miscellaneous manual 1

UNITED INDIA INSURANCE COMPANY LIMITED

MISCELLANEOUS INSURANCE MANUAL

MISCELLANEOUS DEPARTMENT

HEAD OFFICE

24, WHITES ROAD, CHENNAI – 600 014

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CONTENTS

S.N Particulars Page

No.

1 Preface 6

2 Miscellaneous insurance 9

3 Personal Accident ( Individual & Group ) 31

4 Flight Coupons 54

5 Students Safety Insurance Scheme 57

6 Bhagyashree Child Welfare 61

7 Rajarajeswari Mahila Kalyan Bima Yojana 67

8 Cradele Care 79

9 Burglary Insurance ( Business Premises ) 85

10 Travelers baggage insurance 94

11 All risk Insurance 98

12 Money in transit Insurance 103

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13 Plate Glass Insurance 113

14 Television Insurance 116

15 Pedal Cycle Insurance 118

16 Cycle Rickshaw Insurance 121

17 Gun Insurance 123

18 Golfer’s 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

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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

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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

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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

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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.

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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.

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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)

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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 holder’s 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

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

mortgagor)

b. Lawful possession proprietors for carriers & pawn brokers)

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

5. 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.

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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 INTEREST-

Insurance 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

employer’s 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

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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.

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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

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• 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

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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 Rs.1,500/-

Let the amount of loss sustained be 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 = Claim payable

Total value Loss Sustained.

OR

Claim payable = Sum Insured x Loss sustained

Total value = 1000

1500 x 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.

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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

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the loss. The premium thus calculated should be the "pure risk premium". The actual

premium charged to the insured is suitably loaded to take 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.

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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

1 Month - 25% of Annual Rate

2 Months - 35% 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.

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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.

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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.

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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.

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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.

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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.

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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 anything to the

contrary which the policy 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.

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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

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ionizing radiation, or contamination by radio activity from any nuclear fuel or from any

nuclear weapons material.

E. DEPRECIATION, DELAY, LOSS OF MARKET :

F 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

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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.

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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

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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 claims

procedural Manual may be referred for further details

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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, Golfer’s

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.

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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 proposer’s 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 be more

32

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/-.

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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 insured’s 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 insured’s 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 :

Table I- 48 - 60 months salary /income

Table II & III -48-60months salary income

Table IV - 24 months salary / income

4a. 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.

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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

TableRisk Group

IRisk Group

II

I. Death only 0.45 0.60

II. Death, Permanent Total Disablement

0.65 0.90

III. Death, PTD & Permanent Partial Disablement

0.95 1.25

IV. Death, PTD, PPD & Temporary Total Disablement

1.50 2.00

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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.

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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 - 5

Great - one phalanx - 2

Other than great, if more than one toe lost each 1

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ii. Loss of hearing - both ears 50

iii. Loss of hearing - one ear 15

iv. Loss of four fingers & thumb of the hand 40

v. Loss of four fingers 35

vi. Loss of thumb - both phalanges 25

Loss of thumb - one phalanx 10

vii. Loss of index finger

- Three phalanges 10

- Two phalanges 8

- one phalanx 4

viii. Loss of middle finger

- Three phalanges 6

- Two phalanges 4

- one phalanx 2

ix. Loss of ring finger

- Three phalanges 5

- Two phalanges 4

- one phalanx 2

x. Loss of little finger

- Three phalanges 4

- Two phalanges 3

- one phalanx 2

xi. Loss of metacarpals

- first or second (additional) 3

- third, fourth of fifth (additional) 2

xii. Any other partial disablement % as assessed by the Doctor

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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 Children’s 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.

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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 radiation’s 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 charging 20% extra on the

45

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 class-

wise 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

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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.

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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.

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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 5

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 (Coroner’s 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 :

PASSENGER’S 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

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and irrecoverable loss of sight in INSURED

one eye

C. Cause or necessarily result in the complete THE CAPITAL

and irrecoverable loss of sight in both eyes. SUM INSURED

Clause 2: Should such injury, within 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

disable and prevent the insured from attending

to his business or occupation for the period of

such total disablement with a maximum of 100

weeks from the date of the accident. Maximum

weekly benefit not to exceed 1% of the C.S.I.

subject to a maximum of Rs.5000

1% OF THE

CAPITAL

SUM

INSURER

PER WEEK

Clause 4: Should such injury solely directly and totally

disable the insured and prevent him from

attending to a substantial portion of his business

or occupation, compensation for the period of

such partial disablement with a maximum of 52

weeks from the date of the accident

0.15% OF

THE

CAPITAL

SUM

INSURED

PER WEEK

55

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. Parts Lost in Percentage capital

Benefit Compensation

i. Loss of toes- Great both phalange - Great-one phalanx - Other than Great, if more than

one toe lost – each

all 20521

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

vi. Loss of thumb one Phalanx - both phalanges 25

vii. Loss of index finger - three phalanges-Two phalanges-one phalanx

1084

viii. Loss of middle finger

- three phalanges-Two phalanges-one phalanx

542

ix. Loss of ring finger

- three phalanges-Two phalanges-one phalanx

542

x. Loss of little finger

- three phalanges-one phalanx

42

xi. Loss of metacarpals - First or second(additional)-third, fourth or fifth (additional)

3

2

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. Compensation limits :

A. 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 % AGE OF DISCOUNT250-1,000 51.001-10,000 1010,001-1 LAC 15ABOVE 1LAC-2.5 LACS 30ABOVE 2.5 LACS-5 LACS 35ABOVE 5 LACS-10 LACS 40ABOVE 10 LACS 45

4. AGENCY COMMISSION : 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

Amount disbursement

Payable to

1-5 years Rs.1,200 per annum Surviving parent or guardian for looking after the needs of the child.

6-11 years Rs.1,200 per annum Surviving parent or guardian provided the girl child is admitted in a school and expenditure is incurred on her education.

12-17 years

Rs.2,400 per annum Surviving parent or guardian provided the girl child is admitted in a school and expenditure is incurred on her education.

18 years Balance amount to the credit of the girl

child

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. Policy No. code Agency Code: Dev.: Officer :2. Annual Premium : Rs.3. Name of the girl child to be

insured:

4. Age of the child :5. Names of the parents : Shri.

Smt.6. Address of the parents :7. Name of the guardian nominated :8. Address of the guardian :9. Period of Insurance : From__________ at_______ AM/ PM

To ___________________ (Midnight)10. Proposal Dated :11. 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) SumInsured

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 extendedcover)

7. Nomination details: NameAddressRelationship with proposer

Witness to nominationName & Address with signatureName & Address with signature

8. Policy Period (1 Year to 5 Years)9. Period of Insurance From To

10. 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:

Dev. Officer code

PremiumBasic CoverExtended Cover

: Rs.Rs.

Total Premium : Rs.

Name of the insured :

Address of the Insured :

Age of the insured (Completed years) :

Occupation of the Insured :

Name and Age of the Husband (if applicable)

:

Period of Insurance : From:___ at _____ AM / PMTo______________(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

Insured’s 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. No.

Risk covered Compensation payable

Temporary total disablement arising out of an accident-define d herein above and resulting in hospitalization as an inpatient resulting in total disability to engage in any occupation or work or employment

Rs.500/- per month subject to a maximum of Rs.1,500/-

Legal Divorce: Actual legal expenses necessarily Actuals not

72

incurred for legal divorce proceedings initiated during the currency of the Policy and incurred during 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.

exceeding Rs.2,000/-

Loss and or damage to household goods / personal effects whilst contained in house / dwelling arising out of fire, lightning, riots, terrorism, storm, typhoon, flood cyclone and earthquake.

Upto a limit of Rs.2,000/-

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, semi-

urban 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 %

1 NIL

2 5

3 10

4 15

5 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 AddressRelationship of Claimant with the deceased

a)b)c)

2. State nature of title under which Claimant is claiming the amount

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

3. Name (in full)Last full Postal AddressLast OccupationAge 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 particularsWas 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 ofThe Hospital, Clinic or Nursing Home where the deceased was treated after the accidentThe Physician / Surgeon who attended on the deceased after the

a)

b)

c)

d)i)ii)

77

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

iii)

(i)(ii)

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

a)b) from to

10.

