course anywhere in India resulting in accidental
bodily injury to any person not being a member of the insureds family or household or in
his service. The limit of liability is Rs.50,000/- any one accident and Rs.1 lakh any one
period of insurance. The legal cost if any incurred in addition, are also payable when
incurred with the written consent and approval of the Company. The rate to be charged is
0.30% on the AOY.

126

Section (4) of the-policy provides cover for accidental bodily injury sustained by
the insured whilst on any Golf Course in India with the Sum Insured not exceeding
Rs.1,00,000/- The rate to be charged is as per the PA guidelines.
EXCLUSIONS :
1.

Loss or damage (either in origin or extent) directly or indirectly occasioned

or contributed by or arising out of occurrences like. Earthquake, War and
Warlike perils, Riot, Strikes, Civil Commotion or loot or pillage in
connection there with and confiscation or detention by the order of any
Government, Public or local Authority. The onus of proving that the
loss/damage occurred independently of these lies on the insured.

2.

Wear and tear.

3.

Loss or damage brought about directly or indirectly due to the insured

having caused or suffered anything to be done whereby the risk hereby
insured against was increased.

PREMIUM RATES :
Premium Rates: Taking into account the requirement of Personal accident and the
Liability sections an annual premium or Rs.70/- will be charged. It is not permissible to
delete cover in respect of any section for reduction in premium. All proposals to be
referred to RO for acceptance.

127

GOLFERS INSURANCE POLICY

LIABILITY TO THE PUBLIC
SECTION I: Against legal liability arising out of claims made on him in respect of
accidents caused by him whilst playing or practicing golf on any recognised Golf Course
anywhere in India resulting in
(a) Accidental bodily injury to any person not being a member of the Insureds family
or household or in his service.
(b) Accidental damage to property not belonging to or in the charge of or under the
control of the Insured or a member of his family or household or of any person in
his service.
And All costs and expenses of litigation recovered by any claimant against the insured or
incurred with the written consent of the Company in respect of a claim against the Insured
to which the Indemnity expressed in this Policy applies.
The amount payable in respect of any one accident or series of accidents constituting one
occurrence shall not in any case exceed the sum of Rs. 1,00,000/PERSONAL ACCIDENT
SECTION II: For the amount specified below if any event described herein shall happen to the
insured whilst playing or practicing golf on any recognised Golf Course anywhere in India and
the insured shall thereby suffer any of the results described.
Event
Bodily injury caused solely and directly by violent accident external and visible means
which injury shall independently of any other cause be the sole and direct cause of
any of the Results (1) to (7).
Results

Benefit

Death.

Rs.25000/-

Total and irrecoverable loss of all sight in

both eyes.
Total loss by physical severance of both
hands or both feet or one hand and one foot

Rs.25000/-

Rs.25000/-

Total loss by physical severance of one hand Rs.25000/-

128

5
6
7

or one foot together with the total and

irrecoverable loss of all sight in one eye.
Total and irrecoverable loss of all sight in Rs.12500/one eye.
Total loss by physical severance of one hand Rs.12,500/or one foot.
Total disablement from engaging in or Rs.90/- per for a week
attending to usual

Business or Occupation a period not exceeding 26 weeks from the happening of

event.
OCCURING WITHIN NINETY DAYS OF THE HAPPENING OF THE EVENT
PROVIDED ALWAYS THAT
(a) This Section shall not be operative if at the time of the accident the Insured has
attained the age of 65 years.
(b) No compensation shall be payable under the Policy in respect of any event
consequent upon Suicide (whether felonious or not) or attempt threat, nor in
respect of any Event happening to the Insured whilst insane or intoxicated nor
in respect of any Results attributable either wholly or in part to hernia
however caused, venereal disease, or in the case of a woman, childbirth or
pregnancy.
(c) Compensation shall not be payable-for:
i) more than one Results (1) to (6) and when payable for one of the of those Results
shall not be payable for any other of the Results caused by the same Event (and
compensation in fact previously paid for any Result other than Results (1) to
(6) shall be brought into account and deducted from compensation paid for any
one of Results (1) to (6) caused by the same Event) nor for any of the Results
caused by any subsequent Event all further liability on the Company under this
policy thereupon ceasing.
ii) A period exceeding twenty six weeks for results (7) in respect of any one
Event.
iii) Any of the Results unless the Insured shall as soon as possible after the
happening of the Event which caused such Results procure and follow medical
advice from a duly registered medical practitioner.
BREAKAGE OF CLUBS.
SECTION III: Against Accidental damage to or breakage of Golf Clubs belonging to
the Insured whilst the Insured is actually in course of play or practice therewith on
any recognised Golf Course anywhere in India including the Insureds residence but

129

not exceeding the sum of Rupees one lakh (Rs. 1,00,000/-) in all any one Period of
Insurance.
FIRE AND THEFT
SECTION IV:
Against loss of or damage to Golf Clubs, Bags, Equipment and Accessories, the
Property of the Insured, by Fire, Burglary, Housebreaking, Larceny or Theft whilst
contained in the insureds residence or in any recognised Golf Club House or
Professionals Shop connected therewith or whilst on any recognised Golf Course
anywhere in India, or whilst in transit to or from any such Golf Course, but not
exceeding the sum of Rupees one lakh (Rs.1,00,000/-) in all in any one period of
Insurance.
PROVIDED ALWAYS THAT
a) the Company shall not be liable under Section 4 for loss of or damage to
Watches, Jewellery, Trinkets, Money, Securities or Stamps.
b) on the happening of any loss insured under Section 3 or 4 the Company shall be
entitled to take and keep possession of the property concerned and to deal with
the salvage in a reasonable manner and this Policy shall be proof of leave and
licence for such purpose. No property may be abandoned to the Company.
c) the Company shall not be liable for theft of Golf Clubs, Bags or Bags Trundlers
while contained in an automobile unless all doors and windows are securely
locked, and in the event of a loss by theft from an automobile visible signs of
forcible entry must be shown.

GENERAL EXCEPTION
PROVIDED ALWAYS that the Company shall not be liable in respect of
1. Loss or damage which either in origin or extent is directly or indirectly,
proximately or remotely occasioned or contributed to by any of the following
occurrences, or which either in origin or extent directly or indirectly,
proximately or remotely, arises out of or in connection with any of such
occurrences, namely.
Earthquake, volcanic eruption, war, invasion, acts of foreign enemies, hostilities
(whether war be declared or not) civil war, rebellion, revolution, insurrection,
military or usurped power, strike, riot, civil commotion or loot or pillage in
connection therewith, confiscation or nationalisation or requisition or destruction
of or damage to property by or under the order of any government or public or
local authority. If and when required the Insured shall as a condition precedent to
the payment of any claim, prove to the satisfaction of the Company that the loss or

130

damage was not occasioned directly or indirectly, wholly or partly, by through, or

in consequence of any of the abovementioned, but occurred independently thereof.
2. Wear and tear.
3. Loss or damage directly or indirectly due to the Insured having caused or
suffered anything to be done whereby the risk hereby insured against was
increased.
PROVIDED FURTHER that the observance and fulfilment by the Insured of the terms
and conditions of this Policy and of any endorsements which may be made hereon
(insofar as it is practicable, having regard to the nature thereof for the Insured to
have observed and fulfilled them) shall be a condition precedent to the Insureds right
to recover hereunder.

SCHEDULE

POLICY No.

AGENCY:

THE INSURED:
ADDRESS:

PERIOD OF INSURANCE:
a) From the ------------------------------------

PREMIUM:

Rs.

to the
(at 4.0' clock p.m.)

STAMP DUTY Rs.

b) Any subsequent period for which the

Insured shall pay and the Company shall

TOTAL

Rs.

agree to accept a renewal premium:

IN WITNESS WHEREOF the undersigned being duly authorised by the company and
on behalf of the Company hereunto set his hand at ------------------------ on the
------------day of --------------------------20
Checked ----------------

131

HOARDING/SIGNBOARD INSURANCE
SELECTION OF RISKS :
Advertisement is one of the major factors for development of Organisation and
advertisement by hoarding has come to stay. Hoarding Insurance is intended to
compensate for any loss or damage to the hoarding insured as also public liability
consequent upon falling of hoarding.
SCOPE OF COVER :
Section I of the Policy will indemnify the insured in respect of loss of or damage
to the hoarding mentioned in the schedule, caused by fire, burglary, accidental damage,
earthquake, storm, tempest, flood, cyclone, hurricane, inundation and Riot and Strike.
It also pays a sum not exceeding Rs.500/ towards debris removal.
Section II takes care of any liability that may arise in respect of accidents caused
by the falling of hoarding on account of any of the insured perils under Section I and also
litigation expenses incurred by the Insured with the written consent of the Company.
However the total liability is limited toRs.25,000/-for any one period of Insurance.

SPECIAL EXCEPTION :
1.

The Company shall not be liable in respect of loss or damage occasioned by

improper maintenance of hoarding.

2.

There would be no liability in respect of claims arising through intentional

injury / death / damage.

132

GENERAL EXCLUSIONS :
The Company shall not be liable in respect of:
1.

Loss or damage whether direct or indirect, occasioned by or happening

through or arising from any consequence of war, invasion, act of foreign
enemy, hostilities (whether war be declared or not) civil war, rebellion,
revolution, insurrection, military or, usurped power or civil commotion in
connection therewith.

4.

2.

Any claim arising out of any contractual liability.

3.

Consequential loss of any kind.

a.

Loss, destruction of or damage to any property whatsoever or any loss or

expense whatsoever resulting or arising there from or any consequential
loss.

b.

Any legal liability of whatsoever nature, directly or indirectly caused by or

contributed to by or arising from ionising radiation or contamination by
radio activity from any nuclear fuel or from any nuclear waste from the
combustion of nuclear fuel or from and nuclear weapons material.

PREMIUM RATE :
2% on the value of hoarding for comprehensive cover i.e. accidental loss including
theft as a whole and TP. Liability for a maximum amount of Rs. 25,000/-.

133

SPECIAL CONTINGENCY INSURANCE

SELECTION OF RISKS :
Quite often clients who may find conventional policies in fire or miscellaneous
department not fully catering to their requirements apply for special tailor- made policies.
The cover is a combination of fire, burglary, accidental damage and other contingencies.
To facilitate issue of such tailor made policies, a Special Contingency policy can been
devised. The chief merit of this Policy, is that the scope of contingencies to be covered, is
kept open which in each case has to be determined and set out in the schedule of the
Policy.

Underwriting factors:
This policy is designed to suit the needs of the client and the covers can be
packaged as required. The following will have to be taken into consideration while
underwriting a special contingency policy:
a.

If a part of the package has any cover that is governed by the tariff, the relevant
rates terms and conditions will have to be applied.

b.

If any of the covers sought for by the client fall under the EXCLUSIONS of the
existing policies, such covers CANNOT be covered under the policy.

c.

If for any of the covers sought there are any tariff rates or guideline rates in
existence, then these rates will have to be applied.

d.

All proposals for special contingency policies will have to be forwarded to RO/HO
with complete extent of the cover sought as well as the detailed split of the rate

134

suggested by the DO and also the reasons for the need to issue the policy in the
prescribed form.

EXCLUSIONS :
i.

Loss or damage, attributable to war and warlike perils, riot, strike or civil
commotion or loot or pillage in connection therewith or confiscation or detention
by the order of any Government or Public Authority, earthquake volcanic eruption,
flood, storm, tempest, typhoon, hurricane, tornado, cyclone or other similar
convulsions of nature and atmospheric disturbance.

ii.

Damage caused by overloading or strain.

iii.

Consequential loss, depreciation, wear and- tear or mechanical breakdown.

iv.

Loss or damage occurring whilst being used for racing or peacemaking.

v.

Nuclear perils.

vi.

Any other exclusion according to individual merits of the proposal.

PLEASE NOTE :
From Reinsurance Point of view special contingency risks are viewed differently
in the western market, and hence whenever special contingency policy is issued, perils
covered thereunder must be specifically mentioned while reporting to controlling office.
Cover should not be confirmed without clearance from the Regional Office.

135

This Policy should be issued only in case large clients & exigencies the
recommended rates should not be lower than the prescribed tariff rates for the perils
covered.

POLICY DRAFTING:
The printed special contingency policies are very general in nature. The actual
covers sought, the scope of cover, conditions and exclusions, should be clearly defined
section-wise in the policy issued.
A separate excess will have to be applied under each section /peril covered apart
from the excess applicable to the tariffed sections.

136

PUBLIC LIABILITY INSURANCE (NON INDUSTRIAL RISK)

INTRODUCTION TO LIABILITY
Liability insurance gained importance and also caught the eyes of the Industry as
well as the Government only after the Bhopal Gas Tragedy and after the historic
judgement delivered by the Supreme Court against Shriram Foods and Fertilizers and
triggered changes in the Liability scenario. The Public Liability Act 1991 is a milestone
in this direction.
Penetration of the Liability market can be attributed to the Customers lack of
awareness of Liability suits and the length of time taken in our country for settling legal
suits. However, the demand for liability insurance in India I on the rise for the following
reasons to name a few:
Increasing number of accidents resulting in Bodily Injury or damage to property
Growing consciousness amongst public of their right and legal recourse
Introduction of new legislations identifying new areas of legal liability
Introduction of Foreign Capital
Liability made Mandatory for certain products/services/conditions while awarding
contracts
Increasing number of Professional negligence suits. Clear definition of responsibilities of
Directors towards the various stake holders
Increasing number of recalls in Pharma/Motor industry following stricter quality
controls

137

SCOPE OF COVER (GENERAL):

Public Liability insurance policy is meant to indemnify the Insured against the
Insureds legal liability to pay compensation including claimants costs, fees and
expenses in respect of injury and/or damage arising out of accidents. The claim for
compensation should be in connection with the business specified in the schedule of the
policy and not arising out of pollution of any product. For the purpose of determining the
indemnity:i)

Injury shall mean, death, bodily injury, illness or disease to any person.

ii)

Damage shall mean actual and/or physical damage to tangible property.

iii)

Pollution shall mean Pollution or contamination of the atmosphere, any water, land
or other tangible property.

iv)

Accident means a fortuitous event or circumstances which. is sudden unexpected

and unintentional including resultant continuous intermittent or repeated exposure
arising out of the same fortuitous event or circumstance.,

v)

Policy period means the period commencing from midnight on the inception date
and terminating at midnight on the expiry date of the policy.

vi)

Period of insurance means the period commencing from the retroactive date and
terminating on the expiry date of the policy.

NON INDUSTRIAL: RISKS POLICY

For Non Industrial Risks, Public Liability Insurance cover will apply to any type
of Non Industrial Risk like, Hotels, Clubs, Public Halls, Pandals, Air Port Premises, Film

138

Studios Zoos, Godowns, Shops etc. The proposal form should be completed in all
respects by the BOs/DOs. It is to be noted in this connection that pollution risk is not
covered under the basic policy and it is an extension by charging extra premium as per
erstwhile Market Agreement and fulfilling the other requirements.
Multiple Units situated at various locations can be covered under single limit of
indemnity per any one accident / any one policy period at appropriate extra premium. But
subsidiaries and Associate concerns have be covered under separate policies only. The
Insured has to choose Any one Accident limit that isAOA and also Any one year
limit i.e. AOY for the policy period. Normally, the ratio of AOA to AOY should not
exceed 1: 4. In terms of HO instructions, all proposals irrespective of AOA, AOY limits,
are to be referred to concerned RO for rating and acceptance. Proposals exceeding the
above limit are to be referred by concerned RO to HO Technical Miscellaneous
Department for their approval and acceptance as well as quotation of premium. The rates
given in the erstwhile Market Agreement are annual and it is necessary to accurately
assess the annual turnover and the same should be indicated correctly in the proposal
form.
Act of God Perils will be included in the policy on payment of additional premium
according to the Seismic Zones in which the risk is situated as per the rates indicated. It is
possible to cover liability arising out of discharge of treated effluents outside the Insured
premises through pipelines, at suitable extra premium. Similarly Transportation Liability
is an extension under the policy. Should there be any increase or decrease in the turn over
the insured advise the same to our underwriting office and suitable adjustment in
premium has to be made before expiry of the policy. However, the policy does not
provide for adjustment on expiry, which has to be noted very carefully. In view on this
position B.O./D.O. should endeavour to obtain correct details of turn over at the earliest
for correct rating of the policy. No revision in AOA is permitted during the policy period.
However, within the same indemnity limits, additional units may be included by applying
short period scale of premium.

139

There will be a compulsory excess of 1/2 % of AOA, subject to a minimum of

Rs.2,50,000/- and a maximum of Rs.10 lacs per claim. It is permissible for the Insured to
bear a voluntary excess at a slightly reduced rate of premium. This should be indicated in
the proposal form clearly while it is forwarded to RO for rating and acceptance.
A short period policy for less than one year is also possible at a specific short
period scale of rate.
The policy will have the following important clauses:
NOTIFICATION EXTENSION CLAUSE :
Should the Insured notify the Company during the policy period in accordance
with the General Condition 9.1 of any specific event or circumstance which the Company
accepts may give rise to a claim which form the subject of indemnity by the policy, then
the acceptance of such notification means that Company will deal with such claim or
claims as if they had first been made against the Insured during the policy period. The
extension under this clause will be subject to the maximum time laid down under the
Indian Limitation Act in force from time to time.
EXTENDED CLAIM REPORTING CLAUSE :
In the event of non-renewal or cancellation of this policy, either by the Company
or by the insured, the Company will allow a time limit not exceeding 90 days from the
date of expiry or cancellation of the policy for notification of claims for accidents which
had taken place during the period of insurance but could not be made during the policy
period. Provided however all claims made during the extended reporting period shall be
handled as if they were made on the last day of the expiring policy period and are subject
to the limits of indemnity and the terms, conditions and exceptions of the policy.
INDEMNITY TO OTHERS :

140

The indemnity granted extends to:

1.

Officials of the Insured in their business capacity arising out of the performance of
their business or in their private capacity arising out of temporary engagement of
the Insureds employees.

2.

The Officers, Committees and Members of the Insureds canteen social, sports,
medical, fire fighting and welfare organisations in their respective capacities as
such;

3.

The personal representatives of the estate of any person who would otherwise be
indemnified by this Policy but only in respect of liability incurred by such person.
Provided always that such persons or parties shall fulfil and be subject to terms,

conditions and exclusions of this policy as though they were the Insured.
CROSS LIABILITIES :
Each person or party indemnified, is separately indemnified in respect of claims
made against any of them by any other person or party (other than the named insured)
subject to Companys total liability not exceeding the limits of indemnity stated in the
Schedule of the policy.

DEFENCE COSTS :
The Company will pay all costs, fees and expenses incurred with their prior
consent in the investigation, defence or settlement of any claim made against the Insured
and the costs of representation at any inquest, inquiry or other proceedings in respect of
matters which have a direct relevance to any claim made or which might be made against
the Insured, provided such claim or claims are the subject of indemnity under Policy,

141

whether liability ultimately attaches to the policy or not.

Such cost, fees and expenses

are called Defence Costs.

INDEMNITY LIMITS :
Companys total liability to pay compensation, Claimants costs, fees and expenses
and defence costs shall not exceed the Indemnity limit stated in the schedule. Indemnity
limit for any one accident applies to any one claim or series of claims arising from one
Originating cause. Indemnity limit for the period of Insurance shall represent the total
amount of Companys liability during the policy period.
CLAIMS SERIES CLAUSE:
For the purpose of this policy where a series of and / or several bodily injuries
and / or property damages occur which are attributable directly or indirectly to the same
accident all such bodily injuries and/or property damages shall be added together and the
total amount of such bodily injuries and / or property damages shall be treated as one
occurrence. There shall, however, be no coverage for claims made arising from specific
cause which are made later than 3 years after the first claim of the series.

EXCLUSIONS
Exclusions under the policy are enumerated here under:
i)

Liability assumed by the insured by agreement and which would not have
attached in the absence of such, agreement.

ii)

Liability arising out of earthquake, flood, storm or other similar convulsions

of nature.

142

iii)

Liability arising out of deliberate, wilful or intentional non compliance of

any statutory provision.

iv)

Liability arising out of loss of goodwill, loss of market etc.

v)

Liability arising out of all personal injuries and mental, anguish or shock
resulting there from.

vi)

Liability arising out of infringement of plans, copy right, trade name, trade
mark, registered design etc.

vii)

Liability arising out of fines, penalties, punitive or exemplary damages and

other damages resulting from the multiplication of compensatory damages.

viii)

Liability, directly or indirectly caused by war and warlike perils, nuclear

and radioactive materials.

ix)

Liability, directly or in-directly caused by or contributed to by ionising

radiations or contamination by radioactivity from any nuclear fuel, toxic, or
other hazardous properties of any explosive nature.

x)

Liability arising out of transportation of materials and / or hazardous

substances outside the Insureds premises unless specifically covered.

xi)

Liability arising out of the ownership, possession of any motor vehicle/

trailer etc.

xii)

Liability arising out of damage to Insureds property, or leased or hired or

under hire purchase or loan to the insured, or premises temporally occupied
by the Insured, or other property temporarily in the custody of the Insured,
employees and visitors clothing and personal effects, or premises Tenanted
by the Insured to the extent that the Insured would be legally held liable in
the absence of any specific agreement.

143

xiii)

Liability arising out of injury or damage arising prior to the retroactive date.

xiv)

Liability arising out of conscious or intentional disregard of the insureds

technical or administrative management of the need to take all reasonable
steps to prevent claim.

xv)

Liability for any injury to any person under a contract of employment etc.

xvi)

Liability arising out of ownership, possession of, use by or on behalf of the

Insured of any Motor Vehicle or trailer for which compulsory insurance is
required by legislation other than claims caused by use of any tool or plant
in a motor vehicle or trailer, etc.

Any other normal condition applicable for other Miscellaneous Accident Policy
will apply in this case also.
OTHER FEATURES
1.

Payment of claim reduces the limit of liability to the extent of payment.

It is

not possible to reinstate the aggregate limit of indemnity even on payment of extra
premium.
2.

For cancellation of the policy, a notice of 30 days is necessary subject to a

minimum premium to be retained. In case of cancellation by the Insurer the refund
will be on pro-rata basis, otherwise the insurer will retain the premium on short
period scale. In the case of any claim under the policy the Insured will
eligible for any refund.

PUBLIC LIABILITY
(Non - Industrial Risks)
1.

Applicability

144

not be

This policy applies to non - industrial risks such as Hotels, Motels, Club Houses,
Restaurant, Boarding and Lodging Houses, Flight Kitchens, Cinema Halls,
Auditorium, Theatres, Public Halls, Pandals, Open Air Theatres, Residential
Premises, Offices/Administrative Premises, Medical Establishments, Institutions,
Airport Premises (other than aviation liabilities), Schools / Educational
Institutions, Libraries, Exhibitions, Fairs and Fetes,
Stadiums and Pandals, Permanent Amusement Parks, Film Studios -Indoor &
Outdoor, Zoos, Depots, Warehouses, Godowns, Shops Tank Farms and similar
other non-industrial risks with aggregate limits of indemnity any one year/ during
the policy period upto the capacity of the Company under its net retention and
Automatic Reinsurance facilities.
Any proposals outside the scope of the erstwhile Market Agreement may be
considered by the offices on merits.

Premium, rates and other terms and

conditions for such covers may be decided by the Head Office and if required, in
consultation with Reinsurers.
Risks which are not at present specified under the erstwhile Market Agreement
will be rated by the offices using the erstwhile Market Agreement as guidelines for
like or similar risks. In respect of risk for which there are no guiding Market
Agreement provisions, the same may be rated by the operating offices with
reference to the respective RO or HO. Details of such proposals, however, are to
be sent to for approval.

2.

Standard Proposal Form

Insurer shall obtain duly completed Standard Proposal Form from the proposers at
inception and subsequent renewals. The specimen proposal form is prescribed in
the erstwhile Market Agreement. No cover shall be granted unless a declaration as

145

provided for in the proposal form is obtained from the proposer to the effect that
all statutory requirements relating to the business activities are complied with.
3.

Standard Policy Form

All Polices fresh and renewals issued under this policy be in the. Standard Policy
Form prescribed hereunder.

4.

Liabilities Covered
Policies issued Cover all sums which the Insured becomes legally liable to pay as
damages to third party in respect of accidental death/bodily injury/ disease and
loss of or damage to property arising out of claims first made in writing against the
Insured during the policy period including legal costs and expenses incurred with
prior consent of Insurers, subject always to the limits of indemnity and other
terms, conditions and exceptions of the policy.
It shall not be permissible to issue any Public Liability Insurance Policy with
unlimited liability. The ratio of limit of indemnity any one accident to any one year
shall not exceed 1:4.

5.

Pollution Risks
Policies issued shall not include cover for Pollution risks unless otherwise
specifically included by endorsement prescribed hereunder and additional
premium collected thereof. Wherever applicable the proposer shall furnish
certificate / consent letter from the Pollution Control Board granting permission to
carry on their activities.

6.

Cover for Multiple Units

146

It shall be permissible to insure various units situated at different locations under

single limits of indemnity per Any One Accident / Any One Policy period
provided appropriate premium is paid as per the Rating Schedule - Section II.
7.

Extension sought under the main policy shall not have indemnity limit in excess of
the main cover.

8.

Premium
The rates of premium under this policy are annual rates. Full premium under the
policy shall be paid at inception. It is not permissible to accept premium in
installments.
Turnover figure wherever required shall be accurately assessed and declared by
the proposer at inception of the policy. In case the insured anticipates any increase/
decrease in turnover, during the policy period such fluctuations should be
immediately notified to the insurer and necessary adjustments made. Under no
circumstances it shall be permissible to adjust the premium for the turnover after
expiry of the policy.

9.

Retroactive Date
Retroactive Date is the date when the risk is first incepted under a claims made
policy and thereafter renewed without break in the period of cover.

10.

Revision in Limits of Indemnity

a)

Mid -term increase /decrease in the limits of indemnity limit during the
currency of the policy period will be at the discretion of the Head Office of

147

the Company. Whenever changes in indemnity limits are agreed to, the
revised retroactive date showing indemnity limits available at various dates
shall be incorporated in the Policy Schedule.
If insured wish to seek protection for an anticipated liability in excess of available
limits of indemnity for past periods due to different retroactive dates the Company may
consider granting run-off cover based on merits of each case. Rates, terms and
conditions for such run-off covers may be finalised by the Head Office and if necessary,
Reinsurers.
b)

Similar procedure as detailed in the earlier paragraph shall be followed

whenever an insured changes his Insurers.

12.

Compulsory Excess
All Policies issued under this Agreement shall be subject to compulsory excess of
1/2% of the limits of indemnity per any one accident subject to a minimum of
Rs.2,50,000 (Rupees Two lakh fifty thousand only) and a maximum of
Rs.5,00,000 (Rupees five lakh only). The Insured shall bear this Compulsory
Excess which is applicable to both property damage claims and death / bodily
injury claims inclusive of defence costs arising out of any one accident.

14.

Short Period Premium

It shall not be permissible to issue Policy for periods more than 12 months. The
following short period scale of premium shall apply to (i) policies issued for
periods less than 12 months and (ii) policies cancelled during the currency at the
request of the insured subject to no claim :
Period

Rate

(Not exceeding)

148

Week

10% of the Annual rate

Month

25% of the Annual rate

Months

35% of the Annual rate

Months

50% of the Annual rate

Months

60% of the Annual rate

Months

75% of the Annual rate

Months

85% of the Annual rate

Exceeding 8 months . ......................... Full Annual premium

In case turnover declared relates to the period of cover selected the above short
period scale will be applicable only on the indemnity premium and full turnover
premium should be charged. For annual policies cancelled during the currency at
the request of the insured, premium should be adjusted at the Short Period Scales
for the actual period of cover subject to no claims. No refund is permissible in case
of any claim under the policy.
The short period premium is subject to the minimum premium in the Rating
Schedule.
15.

Third Party Liability Insurance in respect of LIFTS are to be issued on the policy
wording prescribed for Public Liability Insurance. The premium will be Rs.3 per
mille on the annual limit (AOY) under the policy. The applicable excess will be
0.50% & of AOA limits subject to minimum of Rs.10,000/- and maximum of
Rs.2.5 lacs.

149

RATING
The various covers falling within the scope of this policy have rating structure
depending on two main components viz., Limit of indemnity opted under the policies and
estimated annual turnover, as provided for and explained in Tables
The basic rate depends upon Risk Group (as given in relevant sections based on
(i)

Type of construction of the Risk and / or occupancy / storage (as per Annexure A
& B)

(ii) The ratio of limits of indemnity of any one accident to any one year selected.
Classification of the construction is applicable to the main structure or premises
etc., However detached structures of inferior constructions outside 15 metres of the
main structure shall not effect the classification of construction.
Additional premium :
For premises having height of more than 22 meters - 10 pct of the applicable
indemnity premium should be charged.
For lift / s -10 pct of indemnity premium.
(Additional premium are not cumulative).
A.

On Indemnity Limit per Any One Accident.

The basic rate depends upon (i) Risk Group (ii) the ratio of limits of indemnity of

any one accident to any one year selected.

The basic rate (applicable per mille) for the ratio of limits of indemnity of any one
accident to any one year will be as given under

150

TABLE - 1
Risk Ratio of Indemnity AOA to AOY
Risk Group

Ratio
Indemnity
to AOY

of
AOA

1:1
1
2
3
4

0.15 pm
0.18 pm
0.21 pm
0.24 pm

1:2

1:3

0.22 pm
0.26 pm
0.30 pm
0.34 pm

0.27 pm
0.32 pm
0.37 pm
0.42 pm

To arrive at the final rate, the above basic rate is to be multiplied by the applicable
multiplier as per the following table of limit of indemnity per any one accident opted.

151

TABLE - 2
LIMIT OF INDEMNITY AND MULTIPLIER THEREOF
Limit of indemnity per
any one accident
(Rs. in lacs)
Upto 10
Upto 25 - 1st
Next
Upto 50 - 1st
Next
Upto 75 - 1st
Next
Upto 100 - 1st
Next
Upto 150 - 1st
Next
Upto 200 -1st
Next
Upto 250 1st
Next
Upto 300 - 1st
Next

Multiplier
28

10
15
25
25
50
25
75
25
100
50
150
50
200
50
250
50

28
26
26
25
25
24
24
23
23
21
21
20
20
19
19
18

Limit of Indemnity per

any one accident
(Rs. in lacs)
Upto 350 - 1st
Next
Upto 400 - 1st
Next
Upto 450 - 1st
Next
Upto 500 Ist
Next
Upto 600 - 1st
Next
Upto 700 1st
Next
Upto8001st
Next
Upto9001st
Next
Upto10001st
Next

300
50
350
50
400
50
450
150
500
100
600
100
700
100
800
100
900
100

Multiplier
18
17
17
16
16
15
15
14
14
13.5
13.5
13
13
12
12
11
11
10

The final rate so arrived at is to be applied on the limit of indemnity per any
one accident.

152

Multiple units covered under Single Indemnity Limit :

If more than one unit / establishment of the insured, located at different sites is to
be covered within one single overall indemnity Limit per any one accident / any one year
under the policy, the premium on Indemnity Limits (vide A above) shall multiplied by
the following multipliers :
TABLES - 3

No. of Location

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15 & above

Ratio of
Indemnity AOA
to AOY
1:1

1:2

1:3

1.0
1.35
1.50
1.65
1.8
1.9
1.95
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0

1.0
1.5
1.70
1.90
2.05
2.15
2.25
2.35
2.45
2.50
2.50
2.50
2.50
2.50
2.50

1.0
1.6
2
2.25
2.5
2.65
2.75
2.85
2.95
3
3.05
3.10
3.15
3.15
3.15

If the units / establishments belong to different risk groups the premium on

indemnity limits vide A above shall be based on the highest risk group.

153

TABLE 4
LOADING ON TURNOVER
(For Risk Group 1)
Annual Turnover

Premium 0%

First Rs.1 crore

Exceeding Rs.1 crore but not
exceeding Rs.5 crore (Next Rs.4 crore)

Rs.1000 (min)
Rs.1000 + 0.07%o on the excess
over Rs.1 crore

Exceeding Rs.5 crores but not

exceeding Rs.10 crores
(Next Rs.5 crores)

Rs.3800 + 0.06 %o on the excess

over Rs.5 crores

Exceeding Rs.10 crores but not

Exceeding Rs.50 crores
(Next Rs.40 crores)

Rs.6800 + 0.05%o on the excess over

Rs. 10 crores

Exceeding Rs.50 crores but not

exceeding Rs.100 crores
(Next Rs.50 crores)

Rs.26800 + 0.04%o on the excess

over Rs.50 crores

Exceeding Rs.100 crores but not

exceeding Rs.250 crores
(Next Rs.150 crores)

Rs.46800 + 0.03%o on the excess

over Rs.100 croes

Exceeding Rs.250 crores but not

exceeding Rs.500 crores
(Next Rs.250 crores)

Rs.91800 + 0.02 %o on the excess

over Rs.250 crores

Exceeding Rs.500 crores

Rs.141800 + 0.01 %o on the excess

over Rs.500 crores

The above Table is applicable for Risk Group 1. For Risk Groups 2,3 and 4 the
premium as per Table 4 above shall stand increased as under :
RISK GROUP
2
3
4

PREMIUM
110% of Group 1 Premium
120% of Group 1 premium
140% of Group 1 Premium

154

If more than one unit/ establishment situated at different locations, is covered

under one single Indemnity Limit under the Policy,

separate loading on Turnover shall

be applied as above for each unit/ establishment depending on the Risk Group or on the
total turnover treating the risk under the highest Risk Group applicable whichever is
favourable to the Insured.
For the purpose of applying Turnover loading if turnover of such units/
establishments is not ascertainable separately the premium for such units establishments
shall be calculated at the rates applicable to the highest Risk Group.
Transportation Cover :
It is permissible i.e. to extend the policy to cover transportation by collecting
addition premium as below:
When transportation limits sought are less than the Sum Insured under the policy
and form part of the Premises Indemnity granted, then 50% of the premium applicable to
the premises indemnity limit shall be applied to the limit chosen for transportation in the
proportion that the premises limit of indemnity bears to the transportation limit of
indemnity.
If the transportation limits sought:
(a)

Are more than the limit of the Premises Risks or

(b)

The ratio of AOA

to AOY required for transportation risks are different from

those opted for the premises risks or

(c)

Transportation cover is required without premises cover.

155

Then a separate policy may be issued for transportation collecting 100% as

applicable.
Act of God Perils :
Additional Premium will be as under, depending on the Seismic Zones in which
the Risk is situated:
Zone 1

10 pct on gross premium

7.5 pct on gross premium

2.5 pct on gross premium

pct on gross premium

If more than one unit/establishment, situated in different Seismic Zones are

covered under one Policy, additional premium will be charged depending on the risk
attracting the highest rate.

156

MEDICAL ESTABLISHMENTS (GUIDELINES)

The Policy will indemnify the insured in respect of any act committed by the
professionals or qualified assistants named in the proposal engaged by the medical
establishment which gives rise to any Third Party legal liability. Such activities will be
part of the declared medical activities of the establishment.
Such an Act would have taken place in the duration of the policy commencing
from the retroactive date.
In normal course all claims for compensation have to be legally established in a
court of law. However, insurers may arrive at compromised settlement if prima facie liability exists under the policy.
Only Indian Law shall be applicable to such action.
The limits of indemnity would be limited to any one year limit under the policy.
Short period policies are not permitted. In case Insured desires cancellation short
period scale rates as provided for will be applicable.
Medical establishments shall be Registered with competent authority as per the
local regulations.
Explanations :
For the purpose whenever necessary applications have been for such registration
and the same have not been rejected, then this requirement shall be deemed to have been
complied with.
In territories where no registration facilities exist, the following minimum norms
need to be complied with for considering the proposal Subject to the condition that as and

157

when official regulations are introduced in the concerned territory the insured shall
comply with registration formalities for continuation of the policy at renewal.
List of eligible Medical Establishments :
1.

Hospitals.

2.

Nursing Homes.

OFFICE / RESIDENTIAL PREMISES / ADMINISTRATION

PREMISES /
MEDICAL ESTABLISHMENTS / RESEARCH INSTITUTIONS AND
LABORATORIES / AIR PORT PREMISES
(other than Aviation Liabilities)
The basic rate is to be arrived at treating the risks under Risk Group I of Table 1
which should be multiplied by applicable multiplier as per Table II depending on the Any
One Accident Limit under the Policy. The resultant rate should be applied on the Any
One Accident Limit to arrive at the indemnity premium.
For risks situated in Class I and Superior Construction the premium would be 25%
of the indemnity premium and for Class II construction 50% of indemnity premium
arrived as above.
Pollution Extension : For extending the policy to cover accidental pollution
additional premium of 10% on the above premium should be charged.
Minimum premium under the Policy Rs.500/-.
Compulsory Excess

0.50% of AOA limit subject to 1 minimum of Rs.2,50,000/and a maximum of Rs.5,00,000/-.

158

For Hotels / Motels / Club Houses / Restaurants / Boarding and Lodging Houses /
Guest Houses Including Flight Kitchens
Basic Rates for Class I and Superior construction will be as per Risk Group I of
TABLE 1 and for CLASS II constructions as per RISK GROUP 2 of TABLE 1.
The basic rate as above should be multiplied by applicable multiplier as per
TABLE 2 depending on the Any One Accident limit under the policy. The resultant rate
should be applied on the AOA limit under the policy to arrive at the indemnity premium
under the policy.
LOADING ON TURNOVER :
In addition to the premium on Indemnity as above loading on turnover as shown in
Table 4 shall be charged on the previous years gross annual turnover or the current years
projected annual turnover whichever is higher. The term TURNOVER shall mean all
revenue earned through occupancy in the hotel, sale of food and beverages including
liquor, conferences, marriage parties, outside catering, rental received from shopping
arcades, revenue earned from guests for using hotel facilities and sale across the counter
and other miscellaneous incomes including all levies, taxes and surcharges.
The Policies envisaged under the Market Agreement can be extended to cover
following risks :
(a)

Valuables under Care, Control and Custody (can be restricted to

10% of AOA chosen)

(b)

Food and Beverages (can be restricted to 10% of AOA chosen)

(c)

Extra facilities such as health clubs, beauty parlours shops swimming

pools, indoor and outdoor sports :

(d)

Aqua Sports facilities

159

(e)

For inclusion of Skydiving, skiing and hand gliding

Above additional premiums are to be calculated separately on Indemnity Premium

and not on cumulative basis. The additional premium may be calculated as under :
50% of the premium applicable to the premises limit shall be applied to the limit
chosen for the concerned extension in the proportion that the premises limit of indemnity
bears to the limit of indemnity selected for the extension. The premium however shall in
no case either be less than Rs.250/- or exceed the amount arrived at by applying the
percentage premium stipulated in the erstwhile Market Agreement for limits of indemnity
equal to those placed for premises risk.
Premium as stipulated above shall be charged separately for each facility.
(f)

Act of God Perils :

Additional Premium will be as under, depending on the Seismic Zones in which

the Risk is situated :

Zone 1

10 pct of gross premium

7.5 pct of gross premium

5 pct of gross premium

2.5 pct of gross premium

If more than one unit / establishment, situated in different Seismic Zones are
covered under one Policy, additional premium will be charged depending on the risk
attracting the highest rate.
(g)

Pollution Extra :
When the policy is extended to cover the risk of Accidental Pollution, the

following loading on total premium (Indemnity premium + Turnover loading) shall be

applied :

160

Zone 1

10 pct of gross premium

15 pct of gross premium

30 pct of gross premium

50 pct of gross premium

Compulsory Excess : 0.50% of AOA limit subject to minimum of Rs.2000/- and

maximum of Rs.3,00,000/-.
Minimum Premium under the Policy should be Rs. 1000/-.

161

CINEMA HALLS / AUDITORIUMS / THEATRES / OPEN AIR

THEATRES / PUBLIC HALLS
Basic Rate for risks situated in Class I and Superior Constructions will be as per
RISK GROUP I of TABLE I, which should be multiplied by applicable multiplier as per
TABLE II depending on Any One Accident limit under the policy. The resultant rate
should be applied on Any One Accident Limit under the policy to arrive at the indemnity
premium.
In addition to the indemnity premium loading at the rate of Re.1/- per seat per
head should be charged according to seating capacity. Wherever seating capacity is
not determinable, double the indemnity premium should be charged.
For Risks situated in Class II constructions indemnity Premium arrived at for Class
I construction should be loaded by 10 pct and seating extra to be collected as above.
For extending the policy to cover liabilities arising out of food and beverages
supplied by the Insured the additional premium may be calculated as under and suitable
Endorsement be made as provided for :
50% of the premium applicable to the premises limit shall be applied to the limit
chosen for the concerned extension in the proportion that the premises limit of indemnity
bears to the limit of indemnity selected for the extension. The premium however shall in
no case either be less than Rs.250/- or exceed the amount arrived at by applying the
percentage premium stipulated in the erstwhile Market Agreement for limits of indemnity
equal to those placed for the premises risk.
Minimum premium under the policy should be Rs.1000/-.
Compulsory Excess : 0.50% of AOA limit subject to a minimum of Rs.2,50,000/and a maximum of Rs.5,00,000/-.

162

SCHOOLS / EDUCATIONAL INSTITUTIONS / PUBLIC LIBRARIES

The basic rate is to be arrived at by rating the risk under Risk Group I of Table 1
which should be multiplied by the multiplier as per TABLE II as applicable to Any One
Accident Limit under the Policy. The resultant rate should be applied on Any One
Accident Limit to arrive at the indemnity premium.
For risks situated in PUCA construction the indemnity premium would be 25% of
Indemnity premium. For risks situated in KUTCHA construction the indemnity premium
as per Class I risk should be loaded by 10%.
In addition to Indemnity premium, loading at Re.1/- per non resident student and
Rs.2/- per resident student should be collected.
If desired, the policy can be extended to cover Insureds legal liabilities to their
parties arising out of food and beverages supplied by them subject to consideration of
additional premium.
If policy can also be extended to cover Insureds legal liability arising out of
hazardous sports arranged by them subject to consideration of additional premium. The
additional premium for each extension may calculated as under :
50% of the premium applicable to the premises limit shall be applied to the limit
chosen for the concerned extension in the proportion that the premises limit of indemnity
bears to the limit of indemnity selected for the extension. The premium however shall in
no case either be less than Rs.250/- or exceed the amount arrived at by applying the
percentage premium stipulated in the erstwhile Market Agreement for limits of indemnity
equal to those placed for the premises risk.
Minimum premium under the policy - Rs.1000/-.

163

Compulsory Excess : 0.50% of Any One Accident limit subject to minimum of

Rs.2,50,000/- and a maximum of Rs.5,00,000/-.
(Hazardous sports means mountain climbing, sky diving, hang gliding, skiing and
aqua sports and similar other hazardous sports).
Students are treated as third parties under the policy but not the teachers and other
staff members who are employed by the Institutions.
Kidnapping of students are not covered under the scope of policy and specific
exclusion should be added when policies are issued.

PERMANENT AMUSEMENT PARKS

1.

Premium on indemnity limit

The basic rate will be as per Risk Group IV of Table I which should be multiplied

by applicable multiplier as per table II depending upon the Any One Accident Limit
under the policy. The resultant rate should be applied on the Any One Accident limit to
arrive at the indemnity premium.
2.

Loading on Turnover
In addition to the indemnity premium as per 1 above, loading on turnover as

shown in table iv shall be charged on the previous years gross annual turnover or the
current years projected turnover whichever is higher. The term turnover shall mean all
gate monies, hiring charges for various games and facilities, hiring charges for the use of
the premises paid by corporate clients / film producers etc. and levies and taxes
applicable.
Minimum premium under the policy is Rs.1000/-.

164

Compulsory Excess is 1% of the AOA limit subject to a minimum of Rs.10,000/and maximum of Rs.1,00,000/-.

FILM STUDIOS INDOOR AND OUTDOOR/CIRCUS/ZOO

Basic rate for risk will be as per Risk Group IV of Table I which should be
multiplied by applicable multiplier as per Table II as applicable to AOA limit under the
policy. The resultant rate should be applied on the AOA limit under the policy to arrive at
the Indemnity premium.
In case of outdoor film shooting 25% loading on the Indemnity premium.
In case of circus, if annual policies are taken, cover will operate only when the
circus is located in a place. For covering liability arising while the circus is on the move25% loading on the indemnity premium should be charged.
Minimum premium under the policy is Rs.1000/-.
Compulsory Excess: 0.50% of Any One Accident limit subject to a minimum of
Rs.2,50,000/- and maximum of Rs.5,00,000/-.

DEPOTS/WAREHOUSES/GODOWNS/SHOPS/TANK FARMS
The basic rate is to be arrived at by treating the risk under the applicable Risk
Group which should be multiplied by applicable multiplier as per TABLE II as applicable
to the AOA limit under the policy. The resultant rate should be applied on the indemnity
limit for Any One Accident to arrive at the indemnity premium.

165

For determining the Risk Group of the premises for the purpose of rating, the
goods stored in the premises are classified as Non-hazardous, hazardous and Extra
hazardous as under:
For Superior & Class I Construction:

Risk Group

Shops / Depots
Warehouses

Godowns

Tank Farms
(incl. Handling
operations)

Non - I
Hazardous

50% of gross
premium i.e.
indemnity +
loading on
Turnover as per
table 2

50% of indemnity 100% of

premium + 75%
indemnity
per 1 cub. meter
premium +
Turnover extra.

Hazardous-III

50% of gross
premium i.e.
Indemnity
premium +
loading on
turnover as per
table 2

50% of indemnity as above

premium + 1.50
paise per 1 cub
meter.

Extra IV
Hazardous

50% of gross
premium i.e.
indemnity
premium +
loading on
Turnover as per
table 2.

50% of indemnity as above

premium + Rs.3/per 1 cub. metre.

166

FOR CLASS II CONSTRUCTION & OTHERS

Shops / Depots
Warehouses

Risk Group

Godowns

Tank Farms
(incl. Handling
operations)

Non-I hazardous

75% of gross
prem. i.e.
indemnity +
loading on
turnover as per
table 2

75% of indemnity 100% of

premium + 75%
indemnity
per 1 cub. metre. premium +
turnover extra.

Hazardous - III

75% of gross
premium i.e.
indemnity
premium +
loading on
turnover as per
table 2

75% of indemnity
premium + 1.50%
paise per 1 cub.
metre.

Extra hazardous
IV

75% of gross
premium i.e.
indemnity
premium +
Loading on
turnover as per
table 2.

75% of indemnity as above

premium + Rs.3/per 1 cub. metre.

As above

In case more than one location is to be covered under single policy, location extra
as provided under Table III should be charged. Rating will depend on the highest
category of the risk covered under the policy. Cubic metre extra is applicable for all
locations covered under the policy.
If pollution risk is to covered the additional premium at the following rates should
be charged:
Risk Group I

10% of total premium

III

30% of total premium

IV

50% of total premium

167

Note: In case one hirer wants to cover for part space occupied by him, full
premium as applicable to godown should be charged.
Minimum premium under the policy is Rs.500/-.
Compulsory Excess: 0.50% of AOA limit subject to a minimum of Rs.2, 50,000/and a maximum of Rs.5,00,000/-.
Contractors for Maintenance Jobs:
The basic rate will be as per the Risk Group of the premises on which the job is
carried out (as per table I) which should be multiplied by the applicable multiplier (as per
Table II) as applicable on the AOA limit under the policy + Turnover Extra on contract
Value as per Table 4.
Location Extra as per Table 3 should be charged wherever applicable.
Minimum premium under the policy is Rs.500/-.
Compulsory Excess: 0.25% of AOA limit subject to a minimum of Rs.1000/- and
maximum of Rs.1,00,000/-.
EXHIBITIONS / FAIRS AND FETES / STADIUMS AND PANDALS
The basic rate will be as per risk GROUP IV of Table 1 which should be
multiplied by applicable multiplier as per TABLE II as applicable to Any One Accident
Limit under the Policy. The resultant rate should be applied on the Any One Accident
Limit to arrive at the indemnity premium.
No loading on turnover is applicable.
Minimum premium under the policy - Rs.1000/-.
Compulsory Excess : 0.25 pct of Any One Accident limit subject to a minimum of
Rs.10,000/- and a maximum of Rs.1,00,000/-.

168

PUBLIC LIABILITY INSURANCE (NON INDUSTRIAL RISK)

SCOPE OF COVER (GENERAL):
Public Liability insurance policy is meant to indemnify the Insured against the
Insureds legal liability to pay compensation including claimants costs, fees and
expenses in respect of injury and/or damage arising out of accidents. The claim for
compensation should be in connection with the business specified in the schedule
of the policy and not arising out of pollution of any product. For the purpose of
determining the indemnity:i)

Injury shall mean, death, bodily injury, illness or disease to any person.

ii)

Damage shall mean actual and/or physical damage to tangible property.

iii)

Pollution shall mean Pollution or contamination of the atmosphere, any

water, land or other tangible property.

iv)

Accident means a fortuitous event or circumstances which. is sudden

unexpected and unintentional including resultant continuous intermittent
or repeated exposure arising out of the same fortuitous event or
circumstance.,

v)

Policy period means the period commencing from midnight on the

inception date and terminating at midnight on the expiry date of the
policy.

vi)

Period of insurance means the period commencing from the retroactive

date and terminating on the expiry date of the policy.

NON INDUSTRIAL: RISKS POLICY

For Non Industrial Risks, Public Liability Insurance cover has been devised
from 1.12.1991 by G.I.C. This cover will apply to any type of Non Industrial Risk
like, Hotels, Clubs, Public Halls, Pandals, Air Port Premises, Film Studios Zoos,
Godowns, Shops etc. A revised proposal form has been introduced and the same
should be got completed in all respects by the BOs/DOs. Similarly a revised Policy
format has been introduced which has to be adopted by all our BO/DO. It is to be

169

noted in this connection that pollution risk is not covered under the basic policy and
it is an extension by charging extra premium as per Market Agreement and fulfilling
the other requirements.
Multiple Units situated at various locations can be covered under single limit of
indemnity per any one accident / any one policy period at appropriate extra
premium. But subsidiaries and Associate concerns can be covered under separate
policies only. The Insured has to choose Any one Accident limit that isAOA
and also Any one year limit i.e. AOY for the policy period. Normallly, the ratio
of AOA to AOY should not exceed 1: 4. In terms of HO instructions, all proposals
irrespective of AOA, AOY limits, are to be referred to concerned RO for rating and
acceptance. But ROs have been empowered to quote and accept risks upto 25 lacs
only either AOA or AOY. Proposals exceeding the above limit are to be referred by
concerned RO to HO Technical Miscellaneous Department for their approval and
acceptance as well as quotation of premium.

The rates given in the Market

Agreement are annual and it is necessary to accurately assess the annual turn over
and the same should be indicated correctly in the proposal form.
Act of God Perils[ will be included in the policy on payment of additional
premium according to the Seismic Zones in which the risk is situated as per the
rates indicated in the Market Agreement.

It is possible to cover liability arising out

of discharge of treated effluents outside the Insured premises through pipelines, at

suitable extra premium. Similarly Transportation Liability is an extension under
the policy. Should there be any increase or decrease in the turn over the insured
advise the same to our underwriting office and suitable adjustment in premium has
to be made before expiry of the policy. However, the market agreement does not
provide for adjustment on expiry of the policy, which has to be noted very carefully.
In view on this position B.O./D.O. should endeavour to obtain correct details of turn
over at the earliest for correct rating of the policy. No revision in AOA is permitted
during the policy period.

However, within the same indemnity limits, additional

units may be included by applying short period scale of premium as indicated in the
Market Agreement.

170

There will be a compulsory excess of 1/2 % of AOA, subject to a minimum of

Rs.2,000/- and a maximum of Rs.3 lacs per claim. It is permissible for the Insured
to bear a voluntary excess at a slightly reduced rate of premium. This should be
indicated in the proposal form clearly while it is forwarded to RO for rating and
acceptance.
A short period policy for less than one year is also possible at a specific short
period scale of rate given in the Market Agreement.
The policy will have the following important clauses:
NOTIFICATION EXTENSION CLAUSE :
Should the Insured notify the Company during the policy period in accordance
with the General Condition 9.1 of any specific event or circumstance which the
Company accepts may give rise to a claim which form the subject of indemnity by
the policy, then the acceptance of such notification means that Company will deal
with such claim or claims as if they had first been made against the Insured during
the policy period. The extension under this clause will be subject to the maximum
time laid down under the Indian Limitation Act in force from time to time.

EXTENDED CLAIM REPORTING CLAUSE :

In the event of non-renewal or cancellation of this policy, either by the
Company or by the Insured, the Company will allow a time limit not exceeding 90
days from the date of expiry or cancellation of the policy for notification of claims
for accidents which had taken place during the period of insurance but could not be
made during the policy period.

Provided however all claims made during the

extended reporting period shall be handled as if they were made on the last day of
the expiring policy period and are subject to the limits of indemnity and the terms,
conditions and exceptions of the policy.

171

INDEMNITY TO OTHERS :
The indemnity granted extends to:
1.

Officials of the Insured in their business capacity arising out of the

performance of their business or in their private capacity arising out of
temporary engagement of the Insureds employees.

