Περιστατικά που πρέπει να δηλωθούν στην προσυμβατική δήλωση. Ειρήνη Λέντη ΕΚΠΑ, Νομική Σχολή ΠΜΣ Ναυτικού Δικαίου 2016-2017 Μάθημα: Δίκαιο της Θαλάσσιας Ασφάλισης Επιβλέποντες: Επικ. Καθ. Δ.Χριστοδούλου, Λεκτ. Έφη Κινινή 27.03.2017
Good faith- Duty of Disclosure UK Law: MIA 1906, sections 17-20 s. 17: Insurance is uberrimae fidei (utmost good faith) - by either party Carter v Boehm[1766], Lord Mansfield (“forbids either party by concealing what he privately knows, to draw the other into a bargain”) - or else? Avoidance of the contract by the other party ( void or voidable?) s. 18: Disclosure by assured (“Subject to the provisions of this section, the assured must disclose to the insurer”) When? Timing (“before the contract is concluded”) What? Materiality (“every material circumstance”)- (Inducement) Knowledge of the assured (“known to the assured, and the assured is deemed to know every circumstance which, in the ordinary course of business, ought to be known by him.”) Remedy? Avoidance (“If the assured fails to make such disclosure, the insurer may avoid the contact”) s.19: Disclosure by agent effecting insurance Agent (broker) must disclose : 1) every material circumstance known to him and 2) any other material circumstance which the assured is bound to disclose. Independent duty. Failure? contract voidable Good faith- Duty of Disclosure Section 17: “a contract of marine insurance is a contract based upon the utmost good faith and, if the outmost good faith be not observed by either party, the contract may be avoided by the other party.” Καλή πίστη, όχι μόνο προσυμβατικά, αλλά και σε μεταγενέστερο στάδιο (post- contractual good faith) Assured’s continuing good faith: subscription policies (συνασφάλιση), renewal (ανανέωση σύμβασης), contractual duty to inform, fraudulent claims, ship’s papers (αν ζητήσει ο ασφαλιστής να προσκομίσει ο ασφαλισμένος), declaration policies (σε «ανοιχτό» συμβόλαιο, open cover) Insurer’s: Traditionally not recognised, but recently the courts recognise it in respect of claims handling (see Merkin, Marine Insurance Legislation, 5th ed., informs law fron Routledge, 2014, p. 25) Avoidance of contract: Παλαιότερη άποψη: Void contract (ακυρότητα) Νεότερη άποψη: Voidable contract (ακυρωσία) Carter v Boehm (1766) 3 Burr 1905, Lord Mansfield Section 18: Duty to disclose material facts before the contract is made “Subject to the provisions of this section, the assured must disclose to the insurer, before the contract is concluded, every material circumstance, which is known to the assured, and the assured is deemed to know every circumstance which, in the ordinary course of business, ought to be known by him. If the assured fails to make such disclosure, the insurer may avoid the contact. “ Time of disclosure: see also s. 21 MIA 1906 A contact is concluded, when the proposal of the assured is accepted by the insurer, whether the policy be then issued or not. Materiality: The facts not disclosed would have been material, if they would have influenced the judgment of a prudent insurer the information would have had an effect on insurer’s thought process Materiality at the date of making the contract, but in the light of subsequent events Materiality must be assessed with reference to an individual fact (see Merkin ,ibid, p. 28) Inducement: Although not stated in the Act, implied by the Courts (Pan Atlantic Insurance Co Ltd v Pine Top Insurance Co Ltd) [1994] 2 Lloyd’s Rep. 427) in order to bring insurance law in line with the general law. = Πρέπει η λανθασμένη ή ανακριβής δήλωση να είναι η αναγκαία αιτία που προκαλεί στον ασφαλιστή την απόφαση να συνάψει τη σύμβαση. Το ότι είναι γεγονός είναι ουσιώδες δεν αρκεί από μόνο του για την κατάφαση του inducement. (Assicurazioni Generali SpA v Arab Insurance Group [2003] Lloyd’s Rep IR 131) (see Merkin, ibid, p. 28-29) - Proof of inducement: Difference in Non-disclosure and Misrepresentation Non disclosure: What would the insurer have done if the fact had been disclosed? Misrepresentation: Would the insurer still have the contract if the misrepresentation had not been made? -No inducement : 1) If the outcome is the same with full disclosure or true representatiom 2) Misrepresentation by third party, not assured’s agent. Avoidance: Ab initio, return of premium, no damages available (all- or nothing principle) While pending avoidance, the policy is valid. if the policy is composite (there are 2 or more assureds with different interests), the position of each assured is to be considered separately (see Merkin, ibid, p. 19)
