principles of Insurance Contracts: When You Need A Lawyer

Understanding how insurance contracts work can be very beneficial when you are deciding if you need a lawyer after a car crash or other serious personal injury. There are seven basic principles applicable to insurance contracts relevant to personal injury and car accident cases:

1. Utmost Good Faith
2. Insurable Interest
3. Proximate Cause
4. Indemnity
5. Subrogation
6. Contribution
7. Loss Minimization

Below we explain each item briefly, including how each may relate to a potential injury lawsuit. These principles are open to interpretation. If you think one of these principles has been breached, or your insurance claim has wrongfully been denied, we recommend using our free case evaluation to help decide whether hiring a lawyer makes sense for you.

The Principle of Utmost Good Faith

• Both parties involved in an insurance contract—the insured (policy holder) and the insurer (the company)—should act in good faith towards each other.
• The insurer and the insured must provide clear and concise information regarding the terms and conditions of the contract

This is a very basic and primary principle of insurance contracts because the nature of the service is for the insurance company to provide a certain level of security and solidarity to the insured person’s life. However, the insurance company must also watch out for anyone looking for a way to scam them into free money. So each party is expected to act in good faith towards each other.

If the insurance company provides you with falsified or misrepresented information, then they are liable in situations where this misrepresentation or falsification has caused you loss. If you have misrepresented information regarding subject matter or your own personal history, then the insurance company’s liability becomes void (revoked).

See how a social media post could ruin a personal injury case.

The Principle of Insurable Interest

Insurable interest just means that the subject matter of the contract must provide some financial gain by existing for the insured (or policyholder) and would lead to a financial loss if damaged, destroyed, stolen, or lost.

• The insured must have an insurable interest in the subject matter of the insurance contract.
• The owner of the subject is said to have an insurable interest until s/he is no longer the owner.

In auto insurance, this will most times be a no brainer, but it does lead to issues when the person driving a vehicle doesn’t own it. For instance, if you are hit by a person who isn’t on the insurance policy of the vehicle, do you file a claim with the owner’s insurance company or the driver’s insurance company? This is a simple but crucial element for an insurance contract to exist.

The Principle of Indemnity

• Indemnity is a guarantee to restore the insured to the position he or she was in before the uncertain incident that caused a loss for the insured. The insurer (provider) compensates the insured (policyholder).
• The insurance company promises to compensate the policyholder for the amount of the loss up to the amount agreed upon in the contract.

Essentially, this is the part of the contract that matters the most for the insurance policyholder because this is the part of the contract that says she or he has the right to be compensated or, in other words, indemnified for his or her loss.

The amount of compensation is in direct proportion with the incurred loss. The insurance company will pay up to the amount of the incurred loss or the insured amount agreed on in the contract, whichever is less. For instance, if your car is inured for $10,000 but damages are only $3,000. You get $3,000 not the full amount.

Compensation is not paid when the incident that caused the loss doesn’t happen during the time allotted in the contract or from the specific agreed upon causes of loss (as you will see in The Principle of Proximate Cause). Insurance contracts are created solely as a means to provide protection from unexpected events, not as a means to make a profit from a loss. Therefore, the insured is protected from losses by the principle of indemnity, but through stipulations that keep him or her from being able to scam and make a profit.

The Principle of Contribution

• Contribution establishes a corollary among all the insurance contracts involved in an incident or with the same subject.
• Contribution allows for the insured to claim indemnity to the extent of actual loss from all the insurance contracts involved in his or her claim.

For instance, imagine that you have taken out two insurance contracts on your used Lamborghini so that you are covered fully in any situation. Let’s say you have a policy with Allstate that covers $30,000 in property damage and a policy with State Farm that cover $50,000 in property damage. If you end up in a wreck that causes $50,000 worth of damage to your vehicle. Then about $19,000 will be covered by Allstate and $31,000 by State Farm.

This is the principle of contribution. Each policy you have on the same subject matter pays their proportion of the loss incurred by the policyholder. It’s an extension of the principle of indemnity that allows proportional responsibility for all insurance coverage on the same subject matter.

The Principle of Subrogation

This principle can be a little confusing, but the example should help make it clear. Subrogation is substituting one creditor (the insurance company) for another (another insurance company representing the person responsible for the loss).

• After the insured (policyholder) has been compensated for the incurred loss on a piece of property that was insured, the rights of ownership of this property go to the insurer.