2.

The Officers, Committees and Members of the Insureds canteen social,

sports, medical,

fire fighting

and

welfare organisations

in

their

respective capacities as such;

3.

The personal representatives of the estate of any person who would

otherwise be indemnified by this Policy but only in respect of liability
incurred by such person.
Provided always that such persons or parties shall fulfil and be subject to
terms, conditions and exclusions of this policy as though they. were the
Insured.

CROSS LIABILITIES :
Each person or party indemnified, is separately indemnified in respect of
claims made against any of them by any other person or party (other than the named
Insured) subject to Companys total liability not exceeding the limits of. indemnity
stated in the Schedule of the policy.
DEFENCE COSTS :
The Company will pay all costs, fees and expenses incurred with their prior
consent in the investigation, defence or settlement of any claim made against the

172

Insured and the costs of representation at any inquest, inquiry or other proceedings
in respect of matters which have a direct relevance to any claim made or which
might be made against the Insured, provided such claim or claims are the subject of
indemnity under Policy, whether liability ultimately attaches to the policy or not.
Such cost, fees and expenses are called Defence Costs.
INDEMNITY LIMITS :
Companys total liability to pay compensation, Claimants costs, fees and
expenses and defence costs shall not exceed the Indemnity limit stated in the
schedule. Indemnity limit for any one accident applies to any one claim or series of
claims arising from one Originating cause.

Indemnity limit for the period of

Insurance shall represent the total amount of Companys liability during the policy
period.
CLAIMS SERIES CLAUSE:
For the purpose of this policy where a series of and / or several bodily injuries
and / or property damages occur which are attributable directly or indirectly to the
same accident. all such bodily injuries and/or property damages shall be added
together and the total amount of such bodily injuries and / or property damages
shall be treated as one occurrence. There shall, however, be no coverage for claims
made arising from specific cause which are made later than 3 years after the first
claim of the series.

EXCLUSIONS
Exclusions under the policy are enumerated here under:
i)

Liability assumed by the insured by agreement and which would not have
attached in the absence of such, agreement.

173

ii)

Liability arising out of earthquake, flood, storm or other similar

convulsions of nature.

iii)

Liability arising out of deliberate, wilful or intentional non compliance

of any statutory provision.

iv)

Liability arising out of loss of goodwill, loss of market etc.

v)

Liability arising out of all personal injuries and mental, anguish or shock
resulting there from.

vi)

Liability arising out of infringement of plans, copy right, trade name,

trade mark, registered design etc.

vii) Liability arising out of fines, penalties, punitive or exemplary damages

and other damages resulting from the multiplication of compensatory
damages.
viii) Liability, directly or indirectly caused by war and warlike perils, nuclear
and radioactive materials.
ix)

Liability, directly or in-directly caused by or contributed to by ionising

radiations or contamination by radioactivity from any nuclear fuel, toxic,
or other hazardous properties of any explosive nature.

x)

Liability arising out of transportation of materials and / or hazardous

substances outside the Insureds premises unless specifically covered.

xi)

Liability arising out of the ownership, possession of any motor vehicle/

trailer etc.

xii) Liability arising out of damage to Insureds property, or leased or hired or

under hire purchase or loan to the insured, or premises temporally
occupied by the Insured, or other property temporarily in the custody of
the Insured, employees and visitors clothing and personal effects, or
premises Tenanted by the Insured to the extent that the Insured would be
legally held liable in the absence of any specific agreement.
xiii) Liability arising out of injury or damage arising prior to the retroactive
date.

174

xiv) Liability arising out of conscious or intentional disregard of the insureds

technical or administrative management of the need to take all reasonable
steps to prevent claim.
xv) Liability for any injury to any person under a contract of employment etc.
xvi) Liability arising out of ownership, possession of, use by or on behalf of
the Insured of any Motor Vehicle or trailer for which compulsory
insurance is required by legislation other than claims caused by use of
any tool or plant in a motor vehicle or trailer, etc.
Any other normal condition applicable for other Miscellaneous Accident Policy
will apply in this case also.

OTHER FEATURES
1.

Payment of claim reduces the limit of liability to the extent of payment.

It is not possible to reinstate the aggregate limit of indemnity even on
payment of extra premium.

2.

For cancellation of the policy, a notice of 30 days is necessary subject to

a minimum premium to be retained. In case of cancellation by the Insurer
the refund will be on pro-rata basis, otherwise the insurer will retain the
premium on short period scale. In the case of any claim under the policy
the Insured will not be eligible for any refund.

175

PUBLIC LIABILITY INSURANCE (ACT POLICY)

The Public Liability Act, 1991 was made effective from 1.4.1991. The object of
this Act is to provide through insurance immediate relief by Owners to persons affected
due to accident while handling hazardous substance on no fault liability basis.
This has also been brought under Tariff. The definition of Owner is so comprehensive
as to cover any person who owns or has control over any hazardous substance at the time
of accident. This includes any Firm or its partners, Association or its members, Company
or its Directors and all other persons associated and responsible to that Company in the
conduct of their business.
The various terms like Accident, Hazardous substances as defined in the Act
are given below;
Accident means an accident involving a fortuitous, sudden or unintentional
occurrence while handling any hazardous substance resulting in continuous, intermittent
or repeated exposure to death of, or injury to any person or damage to any property but
does not include an accident by reason only of war or radioactivity.
Handling in relation to any hazardous substance, means the manufacture,
processing, treatment, package, storage, transportation by vehicle, use, collection,
destruction, conversion, offering for sale, transfer or the like of such hazardous substance.
Hazardous Substance means any substance or preparation which is defined as
hazardous substance under the Environment (protection Act, 1986) and exceeding such
quantity as may be specified, by notification, by the Central Government.
Hazardous Substance means any substance or preparation which, by reason of
its chemical properties or handling is liable to cause harm to human beings,

176

other

living creatures, plants, micro-organism, property or the environment (as per

the Environment (Protection) Act 1986.)
INSURANCE LIMITS :
Any

one

accident:

Minimum

equal

to

Paid

up

capital

upto

maximum of Rs.5 crores.

Any one year: 3 times of Any one accident limit subject to a
maximum of Rs.15 crores.
LIABILITY BEYOND INSURANCE :
In case of claim/s exceeding the above statutory limit/s, it is to be met by the
Environmental Relief Fund to be set up under Sec. 7A of the Act and managed by the
Authority appointed by the Central Government.
The liability beyond the total of the insurance and the Relief / Fund is to be borne
by the Owner.
CONTRIBUTION TO THE RELIEF FUND :
Equal to the insurance premium chargeable is to be paid simultaneously by every
owner with the insurance premium to the underwriting Company.
All proposals can be rated and accepted at DO level in terms of the rating structure
laid down by them.
SCHEDULE OF COMPENSATION :
i)

Reimbursement of medical expenses incurred up to a maximum of

Rs.12,500/- in each case.

177

ii)

For a Fatal Accident the relief will be Rs.25,000/- per person in addition to
reimbursement of medical expenses, if any incurred on the victim up to a
maximum of Rs.12,500/-.

iii)

For permanent total or permanent partial disability or other injury or

sickness, the relief will be :
a)

Reimbursement of medical expenses incurred, if any, up to a

maximum Rs.12,500/- in each case and,

b)

Cash relief on the basis of percentage of disablement as certified by

an authorised physician. The relief for total permanent disability will
be Rs.25,000/-

iv)

For loss of wages due to temporary partial disability which reduce the
earning capacity of the victim, there will be a fixed monthly relief not
exceeding Rs.1,000/- per month up to a maximum of 3 months provided the
victim has been hospitalised for a period exceeding 3 days and above 16
years of age.

v)

In respect of damage to private property, up to Rs.6000/- per claim.

CLAIM PROCEDURE - AS PER PROVISIONS OF THE ACT.

a)

As per Sec.6 (2) & (3), every application for relief is to be made within 5
years of the occurrence to the Collector.

b)

The application as per Rule (4) is to be accompanied by the following;

i)

Authorised physicians certificate regarding disability / injury /

illness caused by the accident.

ii)

Death certificate and / or post-mortem certificate in the case of Fatal

Accident.

178

iii)

Employers certificate regarding loss of wages due to temporary

partial disablement with proof of hospitalisation exceeding 3 days
and certificate proving the age of the victim.

iv)

Medical bills and receipts.

v)

Certificate of cost of repairs or replacement to private property

damaged by the accident.

vi)

Any other relevant document.

APPLICATION FOR RELIEF :

This is to made by the injured / owner of the damaged property / legal
representatives of the deceased / authorised agent.
It has to be made to the Collector in the prescribed format with necessary
documents.
It should be made within 5 years of the occurrence of the accident.
This relief is payable to any person other than a Workman. Workman has the
meaning assigned to it in the Workman Compensation Act, 1923. By implication
employees other than such workman are eligible for compensation.
The compensation should be paid by the Insurer within 30 days of announcement
of the Award by the Collector.

RATING UNDER PUBLIC LIABILITY INSURANCE ACT

1.

The turnover loading be restricted to the turnover of only such units / operations
which are involved in the handling of notified hazardous substances.

179

Accordingly, the definition of items 9(1) and 9(2) of Turnover appearing in

the proposal form is amended as under :
9(1) Manufacturing Unit : Entire Annual Gross Sales Turnover including all
levies and taxes of manufacturing units handling hazardous substance as defined in
the PLI Act 1991. For the purpose of this insurance, the term units shall mean all
operations being carried out in the manufacturing complex in one location.
9(2) Godown and Warehouse Owners : Total Annual Rental Receipt of premises
handling hazardous substances as defined in the PLI Act 1991.
The definitions of items iii) Transport Operators and iv) Others under the head
Turnover remain unaltered.
2.

The Tariff Advisory Committee has decided to dispense with the system of special
rating under the class of insurance.
The rating schedule for Public Liability Insurance Cover under PLI Act 1991 is as

under :-

180

PREMIUM FOR PUBLIC LIABILITY INSURANCE COVER UNDER THE

PUBLIC LIABILITY ACT 1991 :
A)

ON FULL LIMIT OF INDEMNITY: ANY ONE ACCIDENT.

Limit of Indemnity (Rs) Rate per Mille

____________________________________________________________
Upto 1.0 lac

0.70

Upto 2.5 lac

0.75

Upto 5.0 lac

0.80

Upto 10.0 lac

0.85

Upto 20.0 lac

0.90

Upto 50.0 lac

0.95

Upto 100.0 lac

1.00

Upto 250.0 lac

1.05

Upto 500.0 lac

1.10

181

A)

TURNOVER LOADING:

TURNOVER
Upto Rs.1.00 cr.
Exceeding Rs.1.00 crores but not
exceeding Rs.5 cr.
Exceeding Rs.5cr. But not
exceeding Rs.10cr.
Exceeding Rs.10 cr. But not
exceeding Rs.50 cr.
Exceeding Rs.50 cr. But not
exceeding Rs.100 cr.
Exceeding Rs.100 cr. But not
exceeding Rs.250 cr.
Exceeding Rs.250 cr.But not
exceeding Rs.500 cr.
Exceeding Rs. 500 cr.But not
exceeding Rs.1000 cr.
Exceeding Rs.1000 cr.But not
exceeding Rs.2000 cr.
Exceeding Rs.2000 cr.

RATE
Rs.0.12 per mille subject to a
minimum of Rs.12/Rs.1200/- +0.084 per mille on
turnover exceeding Rs.1cr.
Rs.4860 + 0.072 per mille on
turnover exceeding Rs. 5cr.
Rs.8160 + 0.060 per mille on
turnover exceeding Rs.10 cr.
Rs.32160 + 0.048 per mille on turnover
exceeding Rs.50 cr.
Rs.56160 + 0.036 per mille on
turnover exceeding Rs.100 cr.
Rs.110160 + 0.010 per mille on
turnover exceeding Rs.250 cr.
Rs.135160 + 0.0075 per mille on
turnover exceeding Rs.500 cr.
Rs.172660 + 0.0050 per mille on
turnover exceeding Rs.1000 cr.
Rs.222660 + 0.0025 per mille on
turnover exceeding Rs.2000 cr.

Minimum premium (A+B) is Rs.100/- per policy.

TIME LIMIT :
For filing an application
for relief

5 years from the occurrence of

accident.

For complying all formalities

and announcing and Award

3 months from the date of

receipt of application.

For delivering copies of the

Award to the parties.

15 days from the date of Award.

For satisfaction of the Award

30 days from the date of the Award. If not

paid within this period, such amount shall be
treated as arrears of land revenue.

182

PUBLIC LIABILITY (INDUSTRIAL RISKS)

1.

APPLICABILITY
This policy applies to industrial storage risks such as Depots, Warehouses,

Godowns, Tank farms within the geographical limits of India.

Proposals in respect of Public Liability Risks (a) outside the geographical limits of
India will have to be referred to Head Office.
2.

Standard Proposal Form

Operating offices shall obtain proposal for Public Liability Insurance in the

Standard Proposal Form. No cover shall be granted unless a declaration as provided for in
the proposal form is obtained from the Insured to the effect that all the statutory
requirements relating to the business activities are complied with.
3.

Liabilities Covered
Policies issued shall cover all sums which the Insured becomes legally liable to

pay as damages to third party in respect of accidental death/bodily injury / disease and
loss of or damage to property arising out of claims first made in writing against the
Insured during the policy period, including legal costs and expenses incurred with prior
consent of Insurers, subject always to the limits of indemnity and other terms, conditions
and exceptions of the policy. It shall not be permissible to issue a Public Liability
Insurance Policy with unlimited liability. The maximum ratio of limit of indemnity any
one accident to any one year shall not exceed 1 - 4.

183

4.

Pollution Risks
Policies issued shall not include cover for Pollution risks unless otherwise

specifically included by endorsement prescribed hereunder and additional premium

Pollution Cover, Wherever opted, shall be subject to the following conditions:(a)

The insured shall submit additional information as per questionnaire

appended to

the Proposal Form.

(b)

The Insured shall furnish a Certificate/consent letter from the Pollution Control
Board granting permission to carry on their activities.
However, if the Insured have approached the Authorities concerned for issuance of

or renewal of consent orders and if the Insurance Company is satisfied that the Insured
have complied with the necessary statutory regulations for enabling the Authorities
concerned to issue such certificates, the Pollution Extension Cover may be granted,
subject to Inspection of the risk by the Companys Engineer and his recommendation as
per Risk Assessment Report.
5.

Transportation risks outside Insureds Premises

Policies issued shall not include liability arising out of and incidental to

transportation of materials including hazardous/dangerous substances unless otherwise

specifically included by endorsement prescribed hereunder and additional premium
collected therefor.
It shall however be permissible to issue a public Liability Policy to exclusively
cover Insureds liability arising out of and incidental to transportation of materials only
including hazardous/dangerous substances outside the Insureds premises provided that
premium at additional rates are charged and all terms, conditions and exceptions of the

184

Policy applied thereto. This Transportation Policy shall not cover the transits for partial
loads.
Wherever, the transportation limits of indemnity sought are in excess

of the

premises limits of indemnity, it will not be permissible to allow coverage of that portion
of such limit corresponding to the premises limit of indemnity as an extension of
premises policy, with the balance limits being insured under a separate policy either with
same or other insurer by charging 100% applicable premium.
6.

Cover for multiple units

The policy, in addition to the Insureds manufacturing plant(s) will also cover nonmanufacturing premises such as offices, depots, warehouses, storage godowns,
tank farms etc. situated at different places which are incidental to the business
activities of the insureds manufacturing plant provided such non--manufacturing
premises are declared and agreed for insurance and additional premium paid
therefor.,
It shall also be permissible to insure more than one manufacturing units located at
different sites under single Limit of Indemnity per Any One Accident / Any One
Policy period provided appropriate premium is paid as per the Rating Schedule
Section II.

N.B. : However, if the Depots, Warehouses etc. are of multiple occupancy, this
cover cannot be granted.
7.

Extension sought under the main policy shall not have indemnity limit in excess of
the main cover.

185

8.

Classification of Risk:
Industries are classified under four Groups as provided in the erstwhile Market
Agreement.
Where the risks cannot be classified into any of the four Groups, the operating

offices may rate such risks by using the erstwhile Market Agreement as guidelines for
like or similar risks. In respect of risks for which there are no guiding provisions, the
same may be rated by the Head Office.
9.

Premium
The rates of premium are annual rates based on the Limits of Liability as well as
the annual turnover. Full premium under the policy shall be paid at inception. It is
not permissible to accept premium by installments.
The turnover under the Policy has to be accurately assessed and declared by the
Insured at inception as far as possible. However, in case the Insured anticipates
any increase in turnover during the policy period, such anticipated increase in
turnover shall be immediately notified to the Company and the additional,
premium paid therefor.
In case the Insured anticipates any decrease in turnover during the policy period
such anticipated decrease in turnover shall be considered by the underwriting
office at its discretion and downward adjustment in premium made accordingly.
Under no circumstances it shall be permissible to adjust the premium for the
turnover on expiry of the policy.

186

10.

Retroactive Date
Retroactive date is the date when the risk is first incepted under a claims made
policy and thereafter renewed without break in the period of cover.

11.

Revision in Limits of Indemnity

Mid - term increase / decrease in the limits of indemnity during the currency of the
policy period will be at the discretion of the Head Office of the Company.
Whenever changes in indemnity limits are agreed to the revised retroactive date
showing indemnity limits available at various dates shall be incorporated in the
Policy Schedule.
If insured wish to seek protection for anticipated liability in excess of available
limits of indemnity for past periods due to different retroactive date, the Company
may consider granting of run-off cover based on merits of each case. Rates, terms
and conditions for such Run-off cover may be finalised by the Head Office and if
necessary reinsurers.
Similarly when an insured changes the Insurance Company, to take care of the
residual liability under the policy issued by the earlier insurer, run off cover may
be issued if desired by the insured. The rates and other terms and conditions may
be finalised by the Head Office.
However, within the same Indemnity Limits, additional units may be included
during the policy period by applying short period premium scale and as per
Section II - Rating with retroactive date at inception of such inclusion in the
policy.
Such retroactive date shall remain unaltered in the event of renewal of the policy
without any break in the period -of cover.

187

12.

Compulsory Excess
All Policies issued under this Agreement shall be subject to compulsory excess of

1/2% of the limit of indemnity per any one accident, subject to a minimum of
Rs.2,50,000/- and a maximum of Rs.5,00,000/- (Rupees five lakhs only) The Insured
shall bear this Compulsory Excess which is applicable to both property damage claims
and death / bodily injury claims inclusive of defence costs arising out of any one
accident.
13.

Voluntary Excess
The following discounts on the premium may be allowed for Voluntary Excess

opted by the Insured.

Voluntary Excess (Percentage of Limit
of Indemnity per any one Accident)
5
7.5
10
15
20
25
35
50

Discount
2.5
5.0
7.5
10.0
12.5
15.0
20
25

The Voluntary Excess shall be in addition to the Compulsory Excess and shall be
applicable to both property damage claims and / or death / bodily injury claims inclusive
of defence costs arising out of any one accident.
14.

Short Period Premium

It shall not be permissible to issue Polices for periods more than 12 months. The

following short period scale of premium shall apply to (i) policies issued for periods less

188

than 12 months and (ii) policies cancelled during the currency at the request of the
Insured subject to no claim:
Period

Rate

(Not exceeding)
1 Week
10% of the Annual rate
1 Month
25% of the Annual rate
2 Months
35% of the Annual rate
3 Months
50% of the Annual rate
4 Months
60% of the Annual rate
6 Months
75% of the Annual rate
8 Months
85% of the Annual rate
Exceeding 8 months .................. Full Annual premium
15. Discounts :
(A)

Any risk having gross total premises premium of Rs.3 lakhs and above as per
Section II - Rating will qualify for discounts as per the Scale of Discounts. The
total quantum of discount however, shall in no case exceed 25% of the gross total
premium arrived at as per Section II - Rating.

(B)

A discount equivalent to the 25% of the premium paid on the Public Liability
Insurance Act Policy (PLI Act, 1991) on the applicable premium of the Market
Agreement Policy can be allowed subject to such discounted premium on the
Market Agreement Policy not being less than 75% of the applicable net premium
thereon, after application of loading and discounts.
Where the number of units insured under PLIA are more than those insured under

erstwhile Market Agreement provisions or vice versa, to give equitable benefit to the
insured as if premium may be worked out in respect of common units both as per the
provisions of PLIA and erstwhile Market Agreement.

189

SECTION - II
RATING
A.

On Indemnity Limit per Any One Accident.

The basic rate depends upon (i) classification of risk (vide Page) and (ii) the ratio
of limits of indemnity of any one accident to any one year selected.
The basic rate (applicable per mille) for the ratio of limits of indemnity of any one

accident to any one year will be as given under:

TABLE - 1
Risk Group

1
2
3
4

Ratio of
Indemnity
AOA to AOY
1:1

1:2

0.15 pm
0.18 pm
0.21 pm
0.24 pm

0.22 pm
0.26 pm
0.30 pm
0.34 pm

1:3
0.27
0.32
0.37
0.42

pm
pm
pm
pm

To arrive at the final rate, the above basic rate is to be multiplied by the applicable
multiplier as per the following table of limit of indemnity per any one accident opted.

190

TABLE - 2
LIMIT OF INDEMNITY AND MULTIPLIER THEREOF
Limit of Indemnity Per
any one accident
(Rs. in lacs)

Multiplier

Limit of Indemnity
per any one accident
((Rs. in lacs))

Multiplier

Upto 10

28

Exceeding 450 but not

Exceeding 500

14

Exceeding 10 but not

Exceeding 25

26

Exceeding 500 but not

Exceeding 600

13.5

Exceeding 25 but not

Exceeding 50

25

Exceeding 600 but not

Exceeding 700

13

Exceeding 50 but not

Exceeding 75

24

Exceeding 700 but not

Exceeding 800

12

Exceeding 75 but not

Exceeding 100

23

Exceeding 800 but not

Exceeding 900

11

Exceeding 100 but not

Exceeding 150

21

Exceeding 900 but not

Exceeding 1000

10

Exceeding 150 but not

Exceeding 200

20

Exceeding 1000 but not

Exceeding 1200

9.25

Exceeding 200 but not

Exceeding 250

19

Exceeding 1200 but not

Exceeding 1500

8.6

Exceeding 250 but not

Exceeding 300

18

Exceeding 1500 but not

Exceeding 2000

8.25

Exceeding 300 but not

Exceeding 350

17

Exceeding 2000 but not

Exceeding 3000

Exceeding 350 but not

Exceeding 400

16

Exceeding 3000 but not

Exceeding 4000

7.75

Exceeding 400 but not

Exceeding 450

15

Exceeding 4000 but not

Exceeding 5000

7.6

Exceeding 5000 but not

Exceeding 10750

7.5

191

The final rates so arrived at is to be applied on the limit of indemnity per any one
accident.
Any of the following would constitute alteration in expiring terms and would
attract rating using revised multiplier:
i)

Increase / decrease in indemnity limit.

ii)

Change in the AOA : AOY ratio

iii)

Inclusion/ Exclusion of Occidental pollution

iv)

Inclusion/ Exclusion of AOG Perils

v)

Inclusion/ Exclusion of transportation cover

Odd Indemnity Limits:

lf any insured wish to avail indemnity limits failing in between the slabs provided
above premium therefor should be calculated using multipliers as shown in the following
example:
Indemnity Limit is Rs. 125 lacs
Multiplier upto Rs. 100 lacs

23

Multiplier on Rs. 25 lacs

21

Multiple units covered under Single Indemnity Limit:

If more than one plant of the Insured, located at different sites, is to be covered
within one single overall Indemnity Limit per any one accident / any one year under the
policy, the premiums on Indemnity Limits (vide A above) shall be multiplied by the
following multipliers:

192

TABLES - 3
Risk Group

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15 & above

Ratio of
Indemnity
AOA to AOY
1:1

1:2

1:3

1.0
1.35
1.50
1.65
1.8
1.9
1.95
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0

1.0
1.5
1.7
1.9
2.05
2.15
2.25
2.35
2.45
2.5
2.5
2.5
2.5
2.5
2.5

1.0
1.6
2.0
2.25
2.5
2.65
2.75
2.85
2.95
3.00
3.05
3.10
3.15
3.15
3.15

If the units / establishments belong to different risk groups the premium on

indemnity limits vide A above shall be based on the highest risk group.
The above multipliers shall be applicable to manufacturing premises and not to
non-manufacturing premises such as offices, warehouse, depots, godowns etc. located in
more than one place.

193

B.

ON TURNOVER
In addition to the premium at the rates mentioned above (applied on indemnity

limits), premium as under shall be charged on the previous years gross annual turnover
or the current years projected annual turnover whichever is higher. The term Turnover
shall mean annual gross sales including all taxes and levies. The turnover figures
should be accurately assessed and duly certified by the competent officials of the
Insured.
TABLE 4
LOADING ON TURNOVER
(For Risk Group)
Annual Turnover

Premium %

First Rs.1 crore

Rs.1000 (min)

Exceeding Rs.1 crore but not

exceeding Rs.5 crores
(Next Rs.4 crores)

Rs.1000 + 0.07% o on the excess

over Rs.1 crore

Exceeding Rs.5 crores but not

exceeding Rs.10 crores
(Next Rs.5 crores)

Rs.3800 + 0.06%o on the excess over

Rs.5 crores

Exceeding Rs.10 crores but not

exceeding Rs.50 crores
(Next Rs.40 crores)

Rs.6800 + 0.05%o on the excess over

Rs.10 crores

Exceeding Rs.50 crores but not

exceeding Rs.100 crores
(Next Rs.50 crores)

Rs.26800 + 0.04%o on the excess over

Rs.50 crores

Exceeding Rs.100 crores but not

exceeding Rs.250 crores
(Next Rs.150 crores)

Rs.46800 + 0.03%o on the excess over

Rs.100 crores

Exceeding Rs.250 crores but not

exceeding Rs.500 crores
(Next Rs.250 crores)

Rs.91800 + 0.02%o on the excess over

Rs.250 crores

194

Exceeding Rs.500 crores

Rs.141800 + 0.01%o on the excess

over Rs.500 crores

Where the ratio of any one accident to any one year is different, the indemnity premium
would be modified as below:
Ratio AOA:AOY

Premium

1:2

80% of the above table 2

1:3

70% of the above table 2

1:4

60% of the above table 2

The above Table is applicable for Risk Group I. For Risk group 2,3,4 the premium as per
above table shall stand increased as under:
Risk

Premium

110% of group I premium

120% of group I premium

130% of group I premium

If more than one plant situated at different locations, is covered under one single
indemnity limit under the policy. Separate loading on Turnover shall be applied as above
for each plant depending on the Risk Group.
In cases where the insured takes one Policy covering of various unites and if insured is
able to give turnover estimates in respect of individual units then the turnover extra may
be computed depending on the risk group of each unit or on the total turnover treating the
risk under the highest risk group applicable whichever is favourable to the insured. If

195

however, no separate turnover is available to separate units premium shall be computed

on the basis of the highest risk group applicable to the risk.

B. pollution cover additional premium

When the policy is extended to cover the risk of pollution (vide reg. 6 ) the following
loading ( percentages of the total premium arrived at on the basis of indemnity limit and
Turnover, ( i.e., total of A and b above shall be applied.
TABLE 5
Risk Group

Loading

10% of the total premium

15% of the total premium

30% of the total premium

40% of the total premium

C-1, Loading for coverage of discharge or treated effluents through pipelines:

The following are the rates of premium to be charged on the indemnity premium for
coverage of pipelines carrying treated effluents to the discharge points situated at distance
mentioned below measured from the premises.
Distance of discharge point from the Additional premium to be charged
premises
on the indemnity premium
1. Upto 1 Km

Nil

2. Upto 5 Km

5%

3. Upto 10 Km

7.5%

196

4. Upto 20 Km

10%

5. Above 20 Km

To be referred to Market Agreement

committee

C-2 Loading is respect of Godowns, warehouses etc., other than works / Factory
premises etc.,
No. of godowns /warehouses offices,

Percentage of additional premium

Depots, rest houses and other

to be charged on the gross premium

business connected with Insureds

including pollution premises

business

extension but excluding

transportation extension

Upto 10

5%

Between 11 & 99

10%

Between 100 & 499

15%

Between 500 & above

20%

C-3 Coverage for AOG perils

It shall be permissible to grant Act of God of Perils Extension under the Policy on
payment of additional premium depending on the Earthquake Zone as per Fire Insurance
tariff in which the risk is situated.
Zone

Additional Premium

10% of Gross premium

II

7.5% of Gross premium

197

III

5% of Gross premium

IV

2.5% of Gross premium

D. Transportation cover Additional Premium

When the policy is extended to cover liability arising out of and incidental to
transportation of materials including hazardous / dangerous substances 9 vide reg.7 )
separate limits of indemnity per any one accident and one year shall be selected for such
transportation cover. These limits shall form part of the overall limits of indemnity as
stipulated in the schedule of the policy in respect of the insured premises.

The additional premium for the transportation extension cover shall be 505 of the
premium computed as under:
a) On Indemnity Limits
At the rates stipulated in section II-A based on the indemnity limits selected for
transportation cover.
b) On Turnover:
At the rates stipulated in section II B on the estimated turnover in transit.
Turnover shall mean total value of goods /materials in transit inclusive of all taxes
and levies.
c) On Pullution
The loading stipulated in section II-C shall be applied on the total of (a) and (b)
above.
d) Act of God Perils extension:

198

Additional premium would be as applicable to premises risk. If only a policy

covering transportation risk is taken, then the rate applicable will be as per Zone 1.
The above rating shall be applicable even if a separate policy for transportation
risks only is issued, bu the premium would be 100%
If so desired by the insured it shall be permissible to issue Transportation policy in
the joint names of the insured and the Transport contractor.

D-1 Inclusion of technical Collaborators liability:

If desired by the insured the underwriting office may consider granting of
Technical Collaborators extension. Before granting such extension of the matter
may be referred to re-insurers when the risk is cede under the automatic of risk
which does not require reinsurance such extension may be granted by the
companies after fixing terms and conditions at their end.
It is necessary for the underwriting office to scrutinize the copy of agreement
between the Collaborators (S) and the insured and details of global liability policy
of the Collaborators (S). Other additional information for proper understanding of
the nature of risk may be called for depending on the need of each case.

199

LIFT (THIRD PARTY LIABILITY) INSURANCE

SECTION OF RISKS :
This Insurance provides indemnity to the owner of the lifts for legal liability for
payment of compensation for loss / damage caused by or in connection with the use
resulting of lift, in bodily injury or death of or property damage of the members of the
public. Although lifts, are provided by the owners for convenience of persons using the
premises, there is a definite obligation to maintain the same in sound and efficient state of
repairs, so that the users will not come to harm whilst using the lift or while they are in
the vicinity of the appliances connected therein. In the circumstances, if as a result of
mechanical defects in the lift or negligence on the part of the lift man, injuries are
sustained by members using the lift, the owner will be liable at law for compensation to
such injured persons in addition to providing the aforesaid indemnity the Company will
also reimburse all costs and expenses incurred with its written consent in defending any
claim for compensation.
SCOPE OF POLICY :
The Policy will indemnify the Insured against all sums which the insured
shall legally become liable to pay in the event of
1.

Bodily injury to any person (not a member of the insured's family or

engaged in or upon the service of the insured).

2.

Loss of or damage to property (not being property belonging to the insured

or any member of the insured's family or a persons engaged in and upon the
service of the Insured).

200

3.

Accidental direct damage to wearing apparel or personal effect of any

person (not being a member of the Insured's family or a person engaged in
and upon the service of the Insured.

The aforesaid indemnity will be in respect of happenings in connection with any

lift specified in the schedule including its machinery, plant, door, safety devices or other
appliances. In addition, the Company will pay all legal expenses for which the Insured
may be liable where any legal processing have been defended with its consent.
EXCLUSIONS
The policy does not cover loss or damage arising from or occasioned by
a.

War, warlike operation etc., Riot Strike or confiscation or detention by the

order of any government or Public Authority, Earthquake, Volcanic
eruption, flood and other similar convulsions of nature and atmospheric
disturbance.

b.

In the course of alteration, repair or replacement of the property.

c.

Bursting of Boilers, fire, explosion, vehicles or animals.

d.

Consequential loss of any kind or description.

e.

Liability arising out of any agreement.

f.

Any building or structure by vibration etc.

g.

Nuclear Risks.

UNDERWRITING CONSIDERATIONS:
The complete particulars of the lift have to be given in the proposal. The limits for
which the cover is required must be mentioned. It is important that the lift insured is
periodically inspected by qualified and reputed firms. The frequency of such inspection
must also be adequate for the type of lift concerned. The manufacturer's

201

recommendations and the instructions for maintenance, must also be followed. The age of
the lift is naturally important. It is necessary to examine the latest inspection report to
ensure that all recommendations and instruction are duly carried out before acceptance.
The history of previous accidents and breakdowns must also be examined carefully and
steps taken to avoid such occurrence in future.
PREMIUM RATES
The basic rate depends up to the risk group (as given in the relevant section) based
on :
1.

type of construction of the risk and / or occupancy / storage

2.

the ratio of the limits of indemnity of any one accident to any one year
related.

ADDITIONAL PREMIUM :For premises having height of more than 22 meters - 10% of the applicable
indemnity premium should be charged.
For lifts - 10% of indemnity premium.
Third Party Liability Insured in respect of lifts are to be issued on the policy
wording prescribed for public liability insurance. The premium will be Rs.3.00 per mille
on the annual limit (AOY) under the policy. The applicable excess would be 0.50% of
AOA limit subject to a minimum of Rs.2000/- and maximum of Rs.1.5 lakhs.
The premium rates depend upon the limit chosen in respect of one person or any
one accident and for any one year of insurance. A discount in the premium could be
granted depending on the number of lifts insured in the same premises.

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LIMITS OF INDEMNITY
Any one person
Rs.

Any one
accident Rs.

5,000
10,000
20,000
50,000
1,00,000

Any one year

Rs.

10,00
25,000
40,000
1,00000
2,00,000

Annual Premium
per lift

25,000
50,000
1,00,000
2,00,000
5,00,000

50
75
100
150
250

PROPOSAL FORM FOR (PUBLIC LIABILITY) INSURANCE

1.

a) Name of Proposer (in full)

b) Address
c) Business

2.

Furnish below details of all Lifts which are required to be covered

Type (Passenger
Gods, Hoist
etc.)

Premises
where
situated

Motive
Power

Maker's
Name and
Address

Carrying
capacity

Method control
(i.e. switch,
button, lever
etc.)

3.

Trader or business carried on at the premises containing the lifts.

4.

a) State the number of Attendants employed in each lift and their a)

working hours.
b) Are the lifts allowed to be operated by users without the b)
assistance of attendant?

5.

a) Is each lift shaft completely enclosed?

a)
b) Is each lift shaft fitted with a gate?
b)
c) Is each lift cage fitted with a gate which is securely fastened c)
when shut?

6.

a) State the name and address of the Engineer with whom the a)
Proposer has a contract for maintenance and inspection of lifts.
b) At what intervals is the inspection made?
c) When was the last inspection made? Furnish a copy of the b)
Engineer's report pertaining to that inspection
c)

7.

Is any notice displayed in the Lifts for the information of the users
thereof? If so given details?

203

No. of
floors
served

8.

Has the Proposer insured the lifts under any fire and / or
machinery breakdown policies? If so, for what sums and with
which insurer?

9.

a) Has anyone made any legal liability claim upon the proposer a)
in respect of the Lifts proposed or other Lifts? If so give
particulars.
b) Has the proposer ever made any claim for legal liability in b)
respect of this or other Lifts? If so, give below particulars.
Date of Accident

Details of Claims

Name of Insurer

10. Has any insurer in respect of any lift (public liability insurance
cover)
a) Declined a proposal from the proposer, or
b) Cancelled or declined to renew any policy, or
c) Demanded an increased rate, or
d) Required special terms to insure or grant any renewal?
11. State the limit of indemnity required

Amount
recovered Rs.

Amount
to be
recovered
Rs.

a)
b)
c)
d)

a) Any one accident or series of accidents arising Rs

out of anyone event
.
b) All accidents during the period of insurance
Rs
.

I / we hereby declare that the above statement and answers are true and correct and
complete that no material fact has been with-held, mis-stated or mis-represented and that
I / we agree that this proposal and declaration shall be the basis of the contract between
me/us and _______________ whose standard policy for the Insurance proposed is
acceptable to me/us.
Place:
Date :

Signature of the Proposer

Note: The liability of the Company does not commence until the proposal has been
accepted by the Company and the premium paid.
The standard Lift (Public Liability) Policy provides cover as follows:

204

a)

Insureds legal liability for bodily injury to any person not being of Insureds
family or Insureds service.

b)

Damage to property not being carried in the lift.

c)

Damage to wearing apparel or personal effects of any person not being of

Insureds family or Insureds service. The Company will also pay all legal costs
and expenses incurred in defending any claim with its written consent.

RISKS EXCEPTED: The Policy does not provide indemnity for liability caused by war,
civil war and the like riot and strike, bursting of boiler, fire, explosion, animals or
vehicles, damage to any building or other property caused by vibration etc., contractual
liability. Premium will be quoted on application.

205

PRODUCTS LIABILITY INSURANCE

SELECTION OF RISKS
This insurance is intended to provide an indemnity to the insured (upto the limit of
liability) in the event of a claim being brought against him. This may be caused by
anything harmful or defective in the products sold or supplied by the insured in
connection with the business specified. The company in addition will reimburse all costs
and expenses incurred with its written consent defending such a claim for compensation.
The insurance will however not cover the cost of removing, replacing or repairing
defective products or loss of use thereof.
LIABILITY COVERED
The policy seeks to indemnify the insured against his legal liability to pay
compensation (including claimants costs, fees and expenses) in respect of injury damage
or pollution for third parties for claims arising out of accidents due to any defects in the
products specified in the policy during the period of the insurance and first made against
the Insured during the policy period. For the purpose of determining the indemnity
granted:a.

Injury shall mean death, bodily injury, illness or disease of or to any person.

b.

Damage shall mean actual and I or physical damage to the atmosphere or of

any water, land or other tangible property.

c.

Pollution shall mean pollution or contamination of the atmosphere or of

any water, land or other tangible property.

d.

Product shall mean any tangible property after it has left the custody or
control of the Insured which has been designed, specified, formulated,

206

manufactured, constructed, installed, sold, supplied, distributed, treated,

serviced, altered or repaired by on behalf of the Insured.
e.

Accident shall mean a fortuitous event or circumstance which is sudden,

unexpected and unintentional including resultant continuous, intermittent or
repeated exposures arising out of the same fortuitous event or
circumstances.

SPECIAL FEATURES
1.

CLAIMS MADE BASIS :The policy is on Claims made basis. This means that the accident giving rise to

the claim shall occur during the period of insurance and further that the claim shall be
first made against the Insured during the policy period
2.

RETROACTIVE DATE :This is the date of commencement of the first Claims made product liability

policy. This date will remain unaltered as long as the policy has been renewed without
break and there has been no substantial material change in the risk.
3.

PERIOD OF INSURANCE :
This is the period commencing from the retroactive date and terminating on the

expiry date of the policy.

4.

POLICY PERIOD :
This is the period commencing from the midnight on the inception date and

terminating at midnight on the expiry date of the policy.

207

5.

NOTIFICATION EXTENSION CLAUSE : This clause provides that the Insured should notify company (as soon as

reasonably practicable) of any specific event or circumstance which the company accepts,
which may give rise to a claim or claims which form the subject of Indemnity of the
policy, then acceptance of such notification means that the company will deal with such
claim or claims as if they had first been made against the Insured during the policy
period. This extension is, however, subject to the maximum time limit laid down under
the Indian Limitation Act in force from time to time.
6.

EXTENDED CLAIM REPORTING CLAUSE: By, virtue of this clause in the event of non-renewal or cancellation of the policy a

time limit not exceeding 90days from the date of expiry or cancellation of the policy, is
available to the insured for notification of claims for accidents which had taken place
during the period of insurance, but could not be made during such extended reporting
period shall be handled as if they were made on the last day of expiring policy. This
extended reporting period also does not in any way reinstate or increase the limit of
indemnity of the expiring / cancelled policy.
7.

CLAIMS SERIES CLAUSE :A Claims Series Event shall be deemed to be one accident and date of loss shall be

the date when the first claim of the claims series event is made in writing against the
Insured.
A.

Claim Series Event is defined as a series of two or more claims arising from one
specific common cause which is attributable:

To the same default in design, manufacture, instructions for use or labelling of

products.

208

Or to the supply of the same products and / or services or to products and/or

services showing the same defect.

There shall, however, be no coverage for claims made arising from one specific cause
which is made later than 3 years after the first claim of the series.
8.

DEFENCE COSTS : The company will pay costs, fees and expenses incurred with their prior consent in

the investigation, defence or settlement of any claim made against the Insured and the
cost of representation at any inquest, inquiry or other proceedings in respect of matters
which have a direct relevance to any claim made or which might be made against the
Insured, provided such claim or claims are the subject of indemnity by this policy,
whether liability the ultimately attaches to the policy or not Such costs, fees and expenses
are called Defence Costs.
9.

INDEMNITY LIMIT :The total liability of the Company to pay compensation, claimants costs, fees and

expenses and defence costs shall not exceed the Indemnity Limit. Indemnity Limit for
any one accident applies to any one claim or series of claims arising from the originating
cause. Indemnity limit for the period of insurance shall represent the total amount of
companys liability during the policy period.
10.

CROSS LIABILITY : Each person or party indemnified is separately indemnified in respect of claims

made against any of them by any other person or party (other than the named insured)
subject to companys total liability not exceeding the indemnity limit stated in the policy.

209

11.

EXCESS : The Policy shall be subject to a compulsory excess of 1/2% of the limit of

indemnity per any one accident subject to a minimum of Rs.2,50,000/- and maximum of
Rs.5 lakhs. In the case of exports to North America, the excess applicable will be 1% of
AOA to a minimum of Rs.10,00,000/ per claim. This compulsory excess shall be
applicable to both (a) Death / bodily (b) Property damage inclusive of defence cost
arising out of any one accident.
The insured may also opt for bearing a Voluntary Excess (over and above the
compulsory excess) which shall apply to both
(a)

Death/ bodily injury and

(b)

Property damage claims inclusive of defence costs arising out of any one accident.
The Companys liability shall

attach for claims in

excess of such

compulsory and voluntary excess.

12.

INDEMNITY TO OTHERS : The indemnity granted extends to

1.

Officials

of

the

insured

in

their

business

capacity arising out of the

performance of the Business or in their private capacity arising out of their

temporary engagement of the Insureds employees.
2.

The personal representative of the estate of any person who would otherwise be
indemnified by the policy but only in respect of liability incurred by such person
provided all such persons or parties shall observe, fulfil and be subject to the
terms, Conditions & Exclusions of the policy but only in respect of liability
incurred by such person.

210

13.

POLICY DISPUTES CLAUSE :Any dispute concerning the interpretation of the terms, conditions, limitation and

(or exclusions of the policy) shall be subject to Indian law.

EXCLUSIONS
SPECIAL EXCLUSIONS :a.

The policy excludes liability for costs in the repair, reconditioning,

modification or replacement of any part of any product which is or is
alleged to be defective.

b.

For cost arising out of the recall of any product or part thereof.

c.

Arising out of any product which is intended for incorporation into the
structure, machinery or control of any aircraft.

d.

Arising out of deliberate, wilful or intentional non- compliance of any

statutory provision.

e.

Arising out of pure financial loss such as loss of goodwill, loss of market
etc.,

f.

Arising out of fines, penalties, punitive and exemplary damages.

g.

For injury and / or Damage occurring prior to the Retroactive date shown
in the schedule.

h.

Arising out of deliberate, conscious or intentional disregard of the insureds

technical or administrative management of the need to take all reasonable
steps to prevent claims.

211

i.

For injury to any person under a contract of employment or apprenticeship

with Insured where such injury arises out of the execution of such contract.

j.

Arising out of contractual liability which would not have existed in the
absence of the specific contract.

k.
I.

Arising out of any product guarantee.

Arising out of claims for failure of the goods or products to fulfil I the
purpose for which they were intended.
GENERAL - EXCLUSIONS

1.

War Perils

2.

Nuclear Exclusions
CONDITIONS

SPECIAL CONDITION: a.

Written notice of any claim made against the Insured shall be given to the
Company as soon as reasonably practicable and the Insured shall give all
additional information as the Company may require. Every Claim, writ,
summon or process and all documents relating to the occurrence shall be
forwarded to the company immediately they are received by the Insured.

b.

No admission, offer, promise or payment shall be made or given by or on

behalf of the Insured without the written consent of the Company.

c.

The company has the right but not the obligation to take over and conduct
in the name of the Insured the defence of any claim.

212

d.

The Company may at any time pay to the Insured the amount of limit of
indemnity (less any sum already paid) or any lesser sum for which claims/
can be settled and upon such payment being made the Company shall be
under no further liability in connection with such claims.

e.

The terms, conditions and exclusions of the policy shall be interpreted in

accordance with Indian Law

f.

The Insured shall keep accurate records of annual turnover which terms
shall include all leviable duties and at the time of renewal of Insurance
declare such details as the Company may require. The Company shall have
free access to inspect such record.

g.

In the event of liability under the policy or the payment of claim under the
policy, aggregate limit of Indemnity per any one year shall get reduced by
the quantum of liability to be paid or actual payment of such claim. Under
no circumstances it shall be permissible to reinstate the limit of indemnity
to the original level even on payment of extra premium.

h.

No claim shall be payable unless the cause of action arises in India and the
liability to pay claim is established against the Insured in an Indian courts,
except for claims in respect of export of products covered under the policy.
Only Indian Law shall be applicable to actions brought in India.

GENERAL CONDITIONS :1.

The Insured shall give notice as soon as practicable of any fact, event or
circumstance which materially changes the information supplied at the time of
effecting the policy and the Company may amend the terms of the policy.

213

2.

If there be any other Insurance or Insurances effected by the Insured or any other
person covering the same liability, then the company shall not be liable to pay or
contribute more than its rateable proportion of such liability.

3.

Cancellation condition.

4.

Any claim for which liability has been disclaimed by the company shall be made
subject of a suit in a Court of law within 12months from the date of disclaimer. If
not, the claim for all purposes shall be deemed to have been abandoned and shall
not thereafter be recoverable.

5.

If any claim is in any manner fraudulent or supported by any statement of device

whether by the Insured or by any person on behalf of Insured and/or if the
insurance has been continued in consequence of any material misstatement or the
non-disclosure of any material information by or on behalf of the Insured, the
Company shall not be liable to make any payment under the policy.
POLICY EXTENSIONS

EXPORTS TO NORTH AMERICA

The policy can be extended to cover liability arising out of products

exported to United States of America or Canada subject to the following :a.

A specific amount and Retroactive Date shall be entered in the Schedule

under the heading North American Jurisdiction.

b.

The Indemnity does not apply to awards or damages of a punitive or

exemplary nature whether in the form of fines, penalties, multiplication of
compensatory awards or damages or in any other form whatsoever.

c.

The Company shall not be liable for the amount shown as Applicable
Excess in the Schedule being the first amount of each and every claim.

214

Claim shall be deemed to include compensatory awards, claimants costs,

fees and expenses and associated defence costs.
d.

The indemnity does not apply to the claims arising out of injury and/or
damage occurring prior to the Retroactive Date stated in the Schedule.

2.

VENDORS CLAUSE :Upon payment of suitable additional premium, the persons Insured provisions

can be amended to include any person or organisation (referred to as vendor) as an

insured but only with respect of the distribution or sale in the regular course of the
vendors products subject to the following additional provisions.
1.
A.

The Insurance with respect to the vendor does not apply to

Any express warranty or any distribution or sale for a purpose unauthorised by the
Named Insured.

B.

Bodily Injury or property Damage arising out of :

i.

Any act of the vendor which changes the condition of the products.

ii.

Any failure to maintain the product in mercantile condition.

iii.

Any failure to make such Inspections, adjustments, tests or servicing as the

vendor has agreed to make or normally undertakes to make in the usual
course of business in connection with the distribution or sale products.

iv.

Products which after distribution or sale by the Named Insured have been
labelled or relabelled or used as a container, part or ingredient of any other
thing or substance by or for the vendor.

v.

Any fittings and/or manual Work additional and alterations of whatsoever

nature carried out to the product by the vendor.

215

C.

Bodily injury or Property Damage occurring within the vendors premises.

2.

The Insurance does not apply to any person or organisation as Insured from whom
the Named Insured has acquired such products or any ingredient, part or container,
entering into accompanying or containing such product.
Such vendors could be either named or unnamed and the cover is called limited

Vendors Cover.
UNDERWRITING
The essence of risk assessment in Product Liability Insurance is to evaluate the
risk exposure of the product. This will be possible if the following factors are considered.
1.

NATURE OF THE GOODS :By this we evaluate whether the goods are supplied in the natural state like iron

ore or crude oil or the goods refined in some way i.e., sheet metal or petrol.
Generally speaking the more refined, the goods become more hazardous from the
insurance point of view. This is because the user expects the refined goods to be of a
standard to enable him to put it to some specific use. The Insured has worked on the
goods and owes a greater degree of care to his customer. If that standard is not achieved
the goods may be said to be defective and may cause damage to third parties.
Under Nature of the goods we should also consider whether the goods are more
likely to cause bodily injury or merely have a leaning towards property damage. This
leads to an examination as to which type of product is more hazardous. Generally
speaking products meant for human consumption such as medicines, ready-made food
etc., could be considered as target risks.
2.

The use of the Products

216

3.

Nature of production-whether mass production or hand production, control over

production etc.,

4.

Product Hazard - Classification into high, medium and low.

5.

Technical collaboration about the product.

6.

Marketing and distribution of the product.

7.

Packing and labelling the product with reference to warranties, if any, particularly
warranty as to use of the product.

8.

Safety precautions for the customer.

9.

Degree of quality control, batch testing or batch control.

10.

Advertisement and sales promotion campaign.

11.

Identity of the User

12.

Size and standing of the manufacturer.

13.

Total turnover with bifurcation for different countries - Number of products sold,
sale of new products, history of discontinued production etc.

14.

Claims Experience.

15.

Limits of Indemnity required separate limits for any one accident, any one policy
period should be specified.
A comprehensive risk assessment report has been designed which must be

invariably filled up after on inspection especially if exports are involved.

217

RATING
For purpose of rating, products are classified into 7 categories depending on the
risk exposure. Countries of exports are divided into 3 zones.
1.

USA / CANADA (Factor 15)

2.

Countries belonging to the organisation for Economic co -operation and

Development (OECD) viz., Austria, Belgium, Denmark, Finland, France,
Germany (FRG), Great Britain, Greece, Iceland, Ireland, Italy, Japan, Luxemburg,
New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, Netherlands,
Turkey and Yugoslavia. [Factor (5)]

3.

Other countries including non -OECD countries

The twin factors on which rating is based are turnover and the Aggregate limit of
Indemnity.
However, rating of Products Liability proposals is centralised at the Head Office.
(Factor2)
In view of the peculiarities involved and requirements of knowledge of prevailing

law of the country where claim has arisen, Product Liability claims will be handled at the
Head Office.
Upon intimation of a claim by the insured, the policy issuing office should inform
RO/HO immediately. All developments must be passed. on to the RO/HO with least
delay.

218

PRODUCT LIABILITY
1.

Applicability
Products Liability Policies can be issued by Insurers in India
Exports to U.S.A. / Canada and other countries as provided in Section - III
(Exports) may also be covered under Products Liability Policy provided (a)
domestic turnover of the Insured in covered and (b) rates, terms, conditions, excess
etc., prescribed in Section - III are complied with.

2.

Standard Proposal Form :

Insurer shall obtain Proposal for Products Liability Insurance in the Standard
Proposal Form .
No cover shall be granted unless a declaration as provided for in the proposal form
is obtained from the Insured to the effect that all statutory requirements relating to
the business activities are complied with.

3.

Standard Policy Form :

All Policies, fresh and renewal shall be in the Standard Policy Form prescribed
hereunder.

4.

Liabilities Covered
Policies issued cover all sums which the Insured shall become legally liable to pay
as damages in consequence of accidental death/ bodily injury or disease to Third
Parties and/or loss of or damage to Third Party property arising out of any defect
in the product manufactured and covered under the Policy after such products have
left the insureds premises.

219

It shall not be permissible to issue Product Liability Policies with unlimited

liability.
Extension sought under the main policy shall not have indemnity limit in excess of
the main cover.
5.

Classification of Risks
Industries are classified into seven Groups.
Where the risks cannot be classified into any of these seven groups, the
Companies may rate such risks by using the erstwhile Market Agreement as
guideline for like or similar risks. In respect of risks for which there are no
guiding provisions, the same may be rated by the operating offices as per their
acceptance limits at their end.

6.

