RISK Chapter 5
RISK Chapter 5
CLASSIFICATION OF INSURANCE
From business point of view, insurance can be classified in to two categories. They are: life
Definition 1
Life insurance is a contract whereby the insurer for certain sum of money or premium
proportionate to the age, profession, health and other circumstances of the person whose
life is insured engage that if such person dies with in the period specified in the policy
the insurer will pay the amount specified by the policy according to the term there of to
Definition 2
Life insurance is a social and economic devise by which a group of persons may
cooperate to ameliorate the loss resulting from the premature death of members of the
group. The insuring organization collect contributions from each member, invest this
contribution, grants both their safety and a minimum interest return and distribute
The main purpose of life insurance is financial protection to the dependents of the insured upon
the premature death of the insured. The sum assured is, then, upon the death of the insured will
be paid to the beneficiaries. The financial compensation will provide security for a certain period
of time.
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The insured may also purchase life insurance policy with such objectives as settling personal
loans and other debts. If the insured dies before settling his debts, the insurer will settle the debt
outstanding to the creditors, hence protecting the family from financial loss.
Life insurers are generally engaged in the provision of both protection and saving. The protection
is against financial loss difficulty and is acquired for a consideration called premium, which is
the price that keeps the policy in force. The protection given by the insurer is death benefits to
the beneficiary of the insured, or in the case of survival of the insured, other financial benefits in
insurance protection he needs. The insurer will then decide on the corresponding
The amount of money required to pay the death benefits in a given period are to be collected
in advance so that there should not be shortage of funds to pay claims as they occur.
Each insured in the group should be charged an appropriate premium, which reflects the
amount of risk he brings to the group. In other words, losses are to be distributed among the
The probability of claim increases with the passage of time since insureds exhibit
In addition to protection against uncertainty, life insurance has the function of accumulation
of money/saving.
Life insurance is not strictly a contract of indemnity for the value of a person cannot be precisely
put in financial terms. The provision of life assurance is a quite different process from the
provision of non-life insurance. The main distinction is that in life assurance the event being
assured is either certain to happen, in the case of those policies paying on death, or scientifically
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In addition to these there are a number of special features, which are worth mentioning at this
stage:
a. Premium payments. Life assurance premiums are payable by level amounts throughout
the period of the policy. This means that each person pays the same amount throughout, that
amount being determined by his age on affecting the policy. Premiums can be paid annually,
half-yearly, quarterly or monthly and are often met by standing orders with banks whereby
the policyholder instructs his bank to make the appropriate payments at the correct times. It is
also possible for the insured to pay premiums for a specified period of time or even a single
payment at lump sum at the time the policy is purchased. (This will be discussed in detail in
later section).
b. Participation in profits. Life assurance companies value their assets and liabilities at regular
intervals, say every year or others every three years. This valuation of their operation allows
them to determine whether any surplus exists after calculating all future liabilities and
allowing for other contingencies. Should such a surplus exist, it is distributed among those
policyholders who have 'with-profits' or 'participating' policies. Such policies allow the
policyholder to participate in any profits the company makes. It does not guarantee a bonus
to each policyholder, as the company may not have a surplus, but it does mean that any
The policyholder pays an additional amount for the privilege of participating in profits. The
bonuses are then added to the sum assured and payable at the maturity date. They can be
either simple reversionary bonuses, that are computed at a rate percent on the basic sum
assured, or compound reversionary bonuses, that are computed at a rate percent of the basic
c. Surrender values. When a person no longer wants his policy, or for some reason cannot
continue the premiums, he can ask for the surrender value. (this is discussed in later
sections).
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d. Investments. We have already identified the life assurance industry as being of considerable
size by considering the number of policies in force and the value of premiums paid each year.
These vast amounts of money are held by companies to meet future liabilities and are termed
life assurance funds. These funds do not lie dormant waiting for claims to come in; rather
they are invested to provide income for the companies and so assist policyholders and
shareholders. Not only do these two groups benefit, but the country as a whole benefits, as
whenever it occurs. Premiums are payable either throughout the life of the assured or can cease
This policy provides protection to the dependants of the insured upon the event of his/her death.