If legal divorce is coveredName 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,

a)b)c)

d)

e)

11. If damage to house-hold goods / personal effects ifs coveredTime and date of loss / eventCause of loss / eventDescription of items lost / damagedDescribe in detail the total event giving rise to the claimHas the fire / event loss been reported to Fire Brigade / Police or other Authorities?Extent of loss

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 2. SignatureName NameAddress 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

person2. Residential Address / Permanent Address:3. Address for Correspondence:4. 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?

5. If so, give names and address of each company in respect of i, ii, iii and iv above.

i) Name of Co.--ii) Sum insured iii) Policy No.---

6. Please indicate a) Capital Sum Insured b) Period of insurance

a) Rs. ----------------------------------------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 : Proposer’s SignatureDate : 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:

Policy No:

Date of proposal and DeclarationStatistical code:

Issuing Office:

INSURED:

Name:

Address :

PERIOD OF INSURANCE

From:

To:

Name & Address of the Hospital / NursingHome / Midwife

SUM INSURED Rs.

PREMIUM 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 20Prepared 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. CLAIM NO.

1.A) Name of the Insured:B) Address:C) Occupation:

2. A) Name and address of the mother:B) Age:

C) Height / Weight:

3. a) Date / Year of marriage b) Treatment particulars if any during pregnancy to delivery:

c) Date of delivery:d) Place of delivery:e) Name and address of the Hospital / Nursing Home:f) Name and address of midwife:g) Name of the Physician / Surgeon / Gynaecologist who attended at the time of delivery:

4. a) State of health of the mother prior to delivery:b) State of health of the mother after delivery:c) Health condition of the child after birth:d) 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 ofdelivery, 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, afterany accident.

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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:

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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 Insured’s 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.

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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

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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 insured’s family or employees or any person lawfully in the

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

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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. Nuclear risks.

g. 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 Insured’s option and with the consent of the Insurer.

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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.

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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 Company’s

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

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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 0.125%

b) Vulnerable goods like curios, liquors, metals, motor vehicle parts, pens, radios,

readymade garments, Electronic gadgets, wrist watches etc., 0.30%

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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.

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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 Report, Survey Report, Internal

Investigation report, Legal Opinion (if required)

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TRAVELLERS’ BAGGAGE INSURANCE

SELECTION OF RISKS

This insurance is intended to cover accompanied baggage (not dealer’s stock or

traveller’s 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.

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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 Insured’s 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.

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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.

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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 insured’s attention to the condition of the

policy under which he is required to take all reasonable care to safeguard the property.


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.

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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 jeweller’s 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..

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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. Consequential loss or legal liability of any kind or description.

i. Articles of consumable nature.

j. Loss of or damage to any property whilst being conveyed by any carrier

under contract.

k. Nuclear risks.

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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 insured’s 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

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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.


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%.

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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.

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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

insured’s 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 insured’s

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 insured’s

premises or bank on the day of collection. Authority from the controlling office is

necessary before confirming this extension.

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It is possible to extend the cover when money is carried by persons other than the

insured’s 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 insured’s 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.

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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 Insured’s 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 Insured’s premises

out of business hours against the risk of burglary, house

breaking and hold - up.

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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.

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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 insured’s 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.

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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 insured’s 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.

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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.

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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%



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 day’s 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.

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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


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.

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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.


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.

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CARE OF PROPERTY INSURED :

It is desirable to specifically draw the insured’s 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 :


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.

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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


This insurance is intended to cover Pedal Cycle against loss or damage by

accidental means, Fire, Theft. Insured’s 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. Insured’s 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 insured’s 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.

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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:

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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


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.

2 Insured’s 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. Rs.500/- for damage to the goods.

5. Cost of legal expense incurred with the company’s consent will

also be reimbursed.

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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 workmen’s compensation liability for one domestic servant

as per the provisions of the Workmen’s Compensation Act.

Section 4. Personal accident benefits for the Insured, Insured’s 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 Insured’s 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 :

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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 Insured’s 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.

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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 insuredSection II : For limit of Rs.50,000/- Rs. 15/-

For limit of Rs.1,00,000/- Rs. 25/-Section III : Rs. 10/- per employeeSection IV : As per PA guidelinesSection 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

GOLFER’S INSURANCE POLICY


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 insured’s 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.

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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

GOLFER’S 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 Insured’s 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

1 Death. Rs.25000/-

2 Total and irrecoverable loss of all sight in both eyes.

Rs.25000/-

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

Rs.25000/-

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

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or one foot together with the total and irrecoverable loss of all sight in one eye.

5 Total and irrecoverable loss of all sight in one eye.

Rs.12500/-

6 Total loss by physical severance of one hand or one foot.

Rs.12,500/-

7 Total disablement from engaging in or attending to usual

Rs.90/- per for a week

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 Insured’s 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 insured’s residence or in any recognised Golf Club House or Professional’s 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 Insured’s right to recover hereunder.

SCHEDULE

POLICY No.

THE INSURED:

ADDRESS:

AGENCY:

PERIOD OF INSURANCE:

a) From the ------------------------------------

to the

(at 4.0' clock p.m.)

b) Any subsequent period for which the

Insured shall pay and the Company shall

agree to accept a renewal premium:

PREMIUM: Rs.

STAMP DUTY Rs.

TOTAL Rs.

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


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.

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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.

2. Any claim arising out of any contractual liability.

3. Consequential loss of any kind.

4. 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


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

Insured’s legal liability to pay compensation including claimant’s 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

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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 is’AOA’ 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 :

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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 Insured’s employees.

2. The Officers, Committees and Members of the Insured’s 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 Company’s 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 :

Company’s total liability to pay compensation, Claimant’s 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 Company’s 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.

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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 Insured’s 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 Insured’s 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 insured’s

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.

PUBLIC LIABILITY

(Non - Industrial Risks)

1. Applicability

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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

1 Week : 10% of the Annual rate

1 Month : 25% of the Annual rate

2 Months : 35% 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 of Indemnity AOA to AOY

1 : 1 1 : 2 1 : 3

1234

0.15 pm0.18 pm0.21 pm0.24 pm

0.22 pm0.26 pm0.30 pm0.34 pm

0.27 pm0.32 pm0.37 pm0.42 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)Multiplier

Limit of Indemnity per any one accident


Upto 10 28 Upto 350 - 1st 300Next 50

1817

Upto 25 - 1st 10 28 Upto 400 - 1st 350 17Next 15 26 Next 50 16Upto 50 - 1st 25 26 Upto 450 - 1st 400 16Next 25Upto 75 - 1st 50

2525

Next 50Upto 500 Ist 450

1515

Next 25 24 Next 150 14Upto 100 - 1st 75 24 Upto 600 - 1st 500 14Next 25 23 Next 100 13.5Upto 150 - 1st 100Next 50

23 21

Upto 700 1st 600Next 100

13.513

Upto 200 -1st 150 21 Upto8001st 700 13Next 50 20 Next 100 12Upto 250 – 1st 200Next 50

2019

Upto9001st 800 Next 100

12 11

Upto 300 - 1st 250Next 50

1918

Upto10001st 900Next 100

1110

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 LocationRatio of

Indemnity AOA to AOY

1 : 1 1 : 2 1 : 3

1234567891011121314

15 & above

1.01.351.501.651.81.91.952.02.02.02.02.02.02.02.0

1.01.51.701.902.052.152.252.352.452.502.502.502.502.502.50

1.01.62

2.252.52.652.752.852.95

33.053.103.153.153.15

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.

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TABLE 4

LOADING ON TURNOVER

(For Risk Group 1)

Annual Turnover Premium 0%

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

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

Exceeding Rs.5 crores but not exceeding Rs.10 crores(Next Rs.5 crores)

Rs.3800 + 0.06 %o on the excessover Rs.5 crores

Exceeding Rs.10 crores but notExceeding Rs.50 crores(Next Rs.40 crores)

Rs.6800 + 0.05%o on the excess over Rs. 10 crores

Exceeding Rs.50 crores but notexceeding Rs.100 crores(Next Rs.50 crores)

Rs.26800 + 0.04%o on the excess over Rs.50 crores


Rs.46800 + 0.03%o on the excessover Rs.100 croes

Exceeding Rs.250 crores but notexceeding Rs.500 crores(Next Rs.250 crores)

Rs.91800 + 0.02 %o on the excessover Rs.250 crores

Exceeding Rs.500 crores Rs.141800 + 0.01 %o on the excessover 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 PREMIUM234

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

2 - 7.5 pct on gross premium

3 - 5 pct on gross premium

4 - 2.5 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/-.