Premium
The rates of premium is annual rates based on (i) the annual gross turnover and (ii)
the limit of Indemnity any one year, as specified in Section - II (Rating).
The Premium rates stated in Section-II are applicable to domestic sales only. When

exports are covered under the Policy, additional premium as per Section III along with its
other provisions shall also be applicable.
The turnover under the policy has to be accurately assessed and declared by the
Insured at inception as far as possible. However, in case the Insured anticipates any
increase in turnover during the policy period such anticipated increase in turnover shall
be immediately notified to the Company and additional premium paid therefor. In case
the insured anticipates any decrease in turnover during the policy period such anticipated
decrease in turnover shall be considered by the underwriting office at its discretion and

220

downward adjustment in premium made accordingly. Under no circumstances it shall be

permissible to adjust the premium for the turnover on expiry of the policy.
7.

Revision in limit of Indemnity

Mid - term increase / decrease in the limits of indemnity during the currency of the

policy period will be at the discretion of the Head Office of the Company. Whenever
changes in indemnity limits are agreed to the revised retroactive date showing indemnity
limits available at various dates shall be incorporated in the Policy Schedule.
If insured wish to seek protection for anticipated liability in excess of available
limits of indemnity for past periods due to different retroactive date the Company may
consider granting of run-off cover based on merits of each case. Rates, terms and
conditions for such. Run - off covers may be finalised by the Companies and if
necessary they may consult their reinsurers.
Similarly when an insured changes the Insurance Company, to take care of the
residual liability under the policy issued by the earlier insurer, run off cover may be
issued if desired by the insured. The rates and other terms and conditions may be
finalised by the Companies at their end and if necessary, the matter may be referred to
reinsurers before finalising the cover.
8.

Compulsory Excess
All Policies shall be subject to a compulsory excess of 1/2% of the limits of

indemnity per any one accident subject to a minimum of Rs.2,50,000/and a maximum of

Rs.5 Lakhs. The Insured shall bear this Compulsory Excess which is applicable to both
property damage claims and death/bodily injury claims inclusive of defence costs arising
out of any one accident. For exports to U.S.A./Canada, the Compulsory Excess shall be
1% on AOA subject to a min of 10,00,000/-

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9. Short Period Premium

It shall not be permissible to issue Police for periods more than 12 months. The
following short period scale of premium shall apply to (i) policies issued for periods less
than 12 months and (ii) policies cancelled during the currency at the request of the
insured subject to no claim:
Period

Rate

(Not exceeding)
1 Week

10% of the Annual rate

1 Month

25% of the Annual rate

2 Months

35% of the Annual rate

3 Months

50% of the Annual rate

4 Months

60% of the Annual rate

6 Months

75% of the Annual rate

8 Months

85% of the Annual rate

Exceeding 8 months ............... Full Annual premium

12.

Vendors Liability Extension

It shall be permissible to grant only Limited Vendors Liability extension under
the Policy covering exports as per the Vendors Clause

annexed subject to

charging additional premium as below :(a) For Named Vendors

5% of the premium of Limits of Indemnity plus

export turnover premium.

(b) For Unnamed Vendors

10% of the premium of Limits of Indemnity

plus export turnover premium.

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12.A. In respect of products not manufactured by the Insured but manufactured by Sub Contractors and / or Loan & Licence Manufacturers on their own brand name the
same can be covered under the Products Liability Policy with the following
additional information / particulars for acceptance.
-

Copy of Agreement between Contractor / Sub -Contractor / Loan

Licence Manufacturer and the Insured.

Whether Suppliers have Product Liability. If so, name of Insurer and Limit
of Indemnity granted.

After considering the relevant factors, the Company may charge minimum
additional premium of 10% of the Indemnity premium plus Turnover premium on
products manufactured by third parties.
13.

The limit of Indemnity under the Policies issued under this Agreement shall be
expressed in Indian Currency only. Settlement of claims also shall be Indian
currency.
Proposals for issuance of policies with limits of indemnities expressed in foreign
currency as well as for settlement of claims in foreign currency have a blanket
approval of the Reserve Bank of India

14.

Retroactive Date :
Retroactive date is the date when the risk is first incepted under a claims made

policy and thereafter renewed without break in the period of cover.

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PRODUCTS LIABILITY AGREEMENT

SECTION - II
RATING
A.

On Turnover
The following minimum rates shall be applied on the previous years actual gross

annual turnover or the current years projected annual turnover whichever is higher. The
term Turnover shall mean annual gross sales including all taxes and levies.
TABLE - I

B.

Risk Group

Minimum Rate (permille)

1.
2.
3.
4.
5.
6.
7.

0.03
0.05
0.07
0.09
0.11
0.13
0.15

On Limits of Indemnity - Any One Year

Where ratio of the limit of indemnity any one accident to any one year is 1 : 1

premium as per the following Table - 2 shall be charged in addition to the premium based
on Turnover as above.

224

TABLE - 2
(Where Ratio of Limit of Indemnity per Any One Accident to Any One Year is 1:1)
Limit of Indemnity (any one year) Rate / Premium
Upto Rs.2 Lakhs

Rs.1,000 (minimum)

Exceeding Rs.2
Lakhs but not
exceeding Rs.10
lakhs

Rs.1000 + 2.25 per mille on the excess of Rs.20 lakhs

Exceeding Rs.10
Lakhs but not
exceeding Rs.25
lakhs

Rs.2,800 + 2.15 per mille on the excess of Rs.10 lakhs

Exceeding Rs.25
Lakhs but not
exceeding Rs.50
lakhs

Rs.6,025 + 2.00 per mille on the excess of Rs.25 lakhs

Exceeding Rs.50
Lakhs but not
exceeding Rs.100
lakhs

Rs.11,025 + 1.80 per mille on the excess of Rs.50 lakhs

Exceeding Rs.100
Lakhs but not
exceeding Rs.150
lakhs

Rs.20,025 + 1.60 per mille on the excess of Rs.100

lakhs

Exceeding Rs.150
Lakhs but not
exceeding Rs.200
lakhs

Rs.28,025 + 1.40 per mille on the excess of Rs.150

lakhs

Exceeding Rs.200
Lakhs but not
exceeding Rs.250
lakhs

Rs.35,025 + 1.25 per mille on the excess of Rs.200

lakhs

Exceeding Rs.250

Rs.41,275 + 1.10 per mille on the excess of Rs.250

225

Lakhs but not

exceeding Rs.300
lakhs

lakhs

Exceeding Rs.300
Lakhs but not
exceeding Rs.400
lakhs

Rs.46,775 + 1.00 per mille on the excess of Rs.300

lakhs

Exceeding Rs.400
Lakhs but not
exceeding Rs.500
lakhs

Rs.56,775 + 0.90 per mille on the excess of Rs.400

lakhs

Exceeding Rs.500
Lakhs but not
exceeding Rs.600
lakhs

Rs.65,775 + 0.08 per mille on the excess of Rs.500

lakhs

Exceeding Rs.600
Lakhs but not
exceeding Rs.700
lakhs

Rs.73,775 + 0.07 per mille on the excess of Rs.600

lakhs

Exceeding Rs.700
Lakhs but not
exceeding Rs.800
lakhs

Rs.80,775 + 0.06 per mille on the excess of Rs.700

lakhs

Exceeding Rs.800
Lakhs but not
exceeding Rs.900
lakhs

Rs.86,775 + 0.05 per mille on the excess of Rs.800

lakhs

Exceeding Rs.900
Lakhs but not
exceeding
Rs.10750 lakhs

Rs.91,775 + 0.04 per mille on the excess of Rs.900

lakhs

Where the ratio of AOA to AOY is different, the indemnity period would be modified as
below:

226

Ratio AOA:AOY

Premium

1:2

80% of the above Table II

1:3

70% of the above Table II

1:4

60% of the above Table II

227

PRODUCT LIABILITY
Section - III
EXPORTS
1.

No policy shall be issued for covering exports only, unless the domestic sales are
also covered under the policy.
Category I

U.S.A. and Canada

Category II

OECD countries as under:

Countries belonging to the Organisation for Economic Cooperation and Development

viz.

Austria,

Belgium,

Canada, Denmark, Finland, France, Germany, Greece,

Iceland,

Ireland,

Italy,

Japan,

Luxembourg,

Mexico,

Netherlands, New Zealand, Norway, Portugal, Spain,

Sweden, Switzerland, Turkey, United Kingdom and United
States.
Note:
However, for rating purpose the countries USA and Canada
would continue to be taken under Category I as above.
Category III

Other countries including non-OECD countries.

The additional premium for Exports shall be arrived at as under:

(1)

All the countries of Exports shall be grouped into 3 categories as

defined above.

228

(2)

Total Exports Turnover for each category of countries as defined above

shall be ascertained.

(3)

The basic premium rate as per Section 11-A to be applied on Total Export
Turnover separately for each category of countries.

(4)

The premium so arrived at (at per 3 above) and multiplied by the following
multipliers-will be the Premium on Turnover.

Category of country

5.

Multiplier

15

III

The premium calculated as per Section II B and multiplied by the highest

multiplier (applicable on the basis of the categories of countries of exports
attracting highest multiplier) will be the Premium on Indemnity. When exports are
involved premium on indemnity shall not be charged again for domestic sales.

6.

Total of 4 and 5 will be the total additional premium for exports.

7.

The additional premium for exports so arrived at shall be added to the domestic
sales premium on Turnover only (as per Section II - A) to arrive at the total gross
premium under the policy.

8.

For covering exports to U.S.A. and Canada, the North American Jurisdiction
Extension Clause shall be applied.

9.

Compulsory Excess
All Policies covering exports to U.S.A. and Canada shall be subject to a

Compulsory Excess of 1% (instead of 112% as per Section - I, Reg. 9) of the limit of

229

Indemnity per any one accident, subject to a minimum of Rs.4,000 /and a maximum of
Rs.6 Lakhs. This Compulsory Excess shall apply to both property damage claims and
death / bodily injury claims inclusive of defend costs arising out of any one accident.
Indemnity premium is loaded by times being the highest loading factor applicable
in respect of exports to USA / Canada.
Note:
1)

Additional premium for Vendors Liability Extension, wherever applicable, shall

be charged as per General Regulation 12, of the Agreement.

230

2)

Inclusion of Technical Collaborators Liability :If desired by the Insured, the Insured, the underwriting office may consider

granting of Technical Collaborators extension. Before granting such extension the matter
may be referred to reinsurers when the risk is ceded under the automatic reinsurance
facility or reinsured facultatively. In respect of risk which does not require reinsurance
such extension may be granted by the companies after fixing terms and conditions at their
end.
It is necessary for the underwriting office to scrutinise the copy of agreement
between the Collaborator(s) and the Insured and details of global liability policy of the
Collaborator(s). Other additional information for proper understanding of the nature of
risk may be called for depending on the need of each case.

231

COMMERCIAL GENERAL LIABILITY

Introduction to CGL

CGL was introduced in 1941

Before CGL, Public Liability was popular

CGL Still divided into two categories for risk analysis and rating purposes
-

Premises and Operations Liability

Products and Completed Operations Liability

Exhaustive CASE study required before acceptance of risk should be done by

underwriters (Circumstances, Activity, Security, Events)
Coverage under CGL

CGL exposures are in the following category

Bodily Injury and property damage
Premises and Operation Liability Risks
Products and Completed Operations Risk
Limited Contractual Liability
Personal and Advertising Injury
Medical Payments
Supplementary Payments

EXTENSIONS/POLICY CONDITIONS UNDER CGL

Defense costs included within limit of liability
Designated premises endorsements
Policy covers liability arising out of travel of executives of the Insured worldwide

232

 Act of God perils

72 hours sudden and accidental pollution cover
Auto acquisition of subsidiaries world wide
Waiver of subrogation
Coverage for property under Care Custody and Control
Coverage for Fines, Penalties, Punitive or exemplary damages
Coverage for War, Sabotage, Terrorism
Coverage for Property damage to electronic data
C G L Underwriting Factors
Type of Industry
Size of operation/Turnover
Geographical spread
Raw Materials/End Product
Transportation Exposure
Pollution Exposure/Effluent Treatment
Regulations
Product and completed operations Underwriting Factors
Product/End Use of Product
Quality Control Measures
Turnover
Geographical Split of Turnover
Coverage

233

 Bodily Injury and property damage

Liability of the manufacturers/distributors/retailers to ensure that the use of the
product will not harm the customers/ users
Suits can be based on Strict Liability or Tort
How does a claim arise?
PRODUCT LIABILITY
Plaintiff should prove the following against our Insured
Product was defective when it left the manufacturers/suppliers place
Defective condition of the product made the product dangerous
Defective product cause injury to the plaintiff
COMPLETED OPERATIONS
Injury or damage from work
Injury / damage must occur away from premises
Work causing injury completed or abandoned
Exclusions
Work not yet completed or abandoned
Products still in possession of the insured
Aspects to look at for product and Completed operations
Products made and sold by the insured in the basic coverage territory
Activities of a person in the home territory and away from his home territory

234

 Extension of the coverage territory for the goods or products -worldwide product
coverage
Personal Injury
Coverage applies to advertising injury only if the injury is caused by an offense
committed in the course of advertising the named insureds goods, products and
services.
COVERS
Legal liability of the insured arising out of personal injury if the personal injury is
caused by an offence arising out of the named insureds business is covered
Defence costs are also covered
Examples - Personal Injury
-

False arrest/detention/imprisonment

Malicious prosecution

Wrongful eviction/Wrongful entry

Defamation/libel/slander/product disparagement

Examples of Advertising Injury

-

Use of anothers advertising idea in advertisement

Infringing on others copyright, trademark/slogan

Oral/written publication that violates a persons right of privacy

Medical Expenses Coverage

Strictly not liability insurance. Insured pays regardless of whether he is liable or
not.

235

 Included in CGL to give relief by providing small amount of compensation for

settling minor injury claim
Means of prompt settlement to avoid larger legal liability in future.
In built cover and can be deleted by endorsement
Medical expenses for bodily injury on premises that insured rents/owns
Because of operations
Payments made regardless of faults
Payments within applicable limit of insurance
First aid administered during accident
Necessary medical, surgical, x-ray dental services
Necessary ambulance, hospital, nursing professional and funeral services
Provided
The accident has taken place in the coverage territory and during the policy period
The expenses are incurred and reported within 30 days of accident
Submission for examination by physician as often as reasonably required
Supplementary Payments
Costs that the insurer will pay with respect to
-

Any claim to be investigated or settled by the insurer or any suit the insurer
defends the insured in Premises and Operations and Product or completed
operations

May consist of the following

Cost of bail bond related with bodily injury liability coverage

236

Expenses incurred by the insured at the request of the insurer for

investigation or defence

All court expenses imposed against the insured

CGL EXCLUSIONS
Expected or intended injury
Contractual Liability
Liquor liability
WC or similar liability
Employers Liability
Pollution Liability
Aircraft/Auto or watercraft liability
Damage to owned/rented property
Damaged own product
Damages own work
Recall of products
Electronic data
LIMITS OF INSURANCE
General Aggregate Limit (AOY)
-

Bodily injury/property damage in premises and operations liability) not for

products and completed operations)

Personal and Advertising injury

Medical Expenses coverage

237

 Product and Completed Operations

Each Occurrence Limit (AOA)
Personal and Advertising Injury limit
Fire Damage Limit
Medical expenses limit
IMPORTANT GENERAL GUIDELINES
CGL POLICIES SHOULD NOT BE GIVEN ON OCCURRENCE BASIS
GIVE ALWAYS WITH ONLY RIGHT TO DEFEND CLAUSE AND NOT DUTY
TO DEFEND
BE CLEAR ON TERRITORY AND JURISDICTION OF COVERAGE
ALWAYS SPECIFY THE VALIDITY PERIOD OF QUOTE
FOOT NOTE
The CGL cover is not appropriate for insuring the advertising injury liability
exposure of an advertising agency or other firm involved in providing advertising
services. A cover for Media Liability E&O is appropriate for these agencies.

238

MEDIA LIABILITY INSURANCE POLICY

WHAT IS MEDIA LIABILITY
Media Liability Insurance can be categorised as Errors and omissions in the
written or spoken word resulting in claims alleging financial loss as a
consequence.
Media Liability Insurance can also be called Communications Liability Insurance
and can be synonymous with Multi Media Liability insurance.
Liabilities that are typically covered include:
Copyright and trademark infringement
Defamation of character or product
Personal disparagement
Invasion of privacy or infringement
TRENDS IN MEDIA LIABILITY
Although new media and other publishers worry about claims like libel and
copyright infringement, attorneys and insurers have seen a dramatic rise in the last
few years in the number and severity of claims for Media Liability errors and
omissions.
Unlike traditional claims involving allegations of libel, copyright infringement,
invasion of privacy, piracy and plagiarism, Media Liability errors and omissions
claims seek to impose liability on the publisher for physical injuries or economic
loss allegedly caused by some error or negligent publication in the ideas or
expressions contained in the published material.

239

 Often, a claim or lawsuit may not involve a clear error or omission. For example, a
client is not happy with the result and brings a claim to obtain a different result or
avoid paying a fee. Media Liability Insurance typically pays for the cost of
defending this type of claim.
WHEN IS IT REQUIRED
Any company that distributes information to the public via a web site or other
means of communication (desktop publishing, email) faces the exposures of a
traditional publisher.
WHO IS VULNERABLE
Any company that distributes information to the public via a web site or other
means of communication (desktop publishing, email) faces the exposures of a
traditional publisher.
Publishers and broadcasters of instructional material
Trademark infringement, personal injury liability or unfair competition claims
Electronic transmission
Researching, exhibition, serialization and material distribution services
Electronic publishing services and any other entity engaged in preparing materials
for publication and republication
Television and radio stations, motion picture companies, cable and satellite
broadcasters
Advertising Industries
WHY MEDIA LIABILITY AND NOT CGL?
Excludes Advertising Injury and Personal Injury if the Insured is in the business of

240

Broadcasting

Publishing

Advertising

Internet content or services, such as search engine capabilities, internet access or

acting as service provider

WHO CAN BE THE INSURED?

Authors
-

The book requires the author to have his or her own coverage

Author is going to self publish

Advertisers
-

Any company that advertises its own products and services is an

Advertiser

Restaurants

Banks

Airlines

Advertising Agencies
-

Create and distribute publicity for others and provide related professional
services

Advertising Creation

Branding and Media Placement and Buying

Web hosting and website design

241

Also publicises its own business

Broadcasters- Radio/TV/Cable
-

Radio broadcaster- on air, satellite and/or Internet

Television Broadcaster

Cable Broadcaster

Other- Cellular transmissions

Commercial Printers
-

Reproduction of lottery and Event tickets

Mailing lists, Address cleansing

Film and Programme Producers, distributors and Post Production Companies

-

Produce documentaries, films and other programmes for

Video, Radio, TV Cable Satellite, Theatre or Motion picture release

Limited release educational and training videos/DVD etc

Distribute an existing library of previously produced films

Distribute new and existing programming produced by others

Publishers- Newspapers, Magazines, Newsletters and Books

-

Books

Magazines

Newspapers

Newsletters

Associations and Trade organisations

242

Newsletters, books, magazines

On Line Publishers

Multimedia
-

In Games

Fine Art

Education

Entertainment

Business

Engineering

Mathematical /Scientific Research

Journalism

Personal Appearances
-

Insured is an

Actor

Author

Public Figure

Sports Figure

Celebrity

Provides coverage for

Speaking engagements, panel discussions, TV/Radio appearances/ Talk shows

Endorsement of a third party product- advertisement or infomerical

Contributing editor/author for a third party publication

243

CLINICAL TRIALS INSURANCE

What is a clinical trial?
Clinical Trial means any study involving Human Beings to find out whether an
intervention including treatments or diagnostic procedures, which it is believed
may improve a persons health actually does so.
It may involve testing a drug, a surgical or therapeutic or preventive procedure or a
therapeutic or preventive device
Phases of Trials
Four phases of trials

Phase I - Is the medicine treatment safe? Test the safety of the product, safe
dosage and identification of side effects First trial on humans and so conducted in
small batches of 20-50

Phase II - Does it work?- Test carried out on larger group of people (100 to 300)
to further measure the efficacy, effectiveness and safety

Phase III - Is the drug better than ones already available- Trial demonstrates the
large scale efficacy of the medicine and is conducted on more than 1000 people
across countries/world. Only if the drug is found suitable at phase II I, licence to
be marketed is given

Phase IV- Trials are done after the drug or treatment has been marketed. These
studies continue testing the study drug or treatment to collect information about
their effect in various populations and any side effects associated with its long
terms use.

244

TYPES OF CLINICAL TRIALS

A Clinical Trial can be

Treatment Trial-new drugs/new combination of drugs/new approach for treatment of a

disease

Prevention Trials-Better ways to prevent diseases in people

Diagnostic Trials- Better test for diagnosing disease

Screening Trials-Best ways to detect certain diseases

Quality of Life Trials-Ways to improve comfort and quality of life of patients with
chronic illness

There are four parties involved in clinical trials which have different roles vis a vis their
exposure to clinical liability suits and hence the need for clinical liability insurance.
The four parties are:

The sponsor company testing the new products / procedure. (Basically the sponsoring

Company finances the entire trial.)

ii)

The Clinical Research Organization (CRO) that helps the sponsor manage the
study

iii)

The institution where the study is actually carried out

iv)

The professionals (clinicians) who actually conduct and monitor the study on
behalf of the sponsor.

(Each party involved in conducting the trial have moral and legal responsibilities towards the
human subject. They all have real and significant exposure to liability. Generally, the target for
litigation are the clinical investigators and the research institute involved. The company that
sponsors the trial is also exposed to the risk of liability on account of improper disclosure,
conflict of interest, violation of good clinical practices etc.)
Who are involved?
Subject Matter /Human Volunteer

245

 Investigator/Physician
Public Health Organisation
Clinical Research Organisation(CRO)
Sponsor(Generally our Insured )
Govt Authority/Ethics Committee
Why does the Sponsor need insurance?
To protect sponsor from
Statutory Liability (Act Only)
No Fault Liability- Generally this policy is issued to the Sponsor.
Professional Liability
Coverage
This insurance is limited to the clearly specified trial of clearly listed product/Procedure
Provides indemnity towards legal liability arising out of death/bodily injury/disease
Specifically designed to take care of R&D needs of Pharmaceutical Companies
Underwriting Factors
Phase of Trial (I-IV)
Protocol of Trial
Duration of Trial
Type of Trial
Nature of drug/device/procedure
Number of subjects involved
Previous Phase results
Sum Insured/Deductibles/jurisdiction opted

246

 The protocol is a document that provides all details about the clinical trial including the
details of the Investigators, Clinical Research organisation, Drug, Dosage, duration,
procedures/methods adopted to conduct trial, interpretation of its results. Protocol is a
blue print of the Trial
Protocol will have to be approved by the Local Ethics Committees /Suitable Govt
Authority
Major Exclusions

Professional Error or Omission

Previous Injury /Disease

Non- Compliance of procedures

Statutory violations

Fines and Penalties

Ex-Gratia payments

Losses payable under any other insurance cover

Documents to call for while underwriting Clinical Trials Insurance

Proposal form
Stage of the Trial
Details of the Protocol
Approval of the Ethics Committee
Format for No Objection Certificate of the Volunteer
Details of jurisdiction
Per person limit/AOA Limit/AOY Limit

247

EMPLOYEES (WORKMENS) COMPENSATION INSURANCE

This Insurance is intended to cover the employer for liability towards payment of
compensation under the amended Workmens Compensation Act, 1923. This covers
liability to their employees for personal injuries and to their dependants in the event of
fatal accidents arising out of and in the course of employment. The Employees
(Workmens) Compensation Act applies to all the employees included in the definition of
the Workmen under Section 2 (i) (n) of chapter I and Schedule 11 of the Act. Employees
of subcontractors have the right to claim compensation direct from the principal who
may, however, obtain reimbursement from the main contractor. Cover in respect of claim
on the principal to pay compensation to contractors Workmen is normally excluded from
the scope of the policy. Provision is, however made for including the same by
endorsement when the wages paid to the contractors workmen are included in the
amount of wages declared.
The Fatal Accidents Act, 1855 provides specifically for payment of damages by
any person who by wrongful act, neglect or default cause the death of another person.
The Act gives certain relatives of the person killed, a right to claim damages. in their own
name. The damages are assessed in accordance with the pecuniary loss occasioned to the
relations by the death. It is also based on the earning capacity of the deceased during the
normal expectation of his life, prior to his death. On the other hand, there is a tendency on
the part of the injured workmen to institute a suit against the employer; under Common
Law, alleging negligence on his part. An employer may be liable to pay damages for
injury arising from an accident caused by the negligence of the employer, defects in
machinery, carelessness of the fellow employees etc. Contributory negligence, i.e.
negligence on the part of the injured workmen does not fully absolve the employer from
his liability. Here also, there is no limit to the amount of damage which of may be
awarded to the aggrieved party.

248

The Workmens Compensation Act lays down that if personal injury is caused to a
workman by accident, arising out of and in course of his employment, the employer shall
be liable to pay compensation. The following are the few exceptions under which no
compensation would be payable.
1.

An injury, which does not result in fatal or partial disablement for a period
exceeding 3 days.

2.

For any injury for the first 3 days of disablement unless such disablement lasts for
a period of 28 days or more.

3.

For any, injury not resulting in death caused by accident directly attributable to
i.

Workmen have for the relevant time under the influence of drinks or drugs:

ii.

Willful disobedience of the workman to an order expressly give or to a rule

expressly framed for the purpose of securing safety of the workmen.

iii.

Willful removal or disregard by the workmen of any safety guard or other

device which he knew to have been provided for the purpose of securing
the safety of the workmen.

If a workman institutes a claim before the Commissioner for workmen's

Compensation, for damage in respects of his injury he cannot subsequently institute a
civil suit against his injury he cannot subsequently institute a civil suit against his
employer. Similarly, if he institutes a claim under common law he cannot subsequently
claim compensation under the Workmen's Compensation Act. The workman has to
choose his forum of redressal.
It is also essential that the employer should take steps to ensure that every accident
is brought to the notice of the Company. The occurrence of every fatal or serious accident
should definitely be reported to the Commissioner for Workmen's Compensation within

249

the time limit. The amount of compensation except in the case of a minor is based
entirely on the earnings of the deceased or the injured workmen prior to the accident.
The Compensation payable for death, permanent total disablement and the halfmonthly compensation for temporary disablement are calculated in accordance with the
provisions under Section 4
Consequent to the Amendment of the W.C. Act, 1923 into Employees Compensation Act,
th

1923, vide Notification dated 18

January'2010 there have been several significant

changes, the highlights of which are as under:1. The definition of employee now includes clerical employees & casual employees also.
2. The minimum compensation limits on no-fault basis stand increased to Rs.1,20,000 in
case of death, and Rs. 1,40,000 in case of permanent disability (erstwhile limits being
Rs. 80,000 & 90,000).
3. To compute compensation payable under the act, the monthly wage limit of Rs. 4,000
has been removed
and Central Government has been empowered to specify the
monthly wage limit to be used for determining compensation. Presently, Government
has notified a ceiling of Rs. 8000.
4. Funeral expenses limit has been enhanced to Rs.5000 (from Rs.2,500).
5. The employee shall be reimbursed the actual (full) medical expenditure incurred by him
for treatment of injuries caused during the course of employment.

6. Time limit for disposal of cases relating to compensation has been introduced. The
Commissioner

shall dispose of the matter relating to compensation within 3 months

of reference.
The General Insurance Council had set up a Working Group that has, after several
deliberations, come out with the revised policy wordings. Common Proposal Form,

250

Underwriting Guidelines, Policy Wordings, Schedule & Endorsements have been

designed by the Working Group and the same are As below:

As per the General Insurance Council Workmen's Compensation Policy, Condition of

Average has been introduced, we would have to make it clear to the operating offices that
the correct number of employees (in different categories)and the actual wages will have
to be obtained from the Insured at the beginning of the policy without fail. In case of any
increase in the number of employees and wages during the currency of the policy, the
same will have to be intimated to the operating office and requisite premium collected
from the Insured. In case of decrease in employees, requisite refund can be made. our
Operating Offices will have to be instructed that in case of a claim, our Advocates will
have to present clearly to the WC Commissioner, the extent of our coverage and our
liability after taking into account the Condition of Average.
.
UNDERWRITING GUIDELINES

Who can be covered under the Policy?

These Guidelines apply to all policies issued to Employers to provide

compensation to their Employees in respect of accidents and diseases of
occupation, whether or not such employees come within the scope of the
Employees (Workmens) Compensation Act, 1923, and subsequent amendments
thereto.

Coverage provided under the following Statute/Laws

The Policy can be issued to cover the employees against the following:
Indemnity against legal liability to all employees (coming within the definition of
the term Employee) under the Employees .Act 1923 and subsequent amendment to
the said Act prior to the date of issue of the policy.
Common Law.

251

The coverage under the Policy will be limited as per the Limits, conditions and
exclusions of the Policy

Inclusion of Employees

When coverage is provided under Employees Compensation Act 1923 and

subsequent amendments all employees coming within the provision of the said
Act must be included.

Co-Insurance

The above guidelines does not however, prohibit the issue of joint or separate
policies by two or more Insurers sharing the insurance of a risk as Co-Insurers,
provided always that the entire legal liability in respect of the risk is fully covered,
reimbursement by the insurers being limited to their agreed proportions, and the
period of cover under the joint or different policies is concurrent.
In the event of non-renewal of any of the policies, or alteration in the terms of
cover granted under any of the policies all insurers sharing the risk must be
advised by the leading Office.

Policy Period

All policies are to be issued for 12 months except that;

Policies may be issued for a period in excess of 12 months where an additional
odd period is required to make a policy renewable on a particular date to meet the
convenience of the Insured.
Policies may be issued for a period which is greater or lesser than 12 months in
cases of specific contracts or work provided policies be written for the full period
involved.
All premiums must be paid in advance for the full term of the Policy. Accepting or
agreeing to accept of premiums by installments is not permitted.

Cancellation

The Company or the Insured may cancel this Policy by sending at least 15 days written
notice to the other party on his last known address and in such event the premium shall
be adjusted in accordance with Condition 8.
Declaration of Wages and Employees

252

If after commencement of this insurance the number of Employees and/or the Wages
paid during the Period of Insurance are found to differ from those covered under this
Policy, the Company may proportionately require further premium to be paid and or
refund excess premium received, as the case may be.
Joint Policies
Joint Policies may be issued indemnifying more than one person or firm in respect of
the same employees engaged upon a particular job for an additional premium which
may be modified or waived in the following circumstances: Where an Insurance is required in the names of a Parent Company and its
subsidiary and/or Associated Companies, a Joint Policy may be issued without
additional premium.
Where one of the parties is a Public Authority or Government Department, a Joint
Policy may be issued without additional premium.

Earnings,Wages and salaries

The definition of wages is as given in the Policy:

Wages means the remuneration payable to an Employee by the Insured for the employment in
the Business and includes any privilege or benefit which is capable of being estimated in
money other than a travelling allowance or the value of any travelling concession or a
contribution paid by the employer of a employee towards any pension or provident fund or a
sum paid to a employee to cover any special expenses entailed on him by the nature of his
employment;

Endorsements
The endorsements indicated against the Trade Groups in the erstwhile Tariff must be
placed on all Policies issued against the same.
Insureds liability for Contractors /Sub contractors Employees (W.C.
Endorsement 179 (Erstwhile Tariff)
It is permissible to include the risk of the Insured in respect of the employees of
Contractors at an additional premium which can be calculated and charged as
per the given guidelines:
i. In cases in which the contract is for labour only, upon the total amount of
the contract;

253

ii. In cases in which the contract is for labour and material upon a percentage
of the full contract price to be determined upon the merits of the case, such
percentage in no case to be less than 75 per cent of such contract price;
iii. In cases in which the contract is for labour material and equipment upon a
percentage of the full contract price to be determined upon the merits of the
case, such percentage in non case to be less than 50 percent of such
contract price.
iv. In case where the wages of the employees of the contractors/sub
-contractors is provided it can be ascertained on the amount of wages.

EMPLOYEES COMPENSATION INSURANCE

PROPOSAL FORM

If at any time during the Period of Insurance any Employee of the Insured so declared
shall sustain Injury by accident arising out of and in the course of his employment in the
Business, Indemnity shall be under Law(s) opted for, subject to the terms, exceptions and
conditions contained in the Policy wordings or endorsed hereon, upto the Limit of
Indemnity against all sums for which the Insured shall be so liable which is agreed by
the Insurer and mentioned on the Policy Schedule.
Proposers names in full
___________________________________________________________
Proposers business [Correspondence] address
__________________________________________
Proposers trade or occupation
______________________________________________________
Particulars of work to be covered in Detail:
_______________________________________________________________________
________

254

_______________________________________________________________________
________
_______________________________________________________________________
________
Risk Location address(s)
___________________________________________________________
Policy Period: From: ___________________ To _________________

COVERAGES REQUIRED
Coverage

Employees
Compensation

Common Law

Scope of coverage

Subject otherwise,
to the terms,
conditions &
Exclusions of the
Policy, the amount
of liability incurred
by the Insured.
Subject otherwise,
to the terms,
conditions &
Exclusions of the
Policy, the amount
of liability incurred
by the Insured, but
not exceeding:

Aggregate Limit of Indemnity

Limit: As per
Employees Compensation Act

a)

Limit Per Employee for

any number of accidents
during Period of
Insurance
Rs._________________
___________

Limit Per Accident for

any number of
Employees
Rs.____________________
________
b)

255

Coveag
e
Options
[Yes/N
o]

c)

d)

Medical
Expenses :
e)

Occupational
Diseases

Contractors
Employees

Subject otherwise,
to the terms,
conditions &
Exclusions of the
Policy, the amount
of liability incurred
by the Insured, but
not exceeding:

f)

g)

Aggregate Limit for all

accidents and claims
arising there from during
the Period of Insurance
Rs._________________
___________
Limit Per Employee for
any number of accidents
during Period of
Insurance
Rs._________________
___________
Aggregate liability for all
accidents during the
Period of Insurance
Rs._________________
___________
Limit Per Employee
Rs._________________
___________
Aggregate liability of the
company for all
employees during the
Period of Insurance
Rs._________________
___________

Limit: As per
Employees Compensation Act

ALL PERSONS EMPLOYED MUST BE INCLUDED

-------------------------------------------------------------------------------------------------------------------------------------* Wages means the remuneration payable to an Employee by the Insured for the
employment in the Business and includes any privilege or benefit which is capable of

256

being estimated in money other than a travelling allowance or the value of any travelling
concession or a contribution paid by the employer of a employee towards any pension or
provident fund or a sum paid to a employee to cover any special expenses entailed on him
by the nature of his employment;
OWN EMPLOYEE DETAILS**
Description of
Declared
Employees
Number of
Employees

Total Declared wages

during the period of
insurance.

Place/Places of
Employment

CONTRACTORS EMPLOYEE DETAILS [if the coverage has been opted for]**
Contractors
Registered
Declared
Total Declared Place/Place
Name
Address
Number of wages during the
s of
Employees
period of
Employme
insurance.
nt

** Please attach additional sheets if required.

Does the above, schedule include(a) All persons in your service?
(b) All your contractors/ subcontractors?
Do you comply with all statutory obligations, manufacturer's recommendations and
other safety regulations in conduct of the Business.
Do you maintain an accurate record of the Employees and Wages in respect of the
Business in compliance with all statutory requirements.
Are you at present insured or have your ever proposed for an insurance in respect of
your liability to your employees? If so, please give the name of the Company or

257

Companies.
Has any proposal for an insurance in respect of your liability to your employees or
renewal thereof ever been declined or withdrawn?
State the total Wages paid and particulars of accidents to your employees during the
past three years.**
Year [Past 3 years from this date]
Wages Paid

State the total wages paid and particulars of accidents to your contractors employees
during the past three years.**
Year [Past 3 years from this date]
Wages Paid

** Please attach additional sheets if required.

DECLARATION
I/We the undersigned this.........day of.............20..........desire to effect an insurance in
terms of the Policy to be issued by the Company against my/our Statutory, Common Law
liability and other covers above mentioned.
I/We hereby declare that all the above statements and particulars, which I/We have read
over, checked, are true that I/We have not suppressed misrepresented or mis-stated any
material fact, that I/We have fairly declared my/our total wages and salaries expenditure
and I/We agree that this declaration shall be the basis of the contract between me/us and
the ..............Company.
I/We also agree to inform Company any changes in any respect of any material matter to the
grant of a cover in this proposal form/documents/ risk proposed for insurance after the
submission of this proposal form.
I/we also agree that the contract of Insurance will be effective only upon Company conveying its
acceptance of this proposal, and Company actually receiving or realizing [in case of payment by
cheque/DD/PO] of prescribed premium amount, failing which Company's risk is void ab initio.

258

I/We undertake to exercise all statutory, ordinary and reasonable

precautions for safety of all the Employees as if they were uninsured.

Date........................
.

Signature of Proposer..............................

EMPLOYEES COMPENSATION INSURANCE

POLICY WORDINGS
WHEREAS the Insured by a Proposal which shall be the basis of this Contract
and deemed to be incorporated herein, has applied to ______________ (hereinafter called
the Company) for the insurance hereinafter contained for the Business described in the
Schedule and has paid or agreed to pay the premium stated in the Schedule as
consideration for such insurance.
NOW THIS POLICY WITNESSETH, subject to the terms exceptions and
conditions contained herein or endorsed hereon, that if at any time during the Period of
Insurance any Employee or Employees of the Insured shall sustain Injury by accident
arising out of and in the course of his employment in the Business, for which the Insured
is liable to pay compensation under any Law(s) specified in the Schedule, then the
Company shall indemnify the Insured upto the Limit of Indemnity against all sums for
which the Insured shall be so liable, including costs and expenses for defending any such
claim incurred with the Companys consent.
PROVIDED ALWAYS that in the event of any change in the Law(s) or the substitution of
other legislation therefor, this Policy shall remain in force but the liability of the Company shall
be limited to such sum as the Company would have been liable to pay if the Law(s) had
remained unaltered.
DEFINITIONS
This Policy, the Schedule and any Clauses thereon shall be considered one document and any
word or expression to which a specific meaning has been attached in Definitions bears that
specific meaning wherever it appears in this Policy in bold typeface.
Business means the Business of the Insured as specified in the Schedule in respect of which this
Policy is issued.

259

Injury means physical bodily injury including death resulting from such injury arising out of an
accident but does not include any mental sickness, disease, Occupational Disease, unless caused
by such physical bodily injury.
Insured means the person or organization specified in the Policy Schedule but does not include
their Contractors or Sub Contractors.
Occupational Disease means any occupational disease or illness including but not limited to the
diseases listed under Schedule III of the Employees Compensation Act. 1923 contracted by an
Employee due to employment in the Business.
Wages means the remuneration payable to an Employee by the Insured for the employment in
the Business and includes any privilege or benefit which is capable of being estimated in money
other than a travelling allowance or the value of any travelling concession or a contribution paid
by the employer of an employee towards any pension or provident fund or a sum paid to an
employee to cover any special expenses entailed on him by the nature of his employment;
Employee or Employees means such person or persons in direct employment under the Insured
in the Business, but shall not include any person employed under a Contractor or Sub-Contractor
of the Insured unless specifically shown as covered in the Schedule and by an endorsement.
Schedule means the Schedule attached to and forming part of this Policy.
Period of Insurance means the period for which this insurance is availed by the Insured as
specified in the Schedule, unless cancelled earlier.

Limit of Indemnity means the maximum amount of indemnity as specified

in the Schedule that will be provided under this Policy by the Company
in respect of
a) any particular claim by an Employee and
b) all claims arising out of all accidents for any number of Employees during the Period of
Insurance.

EXCLUSIONS
This Policy shall not cover liability of the Insured:
a) For Injury caused to Employee by accident directly or indirectly caused by or
arising from or in consequence of or attributable to war, invasion, act of foreign
enemy, hostilities (whether war be declared or not) civil war, mutiny, insurrection,
rebellion, revolution or military or usurped power, nuclear weapons material,

260

ionising radiations or contamination by radioactivity from any nuclear fuel or

from any nuclear waste from the combustion of nuclear fuel.
b) Accident occurring at any other place than the Place or Places of Employment
specified in the Schedule, unless the Employee was at such other place whilst on
duty for the purpose of the Business and on the directions of the Insured or any
of its official authorized to exercise control and supervision over the Employee.
c) For Occupational Diseases contracted by an Employee
d) For interest and/or penalty imposed on the Insured under any law or otherwise.
e) Under any Law for medical expenses in connection with treatment of any Injury
sustained by an Employee
f) For persons employed in the Business under a Contractor or Sub-Contractor of the
Insured unless specifically covered in the Schedule
g) For Injury sustained by person whilst in the employ of the Insured otherwise than in the
Business and/or who has is not declared for insurance under this Policy.
h) Assumed by agreement which would not have attached in the absence of such agreement
i) For any sum which the Insured would have been entitled to recover from any party but
for an agreement between the Insured and such party.
j) For any accident occurring whilst the Employee is under the influence of intoxicating
liquor or drugs.
k) For any incapacity or death of an Employee resulting from his/her deliberate self-injury
or the deliberate aggravation of an accidental Injury.
CONDITIONS
1.

The Contract: This Policy and the Schedule shall be read together as one contract and
any word defined herein and shown in bold shall bear such specific meaning wherever it
may appear in the Policy or the Schedule.

2.

Due Observance: The due observance and fulfilment of the terms, conditions and
endorsements of this Policy so far as they relate to anything to be done or not to be done
by the Insured shall be condition precedent to any liability of the Company to make any
payment under this Policy.

261

3.

Mis-representation/Non-Disclosure: This Policy shall be void in the event of any misrepresentation or non-disclosure in the Proposal and the Insured is deemed to warrant the
truth and accuracy of the statements and answers in the Proposal which form the basis of
this Policy.

4.

Written Communication: Every notice or communication to be given or made under

this Policy shall be delivered in writing to the Company.

5.

Safeguards: The Insured shall take reasonable precautions to prevent accidents and
disease and shall comply with all statutory obligations, manufacturer's recommendations
and other safety regulations in conduct of the Business.

6.

Claim Intimation: In the event of any occurrence which may give rise to a claim under
this Policy the Insured shall as soon as possible, and in any case within a period of thirty
days of such occurrence, give notice thereof to the Company in writing with full
particulars. Every letter claim writ summons and process shall be notified to the
Company immediately on receipt. Notice shall also be given to the Company
immediately the Insured shall have knowledge of any impending prosecution inquest or
fatal enquiry in connection with any such occurrence as aforesaid.

7.

Companys Rights After Loss: No admission offer promise or payment shall be made
by or on behalf of the Insured without the consent of the Company which shall be
entitled, without being obliged to do so, if it so desires to take over and conduct in his
name the defence or settlement of any claim or to prosecute in his name for its own
benefit any claim for indemnity or damages or otherwise and shall have full descretion in
the conduct of any proceedings and in the settlement of any claim and the Insured shall
give all such information and assistance as the Company may require.

8.

Declaration of Employees and Wages: It is clearly agreed and Understood that the
Insured shall be bound at all times to declare all Employees and Wages payable in
respect of such Employees on the basis of which the Premium for this Policy is
calculated.
In case of increase in Employees or Wages subsequent to insurance, Insured shall keep
the Company intimated and obtain Endorsement by payment of necessary additional
premium.
The Insured shall as and when require by the Company permit inspection of its records
to verify the Wages and Employees and shall also provide duly authenticated copies
thereof if so required the Company.

9.

Average: Notwithstanding anything contained hereinabove,

(i) a) If the number of Employees (whether on duty or otherwise) employed by the Insured
on the date of accident is higher than the number covered under this Policy, the

262

Company shall indemnify Insureds liability arising out of such accident, only in such
proportion that the number of Employees covered bears to the Employees found
employed on the date of accident.
b) If the amount of Wages declared for this insurance for all Employees is less than the
actual Wages paid until date of accident, the Company shall be liable to indemnify on
any claim only in proportion that the Wages declared bears to the Wages paid. For the
purpose of this clause, the Wages declared shall be calculated proportionately for the
period from commencement of Policy until date of accident for comparison with the
actual wages paid during such period to determine applicability of this clause.
c) If the liability of the Insured for any claim by an Employee is determined on the basis
of Wages higher than covered under this Policy, the Company shall be liable to
indemnify only in proportion that the Wages covered under the Policy for the Employee/
Employees bears to the Wages on the basis of which Insured is held liable. For the
purpose of this clause, the Wages covered in respect of any Employee shall be deemed to
be the average wage per Employee in the category under which the Employee falls as
specified in the Schedule, unless actual Wages paid at the time of accident is
substantiated by submission of documentary evidence to the Company.
(ii)

If more than one of the above clauses is found applicable in respect of a claim, only such
clause under which the liability of the Company is least shall be applied.

10.

Maintenance of record of Employees/Wages: The Insured undertakes to maintain an

accurate record of the Employees and Wages in respect of the Business throughout the
Period of Insurance, in compliance with all statutory requirements or otherwise, and
allow the Company to inspect such records during or upon expiry of this Policy.

11.

Contribution : If at the time of the happening of an accident covered by this Policy there
shall be any other insurance covering the same risk in respect of the Employee whether
or not effected by the Insured, then the Company shall not be liable to contribute more
than its rateable proportion of the amount that would otherwise be payable under this
Policy.

12.

Cancellation: The Company or the Insured may cancel this Policy by sending at least
15 days written notice to the other party at his last known address and in such event the
premium shall be adjusted in accordance with Condition 8 above.

13.

Forfeiture: If the Insured shall make any claim or connive in the making of any claim,
knowing the claim to be false or fraudulent, the Policy shall become void and all claims
will stand forfeited.

14.

Arbitration:

263

a) If any dispute or difference shall arise as to the quantum to be paid under this Policy
(liability being otherwise admitted) in respect of any claim, such difference shall
independently of all other question be referred to the decision of a sole arbitrator to be
appointed in writing by the parties to or if they cannot agree upon a single arbitrator to a
panel of three arbitrators to be appointed in accordance with the provisions of the
Arbitration and Conciliation Act, 1996. The arbitration shall be governed by Indian law.
The venue of arbitration shall be within India.
b) It is clearly agreed and understood that no reference to arbitration can be made if the
Company has either not admitted or has disputed liability in respect of any claim under
or in respect of this Policy.
c) In the event that these arbitration provisions shall be held to be invalid then all such
disputes or differences shall be referred to the exclusive jurisdiction of the Indian Courts.
d) It is further expressly agreed and declared that if the Company shall disclaim liability in
respect of any claim and is not within 12 calendar months from the date of such
disclaimer be made the subject matter of a suit or proceeding before a Court of law or any
other forum, it shall for all purposes be deemed to have been abandoned and shall not
thereafter be recoverable hereunder.
15.

Law and Jurisdiction: It is hereby declared and agreed that this contract of insurance
and all claims thereunder shall be governed by Indian Law and any legal proceeding in
respect thereof shall be raised a competent court of India. All claims shall be paid in
Indian Rupees only.

EMPLOYEES COMPENSATION INSURANCE

POLICY SCHEDULE
(Forming part of Policy No.______________ whose terms are attached herewith)
1. Insured:
2. Address:
3. Business:

264

4. Laws: The Policy covers Liability of the Insured

under the following Law(s) shown as covered, subject
to claim being otherwise admissible as per terms,
conditions and exclusions of the Policy and subject to
Limit of Indemnity as stipulated against each Law:
LAW
LIMIT OF INDEMNITY
4(a)

Employees
Compensation Subject otherwise, to the
Act, 1923 and subsequent terms, conditions &
amendments thereof prior to Exclusions of the Policy, the
the date of issue of this Policy amount of liability incurred by
the Insured

4(b)

Common Law

Subject otherwise, to the

terms,
conditions
&
Exclusions of the Policy, the
amount of liability incurred by
the
Insured,
but
not
exceeding:-

a) Limit Per Employee

for any number of
accidents
during
Period of Insurance
Rs.________
b) Limit Per Accident
for any number of
Employees
Rs.________
c) Aggregate Limit for
all accidents and claims
arising
therefrom
during the Period of
Insurance
Rs.________

5. Period of Insurance:
From __________ to ______________ (both days inclusive)
6. Premium Details:
Premium Rs

265

Service Tax Rs
Total
Rs
Premium

7. Details of Employees Covered:

Description of work Declared
done by Employees Number of
Employees

Declared Wages during Place/Places of

the Period of
Employment
Insurance

8. Subject to following clauses:

Special Conditions: Subject to terms and Conditions of Employees Compensation
Insurance Policy attached herewith.
For
Date: _______________
____________________

Authorised Signatory

The compensation payable in respect of death of a workman must be deposited

with the Commissioner for workman's compensation. In the case of permanent
disablement benefits it is necessary to draw up a Memorandum of Agreement setting
forth the terms of the settlement, which must be registered with the Commissioner for
Workmen's Compensation. This provision is also applicable to women and minors.

266

SCOPE OF THE POLICY

The policy is available under two tables :Table - A

Indemnity to employer against his legal liability for accidents to employees

under the Workmen's Compensation Act, 1923 and subsequent amendment
of the Act, prior to the date of issue of the policy, the Fatal Accidents Act,
1855 and under common Law only.

Table-B

Indemnity to employer against his legal liability for accidents to employees

under the Fatal Accidents Act, 1855 and under common Law only.

Exclusions :
MEDICAL EXPENSES AND OCCUPATIONAL DISEASES ARE NOT COVERED
UNDER THE POLICY
This policy does not cover loss arising from or occasioned by :a.

An injury by accident or disease directly attributable to war, warlike

operation and other convulsions of nature, nuclear fuel or material and
contamination by radioactivity.

b.

The Insured's liability to employees of contractors of the insured.

c.

Any employee who is not a "Workman" within the meaning of Law(s).

d.

Any liability of the Insured which attaches by virtue of an agreement but

which would not have attached in the absence of such agreement.

e.

Any sum which the insured would have been entitled to recover from any
party but for agreement between the insured and such party.

267

f.

Any compensation for diseases mentioned in Part "C" of Schedule III of the
Workmans compensation Act, 1923, which have been brought within the
scope of that Act by the Workmen's compensation (amendment) Act 1956.

PREMIUM RATES :
The premium rates for Workmen's Compensation Insurance is regulated by tariff
depending upon the trade or occupation of the different categories of employees. The
premium rate is applied on the amount of wages, salaries and other earnings paid during
the period of insurance. Therefore at the outset a provisional premium is charged based
on the amount of estimated wages to be paid during the period of insurance and subject to
adjustment at the end of the period based on the amount of wages actually paid. For this
purpose the Insured must furnish to the company on the expiry of the period of insurance
a statement of actual wages paid etc. This is an important aspect which should be borne in
mind. It is necessary to ensure that all the Workmen at the place of work are included in
the insurance. Under no circumstances can certain specified categories of workmen alone
could be declared for insurance.
Where it is necessary to cover liability in respect of diseases mentioned in Part C
of Schedule III, additional premium of 50% of the premium collected under the Policy
has to be charged.
ACCEPTANCE LIMITS :
While there is no limit of acceptance laid down for this class of insurance,
proposals pertaining to the following trades should be referred to the controlling office
before intimating acceptance and submitting quotation. Artists models, Athletic
professionals, breaking up of stone work or concrete work, builders of steeple and tower,
chimney shaft erectors, collieries, cooling towers (making and / or erecting) demolition
contractors, dredger operators, filling tubes with fire extinguishing materials (testing and
demonstrating) film producing for cinematography, fire fighter, firewood cutters and

268

bundlers, fireworks manufactures, fishermen, flax scutch mills, horse trainers,

housebreaker, and excavators, instructors of colliery rescue brigades, machinery
dismantlers or breakers, manufacturers of explosives or any process therein, marine
surveyors, metal merchants (breaking up) quarries riggers, risks consisting of loading
hand grenades, bombs or shells with explosive, saw mills scrap metal dealers, seamen
(other than coastwise passengers and ferry services) ship scalers, sinkers, sinkers-pit,
mines or well-opening up or driving levels or slants, steeplejacks, tree felling, underwater
risks, window cleaners, zoological gardens, risks involving work in compressed air.

269

CLAIM PROCEDURE :TEMPORARY DISABLEMENT CLAIMS :1.

Claim from should be obtained.

2.

Medical certificate in respect of the injury employee and leave certificate are to be
obtained.

3.

The claim is calculated as per W.C Act at 25% of monthly wages for every
fortnight of disablement.

PERMANENT DISABLEMENT CLAIMS :Documents as above are to be obtained.

A memorandum of Agreement as per W.C. Act (Form L) in duplicate should be
completed by the insured and signed by the injured workman.
The dealing office should calculate the compensation payable as per the schedule
of the W.C. Act on the basis of age group and monthly emoluments drawn by the
workman and after applying the appropriate multiplying factor.
The amount so calculated should be deposited with the W.C. Commissioner along
with the Memorandum of Agreement.
FATAL CLAIM :Claim form, Death Certificate as well as copy of Post Mortem Report should be
obtained.
Compensation should be calculated as per schedule of the W.C. Act.
The amount so calculated should be deposited with the commissioner with Form
M- prescribed by the W.C. Act duly filled in (this is done where settlement is done

270

directly with the dependants of the deceased employee). When there is a formal claim
lodged by the dependants with the W.C. Commissioner the award amount will be
deposited with the Commissioner's office.

