the insurance contract

The characteristics of the insurance contract


The insurance contract has the following characteristics: it is consensual (resulting from an agreement of wills), random (its realization is subject to the occurrence of an uncertain event), synallagmatic (creating reciprocal obligations between the insurer and the insured), membership (drafted by the insurer), against payment (subscribed against a premium), successive (it is staggered over time), regulated (subject to the Insurance Code). The risk that is covered is defined by the parties, generally by general conditions and specific conditions. Events that are certain, impossible or dependent on the will of the insured are not insurable.

Insurance can be of two types: damage insurance or personal insurance. Damage insurance covers both the damage suffered by the property and the payments to which the insured is liable when he is held liable for having caused the damage. Personal insurance covers events that affect the insured himself or the beneficiary (health, death, disability, unemployment, etc.).

An insurance contract can be individual (underwritten by an insured) or collective (underwritten by a third party to cover a group of insured), intuitu personae (relating to a person) or not (insurance of property), under private law or public law (when it is concluded within the framework of a public market), civil, commercial or mixed according to the quality of the parties.

Formation of the insurance contract

if the contract is formed, the insured is committed, he owes his premiums and can only withdraw by respecting the rules for terminating the contract (that is to say not immediately, generally);

The insurer, before subscribing, needs information on the risk to know if it is insurable and to set the rate. To do this, he asks the applicant to fill out a questionnaire called the insurance proposal. The proposal does not bind either the insurer or the insured. The insured can at any time withdraw it as long as the insurer has not accepted it.

If the insurance proposal does not bind the insured, on the other hand, the answers to the questions must be exact because when the contract is formed, it will be on this basis that any false declarations which entail penalties will be assessed.

If you contact an insurer simply to obtain information on, for example, its rates and guarantees, it is advisable to inform it beforehand in order to avoid any misunderstanding.

The information of the insured

The insurer is required to provide an information sheet on the price and guarantees of the insured. In the case of a civil liability contract, this information sheet must explain the operation over time of the guarantees.

Like any consensual contract, the insurance contract is formed by the sole agreement of the parties, even verbal. Nevertheless, in practice, the formation of the contract is contractually subject to a formality such as the signature of the policy.

The insurer may have to draw up a provisional contract, either while waiting to study the risk in more depth, or while waiting for the establishment of a definitive contract. He then issues a document called a cover note. It is terminated by the establishment of the final contract. If the contract is not concluded, it ceases to have effect on the scheduled date.

In the absence of any indication to the contrary, the contract takes effect upon its formation. The contract can be formed but the taking effect of the guarantees can be postponed either to an agreed date, or to a formality: signature of the policy, or often, payment of the first premium, because the insurer wants to be sure of have been paid before guaranteeing.

The insurance contract, in its current acceptance, is composed of general conditions which describe the rights and obligations of the parties and the guarantees. These are conditions common to all of a company’s contracts that cover the same risks. In addition, there are special conditions which include the data specific to an insured. It may also include special agreements, or other annexes whose name varies, which relate to the risks covered.

The insurance certificate

With regard to certain compulsory insurance, in particular automobile civil liability, the insurer must issue an insurance certificate proving that the insured has complied with the insurance obligation.

The net premium : sum used to pay claims and the operating costs of the company including, where applicable, the commissions of intermediaries (general agents and brokers).

If the contract taken out is indexed, the expiry notice probably includes the amount of the index. The index chosen is generally an index external to the insurance, but it remains linked to the risk: index of the cost of the building for the insurance of the dwelling, price of the day of hospitalization for the health insurance… he indexation makes it possible to automatically readjust in the same proportion the amount of the contributions and that of the guarantees. It is desirable, especially for the insurance of property whose value increases over the years. Without indexation, very quickly the sums insured would no longer correspond to the value of the goods guaranteed because of the depreciation of the currency and the rise in prices. The indemnity paid to the insured would then be reduced.


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