(September, 2014)
This analysis is based on a review of available coverage
using several policies as examples. There is no standardized policy but there
are similar coverages provided by all carriers
Insuring
Agreement
The insuring agreement establishes the coverage provided
by the policy and, naturally, is located at the beginning of the form. The
remainder of the policy wording clarifies, expands, or restricts the insuring
agreement. Essentially, the insuring agreement states the insurance companies
overall obligation for providing coverage based on the insured’s applicable,
contractual consideration (paying premium, fulfilling policy provisions, use of
qualified pilots, craft maintenance, etc.).
A. Liability Insuring Agreement
Usually under this part of the contract, the insurance
company obligates itself to pay for the bodily injury or property damage that
an insured causes to third parties. Naturally, the injury or damage has to be
directly related to the ownership, maintenance or use of the insured aircraft.
Example: Wayne,
the owner and one of the pilots for “Casual Flyte”
Commuter Air Taxi, is sued by a customer who is hurt when Wayne tossed a
heavy suitcase to him.
Scenario 1: The customer was still on the plane and fell
out when he lost his balance in an attempt to catch the bag.
Scenario 2: The customer was in the airport where Wayne
caught up with him with the forgotten bag. The customer falls after losing
his balance when attempting to catch the forgotten bag.
Scenario 1 is eligible for coverage while scenario B is
not.
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Important
considerations:
·
How does the policy define bodily injury?
·
Does BI include mental anguish?
·
Does coverage include BI to aircraft passengers?
·
Is the coverage conditional on how the aircraft
is being used?
·
Does the coverage apply when an unlisted pilot
is operating the aircraft?
Note: Some policies
express such coverage separately for bodily injury (excluding passengers) and
passenger bodily injury.
B. Medical Services or
Medical Expense Insuring Agreement
The insurance company pays for medical expenses that are
incurred due to an accident involving the covered aircraft. Typically, such expenses
must be incurred within one year from the date of the accident.
Important
considerations:
1. Who is covered? Passengers, crew, pilot?
2. How does the policy define
medical expenses?
Note: Some
policies provide an explanation of covered medical expenses while other forms
respond to expenses that are ordinarily considered to be "necessary"
or "reasonable."
C. Physical Damage to the
Aircraft
The insurance company pays for tangible damage to and/or
disappearance of the aircraft listed on the Declarations. Coverage is generally
provided on an all-risk type basis. Coverage may be offered on a basis of the
aircraft being in motion (taxiing, take-off, flight, landing)
and not in motion.
Example: A
tornado touches down in Middleplace’s Municipal Airport. Hopeless Airlines has one
plane that had a wing ripped off and destroyed. Their policy will respond to
the loss under the limit for Not In Motion Physical Damage.
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D. Non-Owned Aircraft Liability
The insurance company pays for BI or PD that is connected to
an insured's use or operation of an aircraft that the insured does not own.
Important
considerations:
- Who is considered to be
an insured?
- Does the policy cover
only the named insured or does it include the spouse, family members? Does
it cover related parties (such as other relatives or, when an insured is a
business entity, other members of the business or corporation)?
- What aircraft is covered?
Any aircraft? Aircraft that is similar to the scheduled aircraft?
- Are there restrictions
regarding the types, use and conditions of non-owned aircraft?
- Is the coverage
applicable to commercial, business and pleasure use of the aircraft?
Some insurance companies offer additional items as supplementary
payments such as:
·
First-aid
·
Cost of foaming of aircraft
·
Premiums on appeal bonds or bonds to release
attachment
·
Search and rescue costs
Naturally these costs would have to be associated with a
claim that is eligible for loss under the policy. They are extremely valuable
since their use does not reduce the policy’s available coverage limits.
The insurance company has the right and the duty to defend a
bodily injury or property damage suit until the limit of insurance is exhausted
by payment to claimants (via judgments or settlements). This means that the
insurance company will bear the expenses associated with the defense. Most
insurance companies pay these expenses separately, without affecting the
policy’s applicable limit of insurance. These expenses can include the
attorney’s fees, premiums of court bonds, reasonable expenses of the insured
and their employees when testifying or participating in other activities that
assist in the defense against a claim.