271

CINEMA AUDIENCE INSURANCE

INSURANCE COVER FOR AUDIENCE IN CINEMA THEATRES
Following reports in the press about the audience in Cinema Theatres getting
killed / injured grievously because of fire accidents or collapse of theatre buildings some
State Governments have made insurance of such audience against accidents compulsory
for Cinema Theatre owners and operations.
A special contingency policy has been devised to cover audience of cinema theatre
as per terms given below :1.

RISK COVERED :Fire, RSD, MD, Storm, Tempest, Flood, Inundation, Accidental Damage and

collapse of Building leading to Death of or Injury to Audience.

2.

LIMITS OF COVER :Death / Permanent Total Disability / Loss of two limbs or 2 eyes / loss of one limb

and
One eye

Rs. 10,000/- per person

Loss of one limb or one eye

Rs. 5,000/- per person

Overall limit per policy period

Rs. 10,000,000/-

(The cover given above is only in respect of injury to the audience and policy does not
cover loss of or damage to the cinema theatre / building or the machinery like projectors,
sound system, etc., or the films exhibited. These items have to be covered separately for
fire and allied perils or other perils).

272

3.

PREMIUM :-

a.

For permanent and semi-permanent theatres - 0.05 p per seat on the licensed seating
capacity

b.

Touring Theatres - 0.07 p per seat on the licensed seating capacity. Minimum
premium of Rs.250 per theatre is to be charged.
The rates given above are for normal sized theatres where the seating capacity

does not exceed 1,000. If seating capacity exceeds, 1,000 you may refer the proposals to
the HO for rating and acceptance.

273

PROFESSIONAL INDEMNITY INSURANCE

What Does Errors And Omissions Insurance A professional liability insurance that protects companies and individuals against claims
made by clients for inadequate work or negligent actions. Errors and omissions insurance
often covers both court costs and any settlements up to the amount specified on the
insurance contract.
Errors and Omissions Insurance may be referred as: E&O (Insurance), Errors

(&)

Omissions, Professional Liability (Insurance), Malpractice (Insurance), etc. The

Professional Indemnity Insurance is given to PROFESSIONALS like Doctors, engineers,
Chartered Accountants etc., whereas, the E&O policy is given to organisations like BPOs,
Software Engineering concerns etc.,
What is E&O insurance?
Errors and omissions (E&O) is the insurance that covers the Insured, in the event that a
client holds our Insured responsible for a service provided, or failed to provide, that did
not have the expected or promised results. For doctors, dentists, chiropractors, etc., it is
often called malpractice insurance. For lawyers, accountants, architects or engineers, it
may be called professional liability. Whatever you call it, it covers the Insured for errors
(or omissions) that they made or that their client perceives they have made.
Most E&O policies cover judgments, settlements and defense costs. Even if the
allegations are found to be groundless, thousands of dollars may be needed to defend the
lawsuit. They can bankrupt a smaller company or individual and have a lasting effect on
the bottom line of larger companies.
In short, E&O coverage provides protection for the Insured in the event that an error or
omission on their part has caused a financial loss for their client.

274

Who can be given PI/ E&O?

The best-known professionals who need PI insurance are doctors, lawyers, accountants,
architects, engineers, etc. However, less thought about individuals range from advertising
agencies to commercial printers, Web hosting companies to wedding planners.
If the Insured is in the business of providing a service to a client for a fee, the Insured has
an E&O exposure.
Why does the Insured need coverage?
To put it very simply, everyone makes mistakes. Even with the best employees and the
best risk management practices in place, mistakes will be made. No one is perfect.
If a Surgeon operates on the left eye instead of the right, he is exposed to legal liability in
case of a suit.
If a broker gives wrong insurance advice to his client and the Insurer does not settle a
claim, the Broker can be sued by his client.
If a freight forwarder sends a shipment to South America instead of South Africa and it is
a time sensitive shipment and their client loses a sale and, therefore, hundreds of
thousands of dollars, who will pay the loss?
There is also the less tangible loss of reputation for both the professional and his client.
By not purchasing E&O a company can be taking a serious financial risk. These types of
losses are not covered under a general liability policy
Our E&O policies are written on a "claims made" or "claims made and reported" form.
This means that any claims must be made or, in some cases, made and reported, within
the policy period. These policies have a retroactive date that becomes very important.
Claims that arise out of acts committed prior to the retroactive date will not be covered.
The farther back the retroactive date, the more coverage provided.

275

Our E&O/PI policies also include the defence expenses within the limit of liability.
Different information may be needed depending upon the type of exposure.
The cost/premium rate of E&O insurance may vary greatly depending on the class of
business, location, exposure-Whether India/USA/Europe claims experience (both of the
individual insured and of the industry they are in) .
What is covered?
Professional Liability- Damages resulting from any claim for any breach of Duty
of the Insured
Intellectual Property- Damages resulting from any claim for any Infringement
Defamation-Damages resulting from any libel/slander committed unintentionally
by the Insured
Defence- Defence costs incurred in defending a claim that may arise under the
policy or any of the extensions
Fraud/dishonesty of employee (THIS EXTENSION IS GIVEN VERY RARELY)
Exclusions

Antitrust - Loss arising out of or attributable to any actual or alleged antitrust

violation, restraint of trade or unfair competition

Bodily Injury/Property Damage - unless occurring from lack of professional

services

Contractual Liability/Performance Guarantee/Delay in performing professional

services
Employment/Discrimination- Arising out of or attributable to Employment related
practices/discrimination
Insolvency- Insolvency of the Insured

276

 Infrastructure-Liability arising out of Mechanical/electrical / Telecommunication /

satellite failure
Joint Ventures
Fraud/Dishonesty of the Insured
Patent/Trade Secrets
Pollution
Prior claims/circumstances leading to /likely to lead to claims
Trade Debts
War, terrorism

Underwriting Precautions
Obtain Proposal form duly completed
Study the details of their trade/profession
Details of quality control /training/documentation procedures/Internal and External
Audits if any
Copy of relevant portion of the contract in case of a Project Insurance
Geographical spread
Limit of Indemnity selected
Check the financial of the company
Details of previous claims/known instances that may lead to a loss/liability
situation
Impose deductible(Excess)
Obtain proof of fulfilling all statutory requirements

277

Professional Indemnity Policy- Doctors

This Insurance applies to damage / liability arising out of OMISSIONS on the part
of the professionals Doctors and Medical Establishments, Engineers, Architects, Interior
Decorators, Chartered Accountants, Financial Consultants Management Consultants,
Lawyers, Advocates, Solicitors and Counsels. The Policy is issued for an amount towards
the maximum liability during the course of a policy year with an inner limit percent.
Liabilities Covered
Policies issued shall cover all sums which the Insured becomes legally liable to
pay as damages to third Party in respect of ERRORS and / or OMISSIONS on the part of
the Insured whilst rendering professional service, arising out of claims first made in
writing against the insured during the policy period, including legal costs and expenses
incurred with the prior consent of insurer, subject always to the limits of indemnity and
other terms, conditions and exception of the policy. It shall not be permissible to issue
any Professional Indemnity Insurance Policy with unlimited liability.
Extension sough under the main policy shall not have indemnity limit in excess of
main cover.
Premium
The rates of premium are annual rates. Full premium under the policy shall be paid
at inception. It is not permissible to accept premium in installments.
Turnover figure wherever required shall be accurately assessed and declared by the
proposer at inception of the policy. In case the insured anticipates any increase / decrease
in turnover, during the policy period such fluctuations should no circumstances it shall be
permissible to adjust the premium for the turnover after expiry of the policy.

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Retroactive Date
Retroactive Date is the date when the risk is first incepted under a claims made
policy and thereafter renewed without break in the period of cover.
Revision in Limits of Indemnity
a)

Mid-term increase / decrease in the limits of indemnity limit during the

currency of the policy period will be at the discretion of the Head Office off
the Company. Whenever changes in indemnity limits are agreed to the
revised retroactive date showing indemnity limits available at various dates
shall be incorporated in the Policy Schedule.
If insured wish to seek protection for an anticipated liability in excess of
available limits of indemnity for past periods due to different retroactive
dates the company may consider granting "run-off" cover based on merits
of each case. Rates, terms and conditions for such "run-off" covers may be
finalized by the company and if necessary, may consult Reinsurers.

All policies are subject to a compulsory excess of certain fixed percentage of the
limit of indemnity per any one accident or any one year subject to a minimum of
Rs.2,50,000/-. The Insured shall bear this Compulsory Excess which is applicable to both
property damage claims and death / bodily injury claims inclusive of defence cost arising
out of any one accident.
Wherever the policies have AOA limits, the excess will be applicable as a
percentage of AOA limits. Wherever policies are issued only on AOY terms the excess
will be applicable on AOY limits.

279

Short Period Premium

The following short period scale of premium shall apply (i) policy issued for
periods less than 12 months and (ii) policies cancelled during the currency at the request
of the insured subject to no claims :Period

Rate

Not exceeding one week

10% of the annual rate

Not exceeding one month

25% of the annual rate

Not exceeding two months

35% of the annual rate

Not exceeding three months

50% of the annual rate

Not exceeding four months

60% of the annual rate

Not exceeding six months

75% of the annual rate

Not exceeding eight months

85% of the annual rate

Exceeding eight months

Full annual premium

For annual policies cancelled during the currency at the request of the insured,
premium should be adjusted at the Short period Scales for the actual period of cover
subject no claims. No refund is permissible in case of any claim under the policy.
The short period premium is subject to the minimum premium in the Rating
Schedule.
Exceptions of the Policy are:
a)

Libel or Slander.

280

b)

Loss of documents.

c)

Consequential loss.

d)

Losses suffered out of fraudulent act of employee

1.

EXCLUSIONS:

1.

This Policy shall not indemnify the insured against any claim made against them
in respect of:
a)

(i) arising out of all personal injuries such as libel, slander, false arrest,
wrongful eviction, wrongful detention, defamation, etc. and mental injury,
anguish or shock resulting therefrom.

(ii)

infringement of plans, copy-right, patent, trade name, trade mark, registered

design.

b)

infringement of patents and copy-rights or arising from the granting of

licenses by the Insured as a party to the construction project

c)

any dishonest, fraudulent criminal or malicious act or omission.

d)

liabilities assumed by the Insured by agreement and which would not have
attached in the absence of such agreement.

e)

loss of any documents/data/information/losses sustained on account of time

spent in investigating the cause of damage (including costs for re-projecting
in connection with the damage) and claims for losses sustained.

f)

bodily injury, sickness, disease, death, damage to property or financial loss

and/or consequential loss unless arising out of wrongful, faulty or
inadequate design or advice.

g)

liabilities attaching under contract of employment (employers liabilities)

281

h)

The ownership, maintenance, use, occupation, leasing or custody or

property mobile and/or immobile by, to or on behalf of the Insured, or
brought about by damage to or destruction of property owned by, rented or
leased to or in the custody of the Insured. i) deliberate, wilful or intentional
non-compliance of any Statutory provision.

j)

fines, penalties, punitive or exemplary damages or any other damages

resulting from the multiplication of compensatory damages.

k)

any happening through or in consequences of war, invasion, act of foreign

enemy, hostilities (whether war be declared or not), civil war, rebellion,
revolution, insurrection or military or usurped power.

l)

losses directly or indirectly caused by or contributed by:

a)

ionising radiations or contamination by radioactivity from any

nuclear fuel or from any nuclear waste from the combustion of
nuclear fuel

b)

the radioactive, toxic, explosive or other hazardous properties of any

explosive nuclear assembly or nuclear component thereof.

m)

earthquake, earth-tremor, volcanic, eruption, flood, storm, tempest,

typhoon, hurricane, tornado, cyclone or other similar convulsions of nature
and atmospheric disturbances.

n)

any loss and/or damage and/or injury which has its origin in a neglect, error
or omission prior to the Retroactive Date mentioned in the Schedule.

o)

the non-compliance with technical standards commonly observed in

professional practice, laid down by law, or regulated by official bodies

p)

loss of use and or loss due to delay

282

q)

ownership and/or conduct of any other business or activities wholly or

partly owned/operated or managed except the business described in the
Schedule.

r)

arising

from

higher

estimates

and

costs

for

not

adhering

to

deadlines in completing the construction of project or part thereof and from

defective accounts or control of accounts.
s)

inadequate quantities/qualities or arranging or handling the supply of

material

t)

activities of the Insured as joint venture or as partner unless such joint

venture and/or partnership is described in the Schedule; the liability of the
Company being limited to the extent of participation/share in the business
so named

u)

any contract where the Insured acts as a construction contractor whether or

not in conjunction with his/their profession as stated in the Schedule.

v)

liabilities

arising

out

of

pollution

and/or

contamination

of

whatsoever nature.
w)

claims for losses as a consequence of material or construction damage, such

as e.g. loss of production of all kinds, loss for interior performance, poor
quality or lower profitability and additional futile expenditure of the
principal to reach normal performance, quality or profitability.

x)

claims for damage caused by motor vehicles, sea vessels or aircraft.

283

DOCTORS AND MEDICAL PRACTITIONERS (GUIDELINES)

The Policy will indemnify any act committed by the insured, who shall be a
Registered Medical Practitioner, giving rise to any legal liability to Third Parties. The
Insured includes the policy holder and his qualified assistants or employees named in the
proposal.
The Act has to be committed during the period of insurance commencing from the
retroactive date.
In the normal course all claims for compensation have to be legally established in
a court of law. However, insurance may arrive at compromised settlement if
prima-facie liability exists under the policy.
Jurisdiction applicable will be Indian courts.
The limit of indemnity granted under the policy for any one accident or any one
year (per accident per policy year) will be identical.
No short period policies are permitted. However in case of cancellation of the
policy by the insured short period scale rates as provided for will be applicable.
Registered Medical Practitioners shall be classified as :1. Physicians
2. Pathologists
3. Oncologist
4. Cardiologists
5. Psychiatrists
6. Radiologists or Roentgenologists
7. General Surgeons
8. Plastic Surgeons
9. Orthopaedic Surgeons
10.Urologists

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11. Abdominal Surgeons

12.Thoracic surgeons
13.Neuro - Surgeons
14.Cardio - Vascular Surgeons
15.Otorhinolarynologists
16. Proptplogists
17.Ophthalmogic Surgeon
18.Ophthalmogic Physician (Excluding Surgery)
19.Obstetrician and gynaecologist
20.Physician and non-specialist Surgeon
21.Other Practitioner - describe fully.

285

DOCTORS AND MEDICAL PRACTITIONERS

PROFESSIONAL INDEMNITY RATING
Limit of Indemnity for any one accident and policy period would be identical.
SCHEDULE OF RATES
(To be charged on Any One Year Limit)
(Rate per mille)
1

Physicians without dispensing and other

facilities General Pathologist Radiologist

2.

Specialists / Consulting Physician (Non surgical)

Surgeons (excluding specialists in Plastic
2.0 1.6 1.4 1.2
Surgery). Lithotripsy, Dentists & similar
extra corporal
methods of treatment
would fall within this category.
Surgeons
(Plastic
Surgery)
and 3.0 2.4 2.10 1.80
Anaesthetists
3.0 per mille on AOY limit

3.

4.

1:1 1:2 1:3 1:4

0.50 0.40 0.35 0.30
1.0 0.80 0.70 0.60

Whenever Doctors wish to cover unqualified staff working with them the same may
be allowed by collection additional premium of 7.5% of the indemnity premium.
Whenever multiple professional specialisation are involved then the rate
applicable will be that of the specialisation which attracts the higher premium rates.
Minimum Premium Rs.100/-.
Excess: .25% of the AOY limit subject to a minimum of Rs.1000/- and a
maximum of Rs.1,00,000/-

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.
1.

INDEMNITY
The Indemnity applies only to claims arising out of bodily injury and / or death of

any patient caused by or alleged to have been caused by error, omission or negligence in
professional service rendered or which should have been rendered by the Insured or
qualified assistants to be named in the Policy or any nurse or technician employed by the
Insured.
(a)

Where such acts of omission, errors should result in a claim being first
made in writing against the Insured during the policy period.

(b)

There shall be no liability hereunder for any claim made against the insured
for act committed or alleged to have been committed prior to the
Retroactive Date specified in the Policy.

For the purpose of determining the Indemnity granted

(a)

Policy of Insurance means the period commencing from the effective date
and hour as shown in the Policy Schedule and terminating at midnight on
the expiry date as shown in the Policy Schedule.

(b)

Period of Insurance means the period commencing from the retroactive

date and terminating on the expiry date as shown in the Policy Schedule.

(c)
2.

Bodily Injury means death, injury illness or disease of / or to any person.

LIMIT OF INDEMNITY
Irrespective of the number of persons or entities named as insured in the policy or

added by endorsement, the total liability of the company hereunder for damages inclusive
of defence costs (as hereinafter defined) shall not exceed the limit of indemnity set out in

287

the Schedule in respect of any or all claims made against the insured during the currency
of this insurance.
3.

DEFENCE COSTS
The Company will pay all costs, fees and expenses incurred with their prior

consent in the investigation, defence or settlement of any claim made against the Insured
and the costs of representation at any inquest, inquiry or other proceedings in respect of
matters which have a direct relevance to any claim made or which might be made against
the Insured, provided such claims are the subject of indemnity by the Policy. Such costs,
fees and expenses are called Defence Costs.
4.

(a) NOTIFICATION EXTENSION CLAUSE

Should the Insured notify the Company during the Policy Period in accordance

with General Condition No.8.1. of any specific event or circumstance which the company
accepts may give rise to a claim or claims which form the subject of indemnity by this
policy, then the acceptance of such notification means that the Company will deal with
such claim or claims as if they had first been made against the Insured during the Policy
period. The extension under the Clause will be subject to the maximum time limit laid
down under the Indian Limitation Act in force from time to time.
(b)

EXTENDED CLAIM REPORTING CLAUSE

In the event of non - renewal or cancellation of this Policy either by the Company

or by the Insured, the Company will allow a time limit not exceeding 90 days from the
date of expiry or cancellation of the policy, provided no insurance is in force during this
extended reporting period for accidents which had taken place during the period of
insurance but could not be made during the extended reporting period shall be handled as
if they were made on the last day of the expiring policy.

288

5.

CLAIMS SERIES CLAUSE

For the purpose of this policy where a series of losses and / or bodily injuries and /

or deaths are attributable directly or indirectly to the same cause or error or omission
relating to discharge or professional services all such losses and / or death claims shall be
added together and all such losses and / or bodily injuries and / or death shall be treated
as one claim and such claim shall be first of the claims was made in writing. There shall,
however be no coverage of claims which are made arising from one specific cause which
are made later than 3 years after the first claim of the series.
6.
1.

EXCLUSIONS
No liability shall attach to the Company in respect of
(i)

Any criminal act or any act committed in violation of any law or ordinance

(ii)

Services rendered while under the influence of intoxicants or narcotics

(iii)

Their performance by dentists and dental surgeons on

(1)

general anaesthesia or

(2)

Any procedure carried out under general anaesthesia unless

performed in a Hospital,

(iv)

The use of drugs for weight reduction

(v)

Claims made against the Insured arising from the performance of cosmetic
plastic surgery, hair transplants, punch grafts, flap rotations and the like
(hereinafter referred to as cosmetic) it being understood the at the following
shall not be deemed to be cosmetic :
a)

Anaesthetic X-ray or other medical nursing or laboratory service

provided in connection with the performance of cosmoses.

289

b)

Plastic surgical repair of scar tissue being the result of previous

surgery unrelated to cosmoses performed by the Insured.

c)
(vi)

Plastic surgery in connection with burns or other traumatic injury.

Third Party Public Liability

(vii) Claims arising from any condition directly or indirectly caused by or

associated with Human T-Cell Lymphotropic Virus type III (HTLV III) or
LYMPHADENOPATHY ASSSOCIATED VIRUS (VAV) or the mutants
derivatives or variations thereof or in any way related to Acquired Immune
Deficiency Syndrome or any Syndrome or condition of a similar kind
howsoever it may be named.
2.

This Policy does not cover liability

(i)

Assumed by the Insured by agreement and which would not have attached
in the absence of such agreement.

(ii)

Arising out of deliberate, wilful or intentional non - compliance of any

Statutory provision.

(iii)

Arising out of loss of pure financial nature such as loss of goodwill, loss of
market etc.

(iv)

Arising out libel, slander, false arrest, wrongful eviction, wrongful

detention, defamation, etc. and mental injury, anguish or shock.

(v)

Arising out of fines, penalties, punitive or exemplary damages.

(vi)

Directly or indirectly occasioned by happening through or in consequence

of war, invasion, act of foreign enemy, hostilities (where war be declared or

290

not), civil war, rebellion, revolution, insurrection or military or usurped

power.
(vii) Directly or indirectly caused by or contributed by
i.

Ionising radiation or contamination by radioactivity from any nuclear

fuel or from any nuclear waste from the combustion of nuclear fuel

ii.

The radioactive, toxic, explosive or other hazardous properties of any

explosive nuclear assembly or nuclear component thereof

(viii) Arising out of genetic injuries caused by x-ray treatment / diagnosis or

treatment / diagnosis with radioactive substances.
(ix)

In respect of professional services rendered by the Insured prior to the

Retroactive Date in the schedule.

(x)

The deliberate conscious or intentional disregard of the insureds technical

or administrative management of the need to take all reasonable steps to
prevent claims.

(xi)

Injury to any person under the contract of employment or apprenticeship

with the Insured their contractor (s) and / or Sub-Contractor(s) when such
injury arises out of the execution of such contract.

8.

CONDITIONS

8.1

The Insured shall give written notice to the Company as soon as reasonably
practicable of any claims made against the Insured (or any specific event or
circumstances that may give rise to a claim being made against the Insured) and
which forms the subject of indemnity under this policy and shall give all such
additional information as the Company documents relating to the event shall be
forwarded to the Company immediately they are received by the Insured.

291

No admission offer promise or payment shall be made or given by or on behalf of

the Insured without the written consent of the Company.
8.3

The Company will have the right but in no case the obligation, to take over and
conduct in the name of the insured the defence of any claim and will have full
discretion in the conduct of any proceedings and in the settlement of any claim and
having taken over the defence of any claim may relinquish the same. All amounts
expended by the Company in the defence, settlement or payment of any claim will
reduce the limits of indemnity specified in the Schedule of the Policy.
In the event that the Company, in its sole discretion chose to exercise its right
pursuant to this conditions, no action taken by the Company in the exercise of
such right will serve to modify or expand in any manner, the companys liability or
obligations under this policy beyond what the companys liability or obligations
would have been had it not exercised its rights under this condition.

8.4

The Insured shall give all such information and assistance as the Company may
reasonable require.

8.5

The Insured shall give notice as soon as reasonably practicable of any fact, event
or circumstance which materially charges the information supplied to the
Company at the time when this policy was effected and the Company may amend
the terms of the policy.

8.6

The Company may at any time pay to the Insured in connection with any claim or
series of claims under this policy to which an indemnity limit applies the amount
of such limit (after deduction of any sums already paid) or any lesser amount for
which such claims can be settled and upon such payment being made the
Company shall relinquish the conduct and control of and be under no further
liability in connection with such claims.

292

8.7

The Policy and the Schedule shall be read together as one contract and any word
or expression to which a specific meaning had been attached in any part of this
policy or the Schedule shall bear such specific meaning wherever it may appear.
The terms and exclusions of this policy (and any phrase or word contained therein)
shall be interpreted in accordance with the Indian Law.

8.8

If at the time of happening of any event resulting into a liability under this policy,
there be any other liability insurance or insurances effected by the Insured or by
any other person covering the same liability, then the Company shall not be liable
to pay or contribute more than its rateable proportion of such liability.

8.9

This Policy does not cover liability which at the time of happening of any, event
resulting into such liability, be insured by or would but for the existence of this
policy, be insured by, any other policy (but not a liability policy) or policies,
except in respect of any excess beyond the amount which could have been payable
under such policy / policies has this insurance not been effected.

8.10 The Company may cancel this policy by giving thirty days notice in writing of
such cancellation to the Insureds last known address and in such an event the
company will return a pro-rata portion of the premium (subject to a minimum
retention of 25 per cent of the annual premium) for the unexpired part of the
Insurance.
This Policy may also be cancelled by the Insured by giving thirty days notice in
writing to the Company in which event the Company will retain premium at short
period scale provided there is no claim under the Policy during the period of
Insurance. In case of any claim under the policy, no refund of premium shall be
allowed.
8.11

In the event of Liability arising under the Policy or the payment of a claim under
this Policy, the limit of indemnity per any one year under the policy shall get

293

reduced to the extent of quantum of liability to be paid or actual payment of such

claim. Under no circumstance it shall be permissible to reinstate the aggregate
limit of indemnity to the original level even on payment of extra premium.
8.12 It is also hereby further expressly agreed and declared that if the Company shall
disclaim liability to the Insured for any claim hereunder and such claim shall not
within 12 calendar months from the date of such disclaimer have been made the
subject matter of suit in a court of Law, then the claim shall for all purpose be
deemed to have been abandoned and shall not thereafter be recoverable hereunder.
8.13 The Company shall not be liable to make any payment under this Policy in respect
of any claim if such claim shall be in any manner fraudulent or supported by the
statement or device whether by Insured or by any person on behalf of the Insured
and / or if the insurance has been continued in consequence of any material misstatement or the non-disclosure of any material information by or on behalf of the
Insured.
8.14 Policy Disputes Clause
Any dispute concerning the interpretation of the terms conditions limitations and /
or exclusions contained herein is understood and agreed to by both the Insured and
Company to be subject to Indian Law. Each party agree to submit to the
jurisdiction of any Court of competent jurisdiction within India and to comply
with all requirements necessary to give such Court of jurisdiction. All matters
arising hereunder shall be determined in accordance with the law and practice of
such Court.

294

MEDICAL ESTABLISHMENTS (GUIDELINES)

The Policy will indemnify the Insured in respect of any act committed by the
professionals or qualified assistants named in the proposal engaged by the medical
establishment which gives rise to any Third Party legal liability. Such activities will be
part of the declared medical activities of the establishment.
-

Such an Act would have taken place in the duration of the policy commencing
from the retroactive date.

In the normal course all claims for compensation have to be legally established in
a court of law. However, insurers may arrive at compromised settlement if prima facie liability exists under the policy.

Only Indian Law shall be applicable to such action.

The limits of indemnity would be limited to any one year limit under the policy.

Short period policies are not permitted. In case Insured desires cancellation short
period scale rates as provided for will be applicable.

Medical establishments shall be Registered with competent authority as per the

local regulations.

Explanations :
For this purpose whenever necessary applications have been made for such
registration and the same have not been rejected, then this requirement shall be deemed to
have complied with.
In territories where no registration facilities exist, the following minimum norms
need to be complied with for considering the proposal :-The establishment should have :
1.

At least 10 in-patient facility

295

2.

A fully equipped Operation Theatre of its own

3.

Fully qualified nursing staff in its employment round the clock, unless indicated to
the contrary and additional premium paid

4.

Fully qualified Doctor / Doctors should be in charge round the clock.

Subject to the condition that as and when official regulations are introduced in the

concerned territory the insured shall comply with registration formalities for continuation
of the policy at renewal.
List of eligible Medical Establishments :
1.

Hospitals

2.

Nursing Homes.

296

MEDICAL ESTABLISHMENT
RATING-MEDICAL ESTABLISHMENTS
Policy schedule to show only Annual Limit.
Rate : Rs.1.8 per mille on AOY Limit plus.
Rs.5 per each inpatient plus.
Rs.1 per outpatient.
AOA :

RATE PER

AOY

MILLE

1:1

1:2

2.40

1:3

2.10

1:4

1.80

(number of participants to be as per previous years record or the anticipated number of

participants during the year whichever is higher).
Radioactive treatment (other than X-ray : Additional premium of 15 per cent on total
premium.
For employment of unqualified Nurses /
para-medical staff / Technical Staff:

Additional premium of 7.5% of Indemnity

premium.

Total premium including all extras shall be subject to a maximum of 5% of AOY Limit.
Minimum premium under one policy

Rs. 1000/-.

297

Excess : 0.25% of the AOY Limit subject to minimum of Rs.2.5 lacs - within India, for
ROW / 0.5% of AOY limit subject to a minimum of Rs. 5 lacs, for USA & Canada 0.5%
of AOY limit subject to minimum of Rs. 10 lacs.
GROUP DISCOUNT :
Upto 200

Nil

201 to 1000

5%

1001 to 5000

10%

5000 to 20000

15%

Above 20000

20%

298

ENGINEERS, ARCHITECTS AND INTERIOR DECORATORS

(GUIDELINES)
-

This cover is available for professionals in their individual capacities and / or as

firms either on annual basis or on project basis.

The policy - holder or insured and their named employees will be indemnified for
all sums they become legally liable to pay to Third Party as
i.

Material damage - i.e .destruction of or damage to or loss of tangible

property.

ii.

Construction damage - (material damage to or defects in objects built by

Third Party on basis of planning work done by insured or under his
supervision).

iii.
-

Death, bodily injury attributable to error or omission.

The claim has to occur during the period of insurance.

Liability (for claims arising from any damage or injury which has origin in neglect error
or omission) has to be established during the period of insurance commencing from
retroactive date shown in the Schedule.
In the normal course all claims for compensation have to be legally established in a court
of law. However, insurers may arrive at compromised settlement if prima-facie liability
exists under the policy.
The limits of indemnity in respect of any one accident would be limited to 25% of Any
One Year Limit under the policy.

299

Short Period policies are not to be issued normally, but may be issued after Company
satisfying specific needs of the client. The Policy may be cancelled by the insured in
which case the company will retain premium at short period scale as applicable.
For the purpose of computation of premium annual fees shall means average of past 3
years fees earned or current years projected annual fees whichever is higher.
Compulsory Excess : 1/2% of Any one year limit subject to minimum of 2.5 lakhs
1.

ENGINEERS, ARCHITECTS AND INTERIOR DECORATORS

Basic rate
Plus

1:1
12.5

1:2
1:3
10.0
8.75
Re 1 per mille of annual fees

1:4
7.5

Minimum premium Rs 1,000/Excess-0.5% on AOA subject to a minimum of Rs 50,000/2.

CHARTERED ACCOUNTANTS, FINANCIAL ACCOUNTANTS AND

MANAGEMENT CONSULTANTS

Basic rate
Plus
Plus
Plus

1:1
1:2
1:3
1:4
6.70
5.35
4.70
4.0
Rs.100 per capita for qualified persons
Rs.50 per capital for apprentices
Rs.25 per capital for others like clerks, stenographers,
typists etc.

Minimum premium Rs 1000/Excess-0.5% on AOA subject to a minimum of Rs50,000/-

300

3.

LAWYERS, ADVOCATES, SOLICITORS AND COUNSELS

Rate per mille on AOY limits

Basic rate
Plus

1:1

1:2

1:3

1:4

8.35

6.70

5.85

5.0

Rs.150 per capita for qualified persons including

Junior plus Rs.25 per capita for others like clerks, stenographers typists.
Minimum premium Rs 1000/Excess-0.5% on AOA subject to a minimum of Rs.50,000/-

301

CARRIERS LEGAL LIABILITY POLICY

The Policy is designed to cover the legal liability of the road carriers to the owners
of the cargo carried by them under the contract of affreighment.
1.

BASIC COVER :
Under this liability arising out of loss/damage caused by Fire, Explosion or

Accidents to the vehicle carrying the goods arising out of negligence of the insured or
criminal acts of his servants.
2.

WIDER COVER :
Includes in addition to the basic cover

a)

Damage by Fire Burglary Riot, Strike, malicious damage affecting the goods at
warehouses transhipment yards whilst the goods are in the custody of the carriers.

b)

shortage of contents due to theft of cargo at any time whilst the goods are in the
custody of the carriers.

c)

Flood or water damage, taint damage

d)

Breakage leakage, damage due to improper handling. The cover with the loading
of the cargo on board the vehicle and will be in force until unloading of the same
at the discharging point on until expiry of Seven days after the arrival of the
vehicle at the destination point which ever is earlier

UNDER WRITING: Before a CLL Policy is issued the following are to be verified.
1.

The Carrier is a reputed one out the policy

2.

The Vehicle concerned is comprehensively insured.

3.

Such a comprehensive policy is in force through period of the CLL.

4.

The vehicle is maintained in a road worth condition.

302

5.

The consignment note is in the format approved by the Indian banks

association.

6.

One full reinstatement up to 100% Of S.I. is permitted on settlement of

claims a single policy can be issued to cover all the vehicles owned by the
carrier. A schedule may be attached to the policy can also cover the vehicles
hired by the insured provided the period of hire is more than three months
wider cover policy is to be issued only on selective basis.
RATING

Premium depends upon

1.

Licensed carrying capacity

2.

Type of the vehicle-open, closed or special (Refrigerated etc.)

Closed Body

Other than
closed Body

Kgs
508
2032
3048
5080
For each additional

Rs.
571
626
683
946

Rs.
761
836
911
1261

Tankero are
special
Product
carries
Rs.
1022
1172
1322
2022

1016

112.50

150

300

Licenses C.C. Not

Exceeding

303

II

Refrigerated Vehicle

872

III

Trailers :Rs.581 per trailer subject to the number of trailers towed being not more
than two. -if it exceeds two then the same should be referred to TAC for rating.

Riot and strike damage: Insurance against these risks may be provided as an extension
of the basic cover at a rate of premium as follows applied to the limits of indemnity:
Closed body vehicles: 0.50% per annum
Other vehicles and trailers: 0.75% per annum
The suggested rates are for vehicles of over 10 yrs of age. The age of the vehicle is
determined on the date of commencement of the risk by reference to year of
commencement of risk and year of registration of vehicle. An inspection certificate from
a qualified automobile engineer maybe called for .R. C. fitness certificate are to be
properly verified before granting cover.
For vehicles upto 5 yrs old 50% of the suggested rates may be applied.
For vehicles between 6 and 1 0 yrs 75% of the suggested rates may be applied
The basic cover policy can also be extended to cover SRCC risks at an additional
premium of 0.50% for closed vehicles and 0.75% for other vehicles and trailers
The policy is subject to an excess of Rs.2000/- each claim. If the insured is willing
to accept and excess of Rs.5000/-. Each claim a reduction of 10% in the rates may be
given.
Where the limit of indemnity is for more than one lac and there are no special
circumstances indicating unusually high exposure, the additional premium may be
calculated at 0.25% on the portion of the limit in excess of one lac. There is no question
of issuing an open cover to the carrier under any circumstance

304

EXCLUSIONS
The policy does not cover loss or damage arising from or occasioned by
a.

Contractual liability

b.

Liability to property belonging to insured or servant or agent.

c.

Liability due to inherent vice, wear. and tear.

d.

Depreciation, delay, loss of market, consequential loss.

e.

War, warlike operation, strike and riot.

f.

Nuclear risks and

g.

Deductible excess.

General Regulations
a.

Claims-Claims should be settled on the basis of indemnity only and only on

receipt of discharge vouchers from the cargo owners.

b.

Proposal Form: Insurance should be granted only on the basis of a signed proposal

c.

Policy Form: All policies for basic cover should be issued in the specified policy
format.

d.

Prohibition of issue of open cover: No open cover should be issued in the name of
the transport operators even if the names of the owners of the goods are
mentioned, Where the right of recovery against the carrier is waived, at a premium
below whatever is applicable as above.

305

DIRECTORS & OFFICERS LIABILITY INSURANCE

Liability Insurance for the Errors, Omissions and other wrongful acts of the Directors and
Officers has been available since the early 1960s.

What is at stake?
-

Legal liability of the directors and officers

Towards Damages and claim expenses

for any actual or alleged wrongful act in their capacity as directors and
officers

On behalf of entity

Corporate Reimbursement

Protects personal assets of Directors / officers From losses

What is covered
-

Wrongful act

Wrong, actual or alleged act

Omissions / error / judgment / misstatement / misleading statement / neglect

/ breach of duty

By insured

While working on behalf of entity

Who is covered?

Director
-

Past / present / Future director, honorary director, trustee

306

The Company

Losses
-

Legal obligation for insured to pay

Judgements

Settlements

Defence costs

Pre post judgement interest

Punitive / Exemplary damage (Insurable under law)

Legal Liability

Damages to pay compensation for legal liability to third parties arising

out of wrongful act committed and claim made during the period of insurance

Claimants Costs and Fees in accordance with Indian/other Law and claimed
against the insured

Defence costs incurred by the Insured for Investigation, defence or settlement of

any claim against him with prior consent
Cost of representation incurred by the Insured at any Inquiry or other proceedings
relating to the claim against the Insured
Indemnity Limit Damages/Claim Expenses Excess of deductible subject to the limit
chosen at inception of the policy
Insuring Agreement A (Side A Cover For Directors/Officers)
Coverage to the individual officers and directors for claims that are not indemnified by
the Insured Company pursuant to the Bye-laws, statute or due to financial inability. The is
generally no excess/deductible for this cover.

307

Insuring Agreement B (Side B for Corporate Reimbursement)

Coverage provided to the Insured Company when it has indemnified its Directors and
Officers. There can be a significant deductible/excess that can be imposed.
Side C Coverage- Protects the Company for its own wrongful acts. Coverage is
restricted to securities in Public Company D&O policies but can be broader in Private
company policies.
Side D Coverage -"Side D" Coverage - Outside Entity Insured Person Coverage
This insuring clause is available as an option on most D&O policies. It provides coverage
to designated "Insured Persons", for their liability as a result of their membership on an
"Outside Entity" board
Normal Extensions NOT EXHAUSTIVE (most of these can be covered/bought back
on payment of additional premium)
Employment Practices Liability Insurance
Entity Coverage for Private Companies/Securities
Entities Securities Extension
Advancement of defence costs
Spousal liability coverage
Hammer Clause
Major Shareholders Exclusion
IPO
Insured Vs Insured
Outside Directorship Liability Coverage
Outside Entity

308

 Prior Acts Exclusion

Prior and Pending Litigation Exclusion
Professional Liability Exclusion
Punitive Damages Exclusion
Secondary Offering Exclusion
Exclusions
-

any actual or alleged libel, slander or any actual or alleged bodily injury, sickness,
disease or death of any person or actual or alleged invasion of privacy, mental
anguish, emotional distress, infringement of copyright and / or patent, passing off
or plagiarism.

Resulting, directly, from goods or products manufactured or sold or supplied by

the company

Property damage, seepage, pollution

Failure of products

Dishonesty of directors

Illegal profits or gains

Questionable payments

Infringement of copyrights

Professional indemnity

Deliberate acts of breach

Fines

Known actions-If there is information regarding potential claim already, prior

circumstances which had not been identified

309

Underwriting Precautions
Obtain a Proposal form signed by the CEO/FA of the Company
Obtain and study the financial profile of the company
Check Asset size- balance sheet information
The Companys geographical spread
Acquisition profile
Limits of indemnity selected
Impose Deductible
Past claims experience
Exposure to International -particularly US Markets
Obtain the details and the number of Directors to be covered
Trade activities of the Company
Check if there have been any changes to capital structure of the company during
the past years. Check latest audited accounts including that of the Holding
company
Check whether during the past year the Company revealed if it has under
consideration any acquisitions, tender offers or mergers
Check whether any shareholder owns 15% or more of the Companys shares
Obtain proof of fulfilling all statutory requirements

310

PROPOSAL FORM
1.

Please read carefully and answer all questions. If a question is not applicable, so
state. If space is insufficient to answer any question fully, attach a separate sheet.

2.

The original Proposal Form must be submitted

IMPORTANT NOTICE:

1.

This is a proposal form for a claims made policy. That is to say a policy relating
only claims made against the Directors and / or Officers of the Company shown in
answer to question 1 and of its subsidiary companies (hereinafter referred to as the
Proposers) during the currency of the said policy. ANY CLAIM ADVISED TO
UNDERWRITERS AFTER THE EXPIRY DATE OF THE POLICY PERIOD
WILL NOT BE COVERED. The limit of liability available shall be reduced and
may be exhausted by payments made by United India Insurance Company Ltd
(hereinafter referred to as United India) under the policy. The limit of liability is
inclusive of, and not in addition to, costs and expenses.
It is the duty of the Proposers to disclose all material facts to United India. A
'material fact' is one which may influence United Indias judgement in their
consideration of the proposal form. If the proposal form is a renewal, it is likely
that any change in facts previously advised to United India will be material and
such changes should therefore be notified. If there is any doubt whether a fact is
material, it should be disclosed.
Failure to disclose could prejudice the rights of the Proposers to recover in the
event of a claim or allow United India to void this policy. Appropriate enquiries
should be made to ensure that the statements set forth herein are true and complete
and that no material fact has been omitted. Any change in the answers given and

311

any material change in the risk arising before inception of any policy must be
advised to United India and should therefore be notified immediately.
2.

In the event that there is any material change in the answers given to the question
contained in this proposal form prior to the inception of the policy, the Proposers
must notify United India and, at the sole discretion of the United India, any
outstanding quotations may be modified or withdrawn.

3.

Signing the proposal form does not bind the Proposers or United India to enter into
a binding contract of insurance.

4.

Any request for cover or any aspect of cover, by or on behalf of the Proposers does
not compel United India to offer terms and conditions to accede to such request.

5.

The particulars and statements contained in the proposal form and any other
information submitted are the basis for the proposed policy and will be considered
as being incorporated in to a constituting a part of the proposed policy.

1.

Name of the Company

2.

Registered Address:

3.

Country of incorporation

4.

The company has continuously been in business since:

5.

Full description of business activities

312

B
1.

Is the Company
Listed on the Stock Exchange

Yes

No

If yes, please state which stock exchange and date listing obtained:
If no, please advise what type of entity is the company
2.

3.

The Company has continually paid cash dividends on its

i)

Common Stock since

ii)

Preferred stock since

Complete the following in respect of all classes of shares issued by the Company
i)

Class of shares:

ii)

Number of shares outstanding

iii)

Number of shares owned by Directors

(Directly and / or beneficially)

iv)

Number of shares owned by Officers who are not Directors (Directly and / or
beneficially);

4.

Total number of Subsidiary Companies at the date of completing this Proposal

Form
Tick this box if cover is requested for these Subsidiary Companies

313

5.

Does any person or entity own 10% or more of any class of shares issued by the
Company
Yes

No

If yes give details:

C.
Complete the following for each of the three most recent fiscal years
(The figures presented should be taken from the Group Consolidated Reports and
Accounts)
Section a) should be completed if the Company is a financial institution - otherwise
complete Section b) Delete as applicable consult your broker or agent if advice is
required
Total Consolidated Assets
Total Loans
Total Deposits
Net Worth
Reserve for Loan Losses
Non performing loans
Net write offs
Total investment securities
Net Income for Fiscal year
Interest Income
Interest Expense
Cumulative Retained Earnings
Total Capital Adequacy Ratio
Tier 1 Capital Adequacy Ratio
Tier 2 Capital Adequacy Ratio
Return on Assets

19

Return on Equity

314

19

20

Please advise latest independent ratings (giving the dates thereof and name of rating
agency)

b.
Total consolidated Assets
Current Assets
Current Liabilities
Net Worth
Stocks and / or Inventory (including work in
progress)
Net Income for fiscal year
Net Income Per Share
Dividends Per Share
Sales / Revenues

At any time over the last five years have there been breaches of any debts covenants or
loan agreements?
Yes

No

315

D.
1.

2.

Give Details of any current Directors' and Officers' Insurance

i)

Insurer:

ii)

Limit

iii)

Period

iv)

Retention

v)

Premium

Has the Company, in the past two years or under consideration at the present time
any acquisitions, tenders offers, mergers or offering of shares or other securities?
Yes

No

If yes please give details.

3.

Are there any qualifications, comments or observations made within the report and
accounts and / or auditor's report
Yes

No

If applicable, please provide a translation into English

4.

Are there any contingent liabilities / extraordinary terms / litigation shown within
the report and accounts?
Yes

No

If applicable, please provide a translation into English

5.

Has the Company, at any time over the last three years changed its external
auditors or external legal advisors?
Yes

No

316

If yes, give details, reason for change.

Questions in this section are only to be completed if cover is requested for United
States of America or Canada jurisdiction.

E.
1.

Please give the total consolidated assets of the Company and the subsidiary
companies in the United States of America and Canada

2.

Please give the approximate number of employees in the united states of America
and Canada.
Please tick the appropriate box:

3.

0-25

25 - 50

50-75

75-100

100 - 200

200+

Please list those Subsidiary Companies in the United States of America and
Canada that are not wholly owned:

4.

For each subsidiary company set forth in E.3 state who owns the minority stock
together with the percentage ownership?

317

5.

Does the company or any of its Subsidiary Companies:

a)

have any stock, shares or debentures in the United States of America and / or
Canada?
Yes

b)

i)

No

If the answer to E 5 a is 'YES' on what date was the last offer tender issued
made?

ii)

was the offer subject to The United States Securities Act 1993 and / or The
Securities Exchange Act of 1934 and / or any amendments thereto?

c)

have any debt or equity instruments or commercial paper in The United States of
America and / or Canada?
Yes

No

If the answer to E5c is 'YES' give details together with the most recent effective date
6.

Please enclose a copy of the latest 20-F filing made to the regulatory authorities. If
not applicable please tick

F.
1.

Is the Company aware of any claims which, if insurance had been in force similar
to that now proposed would have fallen within the scope of such insurance, have
been made or are now pending against any person (s) proposed for insurance in the
capacity of either director or officer? (if answer is 'none', so state)

318

2.

Is any person proposed for this insurance cognizant of any circumstances which he
/ she has reason to suppose might afford grounds for any future claim such as
would fall within the scope of the proposed insurance/ (if answer is 'none', so
state)

3.

Has any insurance similar to that now proposed been declined, cancelled or
renewal thereof refused/ ( if answer is 'none', so state)

4.

Has the Company and / or any of its subsidiary companies been involved in, or
have any knowledge of, any anti-trust, price - fixing, tax, copyright, patent
litigation, or governmental, regulatory or administrative proceedings or civil and
criminal action? ( if the answer is 'none', so state)

5.

Limit of Indemnity required

6.

Is any fact, circumstance or situation indicating the probability of a claim against

which indemnification would be afforded by the proposed insurance known by any
person(s) or entity(ies) applying for this insurance other than that which is
disclosed in this Proposal form? It is alleged by all concerned that if any person (s)
or entity(ies) to be insured under the Policy has any knowledge of any such fact,
circumstances, or situation any claim subsequently emanating therefrom shall be
excluded from coverage under the proposed insurance. (if the answer is 'none', so
state)

7.

Please state why you wish to designate to receive any and all notices from
Underwriters or their authorised representative(s) concerning this insurance

319

8.

The undersigned declares that:

i)

He / she is authorised to complete this Proposal Form on behalf of all proposers,

and

ii)

The 'IMPORTANT NOTICE' on page 2 of this Proposal Form is understood and

accepted by all proposers, and

iii)

Underwriters are hereby authorised to make any investigation and enquiry in

connection with this Proposal Form and the proposed insurance as is deemed
necessary and,

iv)

To the best of his / her knowledge and belief, and after enquiry, the statements in
this Proposal Form are true.

Warranty Statement:
It is warranted that the particulars and statements contained in the Proposal Form from
the proposed Policy and any materials submitted herewith (which shall be retained on file
by Underwriters and be deemed attached hereto, as if physically attached hereto) are the
basis for the proposed Policy and are to be considered as incorporated into and
constituting a part of the proposed Policy.
Signed

.........................................................

Capacity

.........................................................

Company Date:

.........................................................

320

FIDELITY GUARANTEE
The Fidelity Guarantee policy is a commercial guarantee which is an insurance of
interest. The policy indemnifies the employer for pecuniary loss due to the acts of the
salaried employees. It covers the interest of the employer in the money or property lost
due to the infidelity of the named employee.
Distinguishing features of FG policy:
a)

There are three parties concerned-the guarantor(the insurer), the person on whose
behalf the guarantee is effected(the employer), and the person guaranteed(the
employee).

b)

The contract under a commercial guarantee is between the guarantor (the insurer)
and the person(employer ) to whom the guarantee is given. Where the employee is
guilty of breach of good faith, the validity of the contract is not affected. The
insurer has the right of action against him under Suretyship rights and under
common law.

c)

Indemnity: The amount of loss under a Commercial Guarantee is computed from

the employers books of accounts. This is payable subject to the sum insured. With
many bonds and Govt Guarantees, the amount of loss is indicated on all Official
Certificates signed by the appropriate officer and this is conclusive evidence of the
amount of default which must be made good by the sureties without question.

d)

Subrogation holds good

e)

Contribution: Under F G contribution is not limited to contribution as limited

between insurers, because sometimes private suretyship is also arranged. In such

321

circumstances, the private bondsman may be brought into contribution with the
insurance company.
Perils covered:
The fraud or dishonesty of the employee in connection with his occupation and his duties
is covered under the policy.
As there may be considerable gap between the act of infidelity and its discovery, the
coverage under the policy must be clearly defined in this respect. Once a discovery is
made in respect of a person, the cover ceases to be operative on part of the same person.
Proposal Form :-

Employer/ Employee Referee (optional)

Types of Policies
(i)

Individual Policy

(ii) Collective Policy

(iii) Floater Policy
(iv) Excess Floater Policy
(v) Positions Policy

322

GUIDE RATES
The following factors will have to be considered while arriving at the rate.
(i)

75% on Guarantee Amount.

(ii)

For salesman handling goods cash rate is to be increased by 1/3 (i.e. 33 1/3%)

(iii)

If security deposit is 25% or more of guarantee amount, rates can be scale down by
33 1/3%

(iv)

Govt. and Public Sector undertaking ____________ 0.50% on S.I.

(v)

Above rates can be scales down for group policies (Group Discounts)
Less than 5 persons

No Discounts

6 To 15 persons

15% Discount

16 To 50 persons

25% Discount

Above 50 persons

331/3% Discount.

Above

group

discounts

not

applicable

for

Govt.

undertakings and where lower rates than indicated above are charged.

323

&

Public

Sector

SCOPE OF POLICY
1)

Indemnities the Insured against direct pecuniary loss including loss of goods
caused by fraud or dishonesty of employees.

(i)

The cover is only against direct pecuniary loss and not against any consequential
loss.

(ii)

The Act/s should be committed in the course of the duties of the person to be
guaranteed. And during the uninterrupted service of the employee with the insured.

GEOGRAPHICAL SCOPE: INDIA

Employee :Means any person (other than a person whose employment is of a casual nature
and who is employed otherwise than for the purpose of Insured's Trade or business) who
has entered into a contract of employment.
Discovery :(i)

Fraud has to be discovered \Within 12 months of expiry of the policy.

(ii)

In case the employee ceases to be in the service of the employer, discovery of loss
must be made within 12 months of such death, dismissal or retirement

(iii)

In cases where both (i) & (ii) Apply, Discovery must be made within whichever
time limit expires. earlier.

CONDITIONS :
(i)

Notice regarding any change in nature of business.

324

(ii)

Any change in procedure to be similarly notified.

(iii)

For more than one claim in respect of any one employee.

(iv)

No liability if the Insured / Supervisor continues to entrust the employee with

money or goods after having knowledge of any material fact bearing on the
honesty of the employee.

8.

CONTRIBUTION CLAUSE:
If the insured be guaranteed by any other person, society or company or hold other

security or insurance the company shall be liable to bear the loss rateable with such
person, society or company or securities or Insurance.
9.

CANCELLATION CLAUSE:
7 Days Notice to be given with pro rata refund of premium if no claims lodged.

10.

Change of residence or occupation or change of name whether by marriage or

otherwise to be informed in writing.

11.

Not bound to accept Renewal premium nor give notice that such is due. Accepted
on distinct understanding that risk is not enhanced.

12.

Condition of reasonable care is modified to stipulate insured will take precautions

and checks as stated in proposal form. If these checks and balances are not applied
company is not liable.

13.

Arbitration condition and disclaimer

14.

Due observance and fulfillment of the terms, provisions and conditions and
endorsement of this policy in so far as they relate to anything to be done or
complied with by the Insured and the truth of the statements and answers in the
said proposal shall be condition precedent to liability.

325

FIDELITY GUARANTEE - CLAIMS

1.

On the discovery of the loss or even on reasonable suspicion of a loss having

occurred, insured should give notice to the company.

2.

Within three months thereafter, he must furnish full details of the claim.

3.

All the books of accounts or reports must be open to inspection by the company.

4.

The insured must vigorously pursue the claim against the employed.

5.

The company will pay the legal expenses. The insured must allow the company to
sue the employed in its name and give all information and assistance required to
obtain recovery from the employed or his estate.

6.

From date of discovery of the act of infidelity, the policy is terminated as far as the
particular employee is concerned.

7.

All monies of the employee in the hands of the insured and all monies which
would have become payable must be deducted from the amount of loss payable
under the policy.

8.

Immediately take all steps to prevent further loss.

9.

Supply to the company at his own cost all such proof, information and other
evidence relating to the claim as the company may require.

326

SHOPKEEPERS' INSURANCE
SHOPKEEPERS INSURANCE POLICY is designed to cater to the requirements
of small Shopkeepers by combing under a Single policy a number of contingencies which
are other - wise covered separately.
The following are the guidelines for the issue of the shop keepers policy.
1.

The Building should be of class I construction.

2.

The maximum sum Insured under the policy (for contents only) should not
exceed Rs.2 CRS Excess would be as per the excess in fire Policy including
any changes from time to time.

1.