I.e. the sum assured is payable only upon the death of the insured. One option is that the insured
pays annual premiums as long as he lives. The second option is that premium payments are made
for a specified number of years or up to a certain age limit, normally up to the age of retirement.
Premium payments after retirement are discontinued because of a decline in the income of the
insured. The policy provides permanent protection to the insured’s dependants in the case of
death. Besides this protection, whole life insurance allows for the accumulation of savings over
Whole life policy acquires cash value after two or three years of premium payment. When a
person no longer wants his policy, or for some reason cannot continue the premiums, he can ask
for the surrender value. He ceases payment and receives not a proportion of the sum assured, but
a proportion of the premiums already paid. Not all policies allow a surrender value and surrender
within the first few years of any policy will not normally produce an amount for the
policyholder. This is because surrender value is calculated using the premiums paid, less
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expenses incurred in issuing and renewing the policy, and less the cost of the life assurance cover
provided during the years it was in force. In view of the level premium system, any surrender
The cash value gradually grows to equal the sum assured upon maturity or at the time the insured
attains age 100. If the assured, for some reasons, discontinues premium payments after the policy
accumulates cash value, then the cash value can be used to keep the policy in force under the
automatic premium loan provision. Moreover, the assured can apply for loans when the policy
acquires cash value. In some cases, an alternative to the surrender value is the paid-up policy.
The premiums cease and the policy continues, but on maturity a smaller sum than would
originally have been paid will be due to the policyholder. Depending on the policy and the
company concerned, these paid-up policies may or may not continue to participate in profits.
i. Protection – It protects the insured in the case of premature death. If the insured died
ii. Saving - premium will accumulate with interest till the date of maturity of the policy (age
100) the face value of the policy will be paid to the beneficiary.
Depending upon the manner of premium payments, whole life insurance contracts are classified
interval until the death of the insured or until the achievement of a specified age limit, say 100
determined in advance. That is for 10, 15, 20, 25, and 30, years or up to age 85. After the
expiration of the specified time, the policy is said to be paid-up, which means that no more
premiums are to be paid to keep the policy in force until the time of death of the insured at which
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time compensation amounting the face value of the initial policy is to be made to the insured’s
beneficiary. This policy is desirable when one intends to stop payment of premiums after
reaching a given age level, usually upon retirement, but wants to continue with the insurance
protection till the end of his life. Since premiums are to be paid for a limited period, they are
usually higher than those under the straight life policy. Similarly, the cash values under the
limited whole life insurance are higher than the straight-line policy.
insurance. In most cases, insurance buyers do not prefer this type of arrangement (mode of
payment).
stated period mentioned in the policy. If the insured survives beyond the specified time limit in
the policy, the policy will expire and there will be no payment made by the insurer. Term life
policy gives temporary protection and there is no saving element involved. Since the policy is
taken for a specified period to deal with premature death, the cost of this policy is relatively low.
This is the simplest and oldest form of assurance and provides for payment of the sum assured on
death, provided death occurs within a specified term. Should the life assured survive to the end
of the term then the cover ceases and no money is payable. Depending on the age of the life
assured, this is a very cheap form of cover and would be suitable, for example, in the case of a
young married man with medium to low income who wants to provide a reasonable sum for his
Term policies do not provide the insured with loans, cash surrender or non-forfeiture options.
Insurance coverage terminates at the end of the period unless it provides an option for conversion
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Term life policies can be single or level premium policy. Single premium policy requires the
insured to pay premiums at the time the policy is purchased at lump sum while level premium
requires the payment of equal amount of premiums at definite intervals. Most of the term policies
are level premium. More appropriately, term contracts can be classified as: level term, renewable
example, under a 15-year term policy of birr 30,000, the amount of payment to the insured will
be birr 30,000 if the insured dies at any time during the policy period. Level term policies can be
convertible or nonconvertible.
policy into the other types during the tenure of the term policy. No new evidence of insurability
is required upon conversion. If conversion is not made, the policy lapses at the end of the term.