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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 year’s gross annual turnover or the current year’s

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

2 - 7.5 pct of gross premium

3 - 5 pct of gross premium

4 - 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 :

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Zone 1 - 10 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/-.

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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 :






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/-


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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 Insured’s 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 Insured’s 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 :






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 year’s 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 move-

25% loading on the indemnity premium should be charged.


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 premium + 75% per 1 cub. meter

100% of indemnity premium + Turnover extra.

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

50% of indemnity premium + 1.50 paise per 1 cub meter.

as above

Extra IV Hazardous

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

50% of indemnity premium + Rs.3/- per 1 cub. metre.

as above

166

FOR CLASS II CONSTRUCTION & OTHERS

Risk Group Shops / Depots Warehouses 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 premium + 75% per 1 cub. metre.

100% of indemnity 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.

As above

Extra hazardous IV

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

75% of indemnity 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.


Compulsory Excess: 0.50% of AOA limit subject to a minimum of Rs.2, 50,000/-


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.


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/-.

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PUBLIC LIABILITY INSURANCE (NON INDUSTRIAL RISK)

SCOPE OF COVER (GENERAL):

Public Liability insurance policy is meant to indemnify the Insured against the

Insured’s legal liability to pay compensation including claimant’s 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 is’AOA’

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 Insured’s employees.

2. The Officers, Committees and Members of the Insured’s 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 Company’s total liability not exceeding the limits of. indemnity

stated in the Schedule of the policy.

DEFENCE COSTS :


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 :

Company’s total liability to pay compensation, Claimant’s 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 Company’s 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 Insured’s 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 Insured’s 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 insured’s


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, other

176

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 a

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 physician’s 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) Employer’s 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 RATE

Upto Rs.1.00 cr. Rs.0.12 per mille subject to a minimum of Rs.12/-

Exceeding Rs.1.00 crores but not Rs.1200/- +0.084 per mille onexceeding Rs.5 cr. turnover exceeding Rs.1cr.Exceeding Rs.5cr. But not Rs.4860 + 0.072 per mille onexceeding Rs.10cr. turnover exceeding Rs. 5cr.Exceeding Rs.10 cr. But not Rs.8160 + 0.060 per mille onexceeding Rs.50 cr. turnover exceeding Rs.10 cr.Exceeding Rs.50 cr. But not Rs.32160 + 0.048 per mille on turnover exceeding Rs.100 cr. exceeding Rs.50 cr.Exceeding Rs.100 cr. But not Rs.56160 + 0.036 per mille on exceeding Rs.250 cr. turnover exceeding Rs.100 cr.Exceeding Rs.250 cr.But not Rs.110160 + 0.010 per mille onexceeding Rs.500 cr. turnover exceeding Rs.250 cr.Exceeding Rs. 500 cr.But not Rs.135160 + 0.0075 per mille onexceeding Rs.1000 cr. turnover exceeding Rs.500 cr.Exceeding Rs.1000 cr.But not Rs.172660 + 0.0050 per mille onexceeding Rs.2000 cr. turnover exceeding Rs.1000 cr.Exceeding Rs.2000 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 5 years from the occurrence offor relief accident.

For complying all formalities 3 months from the date of and announcing and Award receipt of application.

For delivering copies of the 15 days from the date of Award.Award to the parties.

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.


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.

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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 Company’s Engineer and his recommendation as

per Risk Assessment Report.

5. Transportation risks outside Insured’s 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 Insured’s liability arising out of and incidental to transportation of materials only

including hazardous/dangerous substances outside the Insured’s 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 Insured’s manufacturing plant(s) will also cover non-

manufacturing premises such as offices, depots, warehouses, storage godowns,

tank farms etc. situated at different places which are incidental to the business

activities of the insured’s 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.

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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.

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10. Retroactive Date

Retroactive date is the date when the risk is first incepted under a “claims made”


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.

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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)

Discount

57.5101520253550

2.55.07.510.012.515.02025

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.


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 rate1 Month 25% of the Annual rate2 Months 35% of the Annual rate3 Months 50% of the Annual rate4 Months 60% of the Annual rate6 Months 75% of the Annual rate8 Months 85% of the Annual rateExceeding 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 Ratio of Indemnity

AOA to AOY

1 : 1 1 : 2 1 : 3

1234

0.15 pm0.18 pm0.21 pm0.24 pm

0.22 pm0.26 pm0.30 pm0.34 pm

0.27 pm0.32 pm0.37 pm0.42 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.

190

TABLE - 2

LIMIT OF INDEMNITY AND MULTIPLIER THEREOF

Limit of Indemnity Per any one accident


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



13



12



11



10



9.25



8.6



8.25



8



7.75



7.6


7.5

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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 Ratio of Indemnity

AOA to AOY

1 : 1 1 : 2 1 : 3

123456789

1011121314

15 & above

1.01.351.501.651.81.9

1.952.02.02.02.02.02.02.02.0

1.01.51.71.9

2.052.152.252.352.452.52.52.52.52.52.5

1.01.62.0

2.252.5

2.652.752.852.953.003.053.103.153.153.15

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 year’s gross annual turnover

or the current year’s 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)


Exceeding Rs.10 crores but not exceeding Rs.50 crores (Next Rs.40 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



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

2 110% 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

1 10% 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 premises

Additional premium to be charged on the indemnity premium

1. Upto 1 Km Nil

2. Upto 5 Km 5%

3. Upto 10 Km 7.5%

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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,

Depots, rest houses and other

business connected with Insured’s

business

Percentage of additional premium

to be charged on the gross premium

including pollution premises

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

I 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 Collaborator’s 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


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.


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.

202

LIMITS OF INDEMNITY

Any one person Rs.

Any one accident Rs.

Any one year Rs.

Annual Premium per lift

5,00010,00020,00050,000

1,00,000

10,0025,00040,000

1,000002,00,000

25,00050,000

1,00,0002,00,0005,00,000

5075

100150250

PROPOSAL FORM FOR (PUBLIC LIABILITY) INSURANCE

1. a) Name of Proposer (in full)b) Addressc) 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.)

No. of floors served

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

working hours.b) Are the lifts allowed to be operated by users without the

assistance of attendant?

a)

b)

5. a) Is each lift shaft completely enclosed?b) Is each lift shaft fitted with a gate?c) Is each lift cage fitted with a gate which is securely fastened

when shut?

a)b)c)

6. a) State the name and address of the Engineer with whom the 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

Engineer's report pertaining to that inspection

a)

b)c)

7. Is any notice displayed in the Lifts for the information of the users thereof? If so given details?

203

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 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 respect of this or other Lifts? If so, give below particulars.

a)

b)

Date of Accident Details of Claims Name of Insurer Amount recovered Rs.

Amount to be

recovered Rs.

10. Has any insurer in respect of any lift (public liability insurance cover)a) Declined a proposal from the proposer, orb) Cancelled or declined to renew any policy, or c) Demanded an increased rate, ord) Required special terms to insure or grant any renewal?

a)b)c)d)

11. State the limit of indemnity required a) Any one accident or series of accidents arising out of anyone event

b) All accidents during the period of insurance

Rs.

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) Insured’s legal liability for bodily injury to any person not being of Insured’s

family or Insured’s 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

Insured’s family or Insured’s 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, claimant’s 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

company’s 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 company’s 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 Company’s 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 Insured’s 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.

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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 insured’s


steps to prevent claims.

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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. Arising out of any product guarantee.

I. 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.

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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.

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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

1 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.

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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. VENDOR’S 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

vendor’s products subject to the following additional provisions.

1. The Insurance with respect to the vendor does not apply to

A. 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.

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C. Bodily injury or Property Damage occurring within the vendor’s 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 vendor’s could be either named or unnamed and the cover is called limited

Vendor’s 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

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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.

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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.

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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.


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 insured’s premises.

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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

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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.