No Manufacturing/ Repair work should be carried on in the premises.

2.

In case there is a Financial Interest involved, the underwriting office should ensure
that the proposal is signed by both the financier as well as the Insured.
SECTION: I (A) BUILDING OF CLASS 'A' CONSTRUCTION ONLY & (B)
CONTENTS:
Against Fire (including Fire resulting from explosion) lightning explosion of gas

in domestic appliances, bursting and overflowing of water tanks, apparatus or pipes,

aircraft or articles dropped there from, riot and strike, Earthquake (Fire and/ or Shock)
malicious act, flood, inundation, storm, cyclone subsidence and landslide (including
Rockslide

damage, impact damage).

CLASS A CONSTRUCTION :
Buildings shall have external wall(s) of stone/Bricks/Concrete Blocks/Asbestos
Sheets Cladding and / or Metal Sheets Cladding / Glass Panel/Partly or fully open sided
and roof or R.C.C / Masonry/ Asbestos concrete Sheets/Metal Sheets Tiles / Wooden
Shingles or Boarding on R.C.C. Steel/Wooden frame work.

327

N.B. 1. Thin layer of grass, hay or reeds on incombustible roofing is permitted.

2. Use of Thermosetting resin fibre glass reinforced sheets is permitted for
skylights.
SECTION II : BURGLARY AND HOUSE BREAKING :
Loss or damage to property by theft involving entry into or exit from the insured
premises by forcible and violent means or following assault or violence or threat thereof
to the insured or any employee of the insured or member of the insureds family.
SECTION III : MONEY INSURANCE :
Money - in Transit and/or in safe and/or in steel cupboards, Cash box and in such
other places under lock and key (covering all business transactions) loss due to any
accident or misfortune subject to limits of liability specified in the schedule.
SECTION IV : PEDAL CYCLES :
Loss or damage-due to fire, lightning, external explosion, riots and strike or
malicious act, earthquake, fire and / or shock, flood, inundation, storm, cyclone and other
like perils, burglary, house breaking and / or theft and/or external accident also legal
liability subject to limit of Rs.10,000/SECTION V : PLATE GLASS :
Fixed Plate Glass against accidental breakage subject to limits of liability specified
in the schedule.
SECTION VI : NEON SIGN/GLOW SIGN :
Against fire, accidental damage, malicious act and/or theft subject to limits
specified in the schedule.

328

SECTION VII : BAGGAGE :

Loss or damage to accompanied baggage by accident or misfortune. In connection
with trade carried by Insured or Employee and personal baggage of proprietor, partner
subject to limits specified in the

schedule.

SECTION VIII : PERSONAL ACCIDENT :

Cover is as per the normal PA.
SECTION IX : FIDELITY GUARANTEE :
Against loss due to any act of fraud or dishonesty by salaried employees at the
Insured's premises subject to limit of liability specified in the schedule.
SECTION X : PUBLIC LIABILITY :
Liability of the Insured to Public for bodily injury to any Third Party or loss of or
damage to Third Partys property whilst caused at the Insured's premises subject to limits
of liability specified in the schedule. Also liability for Employees engaged in connection
with Insureds trade under Workmens Compensation Act, Fatal accidents Act and
Common Law.
There is a provision to provide indemnity against loss of profits arising out of perils
Insured is available.
SECTION XI : LOSS OF PROFITS :
Against loss of profits suffered arising out of the any of the perils insured.

329

MULTI SECTIONAL DISCOUNT :

Section I - B is Compulsory
Where more than 4 and up to 6 sections
(including tariff rated sections)

- 15%on non-tariff rates only

Where more than 6 Sections

(including tariff rated sections)

- 20% -do-

For the purpose of computation of this discount, P.A. is to be treated as Non -tariff.
RISK EXCEPTED
(Illustrative & not Exhaustive)

The Policy does not cover inter-alia loss or damage by

War, civil War, and the like, depreciation, Wear and
Tear, etc.

EXCESS UNDER THE POLICY

a)

The first 5% of each and every claim subject to a minimum of Rs.10,000/ and a
maximum of Rs.25,000/- in respect of each and every loss arising out of ACT OF
GOD perils such as lightning, STFI, Earthquake, Subsidence, landslide, and
rockslide covered under the policy.

b)

The first Rs.10,000/- for each and every loss arising out of other perils in respect
of which the Insured is indemnified by the policy
The excess for all other sections is as per the conditions of the perils covered.
THE MAXIMUM SUM INSURED UNDER THE SHOPKEEPERS POLICY

SHOULD NOT EXCEED RS 2 CRS UNDER SECTION I

330

DUKAN MITRA POLICY

PROPOSAL FORM FOR DUKAN MITRA
(Only premises of Class A construction)
1. Name & address of the Proposer
2. Name of the financial institution (if any financial interest is
involved)
3. Nature of trade or business
4. Address of the premises to be insured
5. Are you the sole occupant? If not, who are the other
occupants?
6. Are stock and sale books maintained?
- How often stock is taken?
- Where are these books kept outside office hours?
7. Please give the details like Name, Age, Sex of persons to be
covered under P.A. Section with nominees details (Name,
relationship etc.,)
8. Please give the details like Name, Age, Sex of employees to
be covered under W.C. Act
9. Do you wish to cover the infidelity of your employee
(restricted to one) also?
10 Please state whether you wish to cover pedal cycles
11. Please state whether you wish to cover the cash in transit

I/ we declare that the above answers are true to the best of my / our knowledge and belief,
that I/ We have disclosed all particulars affecting the assessment of the risk. I / We agree
that this proposal and declaration shall be the basis of the contract between me/us and the
company.
Date :
Place :

Signature of Insured
Section 41 of Insurance act 1938:

No person shall allow or offer to allow either directly or indirectly as an inducement to

any person to take out or renew or continue an insurance in respect of any kind of risk
relating to lives or property in India any rebate of the whole or a part of commission
payable or any rebates of the premium- shown on the policy nor shall any person taking
out or renewing or continuing a policy except any rebate as may be allowed in
accordance with the published prospectus or tables of the insurer.

331

PROPERTY TO BE INSURED
State
whether
Glass is
front,
rear
fixed in
shop or
side or
door

PARTICULARS AND DIMENSIONS

No. of
Square
Panes
CMs
Each
Pane

Whether Plate or Sheet and

whether Plain, Silvered
Embossed, Curved, Stained.
Lettered or Ornamented or
or more than 1/4 in, thick
TOTAL

Size of each Pane

in Cms.
Height

Width

Note: In the event of a loss All Glass is considered plain and of ordinary glazing quality
unless the CONTRARY is specially named in the Policy, No Lettering, Embossing,
Silvering or any Ornamental work is considered insured unless named on the Policy and
the additional premium paid thereon. No insurance is granted in respect of glass not
completely and securely fixed.

332

DUKAN MITRA (SHOP-KEEPER'S ) INSURANCEPOLICY

The DUKAN MITRA policy is a modified version of the shopkeepers policy
which can be issued to smaller establishments. The main features of this policy is that(a)
there is a fixed sum insured, (b) Condition of average need not be applied
Definition: Policy A contains Sections I through VI of the Schedule
Policy B contains Sections I through V of the Schedule
Policy C contains Sections I through IV of the Schedule
Arising out of the operation of an insured peril, if there is a loss / damage to the
property Insured; injury sustained by the Insured; expense incurred / liability attached to
the Insured as the case may be, the Company hereby agrees to indemnify the Insured to
the extent and in the manner specified herein.
Operative Clause
COMMON TO ALL SECTIONS
Company will, subject to exclusions (named in column 5), indemnify in respect of
the subject matter detailed in (column 2) the Schedule, for loss / damage thereto by
operation of one or more of the perils mentioned (in column 3) limited, however, during
the entire period of insurance to the maximum amount indicated (in column 4).
SECTION I
This Section also covers the Insureds property when removed to another premises
for custody during his absence and for a temporary period limited to 90 days in all.
Maximum liability will, however, be restricted to 10 % of the amount in column 4.

333

SECTION II
Loss / damage to the contents whilst contained in insured premises by burglary /
housebreaking.
SECTION III
If bodily injury by external violent means and caused accidentally shall, within 12
months of such injury, be the sole and direct cause of death or permanent total
disablement of the persons named in column 3, the Company will pay each such person
the amount mentioned in column 4. Permanent total disablement would mean total,
irrecoverable loss of sight of both eyes / physical loss of entire hands or entire feet / one
foot and one eye or one eye and one hand / one foot or irrecoverable loss of use of both
limbs.
SECTION IV
This Section indemnifies the Insured subject to the limit under column 4, in
respect of all Sums which the Insured shall become legally liable to pay as compensation
and incur litigation expenses with the Company's written consent.
(1)

in respect of accidental death or bodily injury to any person other than a person
under the Insured's employment.

(2)

accidental damage to property caused by or through fault or negligence of the

Insured or his employee or a member of Insureds household.

(3)

compensation to Insureds employees as per the WC act for any employment

injury (including fatal)
This Section excludes liability for accidents involving Insureds ownership or use

of vehicles, vessels of any kind, aircraft or animals.

334

SECTION V
Indemnifies the Insured for any direct pecuniary loss, subject to the limit under
column 4, caused by an act of fraud or dishonesty committed by any salaried employee of
the Insured in the course of his duty in the insured premises, on conviction and
prosecution of an employee responsible for dishonesty / fraud.
Withholding of any money due to the delinquent employee and deduction of such
moneys from the claim are preconditions to settlement of a valid claim.
SECTION VI
Indemnifies the Insured, subject to the limit per carrying (under column 3), in
respect of loss by accident or misfortune while the Insured's money in his hands or in the
hands of his employees is in transit between any two places within 15 kms from insured
premises (only such money of the Insureds business transactions and entrusted to the
permanent employee handling cash is covered); loss / damage by burglary or
housebreaking whilst contained in a safe, cash box or such place under lock and key; loss
/ damage whilst lying in cashier's till or counter in the Insured's premises during business
hours due to violence, assault or threat.
It is a Policy Condition under this Section that a complete and arithmetic account
of cash in various places be kept and that such records/ account books be kept in a place
other than where money is kept.

335

Terms and Conditions

1.

All communications required by this Policy shall be in writing to the Policy

issuing Office.

2.

The Insured shall take all reasonable care and precautions to protect the insured
property to prevent all accidents and minimise any loss after an insured peril
operates.

3.

The Insured shall take due care to describe the insured property. In the event of
any misrepresentation or non-disclosure of material fact or adoption of fraudulent
means to obtain any benefit, the Policy shall be void without any refund of
premium.

4.

Cancellation of Policy at the option of the Insured entails him a refund of premium
less premium retained at short period scale of rates; while the same is at the option
of the Insurer, a pro rata refund of premium for the unexpired period shall be
made.

5.

Immediate intimation must be given to the Policy issuing Office in the event of
loss followed by such other details and documentation as the Insurer may require
for processing the claim.

6.

Complaint to Police Authorities is mandatory for loss occurring due to

burglary/housebreaking or attempt thereat and any other loss/damage caused by
third parties. Prosecution and conviction of any employee for acts of
fraud/dishonesty resulting in a claim under the Policy is a pre-requisite for
consideration of such a claim under this Policy.

7.

The Company shall pay for or reinstate or repair the property up to the amount
specified in the Policy or actual loss whichever is less, subject to substantiation of
the loss to the satisfaction of the Insurer.

336

8.

All aspects as to arbitration agreement, appointment of arbitrator/s, terms of

reference, award, its effect etc will be in accordance with the provisions of the
Arbitration and Conciliation Act, 1996 (with amendments, if any).

9.

This Policy does not cover:

a)

Loss or damage to fragile articles such as chinaware, articles made of glass

or materials of brittle nature due to impact.

b)

Loss or damage due to war and/or warlike perils, nuclear and/or atomic
radiation.

c)

Loss or damage due to wear and tear, gradual deterioration or slowly

developing flaws.

d)

Consequential loss of any kind.

e)

Loss of or damage caused by or due to action of any lawfully constituted

authority or Government body.

f)

Loss or damage to cash, securities, bullion, stamps, deeds, documents,

manuscripts and articles of antique value.

g)

Loss of valuables due to theft from unattended vehicles.

h)

Loss or damage for which the manufacturer or supplier or repairer or

transporter or any other third party is responsible either by law or by
contract.

10.

If the Company shall disclaim liability to the Insured for any claim hereunder and
if such claim shall not within 12 calendar months from the date of such disclaimer
have been made the subject matter of a suit in a court of law, then the claim shall
for all purposes be deemed to have been abandoned and shall not be recoverable.

11.

The due observance and fulfillment of the terms and conditions of this Policy in so
far as they relate to anything to be done or complied with by the Insured shall be a

337

condition precedent to any liability of the Company to make any payment under
this Policy.
12.

All communications required by this Policy shall be in writing to the Policy

issuing Office.

13.

The Insured shall take all reasonable care and precautions to protect the insured
property to prevent all accidents and minimise any loss after an insured peril
operates.

14.

The Insured shall take due care to describe the insured property. In the event of
any misrepresentation or non-disclosure of material fact or adoption of fraudulent
means to obtain any benefit, the Policy shall be void without any refund of
premium.

15.

Cancellation of Policy at the option of the Insured entails him a refund of premium
less premium retained at short period scale of rates; while the same is at the option
of the Insurer, a pro rata refund of premium for the unexpired period shall be
made.

16.

Immediate intimation must be given to the Policy issuing Office in the event of
loss followed by such other details and documentation as the Insurer may require
for processing the claim.

17.

Complaint to Police Authorities is mandatory for loss occurring due to

burglary/housebreaking or attempt thereat and any other loss/damage caused by
third parties. Prosecution and conviction of any employee for acts of
fraud/dishonesty resulting in a claim under the Policy is a pre-requisite for
consideration of such a claim under this Policy.

338

18.

The Company shall pay for or reinstate or repair the property up to the amount
specified in the Policy or actual loss whichever is less, subject to substantiation of
the loss to the satisfaction of the Insurer.

19.

All aspects as to arbitration agreement, appointment of arbitrator/s, terms of

reference, award, its effect etc will be in accordance with the provisions of the
Arbitration and Conciliation Act, 1996 (with amendments, if any).

20.

This Policy does not cover:

i)

Loss or damage to fragile articles such as chinaware, articles made of glass

or

materials of brittle nature due to impact. j) Loss or damage due to war

and/or warlike perils, nuclear and/or atomic radiation.

k)

Loss or damage due to wear and tear, gradual deterioration or slowly

developing

flaws.

l)

Consequential loss of any kind.

m)

Loss of or damage caused by or due to action of any lawfully constituted

authority or Government body.

n)

Loss or damage to cash, securities, bullion, stamps, deeds, documents,

manuscripts and articles of antique value.

o)

Loss of valuables due to theft from unattended vehicles.

p)

Loss or damage for which the manufacturer or supplier or repairer or

transporter or any other third party is responsible either by law or by
contract.

21.

If the Company shall disclaim liability to the Insured for any claim hereunder and
if such claim shall not within 12 calendar months from the date of such disclaimer
have been made the subject matter of a suit in a court of law, then the claim shall
for all purposes be deemed to have been abandoned and shall not be recoverable.

339

22.

The due observance and fulfilment of the terms and conditions of this Policy in so
far as they relate to anything to be done or complied with by the Insured shall be a
condition precedent to any liability of the Company to make any payment under
this Policy.

Place:

Date:

Authorised Signature

340

Schedule (Policy A/B/C)

Name of the Insured
Full address of the Shop
Nature of trade
Period of Insurance

Section
1
I

:
:
:
:

What is insured?

Policy Coverage Premium (Rs)

A Sec
I to VI
625
B Sec
I to V 550
C Sec
I to IV 500

Against what?

2
3
Building including
Fire, lightning, explosion of
Compound wall, Elec. gas in domestic appliances,
Fixtures, other
riot, strike or
interiors,
fixtures owned by
Insured solely /
partially occupied
Contents
Consisting of -------------

malicious act, terrorist

act, earthquake storm,
tempest, flood, inundation
As above
Burglary and / or
Housebreaking

III

Personal Accident

Death, Permanent Total

Disablement (PTD)
for
the following persons
1.
Sex: Age:
2.
Sex: Age:
3.
Sex: Age:
4.
Sex: Age:

IV

Liability

Fidelity Guarantee

1. Legal Liability towards

general public
2. Legal Liability towards
employees
Loss due to act of fraud,
dishonesty committed
by salaried persons.

VI

Cash in Transit

II

Loss by accident, misfortune

Loss due to burglary
/ Housebreaking whilst in
safe, till / counter

341

Max.
Amount
What is not insured?
Payable
(Rs)
4
5
50000 Loss of or damage to motor
vehicle and pedal cycles, money,
securities bullion, bills of
exchange, business books, unset
precious stones

50,000 Same as above plus loss / damage

50,000 be burglary where any employee
of the Insured or any member of
the Insured's family is concerned.
25,000 per Compensation for more than on
person benefit (death / PTD) in respect of
the same period of disablement
intentional self-injury, suicide, an
attempted suicide; whilst under
the influence intoxicating drugs,
liquid Death / PTD resulting from
childbirth / pregnancy.
5,000 Death of or bodily injury to an
10,000 member of the Insured's family
partners, liability assumed b
agreement.
10,000 More than one claim in respect of
th
same
employee.
Fraud
committed b the Insured's
employee after th discovery of an
earlier frau committed by him.
Loss discovered months after
death, dismissal, an retirement of
the employee or expire of Policy.
20,000 Involvement of employees or
10,000 family members; dishonesty
5,000 /fraud of case carrying employee;
loss due to error omission; loss of
money from safe using key
obtained unaccompanied by
violence, assault or threat.

Schedule (Policy A/B/C)

Name of the Insured
Full address of the Shop
Nature of trade

Period of Insurance
Premium paid
Rt No............ dt............

:
:
:

Policy Coverage Premium (Rs)

A Sec I to VI
875
B Sec I to V
825

:
:

C Sec I to

Section What is insured?

1
2
Building including
Compound wall,
Elec. Fixtures, other
interiors, fixtures
owned by Insured
solely / partially
occupied

II

Contents
As above
Consisting of ------------Burglary and / or

Fire, lightning, explosion of

gas in domestic appliances,
riot, strike or malicious
act, terrorist act, earthquake
storm, tempest, flood,
inundation

Personal Accident

75,000 Same as above plus loss / damage by

75,000 burglary where any employee of the
Insured or any member of the
Insured's family is concerned.

Death,
Permanent Total
Disablement (PTD) for
the following persons

IV

Liability

1.

Sex: Age:

2.

Sex: Age:

3.

Sex: Age:

4.

Sex: Age:

30,000 per Compensation for more than on

person benefit (death /PTD) in respect of the
same
period
of
disablement
intentional self-injury, suicide, an
attempted suicide; whilst under th
influence intoxicating drugs, liquor
Death / PTD resulting from childbirth
/ pregnancy.

1. Legal Liability towards

general public

10,000 Death of or bodily injury to an

20,000 member of the Insured's family
partners, liability assumed by
agreement.

2. Legal Liability towards

employees
V

VI

Fidelity Guarantee

Cash in Transit

What is not insured? 5

75,000 Loss of or damage to motor vehicle

and pedal cycles, money, securities
bullion, bills of exchange, business
books, unset precious stones

Housebreaking
III

775

Max.
Amount
Payable
(Rs) 4

Against what? 3

IV

Loss due to act of fraud,

dishonesty committed
by salaried persons.

Loss by accident,
Misfortune Loss due to
burglary/
Housebreaking
whilst in safe,
till / counter

342

10,000 More than one claim in respect of the

same employee. Fraud committed b the
Insured's employee after the discovery
of an earlier frau committed by him.
Loss discovered months after death,
dismissal, an retirement of the
employee or expire of Policy.
20,000
10,000
5,000

Involvement of employees or family

members; dishonesty /fraud of case
carrying employee; loss due to error
omission; loss of money from safe
using key obtained unaccompanied by
violence, assault or threat.

Name of the Insured

Full address of the Shop
Nature of trade
Period of Insurance

:
:
:
:

Policy Coverage Premium

A
Sec I to VI
B
Sec I to V
C
Sec I to IV

(Rs)
1100
1050
1000

Section

What is insured?

Against what?

Max. Amount
Payable (Rs)

What is not insured?

Building including
Compound wall, Elec.
Fixtures, other interiors,
fixtures owned by
Insured solely /
partially occupied

Fire, lightning, explosion

of gas in domestic
appliances, riot, strike or
malicious act, terrorist
act, earthquake storm,
tempest, flood,
inundation

100000 Loss of or damage to motor

vehicle and pedal cycles,
money, securities bullion, bills
of exchange, business books,
unset precious stones

II

Contents
Consisting of

As above Burglary and /

or Housebreaking

100,000 100,000 Same as above plus loss /

damage b burglary where any
employee of the Insured or any
member of the Insured's family
is concerned.

III

Personal Accident

Death, Permanent Total

Disablement (PTD) for
the following persons
1.
Sex: Age:
2.
Sex: Age:
3.
Sex: Age:
4.
Sex: Age:

IV

Liability

1. Legal Liability towards

general public
2. Legal Liability towards
employees

Fidelity Guarantee

Loss due to act of fraud,

dishonesty committed
by salaried persons.

10,000 More than one claim in respect

of the same employee. Fraud
committed b the Insured's
employee after the discovery of
an earlier frau committed by
him. Loss discovered months
after death, dismissal, an
retirement of the employee or
expire of Policy.

VI

Cash in Transit

Loss by accident,
misfortune
Loss due to burglary
/ Housebreaking whilst in
safe, till / counter

20,000 Involvement of employees or

family members; dishonesty
/fraud of case carrying
10,000 employee; loss due to error
5,000 omission; loss of money from
safe using key obtained
unaccompanied by violence,
assault or threat.

343

30,000 per Compensation for more than on

person benefit (death /PTD) in respect
of the same period of
disablement intentional selfinjury, suicide, an attempted
suicide; whilst under the
influence intoxicating drugs,
liquor Death / PTD resulting
from childbirth / pregnancy.
15,000 25,000 Death of or bodily injury to an
member of the Insured's family
partners, liability assumed b
agreement.

Name of the Insured

Full address of the Shop
Nature of trade
Period of Insurance

:
:
:
:

Policy Coverage Premium

A
Sec
I to VI
B
Sec
I to V
C
Sec
I to IV

(Rs)
1550
1450
1400

Section

What is insured?

Against what?

Max. Amount
Payable (Rs)

What is not insured?

Building including
Compound wall, Elec.
Fixtures, other
interiors, fixtures
owned by Insured
solely / partially
occupied

Fire, lightning, explosion of

gas in domestic appliances,
riot, strike or malicious
act, terrorist act, earthquake
storm, tempest, flood,
inundation

II

Contents
As above
Consisting of -------------Burglary and / or

150000 Loss of or damage to motor

vehicle and pedal cycles,
money, securities bullion, bills
of exchange, business books,
unset precious stones

150,000 Same as above plus loss /

150,000 damage b burglary where any
employee of the Insured or any
member of the Insured's family
is concerned.

Housebreaking
III

IV

Personal Accident

Liability

Death, Permanent Total

Disablement (PTD) for
the following persons
1.

Sex: Age:

2.

Sex: Age:

3.

Sex: Age:

4.

Sex: Age:

1. Legal Liability towards

general public
2. Legal Liability towards
employees

VI

Fidelity Guarantee

Cash in Transit

50,000 per Compensation for more than on

person benefit (death/ PTD) in respect
of the same period of
disablement intentional selfinjury, suicide, an attempted
suicide; whilst under the
influence intoxicating drugs,
liquor Death / PTD resulting
from childbirth / pregnancy.
15,000 25,000 Death of or bodily injury to an
member of the Insured's family
partners, liability assumed b
agreement.

Loss due to act of fraud,

dishonesty committed
by salaried persons.

10,000

More than one claim in respect

of the same employee. Fraud
committed by the Insured's
employee after the discovery of
an earlier frau committed by
him. Loss discovered months
after death, dismissal, an
retirement of the employee or
expire of Policy.

Loss by accident,
misfortune

20,000

Loss due to burglary

/ Housebreaking whilst in
safe, till / counter

10,000

Involvement of employees or
family members; dishonesty
/fraud
of case
carrying
employee; loss due to error
omission; loss of money from
safe using key obtained
unaccompanied by violence,
assault or threat.

344

5,000

DUKAN MITRA INSURANCE - CLAIM FORM

The issue of this form does not constitute admission of liability
Please return this form duly completed together with relevant reports Bills / Certificates etc.,

Policy No:

Claim No:

1. a) Name of the Insured

b) Address

a)
b)

c) Occupation
d) Situation of premises insured

c)
d)

2. a) State the nature of Loss?

(Fire, Burglary / housebreaking, Accident to persons, infidelity
of employees etc.,)
b) Date and Time of Accident / Loss
c) Cause of accident / loss with details
d) If the loss is due to fire, has the matter been reported to Fire
Bridge / Police Station
e) If the loss is by Burglary / housebreaking / misfortune / accident
to persons, name of the Police Station where the compliant was
lodged, FIR No. and Crime No.
f) In case of Burglary / housebreaking do you suspect any body?
g) When and where was the property last seen by the Insured?
h) On what date and time the property Loss was found?
3.

4.

a) Is the Insured sole owner of the property? If not give name and
address of the owner.
b) Are there any other Insurance on the property? If so give
particulars.
In case of loss of money:
a) In whose custody was the money at the time of loss?
b) Who were the persons accompanying the person carrying
money?
c) How was the money carried (whether in pocket, bag, box etc)
d) By what conveyance was the money carried?

In case of accident to persons

a) Name of the injured person
b) Address
c) Occupation
d) Age and next birthday
6. a) Where did the accident occur

a)

b)
c)
d)
e)

f)
g)
h)
a)
b)

a)
b)
c)
d)

5.

a)
b)
c)
d)
a)

345

b) Give full description of injuries sustained with medical report

c) Was the person under the influence of drug / drinks at the time
of accident?
d) Give names and address of witness to accident? (In case of
death person, separate medical report and postmortem report
and death certificate are to be enclosed)
7. a) Particulars of any injury to persons (third Party) or damage to
property of third party.
b) Name and address of the injured person
c) Name of the Doctor or Hospital who have given first aid
assistance/ treatment
d) Has the injured person or property owner made any claim on
you? If so give particulars and also attach a copy of notice.
8. a) In case of Workmen Compensation claim give name and address
of the injured employee and date of appointment
b) Occupation of the employee
c) Nature of work done at the time of accident
d) Details of percentage of disability with medical report
9. In case of Fidelity Guarantee claim
a) Name of defaulting employee
b) His present address
c) Date of Discovery of defalcation
d) Full details of defalcation
e) Date of defalcation
f) In what capacity was he engaged
g) Does the insured hold any security from the employee, if so to
what extent
h) Has the insured taken any action against the employee? If so
state the nature of action taken.
10. Has the Insured sustained similar loss/es prior to this loss? If yes,
give details of insurer and claim amount.
11.
Amount of loss Claimed

b)
c)
d)

a)
b)
c)
d)
a)
b)
c)
d)
a)
b)
c)
d)
e)
f)
g)
h)

Rs.-------

I / we declare that the above information furnished are correct in all aspects.
Date :
Place :

Signature

346

PROPOSAL FORM FOR DUKAN MITRA

(Only premises of Class A construction)
1. Name & address of the Proposer
2. Name of the financial institution (if any financial
interest is involved)
3. Nature of trade or business
4. Address of the premises to be insured
5. Are you the sole occupant? If not, who are the other
occupants?
6. Are stock and sale books maintained?
How often stock is taken?
Where are these books kept outside office hours?
7. Please give the details like Name, Age, Sex of
persons to be covered under P.A. Section with
nominees details (Name, relationship etc.,)
8. Please give the details like Name, Age, Sex of
employees to be covered under W.C. Act
9. Do you wish to cover the infidelity of your employee
(restricted to one) also?
10 Please state whether you wish to cover pedal cycles
11. Please state whether you wish to cover the cash in
transit
I/ we declare that the above answers are true to the best of my / our knowledge and belief, that I/
We have disclosed all particulars affecting the assessment of the risk. I / We agree that this
proposal and declaration shall be the basis of the contract between me/us and the company.
Date :
Place :

Signature of Insured
Section 41 of Insurance act 1938:

No person shall allow or offer to allow either directly or indirectly as an inducement to any
person to take out or renew or continue an insurance in respect of any kind of risk relating to
lives or property in India any rebate of the whole or a part of commission payable or any rebates
of the premium- shown on the policy nor shall any person taking out or renewing or continuing a
policy except any rebate as may be allowed in accordance with the published prospectus or
tables of the insurer.

347

PROPERTY TO BE INSURED
State
whether
Glass is
front,
rear
fixed in
shop or
side or
door

PARTICULARS AND DIMENSIONS

No. of
Square
Panes

Whether Plate or Sheet and size of

each pane

CMS

whether Plain,
Silvered in CMS
Embossed, Curved, Stained.
Lettered or Ornamented or Height
Width each or more than 1/4 in,
thick
TOTAL

Note: In the event of a loss All Glass is considered plain and of ordinary glazing quality
unless the CONTRARY is specially named in the Policy, No Lettering, Embossing,
Silvering or any Ornamental work is considered insured unless named on the Policy and
the additional premium paid thereon. No insurance is granted in respect of glass not
completely and securely fixed.

348

Schedule (Policy A/B/C)

Name of the Insured
Full address of the Shop
Nature of trade
Period of Insurance

:
:
:
:

Premium Paid

Policy Coverage Premium

A Sec I
to VI 625
B Sec I to V 550
C Sec I to IV
500

(Rs)

Rt No.______ dt_______

Section

What is insured?

Against what?

Max. Amount
Payable (Rs)

What is not insured?

Building including
Compound wall, Elec.
Fixtures, other interiors,
fixtures owned by
Insured solely /
partially occupied

Fire, lightning,
explosion of gas in
domestic appliances,
riot, strike or malicious
act, terrorist act,
earthquake storm,
tempest, flood,
inundation

II

Contents
Consisting of ----------

As above

50,000 Same as above plus loss /

50,000 damage b burglary where
any employee of the
Insured or any member of
the Insured's family is
concerned.

Burglary and / or
Housebreaking

III

IV

Personal Accident

Liability

Death, Permanent
Total Disablement
(PTD) for the
following persons
5.

Sex: Age:

6.

Sex: Age:

7.

Sex: Age:

8.

Sex: Age:

50000 Loss of or damage to

motor vehicle and pedal
cycles, money, securities
bullion, bills of exchange,
business books, unset
precious stones

Compensation for more

than on benefit (death /
PTD) in respect of the
same period of
disablement intentional
25,000 per self-injury, suicide, an
person attempted suicide; whilst
under the influence
intoxicating drugs, liquor
Death / PTD resulting
from childbirth/
pregnancy.

3. Legal Liability
towards general public
4. Legal Liability
towards employees

349

5,000 Death of or bodily injury

to an member of the
Insured's family partners,
10,000
liability assumed b

agreement.
V

VI

Fidelity Guarantee

Cash in Transit

Loss due to act of

fraud, dishonesty
committed by salaried
persons.

10,000 More than one claim in

respect of the same
employee. Fraud
committed b the Insured's
employee after the
discovery of an earlier
frau committed by him.
Loss discovered months
after death, dismissal, and
retirement of the
employee or expire of
Policy.

Loss by accident,
misfortune

20,000 Involvement of
employees or family
members; dishonesty
10,000
/fraud of case carrying
employee; loss due to
5,000 error omission; loss of
money from safe using
key obtained
unaccompanied by
violence, assault or threat.

Loss due to burglary

/ Housebreaking
whilst in safe,
till / counter

350

Schedule (Policy A/B/C)

Name of the Insured
Full address of the Shop
Nature of trade
Period of Insurance

:
:
:
:

Premium Paid
Rt No.______ dt_______

Policy Coverage Premium

A Sec I
to VI 875
B Sec I to V 825
C Sec I to IV
775

(Rs)

Max.
Amount
Section What is insured?
Against what?
What is not insured?
Payable
(Rs)
1
2
3
4
5
I
Building including Fire, lightning,
75,000 Loss of or damage to motor vehicle
Compound wall,
explosion of gas in
and pedal cycles, money, securities
Elec. Fixtures,
domestic appliances,
bullion, bills of exchange, business
other interiors,
riot, strike or
books, unset precious stones
fixtures owned by malicious act,
Insured solely /
terrorist act,
partially occupied earthquake storm,
tempest, flood,
inundation
II
Contents
As above
75,000 Same as above plus loss / damage by
Consisting of ----------Burglary and / or
75,000 burglary where any employee of the
Insured or any member of the
Housebreaking
Insured's family is concerned.
III
Personal Accident Death, Permanent
30,000 Compensation for more than on
Total Disablement
per benefit (death /PTD) in respect of the
(PTD) for the
period
of
disablement
person same
following persons
intentional self-injury, suicide, an
attempted suicide; whilst under the
5.
Sex: Age:
influence intoxicating drugs, liquor
6.
Sex: Age:
Death / PTD resulting from
7.
Sex: Age:
childbirth / pregnancy.
8.
Sex: Age:
IV
Liability
1. Legal Liability
10,000 Death of or bodily injury to an
towards general
member of the Insured's family
public
partners, liability assumed by
2. Legal Liability
20,000 agreement.
towards employees
V
Fidelity Guarantee Loss due to act of
10,000 More than one claim in respect of the
fraud, dishonesty
same employee. Fraud committed by
committed by
the Insured's employee after the
salaried persons.
discovery of an earlier frau committed
by him. Loss discovered months after
death, dismissal, an retirement of the
employee or expire of Policy.
VI
Cash in Transit
Loss by accident,
20000 Involvement of employees or family
members; dishonesty /fraud of case
misfortune
Loss due to burglary
10,000 carrying employee; loss due to error
omission; loss of money from safe
/ Housebreaking
whilst in safe,
5,000 using key obtained unaccompanied by
violence, assault or threat.
till / counter

351

Schedule (Policy A/B/C)

Name of the Insured
Full address of the Shop
Nature of trade
Period of Insurance

:
:
:
:

Premium Paid
Rt No.______ dt_______

Policy Coverage Premium

(Rs)
A Sec I
to VI 1100
B Sec I to V 1050
C Sec I to IV
1000

Section

What is insured?

Against what?

Building including
Compound wall, Elec.
Fixtures, other interiors,
fixtures owned by
Insured solely /
partially occupied

II

Contents
Consisting of ----------

Fire, lightning,
explosion of gas in
domestic appliances,
riot, strike or
malicious act,
terrorist act,
earthquake storm,
tempest, flood,
inundation
As above
Burglary and / or
Housebreaking

III

Personal Accident

IV

VI

Liability

Fidelity Guarantee

Cash in Transit

Death, Permanent
Total Disablement
(PTD) for the
following persons
5.
Sex: Age:
6.
Sex: Age:
7.
Sex: Age:
8.
Sex: Age:
1. Legal Liability
towards general
public
2. Legal Liability
towards employees
Loss due to act of
fraud, dishonesty
committed by
salaried persons.

Loss by accident,
misfortune
Loss due to
burglary /
Housebreaking
whilst in safe,
till / counter

352

Max.
Amount
What is not insured?
Payable
(Rs)
100000 Loss of or damage to motor
vehicle and pedal cycles, money,
securities bullion, bills of
exchange, business books, unset
precious stones

100,000 Same as above plus loss / damage

b burglary where any employee of
100,000 the Insured or any member of the
Insured's family is concerned.
30,000 per Compensation for more than on
person benefit (death /PTD) in respect of
the same period of disablement
intentional self-injury, suicide, an
attempted suicide; whilst under the
influence intoxicating drugs, liquor
Death / PTD resulting from
childbirth / pregnancy.
15,000 Death of or bodily injury to an
member of the Insured's family
partners, liability assumed b
25,000 agreement.
10,000 More than one claim in respect of
the same employee. Fraud
committed by the Insured's
employee after the discovery of an
earlier frau committed by him.
Loss discovered months after
death, dismissal, an retirement of
the employee or expire of Policy.
20,000 Involvement of employees or
family members; dishonesty /fraud
10,000 of case carrying employee; loss
due to error omission; loss of
5,000 money from safe using key
obtained
unaccompanied
by
violence, assault or threat.

Schedule (Policy A/B/C)

Name of the Insured
Full address of the Shop
Nature of trade
Period of Insurance

:
:
:
:

Premium Paid
Rt No.______ dt_______

Section What is insured?

I

II

Policy Coverage Premium

(Rs)
A Sec I
to VI 1550
B Sec I to V 1450
C Sec I to IV
1400

Against what?

Building including Fire, lightning, explosion

Compound wall, of gas in domestic
Elec. Fixtures,
appliances, riot, strike
other interiors,
or malicious act, terrorist
fixtures owned by act, earthquake storm,
Insured solely / tempest, flood, inundation
partially occupied
Contents
As above
Consisting of ---------Burglary and / or
Housebreaking

III

Personal Accident Death, Permanent Total

Disablement (PTD) for
the following persons
5.
Sex: Age:
6.
Sex: Age:
7.
Sex: Age:
8.
Sex: Age:

IV

Liability

VI

1. Legal Liability
towards general
public
2. Legal Liability towards
employees
Fidelity Guarantee Loss due to act of fraud,
dishonesty committed
by salaried persons.

Cash in Transit

Loss by accident,
misfortune
Loss due to burglary
/ Housebreaking whilst
in safe, till / counter

353

Max.
Amount
What is not insured?
Payable
(Rs)
150000 Loss of or damage to motor
vehicle and pedal cycles, money,
securities bullion, bills of
exchange, business books, unset
precious stones
150,000 Same as above plus loss / damage
by burglary where any employee
150,000 of the Insured or any member of
th Insured's family is concerned.
Compensation for more than on
benefit (death/ PTD) in respect of
50,000 per the same period of disablement
person intentional self-injury, suicide, an
attempted suicide; whilst under
the influence intoxicating drugs,
liquor Death / PTD resulting from
childbirth / pregnancy.
15,000 Death of or bodily injury to an
member of the Insured's family
25,000 partners, liability assumed b
agreement.
10,000 More than one claim in respect of
the same employee. Fraud
committed by the Insured's
employee after the discovery of
an earlier frau committed by him.
Loss discovered months after
death, dismissal, an retirement of
the employee or expire of Policy.
20,000 Involvement of employees or
family members; dishonesty
10,000 /fraud of case carrying employee;
loss due to error omission; loss of
5,000 money from safe using key
obtained unaccompanied by
violence, assault or threat.

DUKAN MITRA INSURANCE - CLAIM FORM

The issue of this form does not constitute admission of liability
Please return this form duly completed together with relevant reports Bills /
Certificates etc.,
Policy No:

Claim No:

1. e) Name of the Insured

f) Address

a)
b)

g) Occupation
h) Situation of premises insured
2. i)

j)
k)
l)
m)

n)
o)
p)
3.

4.

5.

c)
d)

State the nature of Loss?

(Fire, Burglary / housebreaking, Accident to persons, infidelity
of employees etc.,)
Date and Time of Accident / Loss
Cause of accident / loss with details
If the loss is due to fire, has the matter been reported to Fire
Bridge / Police Station
If the loss is by Burglary / housebreaking / misfortune / accident
to persons, name of the Police Station where the compliant was
lodged, FIR No. and Crime No.
In case of Burglary / housebreaking do you suspect any body?
When and where was the property last seen by the Insured?
On what date and time the property Loss was found?

c) Is the Insured sole owner of the property? If not give name and
address of the owner.
d) Are there any other Insurance on the property? If so give
particulars.
In case of loss of money:
e) In whose custody was the money at the time of loss?
f) Who were the persons accompanying the person carrying
money?
g) How was the money carried (whether in pocket, bag, box etc)
h) By what conveyance was the money carried?
In case of accident to persons
e) Name of the injured person
f) Address

a)

b)
c)
d)
e)

f)
g)
h)
a)
b)

a)
b)
c)
d)
a)
b)

354

g)
h)
6. e)
f)
g)
h)

7. e)
f)
h)
h)
8. e)
f)
g)
h)

Occupation
Age and next birthday
Where did the accident occur
Give full description of injuries sustained with medical report
Was the person under the influence of drug / drinks at the time
of accident?
Give names and address of witness to accident? (In case of
death person, separate medical report and postmortem report
and death certificate are to be enclosed)
Particulars of any injury to persons (third Party) or damage to
property of third party.
Name and address of the injured person
Name of the Doctor or Hospital who have given first aid
assistance/ treatment
Has the injured person or property owner made any claim on
you? If so give particulars and also attach a copy of notice.
In case of Workmen Compensation claim give name and address
of the injured employee and date of appointment
Occupation of the employee
Nature of work done at the time of accident
Details of percentage of disability with medical report

9. In case of Fidelity Guarantee claim

i) Name of defaulting employee
j) His present address
k) Date of Discovery of defalcation
l) Full details of defalcation
m) Date of defalcation
n) In what capacity was he engaged
o) Does the insured hold any security from the employee, if so to
what extent
p) Has the insured taken any action against the employee? If so
state the nature of action taken.
10. Has the Insured sustained similar loss/es prior to this loss? If yes,
give details of insurer and claim amount.
11.
Amount of loss Claimed

c)
d)
a)
b)
c)
d)

a)
b)
c)
d)
a)
b)
c)
d)
a)
b)
c)
d)
e)
f)
g)
h)

Rs.-------

I / we declare that the above information furnished are correct in all aspects.
Date :
Place :Signature

355

COMMERCIAL PACKAGE KIT (COMPACT) INSURANCE

This Policy covers Offices and Establishments (non-manufacturing) for which Fire
Policy A is issued. This Policy does not cover Shops, Godowns and Warehouses per se
unless they are incidental to the activities of the establishment covered hereunder.
The Companys liability under each Section of the Schedule and Endorsements, if
any, attached to this Policy shall be limited to the Sum Insured under that Section or
Endorsement as the case may be unless specified otherwise.

SECTION I Fire & Allied Perils

Sub Section I A (Building):
1.

Definition:

a)

Building:

1.

Building means structure above the plinth and foundation

2.

Building shall also include connected utilities, sanitary fittings, and fixtures
belonging to the Insured as well as that for which he is responsible.

b)

Class A construction:

Buildings shall have external wall(s) of stone/bricks/concrete blocks/asbestos sheets

cladding and/ or metal sheet cladding glass panel/partly or fully open sided and roof
of RCC/masonry /asbestos concrete sheet / metal sheets / tiles / wooden shingles or
boarding on RCC / steel / wooden frame work.

356

N.B
1.

Thin layer of grass hay or reeds on incombustible roofing is permitted under class
A construction.

2.

Use of thermosetting resin fibre glass reinforced sheets is permitted for Skylights
under class A construction.

c)

Reinstatement Value:

It is the cost of replacing or reinstating on the same site, property of the same kind or type
but not superior to or more extensive than the insured property when new.
d)

Market Value:
It is the Replacement Value less depreciation.

2.

What is Covered

a)

Buildings of class A construction only excluding cost of land.

b)

The cost of removal of debris of the insured property affected, dismantling or

demolishing, shoring or propping up of the portion or portions of the property
insured damaged or destroyed by specified perils subject to a maximum of 10% of
the Sum Insured for this Sub-Section provided it is declared for insurance and the
additional premium paid.

c)

The cost of Architects, Surveyors and Consulting Engineer fees for plans,
specifications,

tenders,

quantities

and

service

in

connection

with

the

superintendence of the reinstatement of damage to the building insured under this

Policy. However, this will not include any costs in connection with the Insureds
claim or estimate of loss in the event of damage by insured perils.

357

d)

The additional cost of reinstatement of property damaged during the currency of

Policy by insured perils to comply with building or other Regulations under or
framed in pursuance of any Act of Parliament or with Bye-Laws of any Municipal
or local Authority provided that notice thereunder has not been served on the
Insured before occurrence of damage.

3.

Perils covered:
Loss or damage due to
a)

Fire, Lightning, Explosion/implosion;

b)

Bursting and overflowing of water tanks, apparatus or pipes;

c)

Aircraft or articles dropped therefrom;

d)

Riot, Strike or Malicious Act and Terrorist damage;

e)

Earthquake, Fire and / or Shock Subsidence and Landslide (including

Rockslide) damage;

f)

Flood, Inundation, Storm, Tempest, Typhoon, Hurricane, Tornado or

cyclone;

g)

Impact Damage by any rail/road vehicle or Animal by direct contact.

4.

Exclusions:

1.

Damage occasioned by or through or in consequence of subterranean fire

2.

Damage to property occasioned by its own fomentation or undergoing any heating

or drying process.

3.

Damage to any electrical machine apparatus fixture or fitting (including electrical

fans, electrical appliances) or to any portion of electrical installation, arising from
or occasioned by over- running, excessive pressure, short circuiting, arcing, selfheating or leakage of electricity from whatever cause (lightning included)
provided that this exemption will apply only to the particular electrical machine,

358

apparatus, fixtures, fittings or portion of electrical installation which may be

destroyed or damaged by fire so set up.
4.

Damage to property by members including partners of the Insureds business or

profession or household acting as principal or accessory provided that this
exclusion will not apply to (d) in "Perils covered" column.

5.

Basis of Indemnity
a)

The indemnity shall be on the basis of Reinstatement Value or Market Value

as the case may be as opted by the Insured at the time taking this Insurance.

b)

In the event of the property covered suffering damage during the currency
of the Policy by any of the specified perils covered, the Company will pay
the amount of the damage or at its option replace or repair such damage.

c)

If the property hereby insured under this sub-section shall, at the breaking
out of any fire or at the commencement of any destruction of or damage to
the property by any other peril hereby insured against, be collectively of
greater value than the Sum Insured for this Sub-Section, then the Insured
shall be considered as being his own insurer for the difference and shall
bear a rateable portion of the loss accordingly. Provided however, that if the
Sum Insured hereby on the property insured shall at the breaking out of
such fire or at the commencement of such destruction or damage be not less
than 85% (eighty five percent) of the collective value of the property
insured, this condition shall be of no purpose and effect.

359

Sub Section I B (Contents including incidental stock)

1.

Definition: Contents
Contents shall include that belonging to the Insured and that for which he is
responsible. Contents may include stock if the same does not exceed 10% of the
value of the total contents for coverage under this Sub-Section.

2.

What is covered:
a)

The contents of the insured premises described in detail in the Schedule,

belonging to the Insured or for which he is responsible. Items declared for
coverage under Section IV are not required to be covered under this SubSection.

b)

Contents belonging to the Insured when temporarily removed from the

premises for a period not exceeding 60 (Sixty) days only but remaining
within India for an amount not exceeding 5% of the total Sum Insured for
contents subject to a maximum of Rs.20,000/-.

c)

Stock incidental to the trade for an amount not exceeding 10% of the total
Sum Insured for contents under this Section.

d)

The cost of removal of debris of the insured property affected subject to a

maximum of 10% of the Sum Insured for this Sub-Section shall be covered
in addition to the above provided it is specifically declared for insurance
and the additional premium paid.

3. Perils covered Same as in Section I A

360

4.

Exclusion
1.

Exclusions 1 to 4 as in Sub-section I (A).

2.

Damage to livestock, motor vehicle.

3.

Money, securities for money, stamps, bullion, bonds, bills of exchange,

promissory notes, stock and share certificates, unset precious stones and
jewellery and valuables, pedal cycles unless specifically declared.

4.

Erasure or breakdown of information contained in data carrying materials

and/or consequential loss of any description.

1.

Sum Insured: The basis of valuation shall be on Market Value basis as defined in
Sub-Section I (A)

2.

Basis of Indemnity
a)

The indemnity shall be on the basis of Market Value. Defined in SubSection I (A)

b)

In the event of the contents covered suffering damage during the currency
of the Policy by any of the specified perils covered, the Company will pay
the amount of the damage or at its option replace or repair such damage.

c)

If the property hereby insured under this Sub-Section shall, at the breaking
out of any fire or at the commencement of any destruction of or damage to
the property by any other peril hereby insured against, be collectively of
greater value than the Sum Insured for this Sub-Section, then the Insured
shall be considered as being his own insurer for the difference and shall
bear a rateable portion of the loss accordingly. Provided however, that if the
Sum Insured hereby on the property insured shall at the breaking out of
such fire or at the commencement of such destruction or damage be not less

361

than 85% (eighty five percent) of the collective value of the property
insured, this condition shall be of no purpose and effect.

Sub Section I C (Tenants Legal Liability):

(Applicable only if the Insured is a tenant of the building)
1.

What is covered
Insureds Legal Liability as Tenants of the Insured Premises (but not as Owner of
the Insured Premises) for damage to the buildings of the Offices and landlords
fixture and fittings.

2.

Perils covered Same as in Sub- Section I B.

3.

Exclusions Same as in Sub Section I B.

4.

Sum Insured The basis of valuation shall be Market Value as defined Sub-Section
I (A).

5.

Basis of Indemnity
a)

The indemnity shall be on the basis of Market Value.

b)

The liability of the Company shall be limited to 10 % (Ten percent) of the

Sum Insured on Contents (excluding incidental stock) in respect of each
occurrence of damage but not exceeding in the aggregate 25 % (twenty five
percent) of the Sum Insured on contents (excluding incidental stock) for all
events during the Policy period.

362

SECTION II Contents Burglary & Housebreaking

1.

Definition Burglary & Housebreaking:

The term means theft involving entry into or exit from the insured premises by
forcible and violent means or following assault or violence or threat thereof to the
Insured or any employees of the Insured or member of the Insureds family or any
person residing lawfully in the insured premises.

What is covered
a)

The contents of the insured premises described in detail in the Schedule

belonging to the Insured or for which he is responsible. Items declared for
coverage under Section IV are not required to be covered under this Sub
Section.

b)

Damage to the insured premises and / or safe resulting from Burglary and /
or Housebreaking or any attempt threat subject to a maximum of 5 % of the
Sum Insured for this Section.

3.

Perils Covered Loss or damage by burglary and / or house breaking.

4.

Exclusions

1.

Loss or damage where any employee of the Insured or member of the Insureds
family is involved as principal or accessory.

2.

Loss of or damage to livestock, motor vehicle.

3.

Loss of or damage to money, securities for money, stamps, bullion, deeds, bonds,
bills of exchange, promissory notes, stock and share certificates, business books
manuscripts, documents of any kind unset precious stones and jewellery and
valuables, and pedal cycle unless specifically declared.

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4.

Loss of money and/or other property abstracted from safe following the use of key
to the said safe or any duplicate thereof belonging to the Insured unless such key
has been obtained by assault or violence or any threat.

5.

Sum Insured: The basis of valuation shall be Market Value as defined in Sub
Section I (A).

6.

Basis of Indemnity

a)

The indemnity shall be on the basis of Market Value (Defined in Sub - Section (I
A).

b)

In the event of the contents covered suffering damage during the currency of the
Policy by any of the specified perils covered, the Company shall pay the amount
of the damage or at its option replace or repair such damage.

c)

If the property hereby insured under this Section shall, at the breaking out of any
fire or at the commencement of any destruction of or damage to the property by
any other peril hereby insured against, be collectively of greater value than the
Sum Insured for this Section, then the Insured shall be considered as being his
own insurer for the difference and shall bear a rateable portion of the loss
accordingly.

Section III Mechanical & Electrical Appliances

1.

What is covered:
All electrical and / or mechanical appliances, apparatus, gadgets and / or any
electrical or mechanical installation other than Diesel Generator Sets pertaining to
Insureds business / trade described in detail in the Schedule while contained or
fixed in the insured premises.

364

2.

Perils Covered
Loss or damage due to unforeseen and sudden accidental physical damage caused
by and / or solely due to the mechanical and / or electrical breakdown.

3.

Exclusions
1.

loss or damage caused by or arising out of wilful act or gross negligence of

the Insured or his employees.

2.

Gradually developing flaws, defects, cracks or partial fractures in any part

not necessitating immediate stoppage although at some future time repair or
replacement of the parts affected may be necessary.

3.

Deterioration of or wearing away or wear-out of any item caused by or

naturally resulting from normal use of exposure.

4.

Loss or damage due to faults existing at the time of commencement of this

insurance and known to the insured regardless of whether such faults or
defects were known to the Company or not.

5.

Loss or damage for which the manufacturer or supplier of the property is

responsible either by law or under contract.

6.

Cost of transport to the repair shop and back to the Insureds premises of
any insured item arising out of any damage to such item.

7.

Loss of or damage to any insured item by perils which are insurable under
other Sections of this Policy

4.

Sum Insured:
The Sum Insured in respect of each item specified in the Schedule shall be equal to
the cost of replacement of such item by new item of the same kind and capacity
which shall mean its replacement cost including freight, customs duties and other
dues if any and erection cost provided they are included in the Sum Insured.

365

5.

Basis of Indemnity:
1.

Where damage to an insured item can be repaired the Company will pay
expenses necessarily incurred to restore the damaged item to its former
state of serviceability plus the cost of dismantling and re-erection incurred
for the purpose of effecting the repairs as well as custom duties and other
dues if any to the extent such expenses have been included in the Sum
Insured.
No deduction shall be made towards depreciation in respect of parts
replaced except for parts with limited life of use but the value of salvage
will be taken into account.

2.

