Insurance: Policy Analysis Decision Tree

Initial Policy Analysis Decision Tree

Assumptions:

• No material misrepresentation in policy application;
• Know underlying facts and events giving rise; and
• Have a complete copy of relevant policy/policies.

Policy Coverage Decision Tree

Assumptions:

• Have gone through Initial Policy Analysis Decision Tree;
• No material misrepresentation in policy application;
• Know underlying facts and events giving rise;
• Have a complete copy of relevant policy/policies; and
• Any notices will be given in accordance with the policy (with a copy to the insurance broker).

Basic Interpretation Guide:

• Normal rules of contract interpretation apply with following modifications:
  • Duty on insured to prove matter fits within insuring clause – clause interpreted broadly in favour of insured; and
  • Duty on insurer to prove exclusion clause applies – clause interpreted narrowly against the insurer.

Notification and Defence Costs Decision Tree

Assumptions:

• Have gone through Initial Policy Analysis and Claim Notification Decision Trees; and
• Any notices will be given in accordance with the policy (with a copy to the insurance broker).