The term contract can be converted into whole life or endowment insurance. Conversion may be
effected using either the attained age at the time of conversion of the term policy or using the
date of the initial term policy issued. In the case of the latter, premiums are calculated
retroactively, and the insured would be required to make up the difference in premiums including
interest, through lump-sum payment at the time of conversion. This is similar to term assurance
but includes a clause in the contract which allows the life assured to convert the policy into an
endowment or whole life contract at normal rates, without medical evidence. A young person can
therefore purchase low-cost life cover and convert it into the more expensive types as his career
To eliminate anti-selection problem, the following requirements are expected upon conversion.
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Under this scheme, the term policy cannot be converted into other forms of life insurance
insurability is required, but the premium charges are adjusted to reflect the standard premium at
the attained age. Accordingly, yearly renewable term policies require renewal every year.
Similarly, a 5-year term policy may be renewed upon its maturity. In most cases, group policies
usually issued to cover the outstanding claims (debts) of a creditor (debtor) in the event of
accidental death of the debtor. The outstanding claims (debts) diminish periodically as
installment payments are made by the debtor at regular intervals. In its basic form this is a type
of decreasing term assurance, with the benefit on death paid out by installments every month or
quarter. It is intended to replace the income which the life assured would have produced for his
In each case, under the basic term, decreasing term, convertible term, or family income policy,
the benefit is only paid if the life assured dies within the term of the policy. It should be noted
that all these types of policy can also be coupled with an endowment assurance. This is
particularly true of decreasing term assurance, where the combination can be used in conjunction
with a standing mortgage. In this case, the benefit will be paid on death within the policy period,
This type of policies provides financial protection to the policyholder (creditor) and the family
(dependents) of the debtor. The dependents of the insured are saved from raising funds or selling
Premiums for a decreasing term insurance are made in a lump-sum payment at the beginning
(single payment).
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3. Endowment insurance
This policy provides payment if the insured manages to live till the end of the endowment period
specified in the policy, or upon the death at the time during the term of the policy or whichever
occurs first. The period of this policy is shorter than that for whole life insurance, and hence the
premiums are higher than for the same age level. The shorter the endowment period the higher
the premium. The sum assured is payable in the event of death within a specified period of, say
15, 20, 25 or 30 years. However, if the life assured survives until the end of this period (until the
'maturity date') the sum assured will also be paid. For a given level of cover, the endowment has
the highest premium because the life assurance company is guaranteeing to pay out the sum
assured at a given date, or before it if the person dies. The maturity date is usually no later than
the date when the life assured will reach age 65.
The whole life assurance, mentioned earlier, will be slightly cheaper than a long-term
endowment because the average policy will not become a claim by death until a person is in his
or her seventies. The company has the premiums to invest for a longer period and can charge
lower premiums. The shorter the term of an endowment policy, the more expensive per sum
assured it becomes, since the company has fewer years in which to collect premiums.
Those buying houses can use endowment assurance. The assurance policy is taken out for the
amount of the loan, or mortgage if a building society is involved, and written in such a way that
the sum assured is payable to the lender or society. The borrower then pays the interest and the
premium. At the end of the term of the loan, the endowment policy matures and repays the
amount borrowed (the capital sum) to the lender. In the event of the borrower dying prior to the
end of the repayment period, the interest to date will have been paid and the endowment policy
This can be an expensive method of protecting a loan for house purchase, and therefore many
building societies accept modifications involving convertible or decreasing term and endowment
combinations, which are considerably less expensive, but still provide the same security.
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In addition to the above-indicated types of life insurance contracts, the following can also be
considered.
assured being payable in the event of death of an employee during his term of service with the
employer. Membership of the scheme is open to all employees working on the inception date, or
One policy is issued to the firm and each employee is given a certificate of membership. Many
people wish to make special arrangements for their children, and two common schemes are the
Under a child's deferred assurance, a policy is effected on the life of a parent with an 'option' date
normally coinciding with the child's eighteenth birthday. Should the parent survive until the
option date, the child has the option of continuing the policy in his own name from then on, as
either an endowment or whole life. The policy can be continued without further medical
examination and this can be extremely important where a child has contracted an illness which
would otherwise make effecting a policy difficult or extremely expensive. Alternatively, a lump
sum can be taken at the option date rather than continue cover. In the event of the parent dying
before the option date the policy is continued, with out payment of premiums, until the option
date. Should the child die before the stated age, the premiums can be returned to the parent or the
policy is continued.
some form of pension is available on retirement. Life assurance companies perform a vital role in
running pension schemes. Those constructing a scheme may approach a company to:
organize the whole scheme, receive premium contributions, invest the funds and
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provide life assurance benefits for widows of scheme members who die before retirement
or widowers.