The cost to defend a lawsuit is extremely high and can
quickly use a policy's liability limit. If the limits are used to pay defense
costs and the case is lost, there would be little money left to pay any
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Example: Prinder, a maintenance supervisor at a private airfield,
was seriously injured by a piece of metal that fell from the sky. He sued
Miguel after learning that Miguel's plane landed on the field a few minutes
after he was struck. Miguel is adamant
that he wasn't responsible for Prinder's injury.
Miguel's insurer agreed to defend Miguel against Prinder's
lawsuit. After going through many phases, Miguel lost the suit. His defense
costs totaled $300,000 and Prinder was awarded
$850,000 in damages. Miguel’s aircraft policy limit was $1,000,000.
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Loss Feature
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Aircraft Policy A
Defense costs paid under the insurance limit
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Aircraft Policy B
Defense costs paid under supplemental coverage
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Liability Ins. Limit
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$1,000,000
|
$1,000,000
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Judgment
|
$850,000
|
$850,000
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Defense Costs
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$300,000
|
$300,000
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Total Lawsuit Costs
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$1,150,000
|
$1,150,000
|
Total Paid by Insurer
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$1,000,000
|
$1,150,000
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Under the situation as handled by Policy A, Miguel would
be left with the financial responsibility of paying the $150,000 of the
settlement cost that was not covered by his policy.
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The following are all considered insureds under the policy:
1. The named insured
2. Any person using or riding in
the aircraft with permission
3. Any person or organization
legally responsible for the aircraft; provided they do not fit in any of the
following groups:
·
An employee who injures a fellow employee
·
Un-named student pilots
·
Any person who has paid to use the aircraft
·
Persons who are not employees of the insured but
are employees of repair facilities, flying schools, airports, and similar
services
Exclusions must be studied carefully in order to understand
their impact on policy coverage. Some exclusions will apply to the entire policy while others are
specific to the insuring agreement. A unique aspect of the policy is that some exclusions may apply only when the aircraft is in flight.
The exclusions below are typically found in an aircraft insurance policy.
1. Criminal Acts - There is no coverage when the aircraft is used
for an unlawful or criminal purpose. There is normally a requirement that the
insured or someone with authority in the insured’s operation be aware of the
unlawful use.
Example: Katie,
an employee of Global Real Estate, was granted permission to have the
company's pilot fly their Cessna 182 on a trip to Jamaica. While taking off for the
trip back home, the pilot lost control of the plane and ran off the runway,
damaging several buildings and injuring the buildings' occupants.
The official reason for the trip was to pick up two
clients who were looking for commercial real estate. As it turns out, Katie
was also bringing back 10 kilos of cocaine and used the Global plane in order
to avoid customs. In this case, the bodily injury and property damage claims
arising form the crash would be covered, since the insured, Global Real
Estate, was not aware of Katie's criminal act.
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2. Intentional injury - If an injury or action is the result of an
insured's deliberate action, the policy will not respond to any related loss.
There is one exception. Coverage still applies if the intentional action was
taken to prevent dangerous interference with aircraft operation.
Example: Paul
has completed his final check on his T-6 and starts to enter the cockpit.
Suddenly, a woman pushes him out of the way and attempts to start up the
plane's engine. Paul wrestles with her and throws her out of the cockpit. The
intruder loses her balance and slams onto the floor, unconscious. Paul calls
the police and she is removed from his plane. Several weeks later, Paul
receives a legal notice. The woman is suing Paul for the injuries she
suffered during their scuffle. Paul's insurer advises him that it will defend
him. His intentional acts occurred while he was protecting the aircraft.
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3. Assumption of Liability - If an insured accepts responsibility
for injuries or damage under a contract; coverage for those injuries or damages
is excluded UNLESS the contract is with a governmental authority and for the
purpose of airport operations.
4. Certain In-flight Activities - The policy prohibits coverage for
losses that occur when the aircraft is in flight under the following
circumstances:
a. Pilot is not listed on the
declarations or pilot endorsement
Related Court Case: Unauthorized
Pilot Voids Aircraft Coverage
b. Pilot is listed but is not
approved by current FAA regulations
c. Aircraft does not have FAA
Standard Airworthiness Certificate
Related Court Case: Airworthiness
Certificate Exclusion Applied Despite Insured’s Lack
of Knowledge
d. If a special permit or waiver is
required by the FAA but the waiver or permit has NOT been secured.
e. A student pilot not under the
supervision of a certified flight instructor
f. A student pilot with a passenger
other than a certified flight instructor
Related Court Case:
Student Pilot Endorsement Violation Negated Coverage
5. Nuclear and radioactive activity - All related losses are
excluded.
