quotes insurance or assurance, device for indemnifying or guaranteeing an individual against loss. Reimbursement is made from a fund to which many individuals exposed to the same risk have contributed certain specified amounts, called premiums. Payment for an individual loss, divided among many, does not fall heavily upon the actual loser. The essence of the contract of insurance, called a policy, is mutuality. The major operations of an insurance company are underwriting, the determination of which risks the insurer can take on; and rate making, the decisions regarding necessary prices for such risks.
The underwriter is responsible for guarding against adverse selection, wherein there is excessive coverage of high risk candidates in proportion to the coverage of low risk candidates. In preventing adverse selection, the underwriter must consider physical, psychological, and moral hazards in relation to applicants. Physical hazards include those dangers which surround the individual or property, jeopardizing the well-being of the insured. The amount of the premium is determined by the operation of the law of averages as calculated by actuaries. By investing premium payments in a wide range of revenue-producing projects, insurance companies have become major suppliers of capital, and they rank among the nation's largest institutional investors.
Common Types of Insurance
Life insurance, originally conceived to protect a man's family when his death left them without income, has developed into a variety of policy plans. In a "whole life" policy, fixed premiums are paid throughout the insured's lifetime; this accumulated amount, augmented by compound interest, is paid to a beneficiary in a lump sum upon the insured's death; the benefit is paid even if the insured had terminated the policy.
Under "universal life," the insured can vary the amount and timing of the premiums; the funds compound to create the death benefit. With "variable life," the fixed premiums are invested in a portfolio (with earning reinvested), and the death benefit is based on the performance of the investment. In "term life," coverage is for a specified time period (e.g., 5-10 years); such plans do not build up value during the term. Annuity policies, which pay the insured a yearly income after a certain age, have also been developed. In the 1990s, life insurance companies began to allow early payouts to terminally ill patients.
Fire insurance usually includes damage from lightning; other insurance against the elements includes hail, tornado, flood, and drought. Complete automobile insurance includes not only insurance against fire and theft but also compensation for damage to the car and for personal injury to the victim of an accident (liability insurance); many car owners, however, carry only partial insurance. In many states liability insurance is compulsory, and a number of states have instituted so-called plans, whereby automobile accident victims receive compensation without having to initiate a liability lawsuit, except in special cases. Bonding, or fidelity insurance, is designed to protect an employer against dishonesty or default on the part of an employee. Title insurance is aimed at protecting purchasers of real estate from loss by reason of defective title. Credit insurance safeguards businesses against loss from the failure of customers to meet their obligations. Marine insurance protects shipping companies against the loss of a ship or its cargo, as well as many other items, and so-called inland marine insurance covers a vast miscellany of items, including tourist baggage, express and parcel-post packages, truck cargoes, goods in transit, and even bridges and tunnels. In recent years, the insurance industry has broadened to guard against almost any conceivable risk; companies like Lloyd's will insure a dancer's legs, a pianist's fingers, or an outdoor event against loss from rain on a specified day.
Settled out of Court: The Social Process of Insurance Claims Adjustment
Book by Aldine De Gruyter, 1980
Settled Out Of Court is a classic of the law and behavioral sciences field, and I welcome the publication of a new edition. Ross makes what would seem a simple point -- problems dealt with by people acting within bureaucracies will be solved in ways which serve the interests of those people as they go about their day-to-day work, and these interests are not necessarily the same as those of the organization. While this idea may seem obvious, it is, nonetheless, regularly overlooked by those concerned with law. Scholars, journalists and reformers often write as if the impact of law on behavior were direct and easy to predict. Ross emphasizes that the impact of law on behavior is problematic and often but one of many social and institutional influences. Undoubtedly, this new edition of Settled Out of Court will be read with profit by those interested in sociology. However, I think law students and legal scholars should read it too. Law schools are just beginning to offer seminars and elective courses on the process of dispute resolution, and academic lawyers are just beginning to take account of the reality that trials and appeals stand only at the margin of complex processes which suppress some disputes and affect the resolution of others in ways not contemplated by law books. Lawyers play many roles in these processes. Sometimes they guard the legal system and their own self-interest by turning away potential clients; at other times they change a client's grievance into something that can be settled by a gesture of apology and the payment of money; less frequently, they translate the clients' complicated history into a cause of action which will be tried and perhaps become the subject of an appeal. Only a few of these laywers' roles involve legal research, filing complaints based on real legal analysis or advocacy before judges and jurors. The picture painted by Ross in this book is at least as relevant to real practice skills as is, say, an understanding of the many meanings of the Palsgraf case or Hadley v. Baxendale.
Courses in restitution, and occasionally contracts, often devote time to techniques for overturning insurance releases -- for obvious reasons, insurance releases are a staple in teaching such things as misrepresentation, duress, mistake, and interpretation against the party who drafted a document. An understanding of the system described by Ross would help students understand the contradictions between the ideas of individualism and choice which rationalize free contract and the reality in many situations where a release is under attack. Most students lack experience, and what is offered in appellate opinions as "the facts" typically is, at best, unenlightening if not actually misleading.
I do not think that Ross's book should be confined to the late afternoon ghetto of odd seminars and courses for law professors and students with eccentric tastes. I would like to see it up front in the prime time of the first-year curriculum. Today's torts and contracts teachers so invade each others turf that both could draw on it. To a large extent, the conventional first year of law school is a morality play inculcating traditional normative ideas of individual fault and choice without regard to questions of structure. Moreover, students are offered a model of how the legal system operates, and, by implication, how it should operate. "Facts" are established by an "adversary" process, the elements of which are seldom examined critically, and decisions are reached by the "application" of legal norms. Of course, by the last half of the twentieth century, at least some lessons of legal realism have become the conventional wisdom of the law schools. Most law professors acknowledge that judges seek to carry out some purpose by the rules they adopt and the way in which they apply them. However, few teachers ask whether these goals are likely to be attained in light of social systems such as Ross describes here. Both reformers and law teachers have been quick to see the solution of particular social problems as calling for the creation of new causes of action, but they seldom have thought seriously about how these causes of action might be implemented in a world where there are high cost barriers to litigation and where some social actors have major advantages in the adversary process.
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