Circumstances that need to be disclosed Circumstances that need not to be disclosed PHYSICAL HAZARD (any fact that affects directly the risk insured) Port characteristics Previous loss experiences Port state controls MORAL HAZARD (characteristics of the assured) Over valuation Rumours Allegations of misconduct ? Pending criminal/civil charges ? Pending charges against the assured ’s employees ? Dishonesty of the assured Non- payment of premium? Per se material? High value brand- named goods The history of the cargo: second hand or used goods Subrogation rights Packing and preparation of cargo Circumstances that diminish the risk Circumstances known or presumed to be known to the insurer (online information?) Circumstances as to which information is waived - Express waiver - Implied waiver Circumstances that is superfluous to disclose by reason of any express or implied warranty Asking limited questions IMMATERIAL FACTS Previous refusals to insure Ownership or other interest in the cargo MATERIAL FACTS PHYSICAL HAZARD Port characteristics: Marc Rich & Co AG v Portman [1997] 1 Lloyd’s Rep. 225 (see Merkin, ibid, p. 30) Previous Loss experiences: Substantial loss. Not material if it is modest or insignificant (Sealion Shipping Ltd v Valiant Insurance Co [2012] Lloyd’s Rep. IR 141) Port state controls: In recent period before the inception date of policy (12-18 months )But, not 4 years before. MORAL HAZARD Over valuation: The excessive amount is a stronger indication for fraud. The excessive amount may lead to less careful selection of ship and captain by the assured, less efforts to diminish disaster Rumours: depends on the grounds of rumours and intelligence. Allegations of misconduct: If the assured is under investigation for, or has been charged with an offence, which he knows he did not commit, does he still have to disclose the charge to the insurer? Material, because materiality includes all aspects of the assured’s knowledge (Brotherton v Aseguradora Colseguros SA [2003]1 Lloyd’s Rep IR 746) Not material, if the assured can prove his innocence (Strive Shipping Corp v Hellenic Mutual War Ksks Association (Bermuda) Ltd (the Grecia Express) [2002] 2 Lloyd’s Rep 88) Pending criminal/civil charges: Disclosable whether or not well founded. Facts that raise doubts to assured risk. (North Star Shipping Ltd v Sphere Drake Insurane Pic., [2006] 2 Lloyd’s Rep. 183) But, if every false allegation of dishonesty disclosed, then some assureds may find it difficult to get assured. Pending charges against the assured ’s employees: (Inversiones Manria SA v Sphere Drake Insurance Co, Malvern Insurance Co and Niagara Fire Insurance (the Dora) [1989] 1 Lloyd’s Rep 69) Dishonesty of the assured: A fraudulent attempt to defraud a third party before the insurance contract was concluded. (Insurance Corp of the Channel Islands v Royal Hotel Ltd[1998] Lloyd’s Rep IR 151) (James v CGU Insurance PLc [2002] Lloyd’s Rep IR 206) Non- payment of premium? Per se material? : Κρατούσα not material per se (The Martin P. [2004] 1 Lloyd’s Rep 389) Άλλη άποψη: material per se (The North Star Shipping Ltd v Sphere Drake Insurance PLc [2005] 2 Lloyd’s Rep 76) High value brand- named goods (WISE Underwriting Agency Ltd v Grupo National Provincial SA, [2004] Lloyd’s Rep IR 764) The history of the cargo: second hand or used goods: if it is concerned with the assessment of the extent of loss ______________________________________________________________________________________________________________________________________________________________ Circumstances that diminish the risk: (Decorum Investments Ltd v Atkin (The Elena G) [2001] 2 Lloyd’s Rep 378) Circumstances known or presumed to be known to the insurer (online information?) Judged on particular facts (Sea Glory Maritime Co, Swedish Management Co SA v AL Sagr National Insurance Co, [2013] EWHC 2116 (Comm)) Circumstances as to which information is waived - Express waiver, e.g. express