6. War and terrorism - All related losses are excluded.
7. Noise, sonic boom, pollution, electrical/electromagnet interference,
interference of property use - All such causes of loss are excluded except
when it is created by an actual crash, collision of the aircraft or in flight
emergency.
8. Miscellaneous activities
- The policy excludes damage or injury that results from using the insured
aircraft for the following (this is not a comprehensive list):
advertising
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towing
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photography
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hunting
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herding
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surveillance
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flight instruction
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sky diving
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parachuting
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closed course racing
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off shore business
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Note: If an insured is involved in unusual flight activities, the
application must thoroughly document the aircraft use in order for any aviation
carrier to evaluate and, if applicable, price the risk.
9. Workers compensation and Employer liability situations - Aviation
policies exclude losses that should be handled by WC and/or EPLI coverage. The
exclusion extends to actions brought by family members of an employee.
10. Property damage to items owned, held by or controlled by an insured
- No coverage exists for damage or loss of items that belongs to or is
controlled by an insured with the exception of limited protection for loss
involving either of the following:
- Passenger
carry-on items
- Hangars
that are leased or rented by an insured
11. Other Loss or Damage to the owned aircraft - Other items that
damage an insured's aircraft (or create a loss in value), but which are barred
from coverage include:
a. Embezzlement, repossession or
conversion of the aircraft through the use of bailment, lease or similar
encumbrances whether they are lawful or unlawful
b. Wear and tear and deterioration
losses. Mechanical, engine, hydraulic structural pneumatic and electrical
failures are not covered if they remain confined to the failure.
c. Loss to engines and power units
due to heat or temperature from operation of the engine unless caused by
another covered loss
d. Depreciation
e. Governmental taking or detaining
of the aircraft for any use – peace or war, lawful or unlawful
This is a representative, rather
than an exhaustive, list of actual exclusions found in the reviewed policies. A
given policy's actual exclusions must be carefully evaluated in order to
determine the scope of coverage.
The conditions in a policy outline the responsibilities of
both the insurance company and the insured. It is an area that commonly
triggers disputes between the insurer and the carrier.
Action Against the Insurance Company - No
action can be brought by the insured against the insurance company until the
insured has met all conditions required by the insurance policy. There are time
limits and requirements that differ by policy but, overall, the insured has a
fairly short time frame to sue the insurance company.
Note: State laws and court decisions frequently affect this
provision and insurer actions are adjusted accordingly.
Appraisal
- This provision may be invoked when the company and the insured don’t
agree on the amount of the loss. Each party must select its own qualified
appraiser. The two appraisers then select an umpire. The appraisers then submit
their opinion of the actual cash value and the amount of the loss. If they
don’t reach agreement, they submit this information to the umpire. An agreement
by any two persons is binding on both parties.
The company and the insured have to pay
for the expenses of their own appraiser, as well as equally share the expenses
of the umpire. No other insurer rights are affected by their agreeing to an
appraisal. For instance, if another party has some responsibility for the loss,
the insurer, after paying the appraised amount of loss, may still subrogate the
claim.
Assignment - Policies cannot be assigned by the insured due to a
covered aircraft's sale. The insurance company must be consulted and provide consent
before any assignment takes place EXCEPT for the death or bankruptcy of the
insured. In death or bankruptcy there is 60 days coverage for the legal
representative.
Assistance and Cooperation - The insured is expected to work with
the insurance company during all claim proceedings. This could mean testifying,
helping with witnesses and participating in examinations. The insured does not
have the right to volunteer payments on behalf of the insurance company.
Note: An insured may risk making out of pocket payments without
expectations of being re-paid by the insurer. However, this may not be wise if
the payment is construed as an admission of liability.
Automatic Reinstatement - At the time of loss to the applicable
aircraft, the amount of coverage is reduced with respect to any subsequent
losses until the aircraft’s value has been restored due to completed repairs.