If the cost of repair equals or exceeds the actual value of the insured item
immediately before the occurrence of the damage then the settlement shall
be made on the basis provided for in (3) below:

3.

In case of total loss claims, the Company will pay actual value of the item
immediately before the occurrence of the damage including cost of ordinary
freight, erection and custom duties if any provided such expenses have been
included in Sum Insured. Such actual value is to be calculated by deducting
10 % depreciation per year from replacement value of the item since the
date of manufacture. The maximum depreciation however shall not exceed
50% of the replacement value of the item in respect of which a claim for
total loss is admitted under the Policy.

4.

If the Sum Insured is less than the amount required to be insured, the
Company will pay for the damage in such proportion as the Sum Insured
bears to the amount required to be insured. Every item if more than one
shall be subject to this condition separately.

366

6.

Excess:
The Insured shall bear upon himself 1 % of the Sum Insured in respect of each
item or the sum of Rupees Two hundred and fifty (Rs. 250/- only) whichever is
higher of each and every loss or damage in respect of which a claim is admitted
under the Policy.

7.

Warranty:
ALL electrical, mechanical appliances, apparatus, gadgets and / or electrical /
mechanical installations other than Diesel Generating sets in the Insured's
premises shall be covered WITHOUT SELECTION under this Section.
If at the time of claim, it is found that this warranty has not been complied with,
then the condition No. 4 under Basis of Indemnity of this Section shall apply.

Section IV Electronic appliances:

1.

What is covered:
a)

Electronic appliances, apparatus, gadgets, electronic medical equipment and

/ or any electronic installation pertaining to Insureds trade / business
described in detail in the Schedule while contained in or fixed at the insured
premises.

b)

Portable Computers / Cellular phones / mobile professional instruments

specified in the Schedule and belonging to the Insured and in the personal
custody of the Insured, his employee or director whilst anywhere in the
World, provided they are carried as accompanied baggage.

c)

Data carrying materials and data contained in or on such data carrying

materials and / or Software / Computer Programs (other than own/in

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house developed Software / Computer Programs) to the extent specifically

declared for insurance and mentioned in the Schedule.
2.

Perils Covered Loss or damage due to any cause other than those specifically
excluded.

3.

Exclusions

1.

Damage caused by any faults or defects existing at the time of commencement of

present insurance within the knowledge of the Insured or his representatives
whether such faults or defects were known to the Company or not.

2.

Wilful act or wilful negligence of the Insured or his representative.

3.

Loss arising out of cessation of work whether total or partial

4.

Derangement of the insured property not accompanied by damage covered under

this Policy

5.

Loss of or damage to the property covered under this Policy falling under the
terms of the Maintenance agreement. Such exclusions will also apply to parts
exchanged in course of such maintenance operations.

6.

Damage due to defects of design material or workmanship or otherwise for which

the manufacturer or supplier of the insured items is responsible either by law or
under contract for any amount recoverable under the terms of the Maintenance
agreement.

7.

Damage to or consequent upon wear and tear, gradual deterioration, atmospheric

or climatic conditions, rust, corrosion, moth, vermin or insect.

8.

Loss due to mysterious disappearance and / or whilst left in unattended vehicles in

respect of cellular phones, portable computers and other mobile equipments.

9.

Loss or damage to own/in-house developed software.

368

4.

Sum Insured:
It is a requirement under this Section that the Sum insured in respect of each item
specified in the Schedule shall be equal to the cost of replacement of such item by
new item of the same kind and capacity which shall mean its replacement cost
including freight, dues and custom duty if any and also cost of erection.

5.

Basis of Indemnity:
1.

Where damage to an insured item can be repaired the Company will pay
expenses necessarily incurred to restore the damaged item to its former
state of serviceability or pay the actual value of the item immediately
before the occurrence of the loss, if the cost of repair exceeds or equals the
actual value of machinery.

2.

The company will also pay the cost of dismantling and re-erection incurred
for the purpose of effecting repairs, ordinary freight to and from a repair
shop and customs duties and other dues provided they are included in the
Sum Insured.

3.

No deduction shall be made towards depreciation in respect of parts

replaced except for parts with limited life of use but the value of salvage
will be deducted from the replacement value of the items.

4.

In respect of the data carrying material or the data which is irretrievably lost
and replaced / reproduced within 12 months after the occurrence, the
Company shall pay only the expenses incurred for replacing / reproducing
the lost or damaged data carrying material / data by new data carrying
material / data.

5.

In case of rotating anode X ray tubes with lead sealed exposure counters for
diagnostic equipment installed in Hospitals / Nursing Homes, the
indemnification shall be limited to the actual value of the item immediately
prior to the occurrence of the loss / damage. This shall include ordinary

369

freight, erection costs and customs duties and dues, if any. The actual value
is determined as under:
Number accompanies in % of new replacement value
< 10,000
< 12,000
< 14,000
< 16,000
< 19,000
< 22,000
< 26,000
< 30,000
< 35,000
< 40,000
< 40,000

6.

100
90
80
70
60
50
40
30
20
10

Excess: 10 % of the claim amount subject to a minimum of Rs.1,000/- (Rupees

One thousand only) for each and every occurrence of damage.

7.

Warranty:
a)

ALL electronic appliances, apparatus, gadgets, electronic installations in

the insured premises shall be covered WITHOUT SELECTION under
this Section.

b)

IN RESPECT OF ELECTRONIC INSTRUMENTS / EQUIPMENT

FOR MEDICAL, FOR SURGICAL AND DENTAL PURPOSES the
Maintenance Agreement is maintained during the currency of this Policy
and no variation in the terms of these Agreements shall be made without the
written consent of the Company being obtained. For the purpose of this
warranty the word Maintenance shall mean the following:
i)

Safety Checks

ii)

Preventive maintenance

370

iii)

Rectification of loss or damage or faults arising from normal

operation as well as from aging

Provided that this warranty shall not apply if the additional premium as required by the
Company is paid by the Insured before the commencement of this Insurance for deletion
of this warranty.

Section V Money Insurance:

1.

Definition:
Money: Money shall mean Cash, Coins, Currency notes, Cheques, Postal Orders,
Bank Drafts, Pay Orders, Postage Stamp etc.
Safe : Safe shall also include Cupboards, Almirahs and Cash Boxes made of steel
and is of standard make secured with Standard Locking System.

2.

What is covered:
1.

b)

Money relating to profession or business while in

i)

transit from and to the insured premises described in the schedule,

ii)

safe installed at the insured premises,

iii)

till at the insured premises.

Cost of replacement or repair of the Insured's Safe in the insured premises

in the event of its being damaged by thieves, burglers.

3.

Perils Covered: Loss due to accident or misfortune

371

Exclusions

1.

Shortage of money due to error or omission

2.

Loss of money entrusted to any person other than Insured, authorised employee of
the Insured or directors

3.

Loss arising from fraud or dishonesty of any director or cash carrying employee of
the Insured unless such loss is discovered within 48 hours of its occurrence.

4.

Loss of money extracted from safe following the use of key to the said safe or any
article thereof belonging to the Insured unless such key has been obtained by
assault or threat thereof.

5.

Sum Insured:
The Sum Insured specified in the Schedule under this Section is the maximum
value of money in the possession of the Insured at any one time during the Policy
Period. In the case of Money in transit, the single carrying limit is the Sum Insured
mentioned in the Schedule under this Section.

6.

Warranty:
a)

The insured shall maintain a complete account of cash in Safe, Cupboards,

Cash Box under lock and key secured in some places other than the place
where the money covered is kept and the liability of the Company shall be
limited to the account actually shown by such records not exceeding the
amount stated in the Schedule under this Section.

b)

The money collected by the Insured or the authorised employee/s of the

Insured whilst in transit to the insured premises or bank shall not be in their
personal custody for more than 48 hours.

372

7.

Condition:
1.

If the Sum Insured is less than the amount required to be insured, the
Company will pay for the loss in such proportion as the Sum Insured bears
to the amount required to be insured.

2.

The Company shall be entitled in the name of the Insured to have the
absolute conduct and control of all or any proceedings that it considers
necessary for the purpose of tracing and recovering money lost or of
securing reimbursement in respect of money lost and the Insured shall at
the Companys expense furnish all such assistance as may be reasonably be
required by the Company in connection with such proceedings and in the
event of any or all of the money being recovered. It shall be imperative
upon the Insured to refund to the Company such a proportion of the sum
allowed by way of compensation as the amount recovered bears to the total
money lost.

SECTION VI Personal Accident

1.

Definition:

a)

Insured Person:
The Insured or any director or employee of the Insured aged between 18 years
and 70 years permanently working with the Insured at the Office as stated in
the Schedule.

373

b)

Physical Separation:
For the purpose of items 2 and 3 of Table of Benefits, this shall mean separation of
the hand at or above the wrist and / or of the foot at or above the ankle
respectively.

2.

What is Covered:
1.

This Section covers the Insured Person(s) towards bodily injury solely and
directly caused by accidental, violent, external and visible means resulting
in death or disablement within 12 (twelve) calendar months of the
occurrence of such injury.

2.

This Section also reimburses, in the event of the death of the Insured Person
due to injury caused solely and directly by accidental, violent, external and
visible means outside his/her residence, the expenses incurred for
transportation of the Insured Persons dead body to the place of residence
subject to a maximum of Rs 2,500/-.

3.

This Section further pays, in the event of death or permanent total

disablement of the Insured Person caused solely and directly by accidental,
violent, external and visible means, compensation towards Education Fund
for the dependent children as below:
a)

This benefit is applicable only in cases where CSI is Rs.1,00,000/and above.

b)

If the Insured Person has one dependent child below the age of 23
years who is pursuing studies, an amount of Rs.5,000/- is paid

c)

If the Insured Person has more than one dependent child below the
age of 23 years who are pursuing studies, an amount of Rs.10,000/is paid Provided that the age limit of 23 years shall apply on the date
of accident and not at the beginning of the Policy year.

374

3.

Perils covered Death / disablement solely and directly caused by accidental,

violent, external and visible means.

4.

Exclusions:
1.

Compensation under more than one of the items (I) to (4) of the table of
benefits in respect of the same period of disablement.

2.

Any payment in case of more than one claim under the Policy during any
one period of insurance by which the maximum liability of the Company in
that period would exceed the Sum payable under benefit (1) of the table of
benefits.

3.

Payment of compensation in respect of Death, injury or disablement of the

Insured Person

(i)

from intentional self injury suicide or attempted suicide

(ii)

whilst under the influence of intoxicating liquor or drugs,

(iii)

whilst engaging in Aviation or whilst mounting into, dismounting from or

travelling in any aircraft anywhere in the World,

(iv)

directly or indirectly caused by venereal diseases or insanity,

(v)

arising or resulting from the Insured Person committing any breach of the
law with criminal intent.

4.

Death or disablement resulting directly or indirectly caused by contributed to or

aggravated or prolonged by childbirth or pregnancy or in consequence thereof.

5.

Capital Sum Insured: The Capital Sum Insured (CSI) is the maximum liability of
the Company under this Section which shall not exceed 5 (five) times the annual
income of the Insured Person.

6.

Basis of Settlement: As per PA policy conditions

375

Section VII Infidelity / Dishonesty of employees

Definition: Insured: In this Section means any person, partnership firm or any
body of persons whether incorporated or not with whom the employee who is included in
the Section has a contract of service.
Employee: Employee means any person (other than a person whose employment
is of a casual nature and who is employed otherwise than for the purposes of the Insureds
trade or business) who has entered into a contract of employment with the Insured.
What is covered: Direct pecuniary loss sustained by reason of any act of
fraud/dishonesty committed by any employee in the course of his duty.
Perils covered Direct pecuniary loss caused by act of fraud or dishonesty.
Exclusions As discussed in the Column Conditions under this Section.
Conditions:
a)

It is a condition under this Policy that

i)

The loss shall have occurred in connection with the Employee's

occupation/duties by reason of any act of fraud or dishonesty
committed after the commencement of this Policy and during its
uninterrupted continuance thereof, by the employee of the Insured
and be discovered during the continuance of this Policy or within
twelve (12) calendar months after the death, dismissal or retirement
of such person or twelve (12) months after this Policy shall have
ceased to exist whichever of these events shall happen first.

ii)

The liability of the Company in respect of any one person or all

persons so employed and in respect of all losses in any one period of
insurance is limited to the Sum set opposite in the Schedule

376

b)

The following Conditions are precedent to a claim to become payable under

this Section:
i)

In the event of loss the Insured shall at once give notice to the police
and take all practicable steps for discovering and punishing the
guilty persons and for tracing and recovering the property lost and
shall be bound to satisfy the Company that the loss claimed for has
actually arisen from one of the causes insured against.

ii)

The Company shall not be called upon to pay more than one claim in
respect of the acts or defaults of any one of the employees and the
Company will indemnify the Insured only in respect of acts and
defaults committed since the date of commencement of risk
mentioned in the Schedule hereto for such employee.

iii)

It is also provided and declared that the Company shall not be liable
for any act or default of such employee done or omitted to be done
after the discovery by the Insured of any act of forgery,
embezzlement, larceny or fraudulent conversion on the part of such
employees.

iv)

The Insured shall if and when required by the Company but at the
expense of the Company if a conviction be obtained use all diligence
in prosecuting any of the employees to conviction for any act or
default which such employee shall have committed and in
consequence of which a claim shall have been made under this
Policy and shall at the Companys expense give all information and
assistance to enable the Company to sue for and obtain
reimbursement by any such employee by reason of whose acts of
defaults claim has been made or by the estates of such employee or
any moneys which the Company shall have become liable to pay in
respect thereof.

377

v)

Any money of the employee in the hands of the Insured and any
money which but for the employees dishonesty would have been
due to the employee from the Insured shall be deducted from the
amount otherwise payable under this Policy. Any money recovered
after the settlement of any claim shall be the property of the
Company not exceeding, however, the amount paid by the Company.

Section VIII Legal Liability

A)

Towards Third Parties:

Definition:
Injury: Injury means death, bodily injury, illness or disease of or to any person.
Damage: Damage means actual and/or physical damage to tangible property.
Pollution: Pollution means pollution or contamination of the atmosphere or of any
water land or other tangible property.
Product: Product means any tangible property after it has left the custody or
control of the Insured, which has been designed, specified, formulated,
manufactured, constructed, installed, sold, supplied, distributed, treated, serviced,
altered or repaired by or on behalf of the Insured but shall not mean food and
beverages supplied by or on behalf of the Insured primarily to the Insureds
employees as staff benefit.
What is covered:
This Sub-Section covers the Insureds legal liability (other than liability under the
Public Liability Insurance Act, 1991 or any other Statute based on the Doctrine of

378

Liability) to pay compensation including claimants costs, fees and expenses

anywhere in India, in accordance with the Indian Law.
The indemnity only applies to claims arising out of accidents occurring in the
Insured Premises during the Period of Insurance first made in writing against the
Insured during the Policy period and the Insured is indemnified for and / or arising
out of Injury and /or Damage but only against claims arising out of or in
accordance with the business specified in the Schedule and not against claims
arising out of or in connection with:
a)

Pollution howsoever caused unless specifically covered

b)

Any product.

Perils covered
Legal liability of the insured towards third party described in detail under Item No.2
"What is covered" column above of this Sub-Section.
Exclusions
1.

Any compensation for death of or bodily injury to any member of the Insured
Persons family, partners, managerial staff, contractors employees or damage to
property belonging to or in the custody of or control of the Insured or Insured
Persons family, partner, directors, managerial staff, employees and contractors
employees.

2.

Liability assumed by agreement unless such liability would have attached to the
Insured notwithstanding such agreement.

3.

Injury or damage caused by or resulting from anything sold, supplied, installed,

erected, repaired, altered or treated and / or due to professional advice rendered by
the Insured or by any person on behalf of the Insured other than food or beverages
sold or supplied by the Insured as a service to the employees or visitors for
consumption in the Office.

379

4.

Accidents directly or indirectly caused by, traceable to, arising out of the
ownership, possession or the custody by or on behalf of Insured of animals,
vehicles, aircraft, ships, boats or crafts of any kind.

5.

Liability arising out of loss of pure financial nature such as loss of goodwill, loss
of market etc.

6.

Liability arising out of all personal

a)

injuries such as libel, slander, false arrest, wrongful eviction and detention,
defamation and mental injury arising or shock resulting therefrom.

b)
7.

infringement of plans, copyright, patent, trademark, registered design.

Any fines, penalties, punitive or exemplary damage or any other resulting from the
multiplication of compensatory damage.

8.

a)

Damage to property owned, leased and hired or under hire purchase or on

loan to the Insured or otherwise in the Insureds care custody and control
other than the premises (or the contents thereof) temporarily occupied by
the Insured for work thereon or other property temporarily in the Insureds
possession for work therein (but no indemnity is granted for damage to that
part of the property on which the Insured is working and which arises out of
such work.

b)
9.

Employees and visitors' clothings and personal effect.

Transportation of materials and / or hazardous / dangerous substances outside the

Insureds premises.

10.

Damages arising out of alterations, additions, repairs or decorations to the

Insureds premises specified in the Schedule

380

Excess:
0.5% of the limit of indemnity per any one accident, subject to a maximum of
Rs.3,00,000/- (Rupees Three Lakhs only) and a minimum of Rs.2,000/- (Rupees Two
Thousand only). The excess is applicable to both property damage claims and death /
bodily injury claims inclusive of defence costs arising out of any one accident.
B) Towards Employees:
1.

Definition:
Injury:Injury means death, bodily injury, illness or disease of or to any person.

2.

What is covered:
This Sub-Section covers the Insureds legal liability to employees (listed in the
Schedule) under Fatal Accident Act 1855/Workmens Compensation Act 1923 or
any amendments thereto prior to issuance of this Policy and Common Law to pay
compensation in respect of accidental death or injury sustained during the currency
of the Policy arising out of or during the course of his employment with the
Insured in the business or profession described in the Schedule within India. In
addition to the compensation as stated above, the Company will also pay the
claimants costs, fees, and expenses and defence costs with its consent in
defending any claim for such liability under Sections VIII (A) and VIII (B),
subject to a maximum of Rs.50,000/-

3.

Perils Covered
Legal Liability of the Insured towards his employees described in detail under
Item No.2 What is Covered column above of this Sub Section.

381

4.

Exclusions:

1.

Any interest and /or penalty imposed on the Insured on account of failure to
comply with the requirements laid down under WC Act 1923 and subsequent
amendments of the said Act.

2.

The insureds liability to employees of contractors to the Insured.

3.

Any liability of the Insured, which attaches by virtue of an agreement but which
would not have attached in the absence of such agreement.

4.

Any sum which the Insured would have been entitled to recover from any party
but for an agreement between the Insured and such party.

Section IX Fixed Glass / Sanitary fittings

1.

Definition:

Glass: Glass means fixed plain glass and mirrors in or on the insured premises excluding
painting, tinting, embossing or ornamental works on the glass.
Sanitary Fittings: Sanitary fittings mean fixed wash basins, pedestals, sinks, lavatory
pans and cistern contained in the insured premises.
2.

3.

What is covered: This Section covers

a)

Fixed plate glasses and sanitary fittings

b)

Frames or frame work

c)

Lettering consequent upon the breakage of glasses

Perils covered: loss or damage due to accidental breakage

382

4.

Exclusions
Loss or damage due to Breakage or damage during removal, alterations and/or
repairs in or about the Office premises Disfiguration or scratching or damage of
glass sanitary fittings other than the fracture extending through the entire thickness
of glass, sanitary fittings. Breakage of glass, sanitary fittings which are not
completely and securely fixed. Damage consequent upon interruption or delay of
business or other damage or injury arising from breakage of glass, sanitary fittings
or during replacement thereof. Glass/Sanitary fittings already damaged at the
commencement of this Policy.

5.

Sum Insured: Sum insured shall be on Reinstatement Value basis as defined in

Sub Section I (A).

6.

Basis of indemnity: Basis of indemnity shall be on Reinstatement Value. If the

Sum Insured is less than the replacement value of the property then the Insured
shall be considered his own insurer for the difference between the Sum Insured
and the cost of replacement and accordingly shall bear a rateable proportion of the
damage. Each insured item if more than one, shall be separately subject to this
condition.

7.

Excess:5% of the claim amount subject to a minimum of Rs.500/- per claim.

Section X Neon Sign / Glow Sign / Hoarding

1.

What is covered:

This Section covers Neon sign and/or Glow sign and / or Hoarding belonging to the
Insured.

383

2.

Perils Covered
Loss or damage due to

3.

a)

Accidental external means;

b)

Fire, lightning, external explosion;

c)

Theft of whole sign

d)

Riot, Strike, Malicious Damage;

e)

Storm, Tempest, Flood and Inundation, Rain Hail, Flood and Bad Weather.

Exclusions
Loss or damage due to
1.

Fusing or burning out of any bulb and / or tubes arising from short
circuiting or arcing or any other mechanical or electrical breakdown or
faults.

2.
4.

The action of sun resulting in wear and tear

Sum Insured:
Sum Insured shall be on Market Value basis as defined in Sub-Section I (A)

5.

Basis of indemnity: Basis of indemnity shall be on Market Value. If the Sum

Insured is less than the Market Value of the property at the time of loss, then the
Insured shall be considered his own insurer for the difference between the Sum
Insured and the Market Value and accordingly shall bear a ratable proportion of
the damage. Each insured item if more than one, shall be separately subject to this
condition.

6.

Excess: 10% of the claim amount subject to a minimum of Rs.1000/- per claim.

384

General Conditions
1.

All communications required by this Policy shall be in writing to the policy

issuing Office.

2.

The Insured shall take all reasonable care and precautions to protect the insured
property to prevent all accidents and minimise any loss after an insured peril
operates.

3.

The Insured shall also maintain all records and books of accounts reasonably
required in an accurate manner.

4.

All cover under this Policy shall cease if any alteration be made where by the risk
of damage or injury is increased until such alteration shall be agreed by the
Company in writing.

5.

If any claim is in any respect fraudulent or if any fraudulent means or devices are
used by the Insured or anyone acting on behalf of the Insured to obtain any benefit
under this Policy or if any loss or damage is occasioned by the wilful act or with
the connivance of the Insured, all benefits under this Policy shall be forfeited.

6.

If at the time any claim arises under this policy, there shall be in force any other
insurances covering the same property, interest or liability, the Company shall not
be liable to pay more than its rateable proportion of such claim. This however does
not apply to Section VI Personal Accident.

7.

The Insured shall take due care to describe the insured property. In the event of
any misrepresentation or non-disclosure of material fact or adoption of fraudulent
means to obtain any benefit, the Policy shall be void without any refund of
premium.

385

8.

Cancellation of policy at the option of the Insured (only if no claim has occurred
during the Policy period) entails him a refund of premium less premium retained at
the Companys short period scale of rates for the period the Policy was in force
while if the same is done at the option of the Insurer, a pro rata refund of premium
for the unexpired period.

9.

Immediate intimation must be given to the policy issuing office in the event of loss
followed by such other details and documentation as the Insurer may require for
processing the claim.

10.

The Insured shall comply with all statutory or other regulations and will employ
only competent employees. The Insured shall observe all manufacturers
instructions concerning:
a)

The inspection of machinery, plant, equipment and apparatus

b)

The safety of persons or property

11.

No Sum payable under this Policy shall carry any interest or penalty.

12.

Reinstatement of Sum Insured (Applicable to Sections I, II, III, IV, V, IX and X

only):
Immediately upon the happening of any loss or damage as described in the Policy,
Total Sum Insured upon the various descriptions of property which have been lost
or damaged, shall be reduced by the amount of loss or damage and such reduced
Sums Insured shall be the Limit of the Companys liability in respect of any
further loss or damage occurring during the current period of insurance unless the
Company consents, upon payment of additional premium to reinstate the full Sum
Insured.

13.

This Policy does not cover liability which at the time of happening of any event
resulting into such liability, be insured by or would kept for the existence of this

386

Policy, except in respect of any excess beyond the amount which could have been
payable under such Policy or Policies had this Insurance not been effected.
14.

Complaint to Police Authorities is mandatory for loss occurring due to burglary /

housebreaking or attempt thereat and any other loss / damage caused by third
parties. The Insured shall render full co-operation to the Authorities in prosecuting
and convicting of any employee for acts of fraud / dishonesty resulting in a claim
under the Policy. Prosecution and conviction of any employee for acts of fraud /
dishonesty resulting in a claim under this Policy is a pre-requisite for consideration
of such a claim under this Policy.

15.

The Company at its option pay for or reinstate or repair the property up to the
amount specified in the Policy or actual loss whichever is less, subject to
admissibility and substantiation of the loss to the satisfaction of the Insurer.

16.

All aspects as to arbitration agreement, appointment of arbitrator/s, terms of

reference, award, its effect etc. will be in accordance with the provisions of the
Arbitration and Conciliation Act, 1996 (with amendments, if any).

17.

This policy does not cover:

a)

Loss or damage due to war and/or warlike perils, nuclear and/or atomic
radiation.

b)

Loss or damage due to wear and tear, gradual deterioration or slowly

developing flaws.

c)

Consequential loss of any kind.

d)

Loss of or damage caused by or due to action of any lawfully constituted

authority or Government body.

e)

Loss or damage for which the manufacturer or supplier or repairer or

transporter or any other third party is responsible either by law or by
contract.

387

ENDORSEMENT - A
BAGGAGE EXTENSION
This Policy is extended to cover loss or damage to baggage belonging to the Insured
Person due to accident or misfortune whilst on journey.
Definition:
Insured Person:
Insured Person shall mean the Insured or any Director or any Employee of the Insured
aged between 18 years and 70 years permanently working with the Insured at the Insured
premises stated in the Schedule.
Journey:
It shall mean any trip undertaken in connection with official purpose outside the City,
Town or Municipal Limit of place where the Insured premises is situated.
Baggage:
It shall mean personal goods belonging to the Insured Person or goods for which he or
she is responsible officially and such goods are necessary for his journey purpose and are
being taken by him or her journey or acquired by him / her during the journey.
Description of
baggage
As per list attached

Sum Insured Rs.

Rate (Rs. Per

1000)
7.50

388

Premium Rs.

Exclusions:
1.

First Rs.250/- (Two hundred and fifty only) in each and every damage.

2.

Damage due to confiscation or detention by Custom or any other Public

Authority.

3.

Damage not reported to police within 24 hours of discovery and a written

report obtained.

4.

Damage due to cracking, scratching or breakage of lens or glass whether

part of any equipment or otherwise or china marble, gramophone records
and other articles of a brittle or fragile nature unless such loss or damage
arises from accident to vessel, train, vehicles or aircraft by which such
property is conveyed.

5.

Damage caused by moth, mildew. Vermin or any process of cleaning,

dyeing, repairing or restoring to which the property is subjected.

6.

Damage to any electrical machines, apparatus, fixtures or fittings (including

wireless sets, radio, television sets and tape recorders) arising from
overrunning, excessive pressure, short circuiting, arcing, self-heating or
leakage of electricity from whatever cause (lightning included),

7.

Theft from car except from car of fully enclosed saloon type having all the
doors, windows and other openings securely locked and properly fastened.

8.

Damage whilst being conveyed by any carrier under contract of

affreightment.

9.

Damage to money, securities, manuscripts, deeds, bonds, bills of exchange,

promissory notes, stock or share certificates, stamps, business books or
documents, jewellery, watches, furs, precious metals, precious stones, gold
and silver ornaments, travel tickets, cheques and bank drafts.

10.

Damage, destruction of or to articles of consumable nature.

389

11.

Loose articles such as sticks, straps, umbrellas, sunshades, fans, deck chairs,
property in use on the voyage and / or journey or articles or clothes whilst
being worn on the person or carried about.

12.

Damage or destruction caused by or arising from the leakage, spilling or

exploding of liquids oils or materials of a like nature or articles of a
dangerous or damaging nature.
ENDORSEMENT - B
CONSEQUENTIAL LOSS EXTENSION

Business Interruption:
This Policy is extended to cover:
a)

Loss of Gross Income including Increased Cost of Working.

b)

Additional Expenditure and

c)

Chartered Accountants' Fees if the Business or Profession carried on by the

Insured is interfered with or interrupted during the currency of the Policy by
i)

damage occurring at the Office premises for which the Company has
admitted liability under Section I & II of the Policy;

ii)

damage to electronic equipment installation for which liability has been

admitted under Section IV of the Policy.

Tenant's Legal Liability (Applicable only if the Insured is a Tenant of the Building)
This Policy is extended to cover Insured's legal liability as Tenants of the Buildings (but
not as Owner) of the Office premises for damage to the buildings of the Offices and
landlord's fixture and fittings caused by perils covered under Section I of the Policy.

390

Definition:
Gross Income:
The money paid or payable to the Insured for work done or services rendered in course of
Business or Profession at Offices.
Annual Gross Income:
The Gross Income earned during the 12 months immediately before the date of the
damage.
Standard Gross Income:
The Gross Income earned during that period in the 12 months immediately before the
date of damage that corresponds with the indemnity period.
Loss of Gross Income:
The amount by which the Gross Income during the indemnity period shall in
consequence of the damage fall short of the Standard Gross Income.
Increased Cost of working:
Those expenses reasonably and necessarily incurred with the sole purpose to minimise or
avoid a reduction in Gross Income during the indemnity period but not exceeding the
amount that would have been paid under "Loss of Gross Income" head, had such
expenses not been incurred,
Additional Expenditure:
It is the amount payable beyond that recoverable under head "Increased Cost of working"
and under any other Section of this Policy and shall include expenses necessary and
reasonably incurred during the indemnity period in consequence of damage in connection
with the fitting up of temporary offices, rates, taxes, lighting, heating and insurance

391

thereof, cost for use of substitute equipment and any works thereon, removal costs for
contents and expenses incidental thereto and / or any cost incurred for avoiding reduction
in Gross Income.
Chartered Accountants' Fees:
The fees payable by the Insured to his Auditor or Professional Accountant reasonably and
necessarily incurred for producing and certifying any particulars required by the
Company in connection with a claim under this extension.
Indemnity Period:
It is the period beginning with the occurrence of the damage and ending not later than 12
months thereafter during which the results of Business or Profession shall be affected in
consequence of the damage.
Indemnity
Period
Selected

Sum Insured Rs.

a) Gross Income
b) Additional Expenditure
c) CAs' Fees
Sum Insured
Rs.
d) Legal Liability as tenant Rs.

392

To be rated as per
LOP Tariff
R
R
R
Premium (Rs)
(@Re. 0.75 per
k.mille)

Conditions (Applicable to Business Interruption portion only):

1.

If any charges or expenses of the Business or Profession are reduced during the
indemnity period because of interruption or interference, then the amount payable
will be reduced accordingly.

2.

If during the indemnity period, work is carried out or services rendered elsewhere
than at office premises for the benefit of Business or Profession either by the
Insured or by others on behalf of the Insured, the money paid or payable in respect
of such work or services shall be brought into account in arriving at reduction in
Gross Income.

3.

In respect of each and every occurrence of interference or interruption arising

solely as a result of damage to electronic equipment, the Company shall not be
liable for the excess specified under Section IV of the Policy.

4.

Cost of reinstating data, programs and / or damaged portable computer is not

payable under this Section in case of interference / interruption arising out of
damage to electronic equipment, installation.

5.

Adjustment shall be made to Annual Gross Income and Standard Gross Income
shall be made to provide for trends variations in or special circumstances affecting
the Business or Profession so that the adjusted figure shall represent as far as
practicable the results which would have been obtained during the indemnity
period had the damage not occurred.

6.

The insurance under this Section shall be of no effect if:

a)

the Business or Profession be would up or carried on by a liquidator or

receiver or permanently discontinued

b)

the Insured's interest ceases other than by death

393

7.

If the Insured declares, at the latest 12 months after expiry of any period of
insurance, that the Gross Income earned during the accounting period of 12
months most nearly concurrent with the Period of Insurance, as certified by
Insured's Auditors was less than the Sum Insured thereon, a pro-rata return of
premium not exceeding 50% of the premium paid on such Sum Insured for such
Period of Insurance shall be made in respect of such difference.

8.

If a claim should arise under this endorsement, its effect on the Gross Income
earned will not be taken into account in calculating any return of premium.

9.

If the Sum Insured is less than the Gross Income which would have been earned in
the twelve months following the occurrence of damage, the Amount payable shall
be reduced in that proportion.
ENDORSEMENT - C
STUDENTS' SAFETY INSURANCE EXTENSION

This Policy is extended to cover students studying in the School / College covered under
this Policy towards bodily injury solely and directly caused by accidental violent external
and visible means resulting in death or disablement.
The Company shall pay to the parent or guardian of the student as recorded in the school
register and as certified by the School Authorities the sum or sums insured.

394

Capital Sum Insured

(CSI) as per Schedule
of this Policy

Table of Benefits
1. Death
2. Total and irrecoverable loss of:
i) sight of both eyes or of the actual loss by physical
separation of the two entire hands or two entire feet or
one entire hand and one entire foot or of such loss of
sight of one eye and such loss of the one entire hand or
one entire foot. ii) Use of two hands of two feet or of
one hand and one foot or of such loss of sight of one
eye and such loss of use of one hand or one foot.
3. Total and irrecoverable loss of:
i) he sight of one eye or the actual loss by physical
separation of one entire hand or one entire foot.
ii) use of a hand or a foot without physical separation.
iii) hearing (both ears)
4 Permanent total and absolute disablement
Disabling the insured person from engaging in any
employment or occupation of any description whatsoever.

Exclusions:
In addition to the general exclusions stated in the Policy, the Company shall not be liable
under this Policy for
a.

Compensation under more than one of the foregoing Benefits (1) to (4)
above in respect of the same period of disablement.

b.

Any other payment after a claim under one of the Benefits (1) to (4) has
been admitted and become payable.

c.

Any payment in case of more than one claim under the Policy during any
one period of insurance by which the maximum liability of the Company in
that period would exceed the sum payable under Benefits (1) of this Policy.

d.

Payment of compensation in respect of death, injury or disablement of the

Insured
(a)

from intentional self-injury suicide or attempted suicide,

395

(b)

whilst under the influence of intoxicating liquor or drugs,

(c)

whilst mounting into, dismounting from or travelling in any balloon

or aircraft other than as a passenger (fare paying or otherwise) in any
duly licensed standard type of aircraft.

(d)

Directly or indirectly caused by venereal diseases or insanity.

(e)

Arising or resulting from the Insured committing any breach of law

with criminal intent.

e.

Death or disablement resulting directly or indirectly caused by contributed

to or aggravated or prolonged by childbirth or pregnancy or in consequence
thereof.
ENDORSEMENT - D
Professional Negligence (Errors & Commissions) Extension

This Policy is extended to indemnify the Insured against their legal liability to pay
compensation including defence costs, fees and expenses anywhere in India, in
accordance with Indian Law.
Indemnity:
a)

Medical Establishment:- This indemnity applies only to claims arising out of

bodily injury and / or death of any patient caused by or alleged to have been
caused by error, omission or negligence in professional service rendered or which
should have been rendered by the Insured or qualified assistants named in the
Schedule or any nurse or technician employed by the Insured.

b)

Other than Medical Establishment:- The indemnity applies only to claims arising
out of losses and / or damages during the period of insurance first made in writing

396

against the Insured during the Policy Period and Insured is indemnified in
accordance with Operative Clause for any breach of professional duty by reason of
any negligent act, error or omission, whenever wherever committed or alleged to
have been committed during the period of insurance by
i)

the insured as stated in the Schedule;

ii)

the predecessors in business of the said firm in respect of whom insurance

coverage is expressly provided in the Schedule;

iii)

any person at any time employed by the Insured or by such predecessors in

business in the conduct, by or on behalf of the said firm or such
predecessors of any business conducted ;in their professional capacity.

Exclusions:
1.

No liability shall attach to the Company in respect of

a)

any criminal act or any act committed in violation of any law or ordinance

b)

services rendered while under the influence of intoxicants or narcotics

c)

third party public liability

d)

cosmetic surgery

e)

claims arising from any condition directly or indirectly caused by or

associated with Human T-Cell Lymphotropic Virus type III (HTLV III) or
Lymphadenopathy Associated Virus (LAV) or the mutants derivatives or
variations thereof or in any way related to AIDS or condition of a similar
kind howsoever it may be named.

f)
2.

Genetic injuries caused by Z-ray treatment / diagnosis substance.

This Policy does not cover liability:

i)

assumed by the Insured by agreement and which would; have attached in

the absence of such agreement.

ii)

Arising out of deliberate, wilful or intentional non-compliance of any

397

iii)

statutory provision

iv)

Arising out of loss of pure financial nature such as loss of goodwill, loss of
market etc.

v)

Arising out of all personal injuries such as libel, slander, false arrest,
wrongful eviction, wrongful detention etc. and mental injury, anguish or
shock.

vi)

Arising out of infringement of plants, copy-right, patent, trade name, trade

mark, registered design.

3.

This Extension shall not indemnify the insured against any claim made in respect
of:
a)

infringement of patents and copy0-rights or arising from the granting of

licenses by the insured as a party to the construction project.

b)

any dishonest, fraudulent, criminal or malicious act or omission.

c)

liabilities assumed by the Insured by agreement and which would not have
attached in the absence of such agreement.

d)

Loss of any documents / data / information / losses sustained on account of

time spent in investigating the cause of damage (including costs for reprojecting in connection with the damage) and claims for losses sustained.

e)

Bodily injury, sickness, disease, death, damage to property of financial loss

and / or consequential loss unless arising out of wrongful, faulty or
inadequate design or advice.

f)

Liabilities attaching under contract of employment (employer's liabilities)

g)

The ownership, maintenance, use, occupation, leasing or custody of

property owned by rented or leased to or in the custody of the insured.

h)

Deliberate, wilful or intentional non-compliance of any Statutory

provision.

i)

Fines, penalties, punitive or exemplary damages or any other damages

resulting from the multiplication of compensatory damages.

398

j)

Any loss and / or damage and / or injury which has its origin in a neglect,
error or omission prior to retroactive date mentioned in the Schedule of this
Extension.

k)

The non-compliance with technical standards commonly observed in

professional practice, laid down by law or regulated by official bodies.

l)

Loss of ;use and / or loss due to delay.

m)

Ownership and / or conduct of any other business or activities wholly or

partly owned by / operated or managed except the business described in the
Schedule of this Policy.

n)

Arising from exceeding higher estimates and costs from not adhering to
deadlines in completing the construction of project or part thereof and from
defective accounts or control of accounts.

o)

Inadequate quantities / qualities or arranging or handling the supply of

material.

p)

Activities of the insured as joint venturer or as partner unless such joint

venture and / or partnership is described in the Schedule of this Policy; the
liability of the Company being limited to the extent of participation / share
in the business so named.

q)

Any contract where the Insured acts as a construction contractor whether or

not in conjunction with his / their profession as stated in the Schedule of
this Policy.

r)

Liabilities arising out of pollution and / or contamination whatsoever

nature.

s)

Claims for losses as a consequence of material or construction damage such

as loss of production of all kinds, loss for inferior performance, poor quality
or lower profitability and additional futile expenditure of the principal to
reach normal performance, quality or profitability.

t)

Claims for damage caused by motor vehicles, sea vessels or aircraft.

399

Conditions:
1.

The Insured shall give written notice to the Company as soon as reasonably
practicable of any claims made against the Insured (or any specific event or
circumstances that may give rise to a claim being made against the Insured) and
which forms the subject of indemnity under this Policy shall give all such
additional information as the Company may require. Every document relating to
the event shall be forwarded to the Company as soon as they are received by the
Company.

2.

No admission of offer, promise or payment shall be made or given by or on behalf

of the Insured without the written consent of the Company.

3.

The Company will have the right but in no case the obligation to take over and
conduct in the name of the Insured the defence of any claim and will have full
discretion in the conduct of any proceedings and in the settlement of any claim and
having taken over the defence of any claim may relinquish the same. All amounts
expended by the Company in the defence, settlement or payment of any claim will
reduce the limits of indemnity specified in the Schedule of this Extension.

4.

In the event the Company, in its sole discretion, chooses to exercise its right
pursuant to this condition, no action taken by the Company in the exercise of such
right will serve to modify or expand in any manner, the Company's liability or
obligations under this Policy beyond what the company's liability or obligations
would have been had it not exercises its rights under this condition.

5.

The Company may at any time pay to the Insured in connection with any claim or
series of claims under this Extension to which an indemnity limit applies the
amount of such limit (after deduction of any sums already paid) or any lesser
amount for which such claims can be settled and upon such payment being made

400

the Company shall relinquish the conduct and control of and be under no further
liability in connection with such claims.
6.

In the event of liability arising, under this Extension or the payment of claim under
this Extension, the limit of indemnity per any one year under the Policy shall get
reduced to the extent of quantum of liability to be paid or actual payment of such
claim. Under no circumstance it shall be permissible to reinstate the aggregate
limit of indemnity to the original level even on payment of extra premium.

7.

No claim shall be payable under this Extension unless the cause of action arises in
India and the liability to pay claim established against the Insured in an Indian
Court and understood that only Indian Law shall be applicable to any such action.

ENDORSEMENT - E
Occupants Benefits Extension This Extension Covers
a)

Loss of Belongings:
The contents belonging to the customers of the Insured whilst in the rooms (items
belonging to the customers and kept in the lockers / safes in the insured premises
are, however, not covered under this Extension) legally occupied by them as
evidenced by the registers and other records maintained by the Insured against
perils specified in Section I & II of this Policy. The liability of the Company shall
be limited to 5% of the Sum Insured under Section II of the Policy subject to a
maximum of Rs.25.000/-.

b)

Legal Liability of the Insured towards Occupants:

The legal liability of the Insured towards their customers as per Section VIII of
this Policy wherein the expression "Third Party" shall include the customers

401

legally occupying rooms in Insured's premises as evidenced by registers and

records maintained by the Insured.

c)

Personal Accident Benefit to Occupants:

Death or disablement of the customers solely and directly caused by accidental,
violent, external and visible means. The Company shall pay to the customer or his
Assignee or his legal personal representative the sum or sums as Insured.

Compensation Limits (For PA Section)

Maximum Per Any one accident (AOA)

Rs.25,00,000/-

Maximum Per Any one Policy year (AOY)

Twice the limit for AOA

Premium:
Rs.7.50 per Rupees thousand to be applied on Compensation limit selected per any one
accident

402

Proposal Form
DO/BO Code:
Dev. Officer Code:

Fresh Proposal /
Renewal
Agency Code:

1.

Name of the Insured:

1.

2.

Address for communication:

2.

3.

Description of Business / Profession:

3.

4.

a) Address of the premises to be insured (If different from 2 above

b) Please indicate whether the premises is own or rented
c) Do you wish to cover the building under Section I? If so whether
under Reinstatement Value (RIV) basis or Market Value (MV)
basis?
(please contact our office for exact definition of RIV and MV)

4. a)

5.

6.

b) Own /
Rented
c) Yes / No
If yes, on RIV /
MV basis

Has any of the items covered under the following sections/

endorsements suffered any damage previously? If so, give details of
the same in the following format. Attach a separate sheet, if necessary.
Date of Occurrence
Details of Loss
Amount of Loss (Rs.)

Name of the
Insurance
Company

Give details of previous insurance, if any

7.

Has any Company in respect of any of the items proposed for

insurance hereunder
a)
Declined your proposal?
b)
Cancelled / refused to renew your Policy?
c)
Accepted your proposal on special terms and conditions?
8.
Please indicate the Sections to be covered under the Policy by putting
a tick mark in the appropriate column.
Section No.
Description of property
Sum Insured (Rs.)
I. Fire &
A.
Building. (Refer 4 (c) above)
Rs ---------------Allied
B.
Contents (Incidental stock to
Rs ---------------Perils
be declared specifically)
Rs ---------------(Please attach a separate list).
C.
Tenants Legal Liability
II. Burglary
Contents
Rs--------------& House
breaking
(Please attach a separate list)
III. Electrical &
Mechanical
Appliances

Rate (Rs. Per 1000)

1.80 (*)
(*) The rate is
Rs. 1.80 for Hotels
0.75

Rs.___________ 2.50
Item

Serial No

Year of Mfg.

Please attach a separate list

Note: All items without selection have to be
declared for Insurance
IV. Electronic
Appliances

Rs.___________
Item

Serial No

10.30

Year of Mfg.

Please attach a separate list

Note: All items without selection have to be
declared for Insurance
V. Money Insurance

Please indicate the amount to be insured

a) In transit Max. Limit per carrying
Rs.___________
Rs_________
b) In Safe
Rs.___________
c) In Till
Rs.___________

403

5.00
2.00
2.50

VI. Personal
Accident

Name

Age

Designation
Rs.___________
Capital Sum Insured
(Rs.)
Please attach a separate list

VII. Infidelity /
Dishonesty of
employees
Name

Designation

Limit of
liability

0.60

Rs.6.00 on the
Sum Insure d
selected + Rs.10
per person on
the number of
persons to be
covered

Please attach a separate list

VIII. Legal
Liability

A. Towards Third Parties

AOA= AOY= Sum Insured

Rs._____________ 1.00 for Office; as

As per W. C Act
per market
Agreement for
other
establishments
As per tariff

B. Towards Employees
Est. No . Nature of
Est.
of e m p.
Work
Wages
Please attach a separate list
IX. Fixed Glass
/ Sanitary Fittings
X. Neon / Glow
Sign / Hoarding

Description of plate glass

sanitary fittings
Please attach a separate list
Description

Rs._____________

10.00

Year of Mfg.

Rs._____________

10.00

Please attach a separate list

9.
A.

B.

C.

Do you wish to cover any of the following endorsements? If so, please indicate the endorsements to be covered
under the Policy by putting a tick mark in the appropriate column.
Do you wish to cover baggage?
Yes / No.
If yes, please indicate the amount to be covered.
(If you wish to cover Travelling Advance and
Business Sample, please specify and the value
thereof)
Do you wish to cover the Loss of Profits? If yes, please
Yes / No
indicate
Rs -----------------a) Sum Insured for
Rs -----------------i. Gross Income
----------------- months
ii. Additional Expenditure
iii. CAs Fees
b) Indemnity Period opted for (Indemnity period cannot
exceed 12 months)
Do you wish to extend this Policy to cover students towards
Personal Accident? If yes, please indicate a) limit of liability
i. per student per accident
Rs. --------------ii. per accident for all students
Rs. --------------iii. per year for all students for all accident
Rs. --------------(This endorsement also covers hospitalisation expenses arising

404

D.

E.

out of accident the limit for which depends on the

Compensation limit chosen for a student)
Do you wish to cover Professional Negligence? If so, please
indicate Limit of liability for the establishment
a)
per accident
b)
per year
Do you wish to cover occupants Benefits?
If so, please specify the limits for the following sub-sections
(AOY = Any One Accident)
(AOY = Any One Year)
(AOO = Any One Occupant)
a)
Loss of belongings
b)

F.

Legal Liability towards

Rs. ---------------

AOO AOY- f or all

occupants
a) Rs. 5,000/
Rs.1,00,000/
b) AOA (Rs.)
AOY (Rs.)

i. Valuables under care, control and custody

ii. Food and beverages
iii. Extra facilities such as health clubs, beauty parlours,
shops, swimming pools, indoor and outdoor sports
iv. Aqua sports facilities
v. For inclusion of skydiving, skiing and hang gliding c) AOA (Rs.)
AOY (Rs.)
c)
Personal Accident for occupants
Do you wish to cover additional rent for alternative Rs. ------------------accommodation as consequent of fire to insured premises?
If so, please indicate the amount for which the coverage is
required? Limit of Indemnity:
The sum(s) produced by multiplying the monthly additional
rent or actual additional rent whichever is lower by
number of months for which the Insured Premises was unfit
occupancy or the maximum indemnity period of 12 months.
The sum insured is the maximum liability of the Company
under this Endorsement.
Monthly Additional Rent:
a)
If the Insured is owner-occupant it is calculated
by dividing 10% of the Sum Insured under Section 1(A)
by 12 (twelve).
b)
If the Insured is tenant, it is calculated by dividing the
25% of the Sum Insured on contents under Section I (B)
by 12.
For Office Use only

Total Premium

Rs._________________

Add: Premium for endorsements No.

Rs._________________

Sub : Total (I)

Rs._________________

Less: Section Discount covering more than ----- sections / endorsements

Rs._________________

Sub Total (II)

Rs._________________

Less: Renewal Discount for --------- Renewal

Rs._________________

Sub-Total (II)
NET PREMIUM

Rs._________________

Note :
1. Section / Renewal Discounts are applicable on all sections / endorsements

405

except Sections, I, III, IV, VIII and Endorsements B.

2. Section I is compulsory. The policy should be taken for a minimum of 5
sections including Section I.
The liability of the company does not commence until the proposal has been accepted by the
company and the full premium paid to the Company.

We hereby declare that the particulars contained herein are true and correct and that no
material fact has been withheld, misstated or misrepresented and also that this proposal
cum schedule forming part of the companys standard policy shall be the basis of contract
between us and the Insurance Company. We further declare that the sum insured herein
represents the full value of the property described herein.

Place :
Date :

Signature of Proposer

406

HOUSE HOLDER'S INSURANCE

House Holder's Insurance Policy is designed to cater to the requirement of the
house holder by combining under a single policy a number of contingencies which are
otherwise covered separately. The policy covers as under:
EXCESS TO BE CHANGED FOR THIS POLICY TOO AS PER FIRE AFTER
CIRCULAR IS ISSUED
SECTION (A) BUILDING OF CLASS 'A' CONSTRUCTION ONLY - AND
SECTION 1(B) CONTENTS:
Against Fire, lightning, explosion of gas in domestic appliances, bursting and
overflowing of Water tanks, apparatus or pipes, air craft or articles dropped therefrom,
riot and strike, Earthquake Fire and/or Shock) malicious act, flood, inundation, storm,
cyclone subsidence and landslide (including Rockslide) damage, impact damage.
SECTION II: BURGLARY, HOUSEBREAKING, LARCENY OR THEFT:Loss of damage to property contained in the premises occupied by the Insured
against the above mentioned perils.
SECTION III :ALL RISK :
Jewellery and Valuables against loss or damage by accident or misfortune whilst
any where in India subject to limits of liability specified in the schedule.
SECTION IV : PLATE GLASS :
Fixed plate glass against accidental damage subject to limit of liability specified in
the schedule.

407

SECTION V: BREAKDOWN OF DOMESTIC APPLIANCES :

Damage caused by and / or solely due to mechanical and /or electrical breakdown
of domestic, electrical or mechanical appliances, apparatus or gadgets.
SECTION VI : T. V. SET :
Loss of or damage to Television Set by fire, lightning, explosion of gas in
domestic appliances, bursting and overflowing of water tanks, aircraft and articles
dropped therefrom, earthquake fire and/or shock, inundation, storm cyclone and like
perils, riot strike or malicious act, burglary or house- breaking or theft, accidental
external means mechanical or electrical breakdown. Legal liability limited to Rs. 25,000
and damage to insured's own property due to collapse of antenna up to Rs.3,000/VCR/VCP can also can be covered under this section.
SECTION VII : PEDAL CYCLES :
Loss or damage due to fire, lighting, external explosion, riot and strike or
malicious act, earthquake, fire and./or shock flood inundation, storm, cyclone and other
like perils, burglary, house breaking and/or theft and or external accident, also legal
liability subject to limit of Rs. 10,000/-.
SECTION VIII : BAGGAGE INSURANCE:
Loss or damage to insureds, accompanied Baggage by accident or misfortune
whilst the Insured is travelling on tour or holiday any where in India.
SECTION X : PUBLIC LIABILITY :

408

Insured's legal liability for bodily injury to or loss of or damage to property of

third party limited to amount specified in the schedule and Workmen's Compensation
liability to domestic servants in the Insured's premises.
MULTI SECTIONAL DISCOUNT :
Section I - B is Compulsory
Where more than 4 and up to 6 sections
(including tariff rated sections)

15% on non-tariff rates only

Where more than 6 Section

(including tariff rated section)

- 20%

-do-

For the purpose of this discount

P.A. Section is to be-treated as non Tariff

EXCLUSIONS :
There are general exclusions which are applicable to all sections. They include
War, Nuclear perils, wear and tear and consequential loss. Special exclusions are
applicable to each separate section.

CONDITIONS :
There are general conditions applicable to all sections. They are related to notice
of loss, misrepresentation, reasonable care of property, claims procedure contribution,
fraud, indemnity, average, arbitration and observance of terms and conditions.
Special conditions are included in case of Sections I, III & VII.

409

CLAIMS :
The liability of the insurer depends upon the due observance of policy conditions
regarding giving notice, lodging police complaint, taking loss prevention measures, and
minimisation measures. Subject to relevant excess and limits of liability as applicable
except in case of P.A. section, this policy is a policy of indemnity and condition of
average is applied. There is also provision for contribution where there are other policies
and arbitration in case of dispute.