clauses in the contract (HIH Casualty & General Insurance Ltd v Chase Manhattan Bank, [2003] Lloyd’s Rep IR 230) - Implied waiver: When an insurer does not ask an obvious question to investigate the facts further, despite the signs of existence of further material facts that have not been disclosed by the assured. Circumstances that is superfluous to disclose by reason of any express or implied warranty If a statement made by the assures was drafted as an insurance warranty, all the insurer has to prove is the assured’s breach of warranty. Asking limited questions: If the insurer fails to put questions on all material matters, or puts them on an unclear way. Would a reasonable man think that the insurer had restricted his right to receive all material information and consented to the omission of that information? IMMATERIAL FACTS Previous refusals to insure: Not material the refusal itself, but the underlying reason to refusal Ownership or other interest in the cargo: MacKenzie v Whitworth [1875] 3 Asp MLC 81
s. 20: Representations pending negotiation on the contract Misrepresentation s. 20: Representations pending negotiation on the contract Material representations by assured/agent must be true. If untrue, the insurer can avoid the contract. Representations: as a matter of fact. True, if the difference between what is represented and what is actually correct would not be considered material by a prudent insurer. as a matter of expectation or belief. True, if made in good faith. Inducement: More critical in misrepresentation. Effect of false statement on the underwriter’s mind. Material and inducement in representations are common to non-disclosure. However, special rules to misrepresentation concern factual dispute as to what was said, and the meaning of what was written, rather than issues of non-disclosure. Representations as a matter of fact: -Economides v. Commercial Union Assurance Co [1998] Lloyd’s Rep IR 9 (CA) 21 Representations as a matter of expectation/belief: -Eagle Star Insurance Co Ltd v. Game Video Co (GVC) SA (The Game Boy) [2004]1 Lloyd’s Rep. 238 Kamidian v. Holt and Others [2008] Lloyd’s Rep. Plus 43
Remedies in case of breach of Duty of Representation and Disclosure Misrepresentation : 1) Avoidance of contract (MIA 1906) 2) Damages (Misrepresentation Act 1967, s. 2(2)) Non-disclosure: 1) Avoidance of contract (MIA 1906) NO Damages Regardless innocent/negligent/ fraudulent breach of duty. Loss of right to avoid Waiver of remedy for breach of the duty of good faith Waiver by affirmation Waiver by estoppel Waiver does not extend to other remedies of the insurer No damages in non-disclosure: Banque Financiere de la Cite SA v Westgate Insurance Co[1991] 2 A.C. 249 Loss of right to avoid- Waiver by affirmation/estoppel -Affirmation: The insurers unequivocally elect not to exercise their right of avoidance in full knowledge of that right (Argo Systems FZE v Liberty Insurance Pte Ltd [2011] Lloyd’s Rep. IR 427 para 37, HHJ Mackie QC) Election typically arises where the parties need to know where they stand, whether the contract lives or dies To be election, the representation must communicate a choice of whether or not to exercise a right Election must be communicated by words or conduct, provided the conduct is clear and unequivocal Election, where with knowledge of the relevant facts, the electing party has acted in a manner which is consisted only with his having chosen one of two alternative and inconsistent courses that open to him. Objective test. (Motor Oil Hellas (Corinth) Refineries SA v Shipping Corp of India (the Kanchenjunga))[1990] 1 Lloyd’s Rep 391, 398-9 Lord Goff) Election, where the insurer speaks or acts in a way which would reasonably be understood as consistent only with the insurer having made an informed choice to treat the contract as valid (Involnert Management Inc v Aprilgange Ltd [2015] 2 Lloyd’s Rep. 289, Leggatt J para 161) Affirmation depends not in the actual state of mind of the other party but on the objective manifestation of choice The communication of affirmation must demonstrate an informed choice, that is that the person was actually aware of the right that “looses” (see Guerses , Marine Insurance Law, 2nd ed., Routledge 2017) -Estoppel: The insurer is estopped where he has unequivoically represented expressly or impliedly that he intends to carry on with the policy and the assured has relied upon that representation.