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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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





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

12. Vendor’s Liability Extension

It shall be permissible to grant only “Limited Vendors Liability” extension under

the Policy covering exports as per the Vendor’s 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”


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PRODUCTS LIABILITY AGREEMENT

SECTION - II

RATING

A. On Turnover

The following minimum rates shall be applied on the previous year’s actual gross

annual turnover or the current year’s projected annual turnover whichever is higher. The

term ‘Turnover’ shall mean annual gross sales including all taxes and levies.

TABLE - I

Risk Group Minimum Rate (permille)

1.2.3.4.5.6.7.

0.030.050.070.090.110.130.15

B. 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.

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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


Rs.2,800 + 2.15 per mille on the excess of Rs.10 lakhs











Exceeding Rs.250 Rs.41,275 + 1.10 per mille on the excess of Rs.250

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Lakhs but not exceeding Rs.300 lakhs

lakhs















Where the ratio of AOA to AOY is different, the indemnity period would be modified as

below:

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Ratio AOA:AOY Premium

1:2 80% of the above Table II



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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 Co-

operation 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.

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(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 Multiplier

I 15

I 5

III 2

5. 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.


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

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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 Vendor’s 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 Collaborator’s 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

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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

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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 insured’s 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 insured’s 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 another’s advertising idea in advertisement

- Infringing on other’s copyright, trademark/slogan

- Oral/written publication that violates a person’s 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

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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

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- 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

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- 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

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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 person’s 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.

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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

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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

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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

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EMPLOYEES (WORKMEN’S) COMPENSATION INSURANCE

This Insurance is intended to cover the employer for liability towards payment of

compensation under the amended Workmen’s 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

(Workmen’s) 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 contractor’s 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.

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The Workmen’s 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

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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 half-

monthly 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,

1923, vide Notification dated 18th

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,

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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 (Workmen’s) 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.

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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

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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.

Insured’s 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;

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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.

Proposer’s names in full ___________________________________________________________Proposer’s business [Correspondence] address __________________________________________Proposer’s trade or occupation ______________________________________________________

Particulars of work to be covered in Detail:_______________________________________________________________________________

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______________________________________________________________________________________________________________________________________________________________

Risk Location address(s) ___________________________________________________________

Policy Period: From: ___________________ To _________________

COVERAGE’S REQUIRED

Coverage Scope of coverage Aggregate Limit of Indemnity Coveage Options [Yes/No]

Employees Compensation

Subject otherwise, to the terms, conditions & Exclusions of the Policy, the amount of liability incurred by the Insured.

Limit: As per Employees Compensation Act

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.____________________________

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c) Aggregate Limit for all accidents and claims arising there from during the Period of Insurance Rs.____________________________

Medical Expenses :

Subject otherwise, to the terms, conditions & Exclusions of the Policy, the amount of liability incurred by the Insured, but not exceeding:

d) Limit Per Employee for any number of accidents during Period of Insurance Rs.____________________________

e) Aggregate liability for all accidents during the Period of Insurance Rs.____________________________

Occupational Diseases

f) Limit Per Employee Rs.____________________________

g) Aggregate liability of the company for all employees during the Period of Insurance Rs.____________________________

Contractors Employees

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

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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

EmployeesDeclared

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

Name Registered Address

Declared Number of Employees

Total Declared wages during the

period of insurance.

Place/Places of

Employment

** 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.

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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..............................….


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 Company’s 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.

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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.

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3. Mis-representation/Non-Disclosure: This Policy shall be void in the event of any mis-representation 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. Company’s 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

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Company shall indemnify Insured’s 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:

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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.


POLICY SCHEDULE

(Forming part of Policy No.______________ whose terms are attached herewith)

1. Insured:2. Address:

3. Business:

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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) Employee’s Compensation Act, 1923 and subsequent amendments thereof prior to the date of issue of this Policy

Subject otherwise, to the terms, conditions & Exclusions of the Policy, the 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

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Service Tax RsTotal Premium

Rs

7. Details of Employees Covered:

Description of work done by Employees

Declared Number of Employees

Declared Wages during the Period of Insurance

Place/Places of Employment

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.

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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.

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f. Any compensation for diseases mentioned in Part "C" of Schedule III of the

Workman’s 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

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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.

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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.

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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).

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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.

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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.

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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.

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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

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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

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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


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.

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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.

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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 (employer’s liabilities)

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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

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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.

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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.

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DOCTOR’S 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

1:1 1:2 1:3 1:40.50 0.40 0.35 0.30

2. Specialists / Consulting Physician (Non - surgical)

1.0 0.80 0.70 0.60

3. Surgeons (excluding specialists in Plastic Surgery). Lithotripsy, Dentists & similar extra corporal methods of treatment would fall within this category.

2.0 1.6 1.4 1.2

4. Surgeons (Plastic Surgery) and Anaesthetists

3.0 2.4 2.10 1.803.0 per mille on AOY limit

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) ‘Bodily Injury’ means death, injury illness or disease of / or to any person.

2. 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

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the Schedule in respect of any or all claims made against the insured during the currency

of this insurance.

3. DEFENCE COSTS


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.

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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. EXCLUSIONS

1. 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.

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b) Plastic surgical repair of scar tissue being the result of previous

surgery unrelated to cosmoses performed by the Insured.

c) Plastic surgery in connection with burns or other traumatic injury.

(vi) 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 insured’s 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 company’s liability or

obligations under this policy beyond what the company’s 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.

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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 insurance’s 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 Insured’s 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 mis-

statement 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.

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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

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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.

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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 3

1:2 2.40

1:3 2.10

1:4 1.80

(number of participants to be as per previous year’s 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/-.

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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%

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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 year’s 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

1:1 1:2 1:3 1:4Basic rate 12.5 10.0 8.75 7.5Plus Re 1 per mille of annual fees

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

1:1 1:2 1:3 1:4Basic rate 6.70 5.35 4.70 4.0Plus Rs.100 per capita for qualified personsPlus Rs.50 per capital for apprentices Plus 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/-

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3. LAWYERS, ADVOCATES, SOLICITORS AND COUNSELS

Rate per mille on AOY limits

1:1 1:2 1:3 1:4

Basic rate 8.35 6.70 5.85 5.0

Plus 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/-

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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.

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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.)

Licenses C.C. Not Exceeding Closed Body Other than

closed Body

Tankero are special

Product carries

Kgs Rs. Rs. Rs.508 571 761 10222032 626 836 11723048 683 911 13225080 946 1261 2022

For each additional

1016 112.50 150 300

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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

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EXCLUSIONS


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.

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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

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- 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.

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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 Company’s 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 Company’s 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 India’s 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. The Company has continually paid cash dividends on its

i) Common Stock since

ii) Preferred stock since

3. 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 19 19 20Total LoansTotal DepositsNet WorthReserve for Loan LossesNon performing loansNet write offsTotal investment securitiesNet Income for Fiscal yearInterest IncomeInterest ExpenseCumulative Retained EarningsTotal Capital Adequacy RatioTier 1 Capital Adequacy RatioTier 2 Capital Adequacy RatioReturn on AssetsReturn on Equity

314

Please advise latest independent ratings (giving the dates thereof and name of rating

agency)

b.Total consolidated AssetsCurrent AssetsCurrent LiabilitiesNet WorthStocks and / or Inventory (including work in progress)Net Income for fiscal yearNet Income Per ShareDividends Per ShareSales / 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. Give Details of any current Directors' and Officers' Insurance

i) Insurer:

ii) Limit

iii) Period

iv) Retention

v) Premium

2. 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:

0-25 25 - 50 50-75

75-100 100 - 200 200+

3. 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 No

b) i) 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. & Public Sector

undertakings and where lower rates than indicated above are charged.

323

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 insured’s 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 Party’s 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 Insured’s 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 Proposer2. Name of the financial institution (if any financial interest is

involved)3. Nature of trade or business4. Address of the premises to be insured5. 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 cycles11. 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 PARTICULARS AND DIMENSIONSwhether Glass isfront,rear

fixed inshop orside ordoor

No. ofSquarePanesCMs

Whether Plate or Sheet and Size of each Pane

whether Plain, Silvered in Cms.

Embossed, Curved, Stained.Each Pane

Lettered or Ornamented or or more than 1/4 in, thick

Height Width

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.

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 Insured’s 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 Insured’s household.

(3) compensation to Insured’s employees as per the WC act for any employment

injury (including fatal)

This Section excludes liability for accidents involving Insured’s 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 Insured’s 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.



operates.