410

UNI CARE POLICY (GRIHA RAKSHA)

This policy is similar to the Householders Insurance Policy but is more
comprehensive. There are 4 different fixed sum Insured to choose from. The different
sums Insured are Rs.50,000/-, Rs.75,000/-, Rs.1,00,000/- and Rs.1,50,000/-.
There are six sections under each policy. The insured can choose to insure all the 6
sections, in which case he would be issued the policy A. If the Insured choose to insure
only section 1 to 5, then he would be issued policy B and 4 sections will be covered
under policy C. The premium payable varies depending on the SI and type of policy
chosen and the sections opted for coverage.
SECTION WISE COVERAGE :SECTION I
The section also covers insured's property when removed to another premises for
custody during his absence and for temporary period limited to 90 days in all. Maximum
liability will however be restricted to IO% of the amount in column 4.
SECTION II
Loss damage to the contents whilst contained in insured premises by burglary
housebreaking.
SECTION III
Covers only physical loss/damage due to mechanical/electrical breakdown of
appliances specified. Claims for repair are based on actual cost of repairs incurred while
repairs exceeding or equal to the item's individual value will considered on total loss

411

basis. Settlement of claims on total loss basis will be subject to deduction of 10%
depreciation per year (maximum 50 %)
SECTION IV
If bodily injury by external violent means and caused accidentally shall, within 12
months of such injury, be the sole and direct cause of death or permanent total
disablement of the persons named in column 3, company will pay each such person/ the
amount mentioned in column 4. Permanent total disablement would mean total,
irrecoverable loss of sight of both eyes/ physical loss of entire hands or entire feet/ one
foot and one eye or one eye and one hand / one foot or irrecoverable loss of use of both
limbs.
SECTION V
Covers loss/damage by accident or misfortune to personal baggage of insured or
his family members when they are travelling anywhere in India. Policy will not pay for
(1) items that did not form part of the baggage at the commencement of travel and (ii)
loss/damage of items carried under a waybill, rail receipt etc.
SECTION VI
Covers loss/damage by accident or misfortune whilst anywhere in India, liability
being limited to the sum insured set against such item in the schedule. If damaged item
can be repaired, company will pay expenses necessarily incurred to restore the item to
former state of serviceability.
Does not cover loss/damage to electronic apparatus; loss/damage due to arcing,
self-heating or leakage of electricity or over heating; theft from car except from securely
locked and properly, fastened one; loss/damage while being conveyed under contract of
affreightment.

412

If insured item consists of articles in pair or set the company's liability shall not
exceed the value of any particular part or parts which may be lost or damaged without
reference to any special value which such article or articles may have as part of such pair
or set.
Terms and Conditions
1.

All communications required by this policy shall be in writing to the policy issuing
office.

2.

The insured shall take all reasonable care and precautions to protect the insured
property to prevent all accidents.

3.

The insured shall take due care to describe the insured property. In the event of any
misrepresentation or non-disclosure of material fact or adoption of fraudulent
means to obtain any benefit, the policy shall be void without any refund of
premium.

4.

Cancellation of policy at the option of the insured entails him a refund of premium
at short period scale while the same at the option of the insurer, a pro rata refund
of premium for the unexpired period.

5.

Immediate intimation must be given to the policy issuing office in the event of loss
followed by such other details and documentation as the insurer may require for
processing the claim.

6.

Complaint to Police Authorities is mandatory for loss occurring due to burglary

/housebreaking or attempt thereat, theft, misfortune.

7.

The company shall, at its option, I pay for or reinstate or repair the property up to
the amount specified in the policy or actual loss whichever is less, subject to
substantiation of the loss to the satisfaction of the insurer.

413

8.

All aspects as to arbitration agreement, appointment of arbitrator/s, terms of

reference, award, its effect etc will be in accordance with the provisions of
Arbitration and Conciliation Act, 1996 ( with amendments, if any).

9.

This policy does not cover

a)

loss or damage to fragile' articles such as chinaware, articles made of glass

or materials of brittle nature due to impact.

b)

loss or damage due to war and/or warlike perils, nuclear and/or atomic
radiation.

c)

loss or damage due to wear and tear, gradual deterioration or slowly

developing flaws

d)

consequential loss of any kind

e)

loss of or damage caused by or due to action of any lawfully constituted

authority or government body loss or damage to cash, securities bullion,
stamps, deeds, documents, manuscripts and articles of antique value

g)

loss of valuables due to theft from unattended vehicles.

h)

loss or damage for which the manufacturer or supplier or repairer or

transporter or any other third party is responsible either by law or by
contract

10.

The due observance and fulfilment of the terms and conditions of this policy in so
far as they relate to any anything to be done or complied with by the insured shall
be a condition precedent to any liability of the company to make any payment
under this policy.
The premium payable varies depending on the SI and type of policy chosen and

the sections opted for coverage. The details of the SI, premium are as detailed.

414

Schedule (Policy-A/B/C)
Name of the insured
Full address of the insured
Premises
Period of insurance
Premium Paid
Rt No..........dt .................

:
:
:
:

Policy Coverage Premium (Rs)

A Sec I to VI
700
B Sec I to V
325
C Sec I to IV
300

Section

What is insured

Against what?

1
I.

2
Building including
compound wall, elec.
fixture, other interlors
fixtures, owed by
insured solely / partial
occupied

II.

Contents : Furniture,
fixture fittings,
Household goods
including domestic
appliances (mentioned
in section III)

3
Fire, lighting,
explosion of gas in
domestic
appliances, riot,
strike or malicious
act, terrorist act
earthquake storm,
tempest flood,
inundation
Same as Section I
above and Burglary
House breaking

III.

Breakdown of
domestic mentioned
below
1. Refrigerator
2. Grinder
3. TV / VCR / VCP
4. Music system
5. Domestic
6. Mixie
7. Geyser
8. Vacuum Cleaner
9. Air Conditioner
10. Computer
11. Microwave oven

Max.
What is not insured?
amount
4
5
50,000 Loss of or damage to
motor vehicle and
pedal cycles mone
securities, bullion
bills of exchange.
Business books, unset
precious stones.

75,000 Same as Section I

above plus loss /
damage burglary
where any employee
of the insured or
member of the
insured family is
concerned.
Make year of Mfg. Repairs,
Wilful act or gross
S. No.
Rs.5,000 negligence existing
Any one faults; loss or damage
year for all for which
items total manufacturer /
supplier responsible;
Loss :
Rs.10,000/ wear & tear, transport
cost to repair shop
- for all
items any and back; loss
one year. damage by perils
insurable under other
sections; requirement
or confiscation by the
state.

415

12. Washing Machine

Personal Accident
Death, Permanent
Total Disablement
(PTD) for the
following persons.
1. Sex : Age
2. Sex : Age
3. Sex : Age
4. Sex : Age

V.

Personal baggage
During travel any
accompanying insured where in India

Valuables like
jewellery, watches,
camera.

All risk cover

416

25,000
Compensation more
per person than one benefit
(death PTD) in
respect of the same
period of disablement
intentional self injury,
attempted suicide
whilst under the
influencing
intoxicating drugs,
liquor death / PTD
resulting from child
birth / pregnancy.
2,500/Cracking, scratching
of China marble
articles of brittle
nature, money deeds
travel tickets cheques
articles of
consumable nature.
50,000
Cracking, scratching
breakage of and
glasses mechanical
derangement over
winding of watches.

Name of the insured

Full address of the insured
Premises
Period of insurance
Premium Paid
Rt. No. ................. dt........

:
:
:
:
:
:

Policy Coverage Premium (Rs.)

A Sec I to VI

1000

B Sec I to VI

450

Sec I to IV

425

Selection

What is Insured

Against what

1
I.

2
Building including
compound wall, elec.
fixture, other interlors
fixtures, owed by
insured solely / partial
occupied

II.

Contents Furniture,
fixture fittings,
Household goods
including domestic
appliances
(mentioned in section
III)

3
Fire, lighting,
explosion of gas
in domestic
appliances, riot,
strike or
malicious act,
terrorist act
earthquake
storm, tempest
flood,
inundation
Same as Section
I above and
Burglary House
breaking

III.

Breakdown of
Make year of
domestic mentioned Mfg. S. No.
below
1. Refrigerator
2. Grinder
3. TV / VCR / VCP
4. Music system
5. Domestic
6. Mixie
7. Geyser
8. Vacuum Cleaner
9. Air Conditioner
10. Computer
11. Microwave oven
12. Washing Machine

417

Max.
What is not
Amount
insured?
4
5
5,000 Loss of or damage to
motor vehicle and
pedal cycles mone
securities, bullion
bills of exchange.
Business books,
unset precious
stones.

75,000 Same as Section I

above plus loss /
damage burglary
where any employee
of the insured or
member of the
insured family is
concerned.
Repairs,
Wilful act or gross
Rs.7,500 negligence existing
faults; loss or
Any one
year for all damage for which
items total manufacturer /
supplier responsible;
Loss :
Rs.15,000/ wear & tear,
transport cost to
- for all
items any repair shop and back;
one year. loss damage by perils
insurable under other
sections; requirement
or confiscation by
the state.

V.

Personal Accident

Death,
30,000
Permanent Total per person
Disablement
(PTD) for the
following
persons.
1. Sex : Age
2. Sex : Age
3. Sex : Age
4. Sex : Age

Personal baggage
accompanying
insured

During travel
any where in
India

2,500/-

Valuables like
jewellery, watches,
camera.

All risk cover

75,000

418

Compensation more
than one benefit
(death PTD) in
respect of the same
period of
disablement
intentional self
injury, attempted
suicide whilst under
the influencing
intoxicating drugs,
liquor death / PTD
resulting from child
birth / pregnancy.
Cracking, scratching
of China marble
articles of brittle
nature, money deeds
travel tickets cheques
articles of
consumable nature.
Cracking, scratching
breakage of and
glasses mechanical
derangement over
winding of watches.

Name of the insured

Full address of the insured
Premises
Period of insurance
Premium Paid
Rt. No. ................. dt........

:
:
:
:
:
:

Policy Coverage Premium (Rs.)

A Sec I to VI

1300

B Sec I to VI

550

Sec I to IV

525

Selection

What is Insured

Against what

1
I.

2
Building including
compound wall, elec.
fixture, other interiors
fixtures, owed by
insured solely / partial
occupied

II.

Contents Furniture,
fixture fittings,
Household goods
including domestic
appliances
(mentioned in section
III)

3
Fire, lighting,
explosion of gas
in domestic
appliances, riot,
strike or
malicious act,
terrorist act
earthquake
storm, tempest
flood,
inundation
Same as Section
I above and
Burglary House
breaking

III.

Breakdown of
Make year of
domestic mentioned Mfg. S. No.
below:
1. Refrigerator
2. Grinder
3. TV / VCR / VCP
4. Music system
5. Domestic
6. Mixie
7. Geyser
8. Vacuum Cleaner
9. Air Conditioner
10. Computer
11. Microwave oven
12. Washing Machine

419

Max.
What is not
Amount
insured?
4
5
1,00,000 Loss of or damage to
motor vehicle and
pedal cycles mone
securities, bullion
bills of exchange.
Business books,
unset precious
stones.

1,00,000 Same as Section I

above plus loss /
damage burglary
where any employee
of the insured or
member of the
insured family is
concerned.
Repairs,
Wilful act or gross
Rs.10,000/- negligence existing
faults; loss or
Any one
year for all damage for which
items total manufacturer /
supplier responsible;
Loss :
Rs.20,000/- wear & tear,
for all items transport cost to
repair shop and back;
any one
loss damage by perils
year.
insurable under other
sections; requirement
or confiscation by
the state.

V.

Personal Accident

Death,
30,000
Permanent Total per person
Disablement
(PTD) for the
following
persons.
1. Sex : Age
2. Sex : Age
3. Sex : Age
4. Sex : Age

Personal baggage
accompanying
insured

During travel
any where in
India

2,500/-

Valuables like
jewellery, watches,
camera.

All risk cover

1,00,000

420

Compensation more
than one benefit
(death PTD) in
respect of the same
period of
disablement
intentional self
injury, attempted
suicide whilst under
the influencing
intoxicating drugs,
liquor death / PTD
resulting from child
birth / pregnancy.
Cracking, scratching
of China marble
articles of brittle
nature, money deeds
travel tickets cheques
articles of
consumable nature.
Cracking, scratching
breakage of and
glasses mechanical
derangement over
winding of watches.

Name of the insured

Full address of the insured
Premises
Period of insurance
Premium Paid
Rt. No. ................. dt........

:
:
:
:
:
:

Policy Coverage Premium (Rs.)

A Sec I to VI

2000

B Sec I to VI

825

Sec I to IV

800

Selection

What is Insured

Against what

1
I.

2
Building including
compound wall, elec.
fixture, other interiors
fixtures, owed by
insured solely / partial
occupied

II.

Contents Furniture,
fixture fittings,
Household goods
including domestic
appliances
(mentioned in section
III)

3
Fire, lighting,
explosion of gas
in domestic
appliances, riot,
strike or
malicious act,
terrorist act
earthquake
storm, tempest
flood,
inundation
Same as Section
I above and
Burglary House
breaking

III.

Breakdown of
Make year of
domestic mentioned Mfg. S. No.
below
1. Refrigerator
2. Grinder
3. TV / VCR / VCP
4. Music system
5. Domestic
6. Mixie
7. Geyser
8. Vacuum Cleaner
9. Air Conditioner
10. Computer
11. Microwave oven
12. Washing Machine

421

Max.
What is not
Amount
insured?
4
5
1,50,000 Loss of or damage to
motor vehicle and
pedal cycles mone
securities, bullion
bills of exchange.
Business books,
unset precious
stones.

1,50,000 Same as Section I

above plus loss /
damage burglary
where any employee
of the insured or
member of the
insured family is
concerned.
Repairs,
Wilful act or gross
Rs.10,000/ negligence existing
faults; loss or
damage for which
Any one
year for all manufacturer /
items total supplier responsible;
wear & tear,
Loss :
Rs.25,000/ transport cost to
repair shop and back;
- for all
items any loss damage by perils
one year. insurable under other
sections; requirement
or confiscation by
the state.

V.

Personal Accident

Death,
50,000
Permanent Total per person
Disablement
(PTD) for the
following
persons.
1. Sex : Age
2. Sex : Age
3. Sex : Age
4. Sex : Age

Personal baggage
accompanying
insured

During travel
any where in
India

2,500/-

Valuables like
jewellery, watches,
camera.

All risk cover

1,50,000

422

Compensation more
than one benefit
(death PTD) in
respect of the same
period of
disablement
intentional self
injury, attempted
suicide whilst under
the influencing
intoxicating drugs,
liquor death / PTD
resulting from child
birth / pregnancy.
Cracking, scratching
of China marble
articles of brittle
nature, money deeds
travel tickets cheques
articles of
consumable nature.
Cracking, scratching
breakage of and
glasses mechanical
derangement over
winding of watches.

PROPOSAL FORM FOR "'GRHIHA RAKSHA"

(Only premises of Class "A' construction)
1.

Name & address of the Proposer

2.

Address of the premises to be insured with

construction details with value

3.

Do you wish to insure compound wall,

electrical fittings, interiors and fixtures?

4.

Please attach a list of contents including

domestic appliances (In case of domestic
appliances SI.NO. make etc., should be
mentioned)

5.

Do you wish to cover your valuables like

jewellery, watches & Camera against all risk
covers?

6.

Do you wish to insure your baggage during

travel?

7.

Please give the details like Name, Age, Sex

of persons to be covered under P.A. Section
with nominees details (Name, relationship
etc.,)

I/ we declare that the above answers are true to the best of my/our knowledge and belief,
that, I/We have disclosed all particulars affecting the assessment of the risk. I/We agree
that this proposal and declaration shall be the basis of the contract between me/us and the
company.
Date:
Place:

Signature of Insured

423

UNI HOME CARE POLICY

This policy is developed for the benefit of home financiers like bank or financial
institution who are making home finance. The policy is having two sections. Sec I covers
building against fire and allied perils and Sec II covers the borrower against death due to
accident and is meant to protect the financial interest of the financial company against
loss / damage to the property or death of the borrower. The minimum period of cover
would be 3 years.
ELIGIBILITY:
A Financial Institution engaged in providing Housing loan.
SCOPE OF COVER:
SECTION I
The Insurance Company will indemnify the insured to the extent of his interest in the
financial property at the time of the loss in case the property is lost / damaged due to the
perils mentioned below:
I.

Fire

II.

Lightning

III.

Explosion/Implosion:

IV.

Aircraft Damage:

V.

Riot, Strike, Malicious and Terrorism Damage

VI.

Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Flood, Inundation and

Earthquake Fire and Shock:

VII.

Impact Damage:

424

VIII. Subsidence and Landslide including Rock slide:

IX.

Bursting and/or overflowing of Water Tanks, Apparatus and Pipes

X.

Missile Testing Operations

XI.

Bush Fire
SECTION II
PERSONAL ACCIDENT DEATH ONLY COVER
UNDERWRITING GUIDELINES

1.

This policy may be offered for Home Financial Institutions.

2.

Duly Completed proposal form to be obtained from the proposer / insured.

3.

Policy may be issued for a minimum period of three years and a maximum period
of 15 years.

4.

The premium has to be charged according to the premium table provided, service
tax and surcharge on terrorism are extra.

5.

Agency commission is payable at 5% of the premium collected.

6.

The department No. is 46 and class code No. is 29 for this product.

7.

For issuing master policy the operating office may enter and MOU with the
Financial Institution only after obtaining approval from the Head office.

425

PROPOSAL FOR UNI HOME CARE POLICY

1. Name of Proposer / Financier
2. Address of the proposer / Financier
3. Details of Borrower / person to be insured:
a) Name of the Person to be insured / Borrower
b) Date of Birth / Age
c) Residential / Permanent Address
d) Occupation / Business (Please describe fully) of
the person to be insured
e) Does the occupation requires to engage in manual
labour.
f) Has the Person to be insured /borrower suffered or
suffer from any physical defect or disability.
g) What is the Average Monthly Income of the person to
be insured.
4

Details of property to be insured:

Please state material used for

a) Address of the house property to be insured such as

house no, street name, city, pin code etc.

a.

Walls ----------------

b) Type of construction.

b.

Roof -----------------

c) Occupation of the premises

c.

Floor ---------------

Total Amount of Loan disbursed:

Sum Insured :

1. Building against Fire and Allied perils.

Rs.

2. Person / Borrower against death due to accident.

Rs.

Period of Insurance

From

426

To

I / We hereby declare that the details furnished above are true to the best of my / our
knowledge and belief and I / we hereby agree that this declaration shall form the basis of
the contract between me / us and the Company.
Date:
Place:
SIGNATURE OF INSURED PERSON

SIGNATURE OF PROPOSER
(BANK)

ASSIGNMENT
I ______________ do hereby assign the moneys payable by the United

India

Insurance Co.Ltd. In the event of my death to ___________________ (Name of the

Financial Institution) and I further declare that their receipt shall be sufficient discharge
to the Company.
Date:

SIGNATURE OF THE PERSON TO BE

INSURED/BORROWER

Place:
Witness:
Signature:
Name:
Address:

SIGNATURE OF THE PROPOSER

(FINANCIAL INSTITUTION)

427

PROHIBITION OF REBATES:
The following is an extract of Section 41 of Insurance Act 1938
(1)

No person shall allow or offer to allow either directly or indirectly as an

inducement to any person to take out or renew or continue an insurance in
respect of any kind of risk relating to lives or property in India any rebate of the
whole or part of the commission payable or any rebate of the premium shown on
the policy nor shall any person taking out or renewing or continuing a policy
accept any rebate except such rebate as may be allowed in accordance with the
prospectus or tables of the Insurers.

(2)

Any person making default in complying with the provisions of this section shall be
punishable with fine which may extend to one hundred rupees.

CLAIM FORM FOR UNIHOME CARE POLICY

Policy No.

Claim No.

Name and address

(financier / Bank)

of

the insured

Address of the Insured

Name of the Insured person / borrower

a)
b)

Permanent Address of the Insured person /

borrower
Address of the house property.

a)
b)

Occupation of the Insured person / borrower

Age / Date of birth

Period Insurance

Total Amount of Loan Disbursed to this borrower

Sum Insured : A)
B)

House
Person

428

Amount of Loan outstanding as on date of loss /

accident.

10

If claim is made for loss on house property:

a) Date and time of loss
b) Cause / Nature of Loss
c) Has the loss has been reported to fire
brigade / police? If so give details If not
give reasons for the same.
d) Extent of Loss (Complete details)

11

If the claim is made for accidental death of

insured person / borrower:
a) Date and time of accident
b) Place of accident
c) Full description of accident
d) Name & Address (s) of witness to accident
e) Was the deceased free from infirmity at the
time of accident? If not give particulars.
f) Was the deceased under the influence of
drugs or drink at the time of accident?

g)

h)
i)

j)

Was the deceased under any law

breaking activity with criminal intent at
the time of accident?
Is the claimant satisfied that the death
was directly due to the accident.
Give the name and address of the
Hospital / Nursing where the deceased
was treated after the accident.
Please enclose the originals of
i.
Death certificate
ii.
Postmortem Certificate
iii. FIR / Panchanama relating to
accident

We / I confirm that the above facts / statements are correct to the best of our knowledge
and belief.

429

Signature of the Insured person/Nominee

PLACE:
Signature of Insured
Official of financial institution.
DATE:

430

WEDDING BELLS POLICY

This policy is intended to cover loss of cost of material and expenses incurred due to
postponement / cancellation of marriage caused by one or more factors detailed below.
Loss or damage to property, own / hired, legal liability to third party personal injury /
property damage are also covered.
CAUSATIVE FACTORS :
postponement / stoppage / cancellation of marriage due to :
1.

Impossibility of groom / bride to reach venue due to stranding of train and / or

non-availability of road conveyance or local law and order problem

2.

Death of near ones / Boy / Girl due to accident

3.

Police action of arrest / search of marriage party for reason other than child
marriage or criminal Act/s or any commission / omission by any member of the
house hold of bride bridegroom.

4.

Damage to the marriage hall by acts of negligence of insured, his servant, member
of his household or any member of the marriage party or contents therein by fire,
lightning domestic explosion, RSD, terrorism AOG perils.

5.

Burglary of jewellery, valuables of the insured (including wedding suits, wedding

saris, silver articles) presentation / gifts articles etc.,

431

COVERAGE (ANYWHERE IN INDIA)

Policy provides for making good
I

(a) Expenses actually and already incurred/advances paid in connection with

marriage hall, cooks, catering, purohits, pandits, beauticians, decorators,
accommodation reserved for bride / bridegroom / guests, music parties, photos /
videography, entertainment programs.
b)

Cost of consumable which can neither be returned nor used after a lapse of time.

(c) Loss on cancellation of travel tickets, forfeiture of caution / security deposits.

Liability

is

restricted

only

when

such

cancellation

arises

out

of

cancellation/postponement of marriage itself due to any of the causes mentioned

above.
II. Loss of property at marriage hall due to perils 4 & 5 mentioned above for which
insured is liable.
III. (a) Legal liability of the insured for W.C liability
(b) Third party liability of insured arising out of functions at the marriage hall
TPPD/TPPI
PERIOD OF INSURANCE :
24 hours prior to the commencement of the customary functions / rituals or programme of
events mentioned in the printed invitations till the end of function or 5 days from the
commencement, which ever occurs earlier
SUM INSURED :
1.

Break up of expenses incurred / estimate has to be produced in advance at the time

of proposal along with particulars of parties, ( groom and bride ) the venue of

432

function, copies of invitations, proposed outlay under major headings with

particulars of advances, if any, paid on the date of proposal. Condition of average
applicable
2.

Property taken / to be taken on hire value of jewellery, silver articles, costly items
like wedding suits, wedding saris, bridal. sets etc.,

3.

Legal liability limits for TPPD / TPPI (per person)

NOTE :
(a)

Any one item exceeding in value 5% of sum insured under any subsection under
section I and II has to be declared specifically.

(b)

Policy is, at present, to be issued for overall sum insured not exceeding Rs.25
lakhs.

GENERAL EXCLUSIONS :
This insurance does not cover loss or damage arising due to:
1)

Dispute between the marriage parties (bride and groom) for any reasons
whatsoever

2)

Criminal acts, violation of law, child marriage, marriage under duress.

3)

Wilful negligence, loss by theft, larceny or unexplained loss.

4)

Criminal misconduct of the bride / bridegroom, parents of the prospective

couple or any loss / damage involving the insured family member or
member of insured's household or employees

5)

Insolvency, impersonation or attempt thereat, acts of commission /

omission, under influence intoxicating liquor, drugs.

6)

War group of perils

7)

Nuclear perils, radioactivity

433

8)

Contractual liability, pollution liability, liability arising out of food

poisoning

9)

Consequential loss of any kind whatsoever.

CONDITIONS:
1.

All possible recoveries, including refund of caution / security deposits should be

pursued, realised and deducted from the amount claimed. All efforts to minimise
loss should be taken including engagement of the priests, caterer, videographer,
music parties etc., on alternative days.

2.

Cost of items lost / damaged, expenses incurred, securities / deposit advances

which are lost / forfeited are to be reimbursed only on production of documentary
evidence such as receipts, vouchers etc.,

3.

Rate Of Premium:
Section I Expenses

0.50 %o. on Sum Insured

Section II Property Damage

2.75 %o on Sum Insured

Section III Liability

3.25 %o on per' period figure

Plus Service Tax

434

FILM PRODUCTION INSURANCE POLICY

A Film Production Insurance (FPI) package consists essentially of the following
constituent parts :EXTENDED PRE-PRODUCTION :
This policy indemnifies the Production Company in the event that they need to protect
their finances in the development of a project which involves key named personnel e.g.
famous director, producer, director of photography & /or major artist without whom, in
the event of a serious injury, illness or death, they would have to delay or even abandon
the project.
PRE-PRODUCTION AND CAST INSURANCE :
This policy indemnifies the Production against additional production costs or
abandonment incurred in the event of serious injury, illness or death of key named
personnel e.g. director, producer, director of photography &/or number of key artists
during the period of Principal Photography plus, in most cases, a period prior to tile first
day of Principal Photography. e.g. director, director of Photography, number of key
artistes.
There are Optional Extensions to Pre-Production and Cast as follows
1.

Family Bereavement, which covers the cost of down time incurred duty to an
insured person having to leave the project as a result of the death of a family
member.

2.

Essential Elements, which covers the Production Company in the event that their
financier recalls its funding due to an 'essential' artiste no logger being involved in
tile project due to serious injury, illness or death, 'essential' being regarded as one
without whom the financier would not have agreed to finance tile project.

435

Both 'Extended Pre-Production and Pre-Production and Cast Insurance require the
insured key personnel to attend a medical examination by unapproved doctor. Until such
medical is approved cover on an 'accidental only' basis can be given.
NEGATIVE/FAULTY STOCK, CAMERA AND PROCESSING INSURANCE
This policy indemnifies, the Production Company against additional Production costs/reshoot costs incurred due to the loss or, or damage to raw stock and exposed film,
including sound stock or sound recordings.
PROPS, SETS & WARDROBE
This policy provide the Production Company with 'All Risks' cover for props, sets and
wardrobe items whether owned, hired or on loan whilst under their care, custody or
control.
MISCELLANEOUS EQUIPMENT
As with Props, Sets and Wardrobe, this policy provides the Production Company with
'All Risks' cover in respect of all camera, sound, 'electrical and other equipment whether
owned, hired or on loan whilst under their care, custody or control.
THIRD PARTY PROPERTY DAMAGE
This policy protects the Production Company against legal liabilities for loss of or
damage to Third Party Property whilst under their care, custody or control. This policy
includes loss of use/hire charges which the Production Company may be charged by the
suppliers due to such suppliers not being able to further hire such equipment whilst it is
undergoing repair / awaiting replacement.

436

EXTRA EXPENSE
This policy provides indemnity in the event of essential props, sets, wardrobe, equipment
or facilities being damaged or destroyed therefore resulting in increased production costs.
This policy is similar to Cast Insurance but relates to property as opposed to key
personnel.
MONEY INSURANCE
This policy provides cover for all monies being handled by the Production Company, in
transit and/ or on their business premises for use on the project.
COMMERCIAL VEHICLE PHYSICAL DAMAGE
This policy protects the Production Company against accidental dialogue, fire and theft
incurred to action and facility vehicles which they arc using on the project and for which
they are responsible. Cover under this heading excludes Passenger and Third Party
Liability.
OFFICE CONTENTS
This policy provides the Production Company with 'All latest' cover in respect of all
office contents owned / hired / on loan due to their having to set up temporary offices to
work on the project.
All above types of coverage form what is termed a Film Production Package and are
insured under one policy with the various limits and deductible stated therein.
In addition the following covers may on occasions be required. Employers and Public
Liability (or equivalent ) are exceptions to this as they invariably need to be placed
preferably in the local market)

437

EMPLOYERS LIABILITY / WORKMENS CORPORATION

This policy protects the Production Company against any legal liability for bodily injury,
death, disease or illness of an employee (including freelance personnel and artists
involved in project) whilst under their employ.
PUBLIC LIABILITY / GENERAL LIABILITY
This policy protects the Production Company in respect of its legal liability to pay
damages or compensation to third parties arising out of its negligence.
FOREIGN UNIT, TRAVEL INSURANCE
In accordance with any Film Union Agreements Internationally which operate a
Production Company is obliged to insure all personnel travelling in connection with the
project. This policy usually includes a certain amount for Personal Accident, Temporary
Life, Sickness, Medical Expenses, 'Baggage and Personal Money.
ERRORS & OMISSIONS
This policy indemnifies the Production Company and / or other Insured named on the
policy for claims arising from libel, slander, definitively, plagiarism, Infringement of
copyright, invasion of privacy, incorrect use of formats, ideas and titles.

438

ALL RISK INSURANCE COVER TO FILM PRODUCERS

CAST INSURANCE
SCOPE OF COVER

SPECIAL CONDITIONS

EXCLUSIONS

Reimbursement of any
extra cost incurred to
complete principal
photography of an insured
production over and above
the declared ormal
budgeted cost due to death,
disability injury or sickness
or kidnapping of any
insured person.

Insured and must take a

physical medical
examination from a duly
qualified physician
approved by the company
at their cost not more than
21 days prior to the
declared production.

Loss caused by insured

person taking part in any
hazardous job, flying (other
than as a passenger),
pregnancy, allergy, children
below 6 years, loss of
money paid as ransom for
kidnapping

NEGATIVE FILM AND

VIDEO TAPE
All risk or direct physical
loss of or damage to raw
film or tape stock, exposed
film (developed or
undeveloped) recorded
video tape, sound trailers
and tapes loss determined.
Based on extra cost
incurred in compelling the
insured production.

a. U processed film will not

be accumulated in excess of
3 shooting days / 5
consecutive days:

Intrioration, Atmosphere
changes, charges in
temperature, errors in
judgement in exposure.
Delay in delivery.

b. Warranted that
equipments are fully tested.
c. Any transfer from
negative should be done
after a production print of
negative.
d. Arts drawings to be
preserved until completion.

PROPS, SETS AND

WARD ROBE
Coverage on propos, sets
scenery, costumes, and
similar property against all
does of direct physical loss
damage or destruction
during production

Coverage under this section

is not available. To
equipments, permanent
buildings, furnitures and
fixtures aircraft film, tapes,
jewellery and antiques
(over a limit

a. inherent vice,
insects,vermin damages,
extreme weather,
evaporation, rust
contaminator, leakage,
breakdown, wear and tear
defects.
b. B. While actually worked
upon while undergoing

439

construction.
c. Shortage during
inventory.
d. Short circuit, failure
unless followed b), fire
(and the loss due to fire
only covered)
MISCELLANEOUS
EQUIPMENT
Covers against damage due
to external cause for owned
or rented equipment to
production. Coverage can
be extended to mobile
equipment.

Cover commences and

expires as stated in the
declaration probs, sets,
aircrafts, vehicles,
permanent building
excluded.

a. Inherent vice, insects

vermi damages extreme
weather, evaporation l'ust
contamination, leakage,
breakdown wear and tear
defects.
b. While actually worked
upon while undergoing
construction.
c. Shortage during
inventory.
d. Short circuit, failure
unless followed b) fire (and
the loss due to fire only
covered)
Theft from unattended

THIRD PARTY
PROPERTY DAMAGE
LIABILITY
Damages for destruction of
property of others including
use of property while the
property is in the care.
Custody or control of
production.

a. Liability under MV Act

excluded.
Defence costs are
reimbursable even if the
allegations are groundless
false fraudient.

b. Damage to buildings
other than for production
(eg. Living quarters)
c. Loss of injury to animals.

440

EXTRA EXPENSES DUE

TO INTERRUPTION
Reimbursement the
Perils covered against all
production company for
risk from any external
any extra expenses
cause.
necessary to complete
principal, photography of
insured production due to
loss of damage to
destruction of property /
facilities used in connection
with the production.
Coverage includes losses
due to faulty generated /
mechanical breakdown of
camera.
OFFICE CONTENTS
Covers business personal
property including
furniture, equipment
fixtures, against all risk at
physical loss or damage
including tenants
improvement and
betterments.

Antiques, film not covered.

MONEY INSURANCE
Money in safe / strong
room in transit including
held at outstation location.

Single carrying limit to be

specified. Warranty on
keeping cash at outstation
location.

Standard exclusion of
money policy.

PERSONAL ACCIDENT
Cover to named person and a. The sum assured will be
unnamed person involved limited.
in production.
b. Can be extended to cover
medical expenses.

441

Standard exclusion of PA
policy.

GENERAL
COMMERCIAL
LIABILITY
Cover against claims and
bodily injury or property

a. Filming permit
b. Liability includes legal
costs.

a. Aircraft, vehicle damage

arising out of public
liability policy.
b. Standard exclusions
filming a picture.
c. Insures own property
under care and custody.
d. Garden /plant life.
e. Liability at foreign
countries.
f. any hazardous stunt.

PRODUCER LIABILITY
(ERRORS AND
OMISSION
Similar to D & O policy
Covers legal liability and
defence for production
company against law suits.
Alleging unauthorized use
of title formats ideas,
characters, plots. Unfair
competition or piracy,
breach of contract. Also
protects for alleged libel
slander defamation of
character or invasion of
privacy.

442

Similar to D & O policy

BANKERS INDEMNITY INSURANCE POLICY

SCOPE OF THE POLICY
This insurance is intended to provide an indemnity to the Bank in respect of the following
risks:
a.

ON PREMISES
By reason of any money and/or securities lost, destroyed or otherwise made away
with by fire, riot and strike, burglary or house-breaking or theft, robbery or holdup, whether within the premises or outside. Loss due to the above are payable
whether it is caused by the employees of the Insured or other persons.

b.

IN TRANSIT
By reason of any money or securities being lost, stolen, misappropriated or made
away with, whether due to negligence or fraud -of the employees of the insured or
otherwise, whilst in transit in the hands of such employees The risk of transit will
commence from the, moment the same is received by the - employee on behalf of
the insured and to continue until delivery thereof at destination. A separate cash in
transit policy cannot be issued unless such transits are occasional in nature.

C.

FORGERY OR ALTERATION
By reason of payment made in respect of bogus, fictitious, forged or raised
cheques and/or draft and genuine cheques, drafts and/or Fixed Deposit receipts,
Travellers cheques and/or Gift cheques issued by the Insured, bearing forged
endorsement or the establishment of any credit to any customer on the faith of
such documents whether received over the counter or through the Clearing Houses
or by mail. Bills of discount and other Credit facilities are excluded.

443

d.

DISHONESTY
By reason of dishonesty or criminal act of the employees of the Insured with
respect to loss of Money and/or Securities whether committed singly or in
connivance with others.

e.

HYPOTHECATED GOODS
By reason of fraud or dishonesty by the employee(s) of the insured with respect to
any goods and/or commodities pledged or hypothecated to the Insured and under
the Insured's control.

f.

REGISTERED POSTAL SENDINGS

By reason of loss by robbery, theft or by other cause not herein excepted whilst in
direct transit or intended to be despatched by Registered Insured Post from the
Office of the Insured to the consignee provided that each post parcel shall be
insured with Post Office. However, the Company's liability for anyone
consignment and/or loss is limited to 1 0% of the basic Sum Insured or
Rs.1,00,000/-which ever is lower.

g.

APPRAISERS
By reason of any infidelity or criminal acts on the part of Appraisers, provided that
such Appraisers are in the approved list of Appraisers maintained by the Insured
and further provided that the Insured shall exercise reasonable precaution and
safeguards in the selection and appointment of such Appraisers.
However, the Company's liability for any one loss or all losses during the period of
insurance due to infidelity or criminal acts of each of such Appraisers will be
limited to 5% of the basic sum Insured under this policy or Rs.50,000/- whichever
is lower.

444

h.

JANATA AGENT / CHHOTIBACHAT YOJNA AGENTS / PYGMY

COLLECTORS
By reason of infidelity or criminal act on the part of the Janata agent/ Chhoti
Bachat Yojna agents/Pygmy collectors or persons performing duties of a like
nature provided that such agents are regular part-time commercial agents of the
bank and are appointed after full scrutiny about their credentials guaranteed by
two independent persons. However, the total liability during the period of
insurance in respect of each of such agent will be limited to 5% of the basic sum
insured under this policy or Rs.20,000/-whichever is lower.

EXCLUSIONS
The Company shall not be liable in respect of :a.

Any loss or damage occasioned by on through or in consequence whether

directly or indirectly by any of the following occurrences.
i.

Earthquake, volcanic eruption, subterranean fire or any other

convulsion of nature

ii.

Flood, inundation, hurricane, typhoon, storm, tempest, tornado,

cyclone or atmospheric disturbance (not applicable to mobile
offices)

iii.

War, invasion, act of foreign enemy, hostilities or war-like operation

(Whether war be declared or not), civil war.

iv.

Mutiny, military or popular rising, insurrection, rebellion, revolution,

military or usurped power, martial law or state of siege or any of the
events or causes which determine the proclamation or maintenance
of martial law or state of siege.

v.

Trading loss. Any loss happening during the existence of abnormal

conditions (whether physical or otherwise) which are occasioned by

445

in consequence, directly or indirectly of any of the above said

occurrence shall be deemed to be loss which is not covered by this
policy except to the extent that the insured shall prove that such loss
happened independently of the existence of such abnormal
conditions.
b.

Losses resulting wholly or partially from the wrongful act or default of any
Directors or Partners of the Insured other than salaried.

c.

Loss of any Money and / or securities and/or personal property confined to

the care of the Insured, the nominal value and description of which have
been ascertained by the Insured before loss.

d.

Losses resulting directly or indirectly from trading, actual or fictitious,

whether in the name of the insured or otherwise and whether or not within
the knowledge of the Insured and not withstanding any act or omission on
the part of any employee in connection therewith or with any account
recording the same.

e.

i.

Loss, destruction of or damage to any property whatsoever or any

loss or expense whatsoever resulting or arising there from or any
consequential loss.

ii.

Any legal liability of whatsoever nature, directly or indirectly caused

by or contributed to by or arising from ionising radiation or
contamination by radioactivity from any source whatsoever or from
nuclear weapons material.

f.

Losses attributable directly or indirectly to a manipulation or faulty

computer programme by the employees or outsiders, irrespective of
whether the Computer belongs to the Insured or it is shared by the Insured
with others on serving contract basis.

446

g.

Losses due to any acts or omissions committed by the concerned employees

after the discovery of a loss in which the said employee (s) was involved.

h.

EXCESS. Insured shall bear the first 25% of each loss under items 'A' to 'E'
or 2% of the basic Sum Insured whichever is higher, but not exceeding
Rs.50,0001/- Each loss in respect of each dishonest or criminal act shall be
treated as a separate loss. This excess will however not apply to loss or
damage arising out of Fire, Riot & Strike, Burglary and House-breaking
risks.

In respect of items F.G. & H of the policy (i.e. Registered Postal sending, Appraisers and
Janata Agents etc.) the deductible applicable will be 25% of the claim amount.
Note : It is not permissible to waive or reduce the deductibles even by charging extra
premium.
PREMIUM RATES :
Premium rates for this insurance are governed by the tariff guidelines.
It is based on the basic sum insured and the number of employees. Employees
mean all persons full time or part time and includes apprentices, deposit collectors but
excludes directors and partners.
i.

One the basic sum insured

Rate is 6%

ii.

Rate for staff (employees) lakhs Rs.10/- per employee

and upto Rs.2 lakhs
Sum insure exceeding Rs.2 lakhs Additional Rs.1.25 per employee
and upto Rs.5 lakhs
for each lakhs or part thereof.
Sum insured exceeding Rs.5 Additional Rs.0.60 per employee
lakhs and upto Rs.10 lakhs
for each lakh or part thereof.
Sum insured above 10 lakhs

Additional Rs.0.25 per employee

447

for each lakh or part thereof.

Aggregate
employee

premium

per Staff strength x rate computed on

the above basis.

The staff strength (No. of employees) declared by the Insured as at the end of the
previous financial year shall be increased by 5 % before calculating the premium. Total
premium to be charged is (i) + (ii).
Extra Premium for additional limits :For Additional limits in respect of covers under Sections A and B, in addition to the Basic
Sum Insured limit, additional premium' should be charged at a flat rate of 1 % on the
additional sum insured under Section A and B separately.
Discount for Branches as per the following table may be allowed.
No. of Branches

Discounts

01 to 50

20%

51 to 1 00

15%

101 to 250

10%

251 to 500

05%

Above 500

Nil

This discount is applicable also on the extra premium for additional limits.
Cover against the perils of Flood Risk :This can be granted by charging 2 1/2% on the total premium. However the
Branch discount will not be allowed on the premium for flood risk.

448

SHORT PERIOD RATES :For any period not exceeding 1 month

25%

Exceeding 1 month but not 2 months

37 1/2%

Exceeding 2 month but not 3 months

50%

Exceeding 3 month but not 4 months

62 1/2%

Exceeding 4 month but not 5 months

75%

Exceeding 5 months

100%

UNDERWRITING GUIDELINES:The completed proposal form is examined with particular reference to previous
claims experience. Particularly the premium for this insurance depends upon limit of
indemnity chosen and the total number of staff. The following are some of the important
provisions of the Tariff guidelines.
1.

In respect of any alteration or extension on the Standard Cover it is necessary to

obtain permission from the controlling office before acceptance.

2.

This policy will apply to all Indian branches of the banks in India only. Foreign
Banks in India may be allowed to cover all their Indian branches only.

3.

All policies shall commence and end as per the financial year of the bank. For the
first year of insurance, if the insurance commences from a date other than the
commencement of the financial year of the bank, proportionate premium
calculated on pro-rata basis will be charged.

4.

When additional Sum Insured is required either under Section (A) or (B), an extra
premium of 1% (one percent for each section must be charged. This will also
apply for renewal. In case additional Sum Insured under

Section

(A)

is

required during the currency of the Policy it can be granted by charging an

449

additional premium of 6% (six percent) on short period Scale of rate as applicable

to Fire Tariff.
5.

Extension of the policy to cover Automated Teller Machine can be considered at

an extra premium of 3% (Three percent) on the limit of Indemnity, after getting the
completed proposal for such additional cover. An excess of 2% (Two percent) on
the Sum Insured will apply in the event of a claim.

As per the RBI guidelines, the following stipulation will have to be adhered to by the
banks in respect of cash in transit-Movements of cash to and from the bank should be
entrusted to responsible employees of the bank. The cash should be carried in a box/
briefcase under lock and key as per the warranties indicated in the insurance policy. In
case the bank remits to or brings from other banks huge amounts of cash, it is desired that
proper escort is given to persons carrying/bringing such remittances.
REINSTATEMENT OF SUM INSURED : Upon settlement of any claim, pro-rata annual premium for the amount of such
loss (not exceeding the basic sum insured) shall be deducted from the net claim amount
payable under the policy which would be treated as extra 'premium to reinstate the policy.
But the liability will be limited to twice the sum insured in respect of all losses in any one
period of insurance.
RETROACTIVE PERIOD : The policy is on discovery basis. i.e. losses discovered during the currency of the
policy. The event giving rise to a claim under the policy shall not have occurred prior to
the date the bank obtains insurance cover for the first time. In the event of non-renewal or
cancellation of the policy, the losses should have been discovered within six calendar
months next following the date of expiry or the date of cancellation. Whether the
insurance has been continuously in force, losses sustained within a retroactive period not
exceeding two years from the date of discovery of any such loss, are also payable. Such

450

payment will be as per the terms and conditions of the policy in force at the time of
discovery.
LIMITS OF ACCEPTANCE : In all cases the DO can accept the business only with the prior approval of
Regional Office. The acceptance limit for BO is NIL. For DOs the acceptance limit is
Rs.62.5 lakhs. Large risk advice should be sent to Regional Office in case the sum
insured exceeds Rs.62.5 lakhs.
Effective from 1.4.94, the business has been de-tariffed and our HO has given
certain guidelines for underwriting this business, the salient features of which are
enumerated below :1.

Nationalised / Scheduled Banks:-

a)

i)
ii)

No change in the rating pattern.

Accounts with favourable claims Experience will become entitled to
reduction in premium as per following slabs:-

451

CLAIM RATIO - DISCOUNT

CLAIM RATIO

iii)

DISCOUNT

1.

Less than 10%

40%

2.

10% to 25%

20%

3.

25% to 50%

10%

4.

Over 50%

No discount

Accounts with unfavourable claim experience will be subject to a loading in

premium as per following safe:

CLAIM RATIO - LOADING

a)

1.

80 - 90%

10%

2.

90 -100%

15

3.

100 - 115%

25%

4.

115 - 130%

35%

5.

130 -150%

50%

6.

150 -175%

75%

7.

175 - 200%

100%

Where the experience is more than 200%, renewal should not be granted. In

analysing the experience the premium and claim figures of 3 completed years excluding
the policy year (expiring year) should be taken into account. In calculating the incurred
loss, claims which have already been settled and claims becoming admissible in principle
have to be taken into account.
b)

Excess will not be applicable for contingency (a)&(b) of the standard policy.

452

c)

Provision relating to installation of alarm and provision of armed guards

requirements stand replaced by the stipulation that the rules, regulations and
directive given by RBI and any other instructions issued by the insured Bank
themselves as regards safety and security should be strictly adhered to.

No other change in Tariff guideline Provisions except prohibition of issue of specific

policy like burglary, cash in transit and fidelity guarantee etc.
II CO -OPERATIVE BANKS :1.

All aspects excepting - a ) indicated above will be applicable for co-operative

banks also.

2.

Regarding premium rating the change will be as follows :i)

In respect of co-operative Banks with state level operations, a discount of

50% may be offered on the existing tariff guideline rates.

ii)

Banks with only district level operations a discount of 50% may be allowed
on the existing tariff guideline rates.

iii)
3.

The branch discount stands withdrawn.

In respect of the following situations, individual cases may be referred to HO:

i)

Higher discount than permitted in the slabs referred to above relating to

claim experience.

ii)

Midterm increase in basic sum insured sought by the Banks arising out of
some extraneous situations.

iii)

Where the claim experience in the last 3 years is more than 200% but
deserve special consideration in organisational interest.

iv.

All fresh renewal to be approved - by RO.

453

JEWELLERS BLOCK INSURANCE POLICY

SCOPE OF JEWELLERS BLOCK POLICY
TYPE
SECTION I
Stock-in trade / with
cash in premises and
bank lockers

1. Property on
premises
2. Property on
premises in
window
display during
night not
covered
3. Property in
safes
4. Cash and
currency notes
5. Property in
bank
employment
of lockers
Sum insured

SECTION II
Whilst in
custody of other
inured partners,
Employees,
Brokers, Cutters,
Goldsmiths
outside specified
premises of Sec.
I outdoor risk
1. Property
whilst in custody
of the insured
directors,
Partners,
Employees etc.,
2. Property
whilst or custody
or persons not in
regular insured.

SECTION III
Whilst in transit
within India

1.

Registered
insured post
parcel ( Rs.
5 lacs or
10% of SI
under
Section I
2. Air Freight
3. Angadia

Limit for any one Limit for anyone

loss
loss

Warranted that all

stock outside business
hours to be locked in
burglar proof safe at
night

SECTION IV
Office Furniture,
Fixtures & fittings
& safes etc.,

Furniture,
Fixtures, Fittings at
premises and safes
at residence

Sum Insured
Warranted that
basis of valuation
of property under
Section I, IIand \III
is locker, Cost +
10%

454

JEWELLERS BLOCK INSURANCE

The Insurance is intended to cover Stock-in-Trade of Jewellers kept in the
premises against loss or damage by Fire, Explosion, Lightning, burglary, house-breaking,
hold-up, theft and riot and strike,
The policy also covers the stock whilst in the custody of the partners/employees of
the Insured, their Agents. Transit by Insured Post Parcel, Air Freight and through
Angadias are also covered.
The policy is divided into Four sections.
SECTION I
Covers the loss or damage to property whilst contained in the premises where the
Insured's business is carried out or other premises where the Insured's property is
deposited by Fire, Explosion, Lightning, Burglary/House breaking/Hold-up/Theft and
Riot and Strike.
SECTION II
Covers loss or damage to property insured while carried/conveyed outside the
specified premises for the purpose of Insured's business by any cause other than the
specified exclusions under the policy. This cover will include the property under the
custody of the Insured, his partners, his employees, and persons not in the regular
employment of the Insured such as brokers of cutters/polishers, or goldsmiths.
SECTION III
Covers loss or damage to property whilst in transit within India by
1.

Insured Post Parcel

2.

Air Freight

455

3.

Angadia.

Note : For item No. 1, the maximum cover is restricted to 10% of the Sum Insured under
Section I or Rs.5 lakhs whichever is less.
Note : For item No. 2, property conveyed by any other means described above will not be
covered under the policy.
SECTION IV
Covers loss or damage to office furniture, fixtures and fittings in the premises
covered and safes at residence by fire, explosion, lightning, burglary, housebreaking,
theft, riot and strike.
Important Exclusions :
1.

Loss or damage during process of cleaning, repairing or restoring.

2.

Property missing at stock taking.

3.

Loss or damage whilst the articles are being worn or used by the insured, their
Partners, members of the family etc.

4.

Articles whilst at public exhibition.

5.

Theft or disappearance of property from Road vehicles whilst such vehicles are
left unattended.

6.

Depreciation, wear and tear etc.

7.

By theft and or dishonesty by insured's family members, servants, customers'

brokers, angadias, cutters, goldsmiths or their servants/agents etc.

8.

Loss occurring outside the geographical area (Indian Union)

9.

When the property leaves the Insured's premises for export/till the Import property
reaches the Insured's premises.

456

10.

Loss following the use of key or duplicate key unless such key has been obtained
by threat or violence.

11.

Window display after close of business hours.

12.

Earthquake, Flood, Cyclone etc.

Important points to be noted

1.

Under Section II if stock with any person exceeds Rs. 2 lakhs it shall be secured in
a burglar proof safe after business hours.

2.

Sum Insured under Section II should not exceed the aggregate Sum Insured under
Section I.

3.

The valuation of the property in respect of Section I, II

and III shall be the

insured's cost plus 10% thereof.

4.

Window display is not covered.

Rating
The risks are classified as 3 classes
Class I

Having 24 hours watchman for the premises employed by the Insured in all
listed premises.

Class II

Class III -

Common watchman for the building or night watchman employed.

All others.
Rate for

Sum Insured

Class I

Class II

0.25%

0.35%

0.20%

0.30%

SECTION I
Upto Rs.25 lakhs
Above Rs.25 lakhs and upto
Rs.50 lakhs for the sum over Rs.25 lakhs

457

Above Rs.50 lakhs and upto

Rs.75 lakhs for the sum over Rs.50 lakhs

0.175%

0.25%

SECTION II
On the first part of the aggregate of the individual
limits under section II upto 50% of Section I sum
insured

0.30%

On the next 25% of Section I sum insured

On the next 25% of Section I sum insured
SECTION III
1% on the aggregate sum insured under this
section
SECTION IV
0.10% on the sum insured

Important Point to be noted

The details of rating etc. are given only for the information of policy issuing
offices. All proposals irrespective of the Sum Insured has to be referred to HO for
approval. Even the renewals should be referred to HO giving the details of previous
claims if any, at least 30 days prior to the date-of expiry of policy.
Stamp Duty : Re. 1.00
Terrorism @ Rs. 0.02%
Cir 28/98 Dt. 2414198 - EFS @ Rs. 0.03%.
SECTION IV
10% on the sum Insured

458

Discounts :In proportion of prem. applicable to premises entitled to discount.

i)

Round the clock armed guards

(ii)

Closed circuit TV.

iii)

Strong Room

(iv)

Special security built - in - vaults discounts if insured has anyone of above

security system 15 % if more than one.

The Underwriting office may allow discounts in the premium rate for the
following:
1.

Physical features discount- In case the shop has additional security arrangements,
like close circuit TV, Electronic alarms etc, then a discount of 5% for each
additional feature restricted to a maximum of 10% may be allowed subject to an
inspection report of premises by an officer of the company being kept along with
the Underwriting papers.

I.

Good claims experience discount may be allowed when

policy is in force for a minimum period of three consecutive years

If

average claims experience is less than 50% for the last three years, 5%

discount may be allowed

-

Less than 30% ,10% discount may be allowed

Discount should be withdrawn if the claims experience is adverse.

DEFINITION OF PROPERTY
"Stock and stock in trade consisting of Jewellery, Gold or Silver ornaments, plate,
pearls and precious stones on any sort or kind whatsoever, cash and currency notes and/or

459

other merchandise and materials usual to the conduct of the Insured's business belonging
to and / or held in -trust or on commission or which the Insured is responsible."