This provision applies both to eligible and ineligible losses.
Bankruptcy or Insolvency - The insured’s bankruptcy or insolvency
does not affect the insurance company’s obligations under this insurance
policy.
Cancellation - The insured can cancel at any time. When the insurer
wishes to cancel coverage, it must provide notice at least 30 days in advance
except for non-payment when only 10 days is required.
Changes - The policy can only be changed by written endorsements.
In other words, a policy can only be modified in writing, meaning that any
change has to occur with the carrier's permission.
Declaration - Acceptance of the policy by the insured means that
the information that appears in the policy’s declarations is true and the
insurance company may rely on that information’s accuracy. Further, that
information is deemed to be a part of this insurance contract.
Fraud and Misrepresentation - The policy is void if the insured
misrepresents significant information. This is a vital condition since aircraft
applications are very detailed and most of the information is important in
evaluating a submission. While no standard application exists, an insured must
is still obligated to carefully read each question and to respond truthfully
and accurately.
Inspections and Audit - The insurance company has the right to
inspect the aircraft and records that pertain to the aircraft during the policy
period and up to a year afterwards.
More than one Aircraft - If there is more than one aircraft on a
policy, the policy applies to each one separately.
More than one insured - If there is more than one insured, each is
covered as though they are the only insured except that any payment is subject
to the policy's insurance limits. This means that each insured is treated by
the carrier uniquely in defense and discovery with no preference. However, at
the time of settlement, the only limits available are the single set of limits
in the policy.
Notice of occurrence, claim or suit - The insured must notify the
insurance company of an occurrence that could lead to a claim. The notice must
be given as soon as practicable. If a claim or suit is brought, the insured
must immediately send the information to the insurance company.
Other Insurance - If there is more than one policy on the aircraft
then all policies are expected to participate in a loss. The participation is
based on the relationship of the limit to the policy to the aggregate limit
available. Policies purchased as excess policies are not considered in the
aggregate limit. Also coverage for non-owned aircraft is excess over any other
available insurance.
Return premium - If the insured cancels, the return is based on a
short rate table but if the insurance company cancels the return premium is
based on prorate tables. If a plane is a total loss, the insurance company is
not required to refund any remaining premium.
Rights of Recovery - The insured must agree to give the insurance
company full rights of recovery and do nothing to hurt (prejudice) the
insurance company’s ability to exercise those rights and will help the
insurance company exercise those rights.
Example: Mabel
and her Cessna 150 were insured by Acme Airsurers
when she had her plane serviced by Tempe Air Garage. A Tempe employee accidentally nicked a
hydraulic line on Mabel’s Cessna 150, causing a leak that went unnoticed when
the plane was returned. A few days later, when she tried to take off, the plane
lifted slightly off the ground, stuttered and then crashed. The plane
seriously damaged the main building of an FBO and the plane was demolished.
Acme paid the losses to the FBO. After an investigation determined Tempe's error, Acme
assumed Mabel's recovery rights and sued Tempe Air Garage. She cooperated
with the insurer and the company received reimbursement from the garage and
repair firm.
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Territory - The territory is the United
States, Canada
and Mexico
and the airspace while en route between the mentioned countries. Some policies
include the US territories
and possessions, the Bahamas
and West Indies. The policy's territory
definition should be carefully reviewed in order to understand the areas within
which aviation losses are eligible for coverage.
When an insured regularly travels
outside Canada, Mexico or the United States, consideration should
be made to purchasing a policy just for that country using a representative in
that country.
Valuation - If the aircraft loss is total, the insurance company
pays the limit shown on the declaration or summary page. However, if the loss
is partial, the loss is settled based on who repairs the plane. If the insured
repairs it – cost of like kind or quality material plus the straight time rate
wages plus an amount for supervisory and overhead is paid. If someone other
than the insured makes the repairs, the net cost to the insured is paid.
Note: Where is the plane repaired? Normally it must be repaired at
the loss site or at the aircraft's home airport. The insurance company pays the
cost of transportation for the aircraft and the parts. The insurer has the
discretion of finding the most economical method to handle the move. The
insured has the right to choose another place for repair or another mode of
transportation, but then will have to pay the additional cost.
When parts are replaced or the
entire plane is replaced, the insurance company has the right to all salvage.