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.


reference, award, its effect etc will be in accordance with the provisions of the


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


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


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 : Policy Coverage Premium (Rs)Full address of the Shop : A Sec I to VI 625Nature of trade : B Sec I to V 550Period of Insurance : C Sec I to IV 500

Section What is insured? Against what?

Max. Amount Payable

(Rs)

What is not insured?

1 2 3 4 5I Building including

Compound wall, Elec. Fixtures, other interiors,

Fire, lightning, explosion of gas in domestic appliances, riot, strike or

50000 Loss of or damage to motor vehicle and pedal cycles, money, securities bullion, bills of exchange, business books, unset precious stones

fixtures owned by Insured solely / partially occupied

malicious act, terrorist act, earthquake storm, tempest, flood, inundation

II ContentsConsisting of -------------

As aboveBurglary and / orHousebreaking

50,000 50,000

Same as above plus loss / damage be 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 persons1. Sex: Age:2. Sex: Age:3. Sex: Age:4. Sex: Age:

25,000 per person

Compensation for more than on 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.

IV Liability 1. Legal Liability towards general public

2. Legal Liability towardsemployees

5,000 10,000

Death of or bodily injury to an member of the Insured's family partners, liability assumed b agreement.

V Fidelity Guarantee Loss due to act of fraud, dishonesty committed by salaried persons.

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.

VI Cash in Transit Loss by accident, misfortuneLoss due to burglary / Housebreaking whilst in safe, till / counter

20,000 10,0005,000

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.

341

Schedule (Policy A/B/C)Name of the Insured : Policy Coverage Premium (Rs)Full address of the Shop : A Sec I to VI 875Nature of trade : B Sec I to V 825Period of Insurance : C Sec I to IV 775Premium paid :Rt No............ dt............

Section 1

What is insured?

2Against what? 3

Max. Amount Payable

(Rs) 4

What is not insured? 5

I 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

75,000 Loss of or damage to motor vehicle and pedal cycles, money, securities bullion, bills of exchange, business books, unset precious stones


As above

Burglary and / or

Housebreaking

75,000 75,000

Same as above plus loss / damage by 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:

30,000 per person

Compensation for more than on 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.

IV Liability 1. Legal Liability towards general public

2. Legal Liability towards employees

10,000 20,000

Death of or bodily injury to an member of the Insured's family partners, liability assumed by agreement.


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 10,000

5,000


342


Section What is insured? Against what? Max. Amount Payable (Rs) What is not insured?

1 2 3 4 5




II ContentsConsisting 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.


30,000 per person

Compensation for more than on 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.

IV Liability 1. Legal Liability towards general public2. Legal Liability towards employees

15,000 25,000 Death of or bodily injury to an member of the Insured's family partners, liability assumed b agreement.


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

10,0005,000


343



1 2 3 4 5






150,000 150,000

Same as above plus loss / damage b burglary where any employee of the Insured or any member of the Insured's family is concerned.


50,000 per person

Compensation for more than on 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.

IV Liability 1. Legal Liability towards general public2. Legal Liability towards employees

15,000 25,000 Death of or bodily injury to an member of the Insured's family 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.

VI Cash in Transit Loss by accident, misfortune Loss due to burglary / Housebreaking whilst in safe, till / counter

20,000

10,0005,000


344

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 a)b) Address b)c) Occupation c)d) Situation of premises insured d)

2. a) State the nature of Loss?(Fire, Burglary / housebreaking, Accident to persons, infidelity of employees etc.,)

a)

b) Date and Time of Accident / Loss b)c) Cause of accident / loss with details c)d) If the loss is due to fire, has the matter been reported to Fire

Bridge / Police Stationd)

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.

e)

f) In case of Burglary / housebreaking do you suspect any body? f)g) When and where was the property last seen by the Insured? g)h) On what date and time the property Loss was found? h)

3. a) Is the Insured sole owner of the property? If not give name and address of the owner.

a)

b) Are there any other Insurance on the property? If so give particulars.

b)

4. 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?

a)b)

c)d)

5. In case of accident to personsa) Name of the injured personb) Addressc) Occupationd) Age and next birthday

a) b) c) d)

6. a) Where did the accident occur a)

345

b) Give full description of injuries sustained with medical reportc) 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)

b) c)

d)

7. a) Particulars of any injury to persons (third Party) or damage to property of third party.

b) Name and address of the injured personc) Name of the Doctor or Hospital who have given first aid

assistance/ treatmentd) Has the injured person or property owner made any claim on

you? If so give particulars and also attach a copy of notice.

a)

b) c)

d)

8. a) In case of Workmen Compensation claim give name and address of the injured employee and date of appointment

b) Occupation of the employeec) Nature of work done at the time of accidentd) Details of percentage of disability with medical report

a)

b) c) d)

9. In case of Fidelity Guarantee claima) Name of defaulting employeeb) His present addressc) Date of Discovery of defalcationd) Full details of defalcatione) Date of defalcationf) In what capacity was he engagedg) Does the insured hold any security from the employee, if so to

what extenth) Has the insured taken any action against the employee? If so

state the nature of action taken.

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

h)

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 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 Proposer2. Name of the financial institution (if any financial

interest is involved)3. Nature of trade or business4. Address of the premises to be insured5. 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?


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 cycles11. 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

Statewhether Glass isfront,rear

fixed inshop orside ordoor

PARTICULARS AND DIMENSIONS

No. ofSquare

Panes

Whether Plate or Sheet and size of each pane

whether Plain, Silvered in CMS

CMS

Embossed, Curved, Stained.

Lettered or Ornamented or Height Width each or more than 1/4 in,

thickTOTAL

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



Premium Paid :

Rt No.______ dt_______


1 2 3 4 5




II ContentsConsisting of ----------


50,000 50,000



25,000 per person

Compensation for more than on 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.

IV Liability 3. Legal Liabilitytowards general public4. Legal Liabilitytowards employees

5,000

10,000

Death of or bodily injury to an member of the Insured's family partners, liability assumed b

349

agreement.


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.

VI Cash in Transit Loss by accident, misfortuneLoss due to burglary / Housebreaking whilst in safe,till / counter

20,000

10,000

5,000


350


Name of the Insured : Policy Coverage Premium (Rs)Full address of the Shop : A Sec I to VI 875Nature of trade : B Sec I to V 825Period of Insurance : C Sec I to IV 775Premium Paid :Rt No.______ dt_______


Max. Amount Payable

(Rs)


1 2 3 4 5I Building including

Compound wall, Elec. Fixtures, other interiors, fixtures owned by Insured solely / partially occupied


75,000 Loss of or damage to motor vehicle and pedal cycles, money, securities bullion, bills of exchange, business books, unset precious stones



75,000 75,000

Same as above plus loss / damage by burglary where any employee of the Insured or any member of the Insured's family is concerned.


30,000 per

person


IV Liability 1. Legal Liabilitytowards generalpublic2. Legal Liabilitytowards employees

10,000

20,000

Death of or bodily injury to an member of the Insured's family partners, liability assumed by agreement.



VI Cash in Transit Loss by accident,misfortune Loss due to burglary / Housebreakingwhilst in safe,till / counter

20000

10,000

5,000


351




Max. Amount Payable

(Rs)







100,000

100,000



30,000 per person


IV Liability 1. Legal Liabilitytowards generalpublic2. Legal Liabilitytowards employees

15,000

25,000




VI Cash in Transit Loss by accident, misfortuneLoss due to burglary / Housebreaking whilst in safe,till / counter

20,000

10,000

5,000


352




Max. Amount Payable

(Rs)







150,000

150,000

Same as above plus loss / damage by burglary where any employee of the Insured or any member of th Insured's family is concerned.


50,000 per person

Compensation for more than on 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.