Many employers' pension schemes are insured by means of group or master policies issued to the
employer or to the trustees of the scheme. These provide retirement pensions and other benefits
in respect of the employees who are eligible for the scheme, usually related to their service and
salary.
A record-keeping and administration service is usually provided in association with the issue of
the policy. The contract may be based on one of the types of policy used in ordinary life
assurance, for example endowment assurances, or annuities (as described later), or it may be
specially devised for the purpose. The extent to which there is a transfer of risk varies
considerably, and in some cases the main emphasis is on the provision of an investment service
In association with the provision of retirement benefits, policies are usually issued insuring death
in service benefits for those employees who do not reach retirement age. These may be in the
6. Annuities
Certain of the assurances mentioned above have had the aim of ensuring an income of one form
or another. An annuity is a method by which a person can receive a yearly sum in return for the
payment to an insurance company of a sum of money. This is not life assurance as we have
described it, but it is dealt with by life assurance companies and is based on actuarial principles.
When a person has a reasonably large sum of money and wants to provide an income for himself
after he retires, or at some other time, he can approach a life assurance company and purchase an
annuity. The annuity may start at once, an immediate annuity, also sometimes called annuity due,
or may start at some date in the future, a deferred annuity. Regardless of when it starts it can take
various forms. It may provide an annuity for the life of the person, the annuitant, or it may be
payable irrespective of death for a certain period, as in the case of the annuity certain. The
guaranteed annuity is similar in that it provides the annuity for a guaranteed period or until the
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annuitant dies, whichever is later. The reversionary annuity provides for payment to the
annuitant, say the wife, on the death of another named person, say the husband. The joint and last
survivor annuity is payable while two people, husband and wife, are alive and on the death of
one will continue at the same or smaller rate on the life of the survivor.
quite logical for you to know about the types of premiums available in life insurance. To this
1. Net premium. The determination of net premium considers only the mortality rate and rate
of interest. It ignores operating costs charged by the insurer. N.B. Net premium provides the
insurer only with the amount of money required to pay death claims. The net premium to be
paid could be single or level premium. Net single premium is the net premium to be paid as a
single sum at the beginning of the contract while a net level premium is a premium charge
that doesn't change from year to year throughout the term of the policy.
2. Gross Premium. The insurer's costs of operating the business are added to the net premium,
which is called loading. Loading is the act of adding costs of running business to the net
which have come about by practice within insurance company offices, and by the influence of
legislation controlling the financial aspects of transacting insurance. Insurance offices are
generally split up into departments or sections, each of which will deal with types of risk, which
have an affiliation with each other. There is a very wide variety in the way in which companies
organize their business, but the following divisions are not unusual:
Accident, including theft, all risks, goods in transit, glass, money, credit, fidelity
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Liability, including employers' liability, public liability, products and professional
indemnity;
from engaging in his usual occupation due to sickness. Personal accident and sickness
policies are renewable annually and, if a claim has occurred, which could be of a recurring
nature, the cover may be restricted at renewal or in severe cases renewal may not be offered.
sickness policies. It provides benefits for those who are disabled for longer periods or who,
due to accident or illness; have to change to a lower paid occupation. It may also be called
It is usual to arrange cover to exclude the first month, six months or twelve months of
disablement with appropriate discounts in the premium rates, since many people will receive
a substantial part of their salaries for a certain period when off-work. Cover cannot continue
beyond age 65 and in order to save premium some people elect for cover to cease at age 55
or 60. The maximum benefit payable is usually 66 per cent or 75 per cent of earnings, less
The intention of the basic policy is to provide compensation in the event of an accident
causing death or injury. What are termed capital sums are paid in the event of death or
certain specified injuries, such as the loss of limbs or sight as may be defined in the policy.