Greek case law Άρθρο 3 παρ. 1 εδ. α’ ΑσφΝ (2496/1997) Περιγραφή του κινδύνου «Κατά τη σύναψη της σύμβασης ο λήπτης της ασφάλισης υποχρεούται να δηλώσει στον ασφαλιστή κάθε στοιχείο ή περιστατικό που γνωρίζει, το οποίο είναι αντικειμενικά ουσιώδες για την εκτίμηση του κινδύνου, καθώς επίσης να απαντήσει σε κάθε σχετική ερώτηση του ασφαλιστή. Στοιχεία και περιστατικά, για τα οποία ο ασφαλιστής έθεσε σαφείς γραπτές ερωτήσεις, τεκμαίρεται ότι είναι τα μόνα τα οποία επηρεάζουν την από μέρους του εκτίμηση και αποδοχή του κινδύνου.» Ελληνική νομολογία : ΠρΠειρ 2823/2015 (Ναυτικό Τμήμα) «Κάθε περιστατικό θεωρείται ουσιώδες, εφόσον μπορεί να επηρεάσει ένα συνετό ασφαλιστή στον προσδιορισμό του ασφαλίστρου ή στην απόφασή του να αναλάβει τον κίνδυνo. Τόσο η παράλειψη ανακοινώσεως (non disclosure), που αναφέρεται στο άρθρο 18 Μ.Ι.Α. 1906, όσο και η εσφαλμένη ή η πεπλανημένη απεικόνιση (misrepresentation) του άρθρου 20 Μ.Ι.Α. 1906, οι οποίες αμφότερες είναι αρχές που απορρέουν και έχουν τις ρίζες τους στην απόλυτη καλή πίστη, έχουν ως συνέπεια ότι σε περίπτωση παραβάσεως τους, καθιστούν τη σύμβαση ακυρώσιμη κατά την απόλυτη διακριτική ευχέρεια του βλαπτόμενου μέρους (κατά λεκτική δε κυριολεξία παρέχουν στο μέρος αυτό τη δυνατότητα «να αποστεί από το ασφαλιστήριο» - “to avoid the contract”» «Κατά πόσον ένα περιστατικό συγκεκριμένο, το οποίο δεν ανακοινώθηκε, είναι ή όχι ουσιώδες, κρίνεται κατά περίσταση» Ενάγουσα: εταιρεία-ιδιοκτήτρια, εναγόμενη: ασφαλιστική εταιρεία Ασφαλιστήριο συμβόλαιο, αγγλικό δίκαιο Επαγγελματικό – τουριστικό σκάφος αναψυχής Απώλεια ασφαλισμένου σκάφους (υπεξαίρεση)-Επέλευση ασφαλιστικού κινδύνου Εναγόμενη: όροι του συμβολαίου δεν καλύπτουν την περίπτωση αυτή, καλύπτεται μόνο η βίαια κλοπή «Από τα παραπάνω συνάγεται ότι η ενάγουσα έλαβε γνώση όλων των όρων του ασφαλιστηρίου, χωρίς ουδέποτε να εναντιωθεί σε αυτούς και χωρίς να κάνει χρήση των δηλώσεων εναντίωσης, απορριπτομένου ως ουσιαστικά αβάσιμου του περί του αντιθέτου ισχυρισμού της, ότι δηλαδή είχε άγνοια σχετικά με το περιεχόμενο και το εύρος των καλυπτόμενων από αυτό κινδύνων» Επισημαίνεται ότι μόνη η υποβολή μηνύσεως για την πράξη της υπεξαίρεσης (άρθρο 375 Π.Κ. ) δεν αρκεί, κατά τους προαναφερόμενους κανόνες του αγγλικού ουσιαστικού δικαίου προς απόδειξη της επελεύσεως του ασφαλιστικού κινδύνου, καθόσον δεν αποδεικνύει την παράνομη αφαίρεση του σκάφους από την κατοχή της ενάγουσας με βίαιο τρόπο, η οποία και μόνο -με βάση την προκειμένη σύμβαση ασφαλίσεως- καλύπτεται ασφαλιστικώς, σε αντίθεση με την υπεξαίρεση, που συνιστά παράνομη πράξη που ρητώς εξαιρείται από τους καλυπτόμενους κινδύνους, με βάση τον όρο 4.1.3 του συμβολαίου, σημειωτέον δε ότι η πράξη αυτή έλαβε χώρα σε σκάφος που είχε ναυλωθεί και δεν χρησιμοποιήθηκε αποκλειστικά προς το σκοπό αναψυχής, αντίθετα με τον προαναφερθέντα γενικό όρο 4.2 του επίδικου ασφαλιστηρίου συμβολαίου. Επομένως, η φέρουσα κατά τις προαναφερόμενες διατάξεις του αγγλικού ουσιαστικού δικαίου το βάρος της αποδείξεως ενάγουσα ασφαλισμένη δεν απέδειξε τα πραγματικά περιστατικά που θεμελιώνουν την ασφαλιστική περίπτωση, ήτοι την επέλευση του ασφαλιστικού κινδύνου της κλοπής του σκάφους με τη χρήση βίας, ενώ αποδεικνύεται ότι έλαβε χώρα υπεξαίρεση (και όχι βίαιη κλοπή) του σκάφους, που συνίσταται στην παράνομη ιδιοποίηση του σκάφους στο πλαίσιο της καταρτισθείσας σύμβασης ναύλωσης, η οποία, όμως, δεν καλύπτεται ασφαλιστικώς, κατά τα προεκτιθέμενα. Κατ’ ακολουθία των ανωτέρω, η υπό κρίση αγωγή τυγχάνει απορριπτέα στο σύνολό της ως αβάσιμη από ουσιαστική άποψη, για τους ανωτέρω αναφερόμενους λόγους, παρελκούσης της έρευνας της ουσιαστικής βασιμότητας των προαναφερόμενων ενστάσεων της εναγομένης ασφαλιστικής εταιρίας
Sources Dunt John, Marine Cargo Insurance, Routledge 2013, Chapter 5, p. 69-93 Guerses Ozlem,Marine Insurance Law, 2nd ed., Routledge 2017, Chapter 4-Duty of utmost good faith Merkin Robert, Marine Insurance Legislation, 5th ed. Infroma law from Routledge, 2014, p. 18-42 http://www.protodikeio-peir.gr/opencms_prot/opencms/ProtSite/nomologia/2015/m282315.txt
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