IV Liability 1. Legal Liabilitytowards generalpublic2. Legal Liability towards employees

15,000

25,000





20,000

10,000

5,000


353

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.,


1. e) Name of the Insured a)f) Address b)g) Occupation c)h) Situation of premises insured d)

2. i) State the nature of Loss?(Fire, Burglary / housebreaking, Accident to persons, infidelity of employees etc.,)

a)

j) Date and Time of Accident / Loss b)k) Cause of accident / loss with details c)l) If the loss is due to fire, has the matter been reported to Fire

Bridge / Police Stationd)

m) 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.

e)

n) In case of Burglary / housebreaking do you suspect any body? f)o) When and where was the property last seen by the Insured? g)p) On what date and time the property Loss was found? h)

3. c) Is the Insured sole owner of the property? If not give name and address of the owner.

a)

d) Are there any other Insurance on the property? If so give particulars.

b)

4. 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?

a)b)

c)d)

5. In case of accident to personse) Name of the injured personf) Address

a) b)

354

g) Occupationh) Age and next birthday

c) d)

6. e) Where did the accident occurf) Give full description of injuries sustained with medical reportg) Was the person under the influence of drug / drinks at the time

of accident?h) 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)

a) b) c)

d)

7. e) Particulars of any injury to persons (third Party) or damage to property of third party.

f) Name and address of the injured personh) Name of the Doctor or Hospital who have given first aid

assistance/ treatmenth) Has the injured person or property owner made any claim on

you? If so give particulars and also attach a copy of notice.

a)

b) c)

d)

8. e) In case of Workmen Compensation claim give name and address of the injured employee and date of appointment

f) Occupation of the employeeg) Nature of work done at the time of accidenth) Details of percentage of disability with medical report

a)

b) c) d)

9. In case of Fidelity Guarantee claimi) Name of defaulting employeej) His present addressk) Date of Discovery of defalcationl) Full details of defalcationm) Date of defalcationn) In what capacity was he engagedo) Does the insured hold any security from the employee, if so to

what extentp) Has the insured taken any action against the employee? If so

state the nature of action taken.

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

h)

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 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 Company’s 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 Insured’s

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 overrunning, excessive pressure, short circuiting, arcing, self-

heating 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 Insured’s 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 Sub-

Section.

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)


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 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 (Tenant’s Legal Liability):

(Applicable only if the Insured is a tenant of the building)

1. What is covered

Insured’s 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 landlord’s

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).


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 Insured’s family or any

person residing lawfully in the insured premises.

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 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 Insured’s

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.

363

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).


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

Insured’s 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 Insured’s 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 Insured’s 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 –

367

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< 12,000 100< 14,000 90< 16,000 80< 19,000 70< 22,000 60< 26,000 50< 30,000 40< 35,000 30< 40,000 20< 40,000 10

6. 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. 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.

b) 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

4 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 Company’s 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 Person’s 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

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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 Insured’s

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 Company’s 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 employee’s 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 Insured’s

employees as staff benefit.

What is covered:

This Sub-Section covers the Insured’s 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 claimant’s 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

Person’s family, partners, managerial staff, contractor’s employees or damage to

property belonging to or in the custody of or control of the Insured or Insured

Person’s family, partner, directors, managerial staff, employees and contractor’s

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) infringement of plans, copyright, patent, trademark, registered design.

7. 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 Insured’s 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 Insured’s

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) Employee’s and visitors' clothing’s and personal effect.

9. Transportation of materials and / or hazardous / dangerous substances outside the

Insured’s premises.

10. Damages arising out of alterations, additions, repairs or decorations to the

Insured’s 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 Insured’s legal liability to employees (listed in the

Schedule) under Fatal Accident Act 1855/Workmen’s 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

claimant’s 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 insured’s 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. 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

3. 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


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.

3. Exclusions


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. The action of sun resulting in wear and tear

4. 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.



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.




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 Company’s 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 manufacturer’s

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 Company’s 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.


reference, award, its effect etc. will be in accordance with the provisions of the


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


e) Loss or damage for which the manufacturer or supplier or repairer or


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 Sum Insured Rs. Rate (Rs. Per

1000) Premium Rs.

As per list attached 7.50

388

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

SelectedSum Insured Rs. To be rated as per

LOP Tariff

a) Gross Incomeb) Additional Expenditurec) CAs' Fees

RRR

Sum Insured Rs. Premium (Rs)(@Re. 0.75 per k.mille)

d) Legal Liability as tenant Rs.

392

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

Table of BenefitsCapital Sum Insured (CSI) as per Schedule

of this Policy1. Death2. 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 disablementDisabling 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) Genetic injuries caused by Z-ray treatment / diagnosis substance.

2. 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 re-

projecting 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: Fresh Proposal / Renewal

Dev. Officer Code: 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 rentedc) 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)

b) Own / Rented

c) Yes / NoIf yes, on RIV / MV basis

5. 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

6. Give details of previous insurance, if any7. Has any Company in respect of any of the items proposed for

insurance hereundera) 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.) Rate (Rs. Per 1000)I. Fire &AlliedPerils

A. Building. (Refer 4 (c) above)B. Contents (Incidental stock tobe declared specifically)(Please attach a separate list).C. Tenant’s Legal Liability

Rs ----------------Rs ----------------Rs ----------------

1.80 (*)(*) – The rate isRs. 1.80 for Hotels

II. Burglary& Housebreaking

Contents

(Please attach a separate list)

Rs--------------- 0.75

III. Electrical &Mechanical Appliances Item Serial No Year of Mfg.

Rs.___________ 2.50

Please attach a separate listNote: All items without selection have to be declared for Insurance

IV. Electronic Appliances Item Serial No Year of Mfg.

Rs.___________ 10.30

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 insureda) In transit Max. Limit per carrying

Rs_________ b) In Safec) In Till

Rs.___________

Rs.___________Rs.___________

5.00

2.00 2.50

403

VI. PersonalAccident

Name Age DesignationCapital Sum Insured (Rs.)

Rs.___________ 0.60


VII. Infidelity / Dishonesty of employees

Name Designation Limit of liability

Rs.6.00 on the Sum Insure d

selected + Rs.10 per person on the number of persons to be

coveredPlease attach a separate list

VIII. Legal Liability

A. Towards Third PartiesAOA= AOY= Sum Insured

Rs._____________As per W. C Act

1.00 for Office; as per market Agreement for other establishmentsAs per tariff

B. Towards Employees

Est. No .of e m p.

Nature of Work

Est.Wages


IX. Fixed Glass / Sanitary Fittings

Description of plate glass / sanitary fittings

Rs._____________ 10.00


X. Neon / Glow Sign / Hoarding

Description Year of Mfg. Rs._____________ 10.00


9. 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.

A. Do you wish to cover baggage?If yes, please indicate the amount to be covered.(If you wish to cover Travelling Advance andBusiness Sample, please specify and the valuethereof)

Yes / No.

B. Do you wish to cover the Loss of Profits? If yes, please indicatea) Sum Insured fori. Gross Incomeii. Additional Expenditure iii. CA’s Feesb) Indemnity Period opted for (Indemnity period cannot

exceed 12 months)

Yes / NoRs ------------------Rs ----------------------------------- months

C. Do you wish to extend this Policy to cover students towards Personal Accident? If yes, please indicate a) limit of liabilityi. per student per accidentii. per accident for all students iii. per year for all students for all accident (This endorsement also covers hospitalisation expenses arising

Rs. ---------------Rs. ---------------Rs. ---------------

404

out of accident the limit for which depends on the Compensation limit chosen for a student)

D. Do you wish to cover Professional Negligence? If so, please indicate Limit of liability for the establishmenta) per accidentb) per year

Rs. ---------------

E. 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) Legal Liability towards

i. Valuables under care, control and custodyii. Food and beverages iii. Extra facilities such as health clubs, beauty parlours,

shops, swimming pools, indoor and outdoor sportsiv. Aqua sports facilities v. For inclusion of skydiving, skiing and hang gliding

c) Personal Accident for occupants

AOO AOY- f or all occupants

a) Rs. 5,000/Rs.1,00,000/

b) AOA (Rs.) AOY (Rs.)

c) AOA (Rs.) AOY (Rs.)

F. Do you wish to cover additional rent for alternative 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.

Rs. -------------------

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 company’s 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 housebreaking 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


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


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 Policy Coverage Premium (Rs)Premises : A Sec I to VI 700Period of insurance : B Sec I to V 325Premium Paid : C Sec I to IV 300Rt No..........dt .................

Section What is insured Against what? Max. amount What is not insured?

