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.

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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.

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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).