PERILS COVERED
SECTION I
Loss or damage to property by fire, Explosion, lighting, Burglary, House Breaking
and theft, Riot & Strike, Hold-up, Robbery and malicious, damage only.
SECTION II
Loss or damage to property being carried / conveyed outside the specified
premises for the purpose of Insured's business by any cause whatsoever except as
hereinafter provided.
SECTION III
Loss or damage to property whilst in transit by any cause whatsoever except as
herein provided.
SECTION IV As mentioned under section 1.
Damages caused by burglars to the premises and / or Land Lord's Fixtures
(Fittings for which Insured is legally responsible as tenant up to 1 % of S.I. under this
section.
Exclusions
1.

Loss o r damage during the process of cleaning, repairing or restoring.

2.

Property missing at stock taking.

3.

Loss or damage whilst the articles are being worn or used by the Insured,
their partners, members of family etc.

460

4.

Articles whilst at Public Exhibition.

5.

Theft or disappearance of property from road vehicles whilst such vehicles

are left unattended.

6.

Depreciation, wear & tear.

7.

By theft and or dishonesty of Insured's family members, servants,

customers brokers, angadias, cutters, goldsmith or by their collusion.

8.

Loss arising outside geographical area. (India)

9.

Loss arising outside use of duplicate key / original key unless such key has
been obtained by threat or violence.

10.

Window display after 'close of business hours.

11.

Earthquake, flood, cyclone etc., (can be included by charging additional

premium as provided under fire tariff.)

12.

War & Nuclear Perils.

13.

Consequential loss or legal liability.

14.

If - Insured causes any material alteration in the premises or anything

done where by risk is increased.

15.

Where interest passes other than by law.

16.

Transit risk for import/ export articles.

17.

Loss or damage due to detention, confiscation, seizure etc by or under order

of Govt./Public /Local Authority.

CONDITIONS
1.

All notices /communications to be in writing.

2.

Reasonable care & precautions for safety of property. Proper supervision of

employees in ensuring that doors, windows are secured & properly.

461

3.

Void in case of mis -description, mis-representation non -disclosure.

4.

Insured should keep proper stock and account books in which all sales and
purchases are recorded. A separate register for withdrawals stock from bank
lockers, Januad slips to be maintained serially.

5.

In case of loss, take all practical steps to trace and recover the property.
Prosecute the culprit.

6.

Cancellation condition.

7.

If fraudulent means or devices be used by insured representative, claim is

not payable.

8.

Use due diligence and concur in taking all steps to avoid or diminish the
loss.

9.

No liability in respect of any loss or damage if not discovered within 60

days of happening the same.

10.

In case of loss or damage, it shall be lawful for the insured to take all steps
for recovery without prejudice to this insurance or waiver of Insured's
rights.

n)

Claims Procedure
(a)

Upon the happening of any event giving rise or likely to give rise to a claim,
the Insured should give notice to the police and to the company within 24
hours and take all steps to discover the guilty person, and to prosecute and
obtain conviction of such persons and to recover the property lost or stolen.

b)

A detailed statement in writing of the loss or damage with an estimate of the

actual value of such article lost and the amount of the damage sustained to
be submitted \Within 14 days.

462

c)

Allow authorised representatives of the company to examine the premises

and furnish all records and proof to substantiate the claim.

12.

Reinstate/ Replace any of the property lost or damaged at option of the company.

13.

Contribution Clause.

14.

Subrogation Clause.

15.

The basis of valuation:- For the purposes of this Insurance shall beinsured's Cost +
1 0%.

16.

Reinstatement condition:- immediately upon the happening of any loss or damage,

the S. I under section I shall be reduced by the amount of the loss or damage and
the limit for one loss under the various items specified in section II and section III
of the schedule shall be reduced in the same proportion as the sum Insured section
is reduced and such reduced sum Insured shall be the limit of the company's
liability in respect of any further losses or damage occurring during the current
period of the policy unless company consents payment of pro-rata additional
premium for the unexpired period to reinstate the full-S.I.

17.

Pair & Set Clause

18.

Condition of average applicable to losses under section l & lV of the policy.

19.

Arbitration & Disclaimer Condition.

20.

On account payment provision. 75%.

There are instances where the Jeweller would like to participate in Exhibitions

exclusively for jewelers or other types of exhibition In such cases, the Jeweller may like
to cover the risks of transit of jewellery from had quarters/ exhibit/storage after hours
/transit back to headquarters for a short period. This coverage can be given under a
special contingency policy. But the for the acceptance of this risk approval of Head
Office is required.

463

LIQUEFIED PETROLEUM GAS DEALERS COMBINED POLICY

A package policy offering various covers under one policy. The policy consists of twelve
sections : SECTION I :Fire and allied perils - usual perils under. the fire policy.
Exclusions
(i)

Loss or damage to livestock, motor vehicles, pedal cycles and tricycles.

(ii)

Money, Securities etc., documents of any kind unset precious stonesand

jewellery and valuables subject to condition of average.

RATING :- As per fire tariff in respect of the following :1.

SHOP - CUM GODOWN

a)

Building of "A class construction only

b)

Contents

within

shop - cum

godown

(Excluding

money

valuables)
i)
ii)
2.

Stock in trade
F. F. F.

Godown Exclusively
a)

Building - I Class only.

b)

Contents with in the Godown (Excluding money and valuables)

i) Stock in trade.
ii)

a)

F. F. F. Shop only

Building - I Class only

464

and

b)

Contents within the shop (Excluding money and valuables)

i)

Stock in trade

ii)

F. F. F.

Maximum stock equivalent to 3 days consumption is permissible. Where it is

exceeded -the rate applicable to shops -cum godown will be applied.
SECTION II : -BURGLARY AND HOUSE BREAKING: Usual

cover

under

burglary

(B.P.)

Policy.

(Excluding

money

and

valuables)
Exclusions
(i)

Where any employee or members of his family is an accessory or principal.

(ii)

Livestock, Pedal Cycle, Motor Vehicles.

(iii)

Money Security etc., documents of any kind, unset precious stones and
jewellery and valuables.

(iv)

If the premises is left unoccupied by day and night for seven consecutive
days and nights

Rate:-

In shop cum godown:-

Rs. Three per mille.

The S.I. under sec., II should be same as S.I. under sec., I for contents.
SECTION III GAS CYLINDERS IN TRANSIT:Loss \ damage to gas cylinders (Whether filled or empty) due to accident, robbery,
Hold - up theft whilst in the hands of the Insured / Employees whilst in transit between
the Insured's premises and the customer's premises.
Maximum Liability any one accident - Rs. 25,000/-

465

and any one period of insurance - Rs.50,000/Rate:- Rs.10/- per mille on A.O.Y Limit.
Cover is applicable only in respect of cylinders carried outside the premises duly
authorised by the Insured.
SECTION IV MONEY INSURANCE:a)

Money lost whilst in the hands of the Insured or their employees in transit
within a radius of 25KM from the insured's premises.

b)

By burglary house breaking whilst contained in safe etc under lock and key.

(c)

Whilst in the premises other than in safe etc., during business hours
consequent upon or following assault, violence, etc provided such money
are in the custody of responsible employee entrusted with the work of
handling cash.

PROVIDED
1.

The maximum liability of the co., is limited to S.I. under the policy both in respect
of any one event and any - one period.

2.

Losses not discovered with in a period of their occurrence and not notified to the
co.,

3.

A complete account of cash sent through authorised employees for depositing in

the bank is kept.

CONDITIONS
A complete account of cash in safe/cash box is to be kept in a secured place other
than the said safe/cash box and the co., 's liability is limited to the loss as reflected in'
such books. No liability for cash stolen by use of key/ duplicate to the safe/cash box
unless such key is obtained by threat or violence.
EXCLUSIONS

466

1.

Where employee / family member is principal or accessory.

2.

Fraud /dishonesty of one or more employees carrying the cash.

3.

Shortage due to error or omission

4.

If the premises is left unoccupied for 7 consecutive days and nights.

Rate:-

Rs.10 per mille in respect of the following:-

1.

In Transit in the custody

of the del. boys

AOY
Rs.5,000/-

2.

In the custody of authorised

employees / Insured to / from bank

Rs. 50,0001/-

Rate: -

For policy period.

Rs. 15,000/Rs. 1,50,000/-

Rs. 5 per mille in respect of the following :-For the policy period

3.

Money in safe/steel cupboard/cash box

4.

Money elsewhere in the premises

Rs. 75,000/-

(other than in safe)

SECTION V

Rs. 10, 000/-

: FIDELITY GUARANTEE

Direct pecuniary loss suffered by the insured due to any act of fraud or dishonesty
on the part of any one' employed by the insured
PROVIDED
Such loss has occurred in connection with his occupation and duties during
his service and during the policy period and discovered within six calender months
of the expiry of the policy and in case of death dismisal or retirment of the employee
within six months of such an event.
The

maximum

liability

under

the

policy

is

limited

to

the

S.I.

(Rs.20,000)mentioned in the policy in respect of any one or all employees and in respect

467

of all losses during the policy period. Max. liability for any one or all losses during the
period of insurance is restricted to Rs.20,000/Rate:-

Ten Percent

SECTION VI

PEDAL CYCLE AND TRI -CYCLE

Fire, BHB, RS., Malicious Act Terrorist Activity. Q., V.E. ETC., Liability is
restricted to market value not exceeding the S.I. mentioned against each.
The policy will also pay legal liability to third party injury/property damage
subject to a maximum of Rs. 1 0,000/- arising out of the use of the pedal tri-cycle covered
under-the policy.
EXCLUSIONS
Accident, loss, damage caused by the cycle
1.

Whilst being used for hire or reward.

2.

Due to over loading or strain or mechanical breakdown.

3.

Whilst being used for racing, pacemaking or speed trials.

4.

Theft of accessories if the vehicle itself is not stolen at the same time.

5.

The first Rs.50/- of each and every claim.

The cycle insured under the policy should be properly locked when left unattended.
Rate:- Ten per mille.
SECTION VII : PUBLIC LIABILITY:Liability to third parties arising out of injury/property damage due to accident or
misfortune at
i)

Any insured's premises mentioned in the policy.

468

ii)

At any registered address of the customers only whilst being installed by the
insured or his employees.

iii)

Whilst the gas cylinders are being carried by the insured or his employees.

The maximum liability under this section in respect of any one claim or series of claims
arising out of a single event and for all accidents/event occurring during any one period
of insurance is limited of Rs.10,00,000/ only inclusive of litigation expenses.
The policy will not pay : i.

Liability for personal injury or property damage

a)

Assumed by the insured under any agreement and which would not
have attached but for such agreement.

b)

Not connected with Insured's trade or business.

c)

Caused by use of any vehicle owned by the insured including waterborne

crafts, lifts elevators. etc.,

d)

Defective sanitary arrangement water pollution or food poisoning etc.,

e)

Arising out of articles supplied repaired or altered or treated by or on behalf

of the insured.

f)
ii.

Caused by poor upkeep and maintenance of the premises.

Loss or damage to that part of the LPG equipment/appliance on which the insured
or servant is working and where the loss is directly due to such work.
In the event of the death of the Insured the benefits under the policy will go to the
legal heir subject to the terms and conditions of the-policy as though they were the
insured provided they observe

Rate:-

and fulfil the terms and conditions of the policy.

5 per mille on A.O.Y. Limit

Liability limited to a maximum of Rs.10,00,000/- per any accident and any one year.

469

SECTION VIII : WORKMEN'S COMPENSATION

Cover as per provisions of-W.C. act and fatal accident act.
Rate:-

As per tariff

SECTION IX : PERSONAL ACCIDENT

Max. C.S.I. Rs.50.000/- per person. age restricted to 16 to 65 years -named
persons.
Cover as per standard P.A. Policy
Cover for insured any named partner director or member of managerial staff or
employees between 16 and 65 years. Temporary total disablement is restricted to
Rs. 250/- per week subject to a maximum of 50 weeks.
Rate as per guidelines rates
SECTION X : P.A. BENEFIT TO ANY CUSTOMER OR ANY
MEMBER OF HIS FAMILY] OR ANY OTHER PERSON:Cover is restricted to accidents during installation of the cylinder at the premises
of the customer benefits restricted to 1 to 5 only. The insured and his employees are not
entitled for this benefit.
Rate:-

Rs 300 per 1,000 customer max S.I. Rs. 15,000/- per customer
RS. 30 PER 1,000 CYLINDERS

SECTION XI : ACCIDENTAL BREAKAGE OF PLATE GLASS

Covers plate glass in the premises of the insured subject to limits mentioned under
the policy.

470

There is no liability when loss or damage occurs: i)

During removal alteration or repair on or about the insured's premises

ii)

Breakage of lettering unaccompanied by breakage or damage of glass.

iii)

Damage to any frame or framework unless specifically declared.

iv)

Disfiguration or scratching etc., other than fracture extending the entire thickness
of the - glass.

v)

Embossed, silvered, lettered, ornamental glass other than plain glass unless
specifically declared.

vi)

Breakage of glass which is not completely and securely fixed.

vii)

Any consequential loss arising out of the breakage of the glass covered under the
policy. (Max. S.I. Rs. 5,000/-)

Rate:- Rs. 40 Flat premium

SECTION XII : DAMAGE TO NEONSIGN /GLOW SIGN
Caused By:i)

Accidental external means.

ii)

Fire, Lightning external explosion or theft.

iii)

R.S. and malicious act.

iv)

Flood etc., perils. Maximum liability restricted to the amount mentioned in

the policy in respect of any one event. or all losses during
period.

471

the

policy

No liability towards:1.

Fusing or burning out of any bulb or tube due to short circuiting etc., or any
mechanical or electrical Breakdown or faults.

2.

Depreciation Wear and tear.

3.

Any consequential loss.

4.

The first Rs.50/- of each and every loss.

Rate Rs. 150 flat premium. max. S.I. Rs. 10,000/The insured should sign a declaration stating
1.

Construction of the premises is as per classification "A"

2.

All opening including doors and windows are properly secured.

3.

Daily sales and purchases invoice and books of accounts are maintained.

4.

Cylinder are carried outside the premises only after due verification.

5.

All necessary safety measures prescribed by the oil co., like testing for leakage
etc., are complied with.

6.

The P.A. cover has been obtained for the benefit of the insured persons and/or their
dependants.

7.

No Insurer has declined the proposal earlier.

472

MARGA BANDHU POLICY

Scope of cover.
SECTION I: (I) PERSONAL ACCIDENT:
If the insured person/s (aged between 5 and 70 years) sustains/s any bodily injury
resulting solely, directly and proximately caused by accident during the currency of this
policy by external, visible and violent means resulting in Death / Disablement then the
company will pay to the insured person/s, his/their assignee, his/their nominee, his/their
legal personal representative as follows:
If such injury, within 6 calendar months of its occurrence, be the sole and direct cause of
death, Permanent Total Disablement or Permanent Partial Disablement. (as defined in PA
policy)
TABLE OF BENEFITS UNDER SECTION NO I PERSONAL ACCIDENT
Benefit
No.
1
2.
3.
4.
5.

Description
Death only ------------------------ of CSI
Loss of Two Limbs, Two Eyes or One Limb and One Eye
---------------------------------------------------100% of CSI
Loss of One limb or One Eye --------------------- CSI
Permanent Total disablement from injuries other than named above
(P.T.D)
100% of CSI
Permanent Partial Disablement ----------------- % age as per
schedule of the Policy

473

ADDITIONAL COVERS:
Medical Expenses: (arising out of an accident), upto 10% of the capital sum insured or
50% of the admissible claim whichever is lower, at additional premium.
EXCLUSIONS:
Pregnancy Clause: The insurance under this Policy shall not extend to cover death or
disablement resulting directly or indirectly caused by, contributed to or aggravated or
prolonged by childbirth or pregnancy or in consequence thereof.
SECTION II:
If the insured person sustains any bodily injury proximately through accident during
currency of this policy, then the Company reimburses the medical expenses, arising out of
such accident, 25% of the admissible claim under the Accident Section or up to
maximum of 10% of the CSI or the actual medical expenses insured, whichever is lower.
BAGGAGE COVER EXTENSION:
1.

The Policy is extended to cover, upon payment of the premium specified in the
schedule, loss, destruction or damage to accompanied baggage due to accident or
misfortune subject to a limit of Rs. 1,000/- per person.

2.

The liability under this extension is limited to the actual value of the item lost /
destroyed / damaged at the time of the loss / damage. Indemnity under this
extension is not however extended to include pens, watches, toiletry, jewelry and
valuables.

474

ADDITIONAL EXPENSES COVER EXTENSION:

The policy is extended to cover, upon payment of the additional premium, specified in the
schedule additional expenses incurred towards alternative travel arrangement on account
of detour caused solely by loss or damage to conveying vehicle due to accident, Act Of
God perils, Riot, Strike (only unannounced sudden strikes like lightning strike, flask
strike, etc.) Terrorism, subject to a limit of Rs. 1,000/- per person. The indemnity under
this extension is net of refund obtained / obtainable from the Railways / Road Transport
or any other means of transport, travel by which has been affected by the perils. This
extension will also take into account the expenses towards onward continuation of tour as
a result of the cancellation or detour.
However this provision shall not apply if the deviation/change of route is under the orders
of any Government Authority.
DEFINITIONS:
Cover A stands for Section I (i) 1. a) and I (ii)
Cover B stands for Sections 1 (i) 1. a) to d) and I (ii)
Cover C stands for Section 1 (i) 1. a) to e) and I (ii)
GENERAL EXCLUSIONS
Loss or damage directly or indirectly caused by or contributed to, by or arising
from:
1.

Gross negligence, violation of rules / guidelines framed by the organisers / school /

college / authorities in the places of tour including overloading of vehicle, boat,
yachts, pleasure crafts, influence of drugs, alcohol, intoxicating drinks and the
like, any clandestine activity.

475

2.

Outbreak of rivalry / dispute / violence among the group for any reason
whatsoever.

3.

War, Invasion, Act of Foreign enemy, Hostilities (whether war be declared on not),
Civil War, Rebellion, Revolution, Insurrection, Mutiny, Military, or usurped power
Capture, Seizure, Arrests, Restraints and detainment of all kings, princes and
people of whatsoever nation, condition or quality.

4.

Loss or damage due to wilful misconduct and also any loss, damage or liability
arising out of any act of commission/omission in which the insured or any member
of his household or anyone in his employ is involved as principal or accessory.

5.

Death of disablement due to pregnancy or child birth.

6.

Consequential Loss / Legal liability of any kind or description.

7.

Any loss or damage

1.

Directly or indirectly caused by or contributed by or arising from ionising

radiation, contamination by radioactivity from any nuclear fuel. For the
purpose of this exception, combustion shall include any self-sustaining
process of nuclear fission / fusion.

2.

Directly or indirectly caused by or contributed to by or arising from nuclear

weapons / material

SPECIAL EXCEPTIONS (BAGGAGE)

In addition to the general exceptions stated above the company shall not be liable in
respect of:
a.

Loss or damage due to cracking, scratching, breakage of lens or glass, whether part
of any equipment or otherwise or of China Marble and other articles of brittle or
fragile nature, unless such loss or damage arises from accident to vessel, train,
vehicle or aircraft by which such property is conveyed.

b.

Loss or damage caused by depreciation or wear and tear.

476

c.

Theft from car except from a car of fully enclosed saloon type having all the doors,
windows and other openings securely locked and properly fastened.

d.

Loss of or damage whilst being conveyed by any carrier under contract of

affreightment

e.

Loss of or damage to money, securities, manuscripts, deeds, bonds, bills of

exchange, promissory notes, stock or share certificates, stamps, business books or
documents, jewelry, watches, furs, precious metal, precious stones, gold and silver
ornaments, travel tickets, cheques and bank drafts.

f.

Loss of or damage to articles which did not form part of the contents of any of the
packages when the journey commenced, unless specifically declared and accepted
by the company. Such intention to have the items purchased during the tour to be
covered has to be mentioned in advance and noted in the policy schedule. Limit on
loss / damage to such purchases will be Rs.500 per person.

g.
h.

Loss, destruction of or damage to articles of consumable nature.

Loose articles such as sticks, straps, umbrellas, sun shades, fans, deck chairs,
property in use on the voyage and / or journey or clothes whilst being worn.

SPECIAL EXCEPTION (PERSONAL ACCIDENT)

In addition to the general exceptions stated above the company shall not be liable under
this policy for
a.

Compensation under more than one of the foregoing sub-clauses I (i) 1. a) to d (i)
1. (e) in respect of the same period of disablement.

b.

Any other payment after a claim under one of the Benefits I (i) 1. a) to d (i) 1. (e)
has been admitted and become payable

c.

Any payment in case of more than one claim under the policy during any one
period of insurance by which the maximum liability of the Company in that period
would exceed the sum payable under Benefits I (i) of this policy.

477

d.

Payment of compensation in respect of death, injury or disablement of the Insured

(a)

From intentional self-injury, suicide or attempted suicide.

(b)

Whilst under the influence of intoxicating liquor or drugs.

(c)

Whilst mounting into, dismounting from or travelling in any balloon or

aircraft other than as a passenger (fare paying or otherwise) in any duly
licensed standard type of aircraft.

(d)

Directly or indirectly caused by venereal diseases or insanity

(e)

Arising or resulting from the insured committing any breach of law with
criminal intent.

(f)

Death or disablement resulting directly or indirectly caused by contributed

to or aggravated or prolonged by childbirth or pregnancy or in consequence
thereof.

478

PROPOSAL FORM FOR MARGA - BANDHU POLICY

1. a)
b)

2.
3.
4.

5.

6,

Name of the Proposer

Names of the insured persons (List of names with age
& sex
sex)
c) Relation between the proposer and the Insured person
Residential Address / Permanent Address:
Address for Correspondence:
a) Have you ever proposed for Marga Bandhu Policy
b) If so, give name of each company and amount of
Insurance
c) Has any company
i) Declined to issued a policy to you?
ii) Declined to continue your insurance
iii) not invited the renewal of your policy?
iv) Imposed any restriction or special conditions?
If so, give names and address of each company in respect i) Name of Co.of i, ii, iii and iv above.
ii) Sum insured
iii) Policy No.--Please indicate
a) Rs. -----------------------------------------a) Capital Sum Insured
b) Benefit - Section I - I (a) & (b)/ I (a) to
(d) / I (a) to (e)
b) Table of cover
c) From -------------------- To --------------c) Period of insurance

7. Do you wish to obtain cover for Medical expenses?

8. Description of Baggage carried by the Insured Persons
9. Do you wish to cover extension for additional expenses
under Baggage Cover?

WE declare that the above answers are true to the best of my knowledge and belief, that
we have disclosed all particulars affecting assessment of the risk. We agree that this
proposal and declaration shall be the basis of the contract me and this Company.
Place :

Proposers Signature

Date :

479

ASSIGNMENT (These details may be incorporated in the schedule of Insured

Persons)
I__________ do hereby assign the monies payable by the in the event of my death to
________ (Name & Relationship to the Insured) and I further declare that his / her receipt
shall be sufficient discharge to the Company. Dead this _______ day of ________ 200
at
WITNESS:
Name & Address :

Signature/s
Signature of the Insured Person

PROHIBITION OF REBATES
The following is the copy of section 41 of the Insurance Act, 1938.
1.

No person shall allow or offer to allow either directly or indirectly as an

inducement to any person to take out or renew or continue an insurance in respect
of any kind of risk relating to lives or property in India any rebate of the whole or
part or commission payable or any rebate or the premium-shown on the policy nor
shall any person taking out or renewing continuing a policy except any rebate as
may be allowed in accordance with the published prospectuses or tables of the
insurer.

2.

Any person making default in complying with the provisions of this sections shall
be punishable with fine which may extend to five hundred rupees.

480

THE SCHEDULE
AGENCY:
Policy No:
Date of proposal and Declaration
Statistical code:
INSURED:

Issuing Office
PERIOD OF INSURANCE

Name:
Address :

From

To
Duration: Cover commences from the time the group starts its first leg of journey from
______ and terminates on return to the same place (unless specified otherwise) or on expiry
of 30 days from the date of commencement of the policy or any extended period for which
additional premium has been paid and endorsement issued whichever occurs earlier.
Tour Covering Places:
BENEFITS COVERED
Covered A/B/C
No. of persons covered
a) Paying participants
b) Non paying participants (or)
Representatives of sports or tour
Operators accompanying the group
(As per enclosed list)
Baggage cover extension opted for Yes/No.
Additional Expenses Cover ExtensionOpted for Yes/No.

CAPITAL SUM INSURED (PA COVER)

CAPITAL SUM INSURED (PA COVER)

Figures

Words

Subject otherwise to the terms provisions and conditions of the policy.

IN WITNESS WHEREOF signed by and on behalf of the Company at
________________ this day of
19
Prepared by:
Examined by:

Authorised Signatory.

481

SUHANA SAFAR POLICY

(Domestic travelers Insurance)
SALIENT FEATURES
The Policy covers the risks of Personal Accident to and loss of Baggage of the Insured,
Spouse and dependant children covered during the period of outstation travel within India
from the declared place of departure (including places of sojourn) up to sums Insured
specified.
The Coverage available under this policy is for a single round trip to the places declared
(including places enroute) up to the scheduled date of return. This policy is not available
for trips exceeding 60 days.
In the event of change in the scheduled date of return after commencement of travel,
nearest office of this Company should be approached for extension of the policy, and
confirmation obtained. However, such extension will be at the discretion of the Company,
and more than one extension is not permissible.
Coverage:
SECTION I
PERSONAL ACCIDENT
(a)

Personal Accident risk upto Rs. 1 lakh per head with reimbursement of reasonable
actual emergency incidental expenses upto Rs.1000/- per head both as defined in
the policy.

(A)

Bodily injury sustained by the Insured Person(s) arising out of an accident

resulting in death or disablement as described below within 12 calendar months of
the occurrence of the accident will be indemnified as per the percentage of Sum
Insured of Rs.1lakh mentioned below.

482

SCHEDULE OF COMPENSATION
Nature of Disablement
Death or loss of physical separation of the whole of
(i) both hands or feet or
(ii) one hand and one foot or
(iii) one hand or one foot and the complete and
irrecoverable loss of sight in one eye or
(iv) complete irrecoverable loss of sight of both eyes
Total permanent disablement
(incapacitating the insured from totally attending to his
profession/business)
Loss by physical separation of the whole of one hand or
one foot or irrecoverable loss of sight of one eye
Partial permanent disablement
(i) Loss of each toe
(ii) Loss of hearing each ear
(iii) Loss of each finger
(iv) Any other permanent partial disablement

% of Sum Insured as
compensation
100

50
4
15
8
% as assessed by a
qualified Medical
Practitioner

SECTION II
BAGGAGE
Loss or damage to personal effects carried as accompanied baggage (except for articles
mentioned under exclusion no. 2) due to fire, riots, strike, terrorism, malicious damage,
storm, tempest, hurricane, flood, inundation, accident, theft or burglary for the actual
value of the articles but not exceeding Rs. 500/- per article unless specifically declared.
The total indemnity under this section shall not exceed in all the sum insured as
depending on the number of persons covered under the policy.

483

(b)

Loss of damage to Baggage arising out of operation of the perils named in the
policy upto the sums insured indicated below on the basis of the number of
persons insured.

No. of Person(s)
Sum Insured (Rs.)

4 and above

5000

10,000

12,500

15,000

Premium

No. of Persons

(Service Tax applicable

extra)

Premium (in
Rs.)

80

140

190

240

280

320

360

400

EXCLUSIONS:
This policy shall not cover any claim(s) arising out of: 1.

Intentional self-injury, under the influence of alcohol or intoxicating substances

and out of engaging in hazardous sports/activities.

2.

Loss of articles of jewelry, and or otherwise made up fully or partially of precious/

semi precious metals/stones, money, securities, manuscripts, deeds, bonds, Bills
of exchange, Promissory Notes, Stocks or Share Certificates, Stamps and
travel tickets or travelers cheques, business books or documents.

3.

War and allied perils, nuclear explosion or ionising radiation

CONDITIONS
1.

Insured must take all necessary precautions and act at all times as if uninsured.

2.

In the event of loss of or damage to baggage, report is to be immediately lodged

with the Police or other authorities as appropriate, and a copy obtained.

484

3.

Immediate written notice is to be given to the issuing office and also to the nearest
office of this Company of any accident or loss. However, the issuing office shall
process all claims.

4.

Proof satisfactory to the company shall be furnished of all matters upon which the
claim is based along with the original policy to the issuing office.

5.

In the event of a loss under Section II being claimable under more than one policy,
this shall pay only its ratable proportion thereof.

6.

No cancellation will be allowed after commencement of Insured travel. However,

request for cancellation of cover arising out of cancellation of the scheduled
journey, will be entertained if made within 2 days of the scheduled date of travel.
No request for cancellation will be entertained after the expiry of this period. For
all cancellation effected, the company shall retain a minimum premium of Rs.30/-.

7.

In the event of death of the insured Person(s) due to an insured peril all benefits
payable in respect thereof under this insurance, shall become payable to the
assignee declared in the proposal and the assignees receipt shall be construed as
full and final discharge to the company, in respect of all liability under this policy.

485

PROPOSAL CUM SCHEDULE

PROPOSERS DECLARATION:
(Please write in Block Letters)
Name and
Address of
the Propos
_________
_________
_________
_________
_____
__________________________________
Date & Place of Departure

Mode of Transport : Rail/Road/Air/Water

Schedule time of departure

By : __________________________________
To : (Specify places of visit)

Date of
scheduled
return to
the place of
departure :

Section I : Personal Accident

Details of proposer and accompanying family members (spouse and dependant children
only)
SL
No.

Name

Relationship with
Age
Proposer

486

Existing
Disability,
if Any

Name & Address of

Assignee

Section II: Baggage (Excluding articles of Jewelry and or otherwise made up fully or
partially of/ semi precious metals / stones, money securities, manuscripts, deeds, bonds,
bills of exchange, promissory notes, Stocks or Share Certificates, stamps and travel
tickets or travelers cheques, business books or documents.)Description of goods
exceeding Rs. 500/- per item

Value Rs.
(i)

(vii)

(ii)

(viii)

(iii)

(ix)

(iv)

(x)

(v)

(xi)

(vi)

(xii)
Grand Total

I hereby declare that the particulars given herein are correct to my knowledge and belief
and I have not withheld any information which is material to this insurance.
Date:
Place:

Signature of the Proposer

487

UNI STUDY CARE INSURANCE POLICY

This policy takes care of insurance needs of the students studying in various educational
institutions. The policy is having four sections, Section-1A provides death / Permanent
Total Disablement cover to the named parent / guardian against accidents. Section-1B
will take care of the future course of study of the wards if the parent / guardian died in the
accident. Section-II provides death / Permanent Total Disablement cover to the student
against accidents. Section III provides Hospitalisation cover due to illness or accident to
the student. Section IV covers baggage of the student against accidents or misfortune.
Sections III and IV are optional.
DETAILS OF COVER::
SECTION-I
A)

If at any time during the currency of this policy the parent / guardian named in the
schedule shall sustain any bodily injury resulting solely and directly from accident
caused by external violent and visible means and if such injury shall within six
calendar months of the occurrence be the sole and direct cause of death or total
and irrecoverable los s of two limbs or two eyes or 100% Permanent Total
Disablement (permanently totally and absolutely disable the parent /guardian from
engaging in any employment or occupation of any description whatsoever) then
the company shall pay to the insured Student or parent / guardian as the case may
be the capital sum insured stated in the schedule.

B)

In

addition to the above benefit mentioned under (A) (if liability is admitted

under clause A above) the student shall be reimbursed for the unexpired period of study,
the tuition fee, development expenses, boarding and lodging charge s and other insured
expenses (excluding payments made prior to accident and / or over due payments as on
date of accident) on actual basis subject to the maximum limits as stated in the schedule.

488

SECTION II
If at any time during the currency of this policy the insured Student shall sustain any
bodily injury resulting solely and directly from accident caused by external violent and
visible means and if such injury shall within six calendar months of the occurrence be the
sole and direct cause of death or total and irrecoverable loss of two limbs or two eyes or
100% Permanent Total Disablement (permanently totally and absolutely disable the
insured student from engaging in any employment or occupation of any description
whatsoever) then the company shall pay to the parent / guardian or insured Student as the
case may be the capital sum insured stated in the schedule .
In case of death of both student and the parent / guardian named in the schedule of the
policy resulting solely and directly from same accident caused by out ward, violent and
visible means, within six calendar months of its occurrence then the company shall pay
the legal heir of the parent / guardian sums state d in the schedule.
DEFINITIONS / EXPLANATIONS APPLICABLE TO SECTIONS I & II:
1.

Death by accident: Death caused by outward, violent and visible means would
include death arising out of or traceable to slipping and/or falling from the
mountain terrain; biting by insects, snakes and/or animals; drowning washing
away in floods, landslides, rock slides, earthquake, cyclone and other convulsions
of nature and/or calamities; murder and terrorist activities.

2.

Permanent Total Disablement: permanently totally and absolutely disable the

Insured student / parent or guardian form engaging in any employment or
occupation of any description whatsoever resulting solely and directly from
accident caused by outward violent and visible means.

489

3.

Tuition Fee: Tuition fee means fees normally charged for the course of study
mentioned in the schedule which may also include transportation charges for day
scholars and does not include any extra fees paid by the student for additional
tuition, examination fees, any other fees, special fees, arrears, security /
library/laboratory/ co-operative society/caution deposit, expenses for industrial
tours or penalties/levy imposed by the colleges for absenteeism or any other
offences.

4.

Development Charges: Development charges means the charges normally

collected from all the students undertaking the same course of study by the college
towards building or infrastructure development as permitted by the concerned
education authority and does not include any additional charges paid by the
insured student or his parent/guardian voluntarily or otherwise.

5.

Boarding: Boarding means the customary diet provided to all students of the
colleges for which charges are uniformly levied on all students. It does not include
charges additionally paid by the insured student for additional diet/guest diet.

6.

Lodging: Lodging means the expenses normally charged per student by the hostel
maintained by the college shown in the schedule of the policy towards dormitory,
electricity and water charges. In case the student resides in a place other than such
hostels, the reimbursement of expenses payable under Section-I B towards
boarding and lodging shall be limited to 50% of the applicable amount shown in
the table

7.

Education Authority: Education Authority means education authority legally

authorised to issue notifications for organising counselling and admissions for the
course of study and college mentioned in the schedule

490

SECTION-III
Subject to the terms, conditions, exclusions and the Company undertakes that if during
the period stated in the Schedule any insured student shall contract any disease or suffer
from any illness or sustain any bodily injury through accident incur at any Nursing
Home/Hospital in India as herein as an inpatient, the Company will pay to the Insured
Person the such expenses as are reasonably and necessarily incurred subject to the limits
as follows but not exceeding the Sum Insured in any one period of insurance stated
against that person in the schedule.
Hospitalisation Benefits

Limits

i) Room, Boarding Expenses as

provided by the Hospital / nursing
home.
ii) If admitted in IC Unit

i)

Surgeon, Anaesthetist, Medical

Practitioner, Consultants, Specialists
Fees, Nursing Expenses

Up to 15% of Sum Insured per

illness / Injury

Anaesthesia, Blood, Oxygen, Operation Up to 15% of Sum Insured per

Theatre Charges, surgical appliances, illness / Injury
Medicines & Drugs, Diagnostic
Materials and X-ray
Dialysis, Chemotherapy, Radiotherapy
Cost of Peacemaker, Artificial Limbs
& Cost of organs and similar expenses.

N.B: a)
b)

Up to 0.5% of Sum Insured per

day
ii) Up to 1% of Sum Insured per
day

Total expenses per illness are limited to 35% of Sum Insured

Company's Liability in respect of all claims admitted during the period of
insurance shall not exceed the Sum Insured per person as mentioned in the
schedule)

491

DEFINITIONS APPLICABLE TO SECTION-III

HOSPITAL / NURSING HOME means any institution in India established for indoor
care and treatment of sickness and injuries and which either: has been registered as a
Hospital or Nursing Home with the local authorities and is under the supervision of a
registered and qualified Medical Practitioner or Should comply with minimum criteria as
under:i)

It should have at least 15 inpatient beds.(in C class towns 10 beds)

ii)

Fully equipped operation theatre of its own wherever surgical operations are
carried out.

iii)

Fully qualified Nursing Staff under its employment round the clock.

iv)

Fully qualified Doctor (s) should be in-charge round the clock.

The term ' Hospital / Nursing Home ' shall not include an establishment which is a
place of rest, a place for the aged, a place for drug-addicts or place of alcoholics a hotel
or a similar place.
Expenses on Hospitalisation for minimum period of 24 hours are admissible.
However, this time limit is not applied to specific treatments, i.e, Dialysis, Chemotherapy,
Radiotherapy; Eye Surgery, Dental Surgery, Lithotripsy (Kidney Stone removal), , D&C,
Tonsillectomy taken in the Hospital / Nursing Home and the Insured is discharged on the
same day, the treatment will be considered to be taken under hospitalisation Benefit. This
condition will also not apply in case of stay in hospital of less than 24 hours provided
a)

The treatment is such that it necessitates hospitalisation and the procedure

involves specialised infrastructural facilities available in hospitals.

b)

Due to technological advances hospitalisation is required for less than 24

hours only.

492

ANY ONE ILLNESS: - Any one illness will be deemed to mean continuous period of
illness and it includes relapse within 105 days from the date of discharge from the
Hospital / Nursing Home where treatment has been taken. Occurrence of the same illness
after a lapse of 105 days as stated above will be considered as fresh illness for the
purpose of this policy.
SECTION- IV:
This section covers loss / damage to personal baggage of insured student:
a)

by accident or misfortune when he is travelling from college hostel to home town

and vice versa and /or places of tour / excursion conducted by college anywhere in
India during the policy period.

b)

due to burglary whilst the baggage is kept in the hostel provided by the college /
institution during the policy period..

EXCLUSIONS:
Provided always that the Company shall not be liable under this policy for:
1.

Compensation under any / all of the Sections in case of discontinuation of studies

by the student for whatsoever reasons prior to the occurrence of an accident giving
rise to a claim under this policy.

2.

Compensation under more than one Section. of Section-I & Section II

3.

Claim arising due to accidental death of any insured person aged more than 70
years.

4.

Payment of compensation in respect of death of the student or parent/ guardian

directly or indirectly arising out of or contributed to by or traceable to any
accidents occurred prior to the date of commencement of this policy.

493

5.

The benefits payable under Section-I (B) of the policy do not have a recurring or
carryover effect in case the student is not promoted to the next semester / next year
of study.

6.

Arrears payable to the college/institution by the student pertaining to the period

prior to the accidental death of the parent/guardian covered under the policy.

7.

The student or the parent / guardian forfeit all the benefits under the policy in case
the student chooses a college or course of study other than those mentioned in the
schedule of the policy. Notwithstanding this provision the Company reserves the
right at their own discretion to extend the benefits of the policy to the Insured
student to prosecute another course of study or at another college or both provided
that the parent / guardian gives advance intimation in writing to the Company
about such change of course or college or both and obtains the Companys
permission by way of endorsement by paying additional premium if any levied by
the Company.

8.

Provided always that the Company shall not be liable under this policy for
payment of compensation in respect of death of parent / guardian or insured
student due to or arising out of :
a)

Intentional self injury, suicide or attempted suicide

b)

Whilst under the influence of intoxicating liquor or drugs

c)

Whilst racing on wheel, Hunting Big game shooting, Mountaineering, or

whilst engaged in winter sports, skiing & Ice Hockey

d)

Directly or indirectly caused by insanity

e)

Arising or resulting from the insured committing any breach of law with
criminal intent

f)

Directly or indirectly connected with or traceable to War, invasion, act of

foreign enemy, hostilities or warlike operations (whether war be declared or
not) Civil war, rebellion, revolution, insurrection, Mutiny, Military or

494

usurped power, seizure, capture, arrests restraints and detainments of all

kings, princess and people of whatever nation, condition or quality
whatsoever
g)

Directly or indirectly caused by or contributed to by or arising from or

traceable to ionising radiation or contamination by radio-activity from any
source whatsoever or from nuclear weapons material.

9.

The company shall not be liable to make any payment under this policy in respect
of expenses whatsoever incurred by any Insured student in connection with or in
respect of:
a)

Any Pre-Existing illness

b)

Any Disease contracted within 30 days of inception of cover

c)

Cataract, Benign, Prostatic, Hyperthrophy, Hysterectomy for Menorrhagia,

or Fibromyoma, Hernia, Hydrocele, Congenital internal disease, Fistula in
anus, piles, Sinusitis and related disorders during first year of operation of
cover.

d)

Domicilliary Hospitalisation

e)

Circumcision unless necessary for treatment of a disease not excluded

hereunder or as may be necessitated due to an accident, vaccination or
inoculation or change of life or cosmetic or aesthetic treatment of any
description, plastic surgery other than as may be necessitated due to an
accident or as apart of any illness.

f)

Cost of spectacles and contact lenses, hearing aids.

g)

Dental treatment or surgery of any kind unless requiring hospitalisation.

h)

Convalescence, general debility; run-down condition or rest cure,

Congenital external disease or defects or anomalies, Sterility, Venereal
disease, intentional self injury and use of intoxication drugs / alcohol

i)

All expenses arising out of any condition directly or indirectly caused to or

associated with Human T-Cell Lymphotropic Virus Type III (HTLB - III) or

495

lymphadinopathy Associated Virus (LAV) or the Mutants Derivative or

Variation Deficiency Syndrome or any syndrome or condition of a similar
kind commonly referred to as AIDS.
j)

Charges incurred at Hospital or Nursing Home primarily for diagnosis x-ray or

Laboratory examinations or other diagnostic studies not consistent with or
incidental to the diagnosis and treatment of positive existence of presence
of any ailment, sickness or injury, for which confinement is required at a
Hospital / Nursing Home

k)

Expenses on vitamins and tonics unless forming part of treatment for injury
or diseases as certified by the attending physician

l)

Treatment arising from or traceable to pregnancy (including voluntary

termination of pregnancy) and childbirth, (including caesarian section)

10.

m)

Naturopathy Treatment

a)

Any loss or damage occurring during the travel other than specified under
section IV of the policy.

b)

Cracking, scratching of articles of brittle nature,

c)

Loss or damage to money, securities, manuscripts, deeds, bonds, bills of

exchange, promissory notes, stocks or share certificates, stamps and travel
tickets or travelers cheques or any other documents, articles of consumable
nature.

d)

Theft of article / item from any vehicle unless the vehicle is fully secured
and locked.

e)

Loss of gold ornaments, valuables, cameras, binoculars, mobile phones and

other electronic items.

496

CONDITIONS:
1.

Upon the happening of any event which may give rise to a claim under this Policy
the Insured shall forthwith give notice thereof to the Company. Unless reasonable
cause is shown the insured shall, within one calendar month after the event which
may give rise to a claim under the Policy, give written notice to the Company with
full particulars of the claim.

2.

Cover automatically ceases in case of death of the student.

3.

Proof satisfactory to the Company shall be furnished of all matters upon which a
claim is based within the space of fourteen days after demand in writing. Any
medical or other authorised representative of the Company shall be allowed to
make a post-mortem examination of the body of the deceased parent/ guardian or
insured student .

4.

Complaint to Police authorities is mandatory for loss under baggage section IV

5.

The Company shall not be liable to make any payment under this Policy in respect
of any claim if such claim be in any manner fraudulent or supported by any
fraudulent statement or device whether by the insured or by any person on behalf
of the insured .

6.

Cancellation of policy at the option of the insured provided no claim is preferred

under the policy entail s him a refund of premium at short period scale while the
same at the option of the insurer, a pro rat a refund of premium for the un expired
period.

497

Period on risk

8.

Rate of premium to be charged

Not exceeding one week

10% of annual rate

Not exceeding one month

25% of annual rate

Not exceeding 2 months

35% of annual rate

Not exceeding 3 months

50% of annual rate

Not exceeding 4 months

60% of annual rate

Not exceeding 6 months

75% of annual rate

Not exceeding 8 months

85% of annual rate

Exceeding 8 months

Full annual rate

If the Insured shall at any time during the continuance of the Policy be insured
against similar scheme for students or medical or baggage insurance with one or
more insurers all the benefits under this policy shall be proportionately restricted
to such amount which the sum insured of the policy bears to the highest sum
insured for a corresponding benefit in any of the policies.

9.

If any dispute or difference shall arise as to the quantum to be paid under this
policy (liability being otherwise admitted) such difference shall independently of
all other questions be referred to the decision of a sole arbitrator to be appointed in
writing by the parties to or if they cannot agree upon a single arbitrator within 30
days of any party invoking arbitration the same shall be referred to a panel of three
arbitrators, comprising of two arbitrators, one to be appointed by each of the
parties to the dispute/ difference and the third arbitrator to be appointed by such
two arbitrators and arbitration shall be conducted under and in accordance with the
provisions of the Arbitration and Conciliation Act, 1996.
It is clearly agreed and understood that no difference or dispute shall be referable
to arbitration as herein before provided, if the Company has disputed or not
accepted liability under or in respect of this Policy.

498

It is hereby expressly stipulated and declared that it shall be a condition precedent

to any right of action or suit upon this policy that the award by such arbitrator/
arbitrators of the amount of the loss or damage shall be first obtained.
10.

It is also hereby further expressly agreed and declared that if the Company shall
disclaim liability to the Insured for any claim hereunder and such claim shall not,
within 12 calendar months from the date of such disclaimer have been made the
subject matter of a suit in a court of law then the claim shall for all purpose be
deemed to have been abandoned and shall not thereafter be recoverable hereunder.

AGE LIMIT:
Insurance cover is available under this policy to persons in the age group of 5 years to 70
years .
NOTICE OF CLAIM
Immediate notice of claim with particulars relating to policy number, nature of loss/name
of the person in respect of whom the claim is made should be sent to policy issuing
office. Final claim along with bills, receipts and other documents should be submitted to
the Company within 30 days from the date of loss / completion of treatment.
SUM INSURED:
Section IA: can be opted up to Rs.3 lakhs per parent / guardian
Section IB: actuals in rupees as per college / institution rules
Section II: can be opted up to Rs.2 lakhs per student
Section III & IV fixed sum insured.

499

PREMIUM (ANNUAL):
Section-I (A&B) Rs.
0.55%0 on CSI

Section-II Rs.
0.55%0 on CSI

Section-III
(SI Rs.25,000)
Rs.189/-

Section IV (SI
Rs.2,500)
Rs.18/-

Note: Section I & II are compulsory and Section III and IV are optional

LONG TERM DISCOUNT:

It is permissible to issue long term policies up to a maximum of 5 years for which the
entire premium has to be paid in the first year of inception of cover. A long term discount
may be allowed as follows:
Policy Period
3 Years
4 Years
5 Years

Discount
5%
7.5%
10%

500

GROUP DISCOUNT:
The policy is devised for groups and premiums are subject to group discount as per the
following table:
No. of persons
101 to 500
501 to 1000
1001 to 2000
2001 to 10000
10001 to 15000
15001 to 25000
25001 to 50000
Above 50000

Group Discount
2.5%
5%
7.5%
10%
12.5%
15%
20%
30%

No group discount for groups consisting of below 101 members.

501

UNDERWRITING GUIDELINES FOR UNI-STUDY CARE GROUP POLICY

1.

Cover shall be offered to the age group of 5 to 70 years.

2.

Section I and II are compulsory and Section III and IV are optional

3.

Pre-existing illness exclusion clause applies to the cover granted under Section III
of the policy.

4.

All the underwriting norms of mediclaim shall be followed while extending the
cover under Section III of the policy.

5.

Extension of cover under Section III and IV shall be on all students or none basis.

6.

The premium is to be underwritten under Department Code No.

7.

This business falls under Miscellaneous Non-Traditional Class.

8.

Agency commission is payable @ 5% of the premium collected.

9.

Sum Insured for the parent/guardian and student as per the option of the proposer.
However it should not exceed Rs. 2,00,000/- per student and Rs. 3,00,000/- per
parent/guardian.

10.

Sum Insured under the head of tuition fee and other expenses shall be fixed as per
the following procedure.

11.

Sum Insured under the head of tuition fee and other expenses for NRI student
should be in equivalent Indian rupees and not in dollars.

12.

The premium has to be charged as per the existing personal accident premium
guidelines as given in the prospectus.

13.

As the policy covers the liability for the future years of study under the head of
tuition and hostel expenses, the sum insured under this head shall be the total
amount for all the remaining years of study including the current year. A specimen
working is given below for your guidance.

Year of
study

Sum Insured for

student + parent

Tuition fee
and other
expenses per
annum Rs.

Balance
years of
study

502

Sum Insured PA+

Expenses (Expenses per
year multiplied by
balance years of study)
Rs.

1st year
2nd year
3rd year
4th year

14.

5,00,000
5,00,000
5,00,000
5,00,000

45,000
45,000
45,000
45,000

4
3
2
1

6,80,000
6,35,000
5,90,000
5,45,000

For long term policies(for complete course period) the Sum Insured shall be the
amount for student and parent as opted by the proposer under PA + tuition fee and
other expenses for one year and the premium arrived on the total sum insured shall
be multiplied by number of years for arriving long term premium.

15.

In case of admissible claim under Section IA of the policy the sum is payable to
the student and in case of Section IB the amount admissible for remaining study
can be deposited in the name of the student in a Nationalised Bank by leaving the
instructions to release yearly amount directly to the college or Institution on
confirmation that the student is continuing his studies.

503

PROPOSAL FOR UNI-STUDY CARE GROUP POLICY

(Persons in the age group of 5-70 years only are eligible for cover)
1.

Name of the College / Educational Institution.: Address of the College /

Institution.:

2.

Details of student and parent /guardian

Name and address
of student
S.No.

3.

4.
5.

Details of tuition fee and hostel

charges
Name and address
Date of
Course and year
of the
birth / Age
of study
For balance
parent/guardian
Per year
course of study

Sum Insured
a) Per Student
b) Per Parent / Guardian (named above) Rs.
c) Tuition fee, Hostel charges etc. Total Rs.
d) Hospitalisation Insurance (optinal)
e) Baggage Insurance (optional)
Are the students and parents / guardians mentioned in item No.2
above do suffer from any physical defect or disability please give
details
Are the above students are in good health and free from physical and
mental diseases if no please give details.

504

6.
7.

Are the persons proposed for insurance does have any existing
inserted cover similar to the proposed one? If yes give details.
Period of Insurance:

Note : Sections I & II are compulsory and Sections III and IV are optional.
I / We hereby declare that the details furnished above are true to the best of my / our
knowledge and belief and I / we hereby agree that this declaration shall form the basis of
the contract between me / us and the Company.
Date:
Place:
SIGNATURE OF PRINCIPAL OR HEAD OF INSTITUTION
PROHIBITION OF REBATES:
The following is an extract of Section 41 of Insurance Act 1938
(1) No person shall allow or offer to allow either directly or indirectly as an
inducement to any person to take out or renew or continue an insurance in respect of
any kind of risk relating to lives or property in India any rebate of the whole or part of
the commission payable or any rebate of the premium shown on the policy nor shall
any person taking out or renewing or continuing a policy accept any rebate except such
rebate as may be allowed in accordance with the prospectus or tables of the Insurers.
(2) Any person making default in complying with the provisions of this section shall be
punishable with fine which may extend to one hundred rupees.

505

UNI-STUDY CARE GROUP INSURANCE CLAIM FORM

The issue of this form does not constitute admission of liability.
Please return this form duly completed together with relevant reports / Bills / Certificates
etc.,
Policy No:

Claim No:

1. (a) Name of the College / Institution

(b) Address

(a)
(b)

c) Name of the claimant

d) Address
2.

Particular of injured person :

(a) Name in full

(a)

(b) Last full postal address

(b)

(c) Last occupation

(c)

(d) Age at the time of accident

(d)

Details of accident:
a) When did the accident happen(Give date and
exact time)
b) Where did the accident happen
c) Give full description of the accident, its cause
and injuries sustained
d) State date, time and place of death
e) Give names and addresses of two persons who
witnessed the accident.
f)

Was the injured person free from infirmity at the

time of accident? If not give particulars.

g) Was the injured person under the influence of

drugs or drink at the time of accident?
h) Name and address of the hospital where the
injured person was treated after the accident.
4

Hospitalisation details:
a) Name of the student (in respect of whom claim is a)

506

made)
b) Present completed age
c) Nature of Disease / Illness contracted or injury
sustained
d) Date of injury sustained or disease/illness first
detected
e) Name and address of the Hospital / Nursing
Home
f) Date of Admission
g) Date of Discharge
h) Details of expenses
(supporting Bills / Receipts / Cash Memos along with
discharge summary are to be enclosed to this claim
form)

b)
c)
d)
e)
f)
g)
h)
i)

a) Give details of baggage lost with cause and value (a)

(attach separate list if necessary)
b) Where and how was the baggage lost? Give full (b)
details.
c) When and to which police station was it reported
(please attach copy of FIR)

Has the Insured sustained similar loss/es prior to this

loss? If yes, give details of insurer and claim amount.

Amount of loss Claimed

Rs...............

I/ we declare that the above information furnished are correct in all aspects.
Date:
Place:

Signature of student / claimant

Signature of principal / head of institution

507