1 2 3 4 5I. Building including

compound wall, elec. fixture, other interlors fixtures, owed by insured solely / partial occupied

Fire, lighting, explosion of gas in domestic appliances, riot, strike or malicious act, terrorist act earthquake storm, tempest flood, inundation

50,000 Loss of or damage to motor vehicle and pedal cycles mone securities, bullion bills of exchange. Business books, unset precious stones.

II. Contents : Furniture, fixture fittings, Household goods including domestic appliances (mentioned in section III)

Same as Section I above and Burglary House breaking

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.

III. Breakdown of domestic mentioned below1. Refrigerator2. Grinder3. TV / VCR / VCP4. Music system5. Domestic6. Mixie7. Geyser8. Vacuum Cleaner9. Air Conditioner10. Computer11. Microwave oven

Make year of Mfg. S. No.

Repairs, Rs.5,000Any one year for all items total Loss : Rs.10,000/- for all items any one year.

Wilful act or gross negligence existing faults; loss or damage for which manufacturer / supplier responsible; wear & tear, transport cost to repair shop and back; loss damage by perils insurable under other sections; requirement or confiscation by the state.

415

12. Washing MachinePersonal Accident Death, Permanent

Total Disablement (PTD) for the following persons.1. Sex : Age2. Sex : Age3. Sex : Age4. Sex : Age

25,000per person

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.

V. Personal baggage accompanying insured

During travel any where in India

2,500/- Cracking, scratching of China marble articles of brittle nature, money deeds travel tickets cheques articles of consumable nature.

Valuables like jewellery, watches, camera.

All risk cover 50,000 Cracking, scratching breakage of and glasses mechanical derangement over winding of watches.

416

Name of the insuredFull address of the insuredPremisesPeriod of insurancePremium PaidRt. 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 Max. Amount



compound wall, elec. fixture, other interlors fixtures, owed by insured solely / partial occupied


5,000 Loss of or damage to motor vehicle and pedal cycles mone securities, bullion bills of exchange. Business books, unset precious stones.

II. Contents Furniture, fixture fittings, Household goods including domestic appliances (mentioned in section III)


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.

III. Breakdown of domestic mentioned below1. Refrigerator2. Grinder3. TV / VCR / VCP4. Music system5. Domestic6. Mixie7. Geyser8. Vacuum Cleaner9. Air Conditioner10. Computer11. Microwave oven12. Washing Machine


Repairs, Rs.7,500Any one year for all items total Loss : Rs.15,000/- for all items any one year.


417

Personal Accident Death, Permanent Total Disablement (PTD) for the following persons.1. Sex : Age2. Sex : Age3. Sex : Age4. Sex : Age

30,000per person






All risk cover 75,000 Cracking, scratching breakage of and glasses mechanical derangement over winding of watches.

418


::::::


A Sec I to VI 1300

B Sec I to VI 550

Sec I to IV 525




compound wall, elec. fixture, other interiors fixtures, owed by insured solely / partial occupied


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.

III. Breakdown of domestic mentioned below:1. Refrigerator2. Grinder3. TV / VCR / VCP4. Music system5. Domestic6. Mixie7. Geyser8. Vacuum Cleaner9. Air Conditioner10. Computer11. Microwave oven12. Washing Machine


Repairs, Rs.10,000/-Any one year for all items total Loss : Rs.20,000/- for all items any one year.


419


30,000per person






All risk cover 1,00,000 Cracking, scratching breakage of and glasses mechanical derangement over winding of watches.

420


::::::


A Sec I to VI 2000

B Sec I to VI 825

Sec I to IV 800




compound wall, elec. fixture, other interiors fixtures, owed by insured solely / partial occupied


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.

III. Breakdown of domestic mentioned below1. Refrigerator2. Grinder3. TV / VCR / VCP4. Music system5. Domestic6. Mixie7. Geyser8. Vacuum Cleaner9. Air Conditioner10. Computer11. Microwave oven12. Washing Machine


Repairs, Rs.10,000/-Any one year for all items total Loss : Rs.25,000/- for all items any one year.


421


50,000per person






All risk cover 1,50,000 Cracking, scratching breakage of and glasses mechanical derangement over winding of watches.

422

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?


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 / Borrowerb) Date of Birth / Agec) Residential / Permanent Addressd) Occupation / Business (Please describe fully) of

the person to be insurede) 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:a) Address of the house property to be insured such as

house no, street name, city, pin code etc.b) Type of construction.c) Occupation of the premises

Please state material used fora. Walls ----------------

b. Roof -----------------c. Floor ---------------

5 Total Amount of Loan disbursed:

5 Sum Insured :1. Building against Fire and Allied perils.2. Person / Borrower against death due to accident.

Rs.Rs.

6 Period of Insurance From To

426

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: SIGNATURE OF THE PROPOSER

Address: (FINANCIAL INSTITUTION)

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(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.

1 Name and address of the insured (financier / Bank)

2 Address of the Insured

3 Name of the Insured person / borrower

4 a) Permanent Address of the Insured person /borrower

b) Address of the house property.

5 a) Occupation of the Insured person / borrowerb) Age / Date of birth

6 Period Insurance

7 Total Amount of Loan Disbursed to this borrower

8 Sum Insured : A) HouseB) Person

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9 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 lossb) Cause / Nature of Lossc) 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 accidentb) Place of accidentc) Full description of accidentd) Name & Address (s) of witness to accidente) 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) Was the deceased under any law

breaking activity with criminal intent at the time of accident?

h) Is the claimant satisfied that the death was directly due to the accident.

i) Give the name and address of the Hospital / Nursing where the deceased was treated after the accident.

j) Please enclose the originals ofi. Death certificateii. Postmortem Certificateiii. FIR / Panchanama relating to

accident

We / I confirm that the above facts / statements are correct to the best of our knowledge

and belief.

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Signature of the Insured person/Nominee

PLACE:

Signature of Insured

Official of financial institution.

DATE:

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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.,

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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

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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

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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

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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.

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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/re-

shoot 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)

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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.

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ALL RISK INSURANCE COVER TO FILM PRODUCERS

CAST INSURANCE

SCOPE OF COVER SPECIAL CONDITIONS EXCLUSIONSReimbursement 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 TAPEAll 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:

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.

Intrioration, Atmosphere changes, charges in temperature, errors in judgement in exposure. Delay in delivery.

PROPS, SETS AND WARD ROBECoverage 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 EQUIPMENTCovers 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 LIABILITYDamages for destruction of property of others including use of property while the property is in the care. Custody or control of production.

Defence costs are reimbursable even if the allegations are groundless false fraudient.

a. Liability under MV Act excluded.

b. Damage to buildings other than for production (eg. Living quarters)

c. Loss of injury to animals.

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EXTRA EXPENSES DUE TO INTERRUPTION

Reimbursement the production company for any extra expenses 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.

Perils covered against all risk from any external cause.

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 ACCIDENTCover to named person and unnamed person involved in production.

a. The sum assured will be limited.

b. Can be extended to cover medical expenses.

Standard exclusion of PA policy.

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GENERAL COMMERCIAL LIABILITYCover 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 OMISSIONCovers 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.

Similar to D & O policy Similar to D & O policy

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BANKER’S 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 hold-

up, 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.

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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.

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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 and upto Rs.2 lakhs

Rs.10/- per employee

Sum insure exceeding Rs.2 lakhs and upto Rs.5 lakhs

Additional Rs.1.25 per employee for each lakhs or part thereof.

Sum insured exceeding Rs.5 lakhs and upto Rs.10 lakhs

Additional Rs.0.60 per employee 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 premium per employee

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.

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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) No change in the rating pattern.

ii) Accounts with favourable claims Experience will become entitled to

reduction in premium as per following slabs:-

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CLAIM RATIO - DISCOUNT

CLAIM RATIO DISCOUNT

1. Less than 10% 40%

2. 10% to 25% 20%

3. 25% to 50% 10%

4. Over 50% No discount

iii) Accounts with unfavourable claim experience will be subject to a loading in

premium as per following safe:

CLAIM RATIO - LOADING

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%

a) 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) The branch discount stands withdrawn.

3. 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.

