Universally complications exist concerning insurance cover for the risks posed by pollution damage. Environmental insurance cover can be procured under first-party or third-party insurance. For the latter, the polluter's statutory or civil liability is required. The determination of liability for compensation, especially delictual liability, remains problematic. The right to the environment in section 24 of the Constitution creates a general duty of care. The introduction of a strict liability regime can be recommended to alleviate the burden of proving fault and contributory negligence. Where there is multiple or cumulative causation or the exact identity of the polluter is unknown, potential solutions regarding the allocation of liability include a pollution-share, joint and several, market-share or, as a last resort, a proportional allocation. Actionable damages should include property damage, pure economic loss, clean-up costs and natural resource damages, including compensation for reduced aesthetic value. Due to the uncertainty and potential magnitude of pollution-related claims, insurers have attempted to avoid or limit these risks by including specific pollution exclusion and limitation clauses in policies. Statutory regulation of policy content and prescribed wording for clauses could address problems relating to the interpretation of policy provisions. Various other issues such as the coverage of gradual pollution, the effect of the various triggers of coverage and the potential long-tail liability of insurer, the lack of information and the unpredictability of the risk cause further complications for both the insured and the insurer. Policies should preferably be issued on a `claims-made' basis linked to retroactive dates. Mandatory third-party insurance to the benefit of a third party should be required within specific high-risk industries, specifically for the benefit of the prejudiced person or an environmental remediation fund. The right of a prejudiced party to claim