However, retaining salvage is the carrier's choice. An insurer is not obligated
to accept salvage.
The liability limits are per occurrence. There is no
aggregate limit. This means that the policy's limit is available to each
separate eligible occurrence. The Declarations states the occurrence limit is
the maximum liability payment for any single occurrence. The definition of
occurrence includes any series of related events. For instance, if a single
accident started a chain reaction, all injuries and damages would be considered
a single occurrence and subject to the occurrence limit.
The policy can have a per person or
a per passenger limit. This is a restriction of coverage. It means that the
maximum coverage available for a single person or passenger is limited to the
per person or passenger limit. The per person limit is more restrictive than
the per passenger limit since it includes the passengers and any other person
who might bring suit.
The Medical Expense Limit is a separate coverage and limit
that operates independently of the policy's occurrence and the per person
limit.
Example: While
Clint was landing his plane, he slightly tilted the wings and crashed into a
small office/hangar. His passenger was thrown around the cockpit and a
maintenance person who had been working in the building was seriously
injured. The property damage loss was $50,000 for the building and its
contents. The passenger suffered back injuries and lacerations and filed suit
for $200,000. The groundskeeper broke
a leg and arm and lost 60 days of work. He sued Clint for $300,000. Clint had
a policy with $1,000,000 per occurrence limit. The policy included a per
person limit of $100,000. This means that his policy pays no more than
$100,000 for the passenger's claim and no more than $100,000 for the
maintenance person's claim. The maximum payment is therefore $250,000 (two
injuries plus the property damage). Clint is responsible for the remaining
$300,000 injury amounts. If Clint’s policy had the per passenger limit
instead of the person limit, insurance company would have paid $50,000 plus
$100,000 plus $300,000 or a total $450,000. In the later instance, Clint
would be responsible for the passenger’s remaining $100,000.
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Any aircraft physical damage is subject to deductibles that
differ according to circumstances surrounding a given loss. The applicable
amounts are:
1. Not-In-Motion Deductible - This
amount applies whenever the aircraft is not moving.
2. In-Motion Deductible - This
applies when the aircraft is intentionally moving either on the ground or in
flight.
3. In-Flight Deductible - This
applies when the aircraft is intentionally in flight.
Typically the required in-flight deductible is the greatest
amount, while the not-in-motion deductible is the least.
The deductibles apply independently based on the actual
loss.
If the insured uses a substitute aircraft for an insured
craft that is out of commission, the policy provides protection. The insured
has liability and medical expense coverage while using the substitute, but the
maximum payout for any occurrence can not exceed what would have been paid if
the primary aircraft was in operation. This is a critical consideration if the
substitute craft has a significantly higher value than the insured craft.
If the insured purchases a new aircraft to replace a
scheduled aircraft, there is automatic coverage provided the insurance company
is notified within 30 days of the purchase and premium payment is made. The
coverage is the same as on the scheduled aircraft.
If the insured purchases an additional aircraft, there is
automatic coverage provided the insurance company currently insures all of the
insured’s owned aircraft. The insured must notify the insurance company within
30 days of the acquisition. The coverage is the same as another aircraft with
similar passenger capacity. The physical damage limit is the actual amount the
insured paid for the aircraft.
Related Court Case: "Reporting Form Dispute
Decided In Insured’s Favor"
Typically, a policy will have a number of terms with a
special meaning. Actual defined terms can vary by insurer, but the following
are items that are likely to appear:
·
Aircraft
·
Bodily Injury
·
Charter
·
Commercial
·
Disappearance.
·
Federal Aviation Administration
·
In Flight
·
In Motion
·
Instruction and Rental
·
Insured
·
Medical Expense
·
Occurrence
·
Partial Loss
·
Passenger
·
Physical Damage
·
Premises
·
Pleasure and Business
·
Premises
·
Property Damage
·
Total Loss
Related Article: Glossary of Aviation Terms – helpful
in better understanding underwriting or claims information involving aircraft
Common endorsements that are used to modify aviation
coverage are in the categories of additional exclusions (such as for terrorism,
pollution), clarifications (such as pilot requirements) and amendatory (such as
cancellation information).
Related Article: Aircraft And
Aviation Insurance Available Endorsements.