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JEWELLERS BLOCK INSURANCE POLICY

SCOPE OF JEWELLERS BLOCK POLICY

TYPE

SECTION I SECTION II SECTION III SECTION IV

Stock-in trade / with cash in premises and bank lockers

Whilst in custody of other inured partners, Employees, Brokers, Cutters, Goldsmiths outside specified premises of Sec. I outdoor risk

Whilst in transit within India

Office Furniture, Fixtures & fittings & safes etc.,

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

1. Property whilst in custody of the insured directors, Partners, Employees etc.,

2. Property whilst or custody or persons not in regular insured.

1. Registered insured post parcel ( Rs. 5 lacs or 10% of SI under Section I

2. Air Freight3. Angadia

Furniture, Fixtures, Fittings at premises and safes at residence

Sum insured Limit for any one loss

Limit for anyone loss

Sum Insured

Warranted that all stock outside business hours to be locked in burglar proof safe at night

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 - Common watchman for the building or night watchman employed.

Class III - All others.

Sum InsuredRate for

Class I Class II

SECTION I

Upto Rs.25 lakhs Above Rs.25 lakhs and upto

0.25% 0.35%

Rs.50 lakhs for the sum over Rs.25 lakhs 0.20% 0.30%

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

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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 and

valuables)

i) Stock in trade

ii) F. F. F.

2. Godown Exclusively

a) Building - I Class only.

b) Contents with in the Godown (Excluding money and valuables)

i) Stock in trade.

ii) F. F. F. Shop only

a) Building - I Class only

464

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 AOY For policy period.of the del. boys Rs.5,000/- Rs. 15,000/-

2. In the custody of authorised employees / Insured to / from bank Rs. 50,0001/- Rs. 1,50,000/-

Rate: - Rs. 5 per mille in respect of the following :-For the policy period

3. Money in safe/steel cupboard/cash box Rs. 75,000/-

4. Money elsewhere in the premises

(other than in safe) Rs. 10, 000/-

SECTION V : 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) Caused by poor upkeep and maintenance of the premises.

ii. 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 and fulfil the terms and conditions of the policy.

Rate:- 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 the policy

period.

471

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. Description

1 Death only ------------------------ of CSI2. Loss of Two Limbs, Two Eyes or One Limb and One Eye

----------------------------------------------------100% of CSI

3. Loss of One limb or One Eye --------------------- CSI4. Permanent Total disablement from injuries other than named above

(P.T.D) 100% of CSI

5. Permanent Partial Disablement ----------------- % age as perschedule 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. Loss, destruction of or damage to articles of consumable nature.

h. 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) Name of the Proposerb) Names of the insured persons (List of names with age

& sexsex)

c) Relation between the proposer and the Insured person2. Residential Address / Permanent Address:3. Address for Correspondence:4. a) Have you ever proposed for Marga Bandhu Policy

b) If so, give name of each company and amount ofInsurance

c) Has any companyi) Declined to issued a policy to you?ii) Declined to continue your insuranceiii) not invited the renewal of your policy?iv) Imposed any restriction or special conditions?

5. If so, give names and address of each company in respect of i, ii, iii and iv above.

i) Name of Co.-ii) Sum insured iii) Policy No.---

6, Please indicatea) Capital Sum Insuredb) Table of coverc) Period of insurance

a) Rs. ------------------------------------------b) Benefit - Section I - I (a) & (b)/ I (a) to

(d) / I (a) to (e)c) From -------------------- To ---------------

7. Do you wish to obtain cover for Medical expenses?8. Description of Baggage carried by the Insured Persons9. 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 : Proposer’s 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 DeclarationStatistical code:

Issuing Office

INSURED:

Name: Address :

PERIOD OF INSURANCE

From

ToDuration: 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/CNo. of persons covereda) Paying participantsb) Non paying participants (or)Representatives of sports or tourOperators accompanying the group(As per enclosed list)

Baggage cover extension opted for Yes/No.Additional Expenses Cover Extension-Opted 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 % of Sum Insured as compensation

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)

100

Loss by physical separation of the whole of one hand or one foot or irrecoverable loss of sight of one eye

50

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

4158

% 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) 1 2 3 4 and above

Sum Insured (Rs.) 5000 10,000 12,500 15,000

Premium No. of Persons 1 2 3 4 5 6 7 8

(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 assignee’s receipt shall be construed as

full and final discharge to the company, in respect of all liability under this policy.

485

PROPOSAL CUM SCHEDULE

PROPOSER’S DECLARATION:

(Please write in Block Letters)

Name and Address of the Propos _________________________________________

__________________________________

Date & Place of Departure

Schedule time of departure

Mode of Transport : Rail/Road/Air/Water

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 Age Relationship with

Proposer

ExistingDisability,

if Any

Name & Address of Assignee

486

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

A i) Room, Boarding Expenses as provided by the Hospital / nursing home.

ii) If admitted in IC Unit

i) Up to 0.5% of Sum Insured per day

ii) Up to 1% of Sum Insured per day

B Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees, Nursing Expenses

Up to 15% of Sum Insured per illness / Injury

C Anaesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-rayDialysis, Chemotherapy, Radiotherapy Cost of Peacemaker, Artificial Limbs & Cost of organs and similar expenses.

Up to 15% of Sum Insured per illness / Injury

N.B: a) Total expenses per illness are limited to 35% of Sum Insured

b) 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 Company’s

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)

m) Naturopathy Treatment

10. 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 traveler’s 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 Rate of premium to be charged

Not exceeding one week 10% of annual rate Not exceeding one month 25% of annual rateNot exceeding 2 months 35% of annual rateNot exceeding 3 months 50% of annual rateNot exceeding 4 months 60% of annual rateNot exceeding 6 months 75% of annual rateNot exceeding 8 months 85% of annual rateExceeding 8 months Full annual rate

8. 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. Section-II Rs. Section-III (SI Rs.25,000)

Section –IV (SI Rs.2,500)

0.55%0 on CSI 0.55%0 on CSI Rs.189/- 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 Discount3 Years 5%4 Years 7.5%5 Years 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 Group Discount101 to 500 2.5%501 to 1000 5%1001 to 2000 7.5%2001 to 10000 10%10001 to 15000 12.5%15001 to 25000 15%25001 to 50000 20%Above 50000 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

Sum Insured PA+ Expenses (Expenses per

year multiplied by balance years of study)

Rs.

502

1st year 5,00,000 45,000 4 6,80,0002nd year 5,00,000 45,000 3 6,35,0003rd year 5,00,000 45,000 2 5,90,0004th year 5,00,000 45,000 1 5,45,000

14. 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

S.No.

Name and address of student Date of

birth / AgeCourse and year

of study

Details of tuition fee and hostel charges Name and address

of the parent/guardianPer year For balance

course of study

3. Sum Insureda) Per Studentb) Per Parent / Guardian (named above) Rs.c) Tuition fee, Hostel charges etc. Total Rs.d) Hospitalisation Insurance (optinal)e) Baggage Insurance (optional)

4. Are the students and parents / guardians mentioned in item No.2 above do suffer from any physical defect or disability please give details

5. Are the above students are in good health and free from physical and mental diseases if no please give details.

504

6. Are the persons proposed for insurance does have any existing inserted cover similar to the proposed one? If yes give details.

7. 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



(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.,


1. (a) Name of the College / Institution(b) Address

c) Name of the claimantd) Address

(a)(b)

2. Particular of injured person :(a) Name in full(b) Last full postal address

(c) Last occupation(d) Age at the time of accident

(a) (b)

(c) (d)

3 Details of accident:a) When did the accident happen(Give date and

exact time)b) Where did the accident happenc) Give full description of the accident, its cause

and injuries sustainedd) State date, time and place of deathe) 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 agec) Nature of Disease / Illness contracted or injury

sustainedd) Date of injury sustained or disease/illness first

detectede) Name and address of the Hospital / Nursing

Homef) Date of Admissiong) Date of Dischargeh) Details of expenses

b)c)

d)

e)

f)g)h)

(supporting Bills / Receipts / Cash Memos along with discharge summary are to be enclosed to this claim form)

i)

5 a) Give details of baggage lost with cause and value (attach separate list if necessary)

b) Where and how was the baggage lost? Give full details.

c) When and to which police station was it reported (please attach copy of FIR)

(a)

(b)

6 Has the Insured sustained similar loss/es prior to this loss? If yes, give details of insurer and claim amount.

7 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

miscellaneous manual 1

Documents

risk insurance

contract of insurance

householders insurance

lift insurance

fidelity insurance

hoarding insurance

compact insurance

golfers insurance