The policy is usually extended to include a weekly benefit for up to 104 weeks, or
compensation if the insured is temporarily totally disabled due to an accident and a reduced
weekly benefit if he is temporarily only partially disabled from carrying out his normal
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duties. In the event of permanent total disablement (other than loss of eyes or limbs) an
annuity is paid.
for companies to arrange coverage on behalf of their employees and many organizations
Motor Insurance
The minimum requirement by law is to provide insurance in respect of legal liability to pay
damages arising out of injury caused to any person. Policies with various levels of cover are
available:
Third party only: provides cover in respect of liability incurred through death or injury
Third party, fire and theft: provides cover as above and in addition includes cover for
Comprehensive: provides cover as above and in addition including cover for accidental
loss of, or damage to, the vehicle itself. This is the most common form of policy.
Private car insurance applies to private cars used for social and domestic purposes and/or
business purposes. Comprehensive policies issued to individuals also include personal accident
benefits for the insured and spouse, medical expenses and loss of, or damage to, rugs, clothing
Vehicles used for commercial purposes (including lorries, taxis, vans, hire cars, milk floats and
police cars) are not insured under private car policies, but under special contracts known as
Separate cover is available for motorcycles. The type of policy depends upon the machine,
whether it is a moped or a high-powered motorcycle, and on the age and experience of the
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Special policies are offered to garages and other people within the motor trade, to ensure that
their liability is covered while using vehicles on the road. Damage to vehicles in garages and
In addition to private cars, motorcycles and commercial vehicles, there are a number of vehicles
which fall into a category known to insurers as 'special types'. These will include forklift trucks,
mobile cranes, bulldozers and excavators. Such vehicles may travel on roads as well as building
sites and other private ground. Where these vehicles are not used on roads and are transported
from site to site, it is more appropriate to insure the liability under a public liability policy, since
the vehicle is really being used as a 'tool of trade' rather than a motor vehicle and include fire,
I. Marine cargo
Marine policies relate to three areas of risk: the hull, cargo and freight. While hull and cargo are
self-explanatory, the word freight may not be: it is the sum paid for transporting goods, or for the
hire of a ship. When goods are lost by marine perils then freight, or part of it, is lost; hence the
The risks against which these items are normally insured are collectively termed 'perils of the
sea' Cargo is usually insured on a warehouse (of departure) to warehouse (of arrival) basis and
frequently covering all risks. Terms of sale and conditions of carriage have important
implications for cargo insurers where goods may change ownership and pass through the hands
of more than one shipper or haulier. It is vitally important in cargo insurance to establish who is
responsible for the insurance cover and to work out when the risk passes from the consignor to
the consignee.
Insurers often rely on inadequate packing/loading to modify claims under cargo covers. Where
appropriate insurers will pay claims and then seek recoveries from carriers.
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The custom has been to provide insurance for three-quarters of the ship owner’s liability for
collisions at sea under a marine policy. The remaining quarter, and all other forms of liability,
are catered for by associations set up for the purpose by ship owners and known as Protecting
and Indemnity Clubs (P and I clubs). It should be noted that the P and I clubs can now insure hull
and technical nature of the risks associated with it, plus the high potential cost of accidents, all
aviation risks, from component parts to complete jumbo jets, are insured in the aviation
insurance market.
Most policies are issued on an 'all-risks’ basis, subject to certain restrictions. The buyers of these
policies include the large commercial airlines, corporate aircraft owners, private owners and
flying clubs. Usually a comprehensive policy is issued covering the aircraft itself (the hull), the
national laws around the world. The main ones are the Warsaw Convention 1929, which made
signatories liable to passengers without negligence, subject to certain maximum amounts, and the
Hague Protocol 1955, which raised some of these limits. The national laws may place higher
limits on domestic flights. For domestic flights within the UK the provisions of the Carriage by
Air Act 1961 apply together with Orders made under it. You will find reference to limits of
liability in the small print, which forms part of the standard airline ticket.
The position has been made more complex by some governments imposing on their national
airlines increased limits of liability, which do not have worldwide approval. Although the
appropriate rules for calculation of legal liability are normally determined by reference to the
country at point of departure and the country of destination recorded on the ticket, an airline
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It is interesting to note that in Goldman v. Thai Airlines International (1981), it was held that
the limits did not apply when the aircrews were 'reckless' in flying the aircraft. In the aftermath
of the Lockerbie disaster, there have been a number of attempts at securing much higher
compensation than the agreements laid down. Some claims have been settled for higher amounts,
especially when the limits have appeared low in relation to the earning capacity of the passenger.
There have been unsuccessful efforts to increase the Warsaw/Hague limits. Change will only be
piecemeal without the support of the major airline operating countries, notably the United States
of America.
The two international agreements also place limits on liability for goods carried by air. Unless of
special risk or value, cargo is usually insured 'all-risks’ in the marine or general markets rather
than in the aviation market. Other groups of persons requiring aviation liability cover are aircraft
of a small factory unit to imagine all that can be damaged and all the ways in which damage can
be sustained. Fire and theft probably come to mind first, but then there are very many different
I. Fire Insurance
In most commercial policies the insured will require cover for buildings, machinery and plant,
and stock. These are the three main headings under which property is insured and in some cases
a list of such items can run to many pages, depending upon the size of the insured company.
In addition to these areas it may be necessary to arrange cover for property while it is still being
built, that is buildings in course of erection, but this form of cover is gradually giving way to a
A standard fire policy is used for almost all business insurances, with Lloyd's of London also
issuing a standard fire policy that is slightly different in its wording. The basic intention of the
fire policy is to provide compensation to the insured person in the event of there being damage to
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the property insured. It is not possible, in the commercial world, to issue a policy that will
provide compensation regardless of how the damage occurs. The insurance companies, the
The standard fire policy covers damage to property caused by fire, lightning or explosion, where
this explosion is brought about by gas or boilers not used for any industrial purpose.
This is limited in its scope because property can be damaged in other ways and, to meet this
need, a number of extra perils (known as special perils) can be added on to the basic policy.
Burst pipes;
Earthquake;
Aircraft;
Malicious damage;
Explosion;
Impact.
It is important to remember that these additional perils must result in damage to the property, and
it is as well to precede each by saying 'damage to the property caused by special peril element'.
The property to be insured, for a commercial venture, will be the same as under the fire policy,
of course except for the buildings. The theft policy will, in addition, show a more detailed
definition of the stock. The reason for this is that fire is indiscriminate, whereas a thief is not, so
The law has its own definition for theft having an impact on insurance companies, as it defined
the term 'theft'. The legal definition was wider than that which the companies were prepared to
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offer, especially for business premises, because the definition did not mention any need for there
to be force and violence in committing a theft. This meant that shoplifting, for example, was
'theft' and this kind of risk had traditionally been uninsurable. To remedy the problem, insurance
companies included in their policies a phrase to the effect that theft, within the meaning of the
policy, was to include force and violence either in breaking into or out of the premises of the
insured.
Comprehensive Insurances
A step on from issuing combined policies, which is only the combination of separate policies
within the one folder, is the comprehensive policy. This form of insurance represents a widening
in the scope of cover. It is also sometimes called a 'package' policy and is an attempt by insurers
to have a single policy section detailing the policy cover, exclusions and conditions. For
example, the household comprehensive policy covers the basic perils mentioned above and also
includes cover against damage caused by collapse of television aerials, leakage of central heating
oil, the breakage of underground water pipes, sanitary fittings and many more risks.
This widening of scope of the perils insured has been accompanied by alterations in the basic
policy which provides cover against damage caused by almost any event and with the amount
being paid representing what it will actually cost to replace the damaged property.
This widening in cover has not been without its problems and many insurers have experienced
large losses on their household insurance business, as a result of which substantial increases in
Comprehensive policies are also available for offices and shops, where cover is provided as a
package. This is an efficient and relatively inexpensive way of providing cover for small offices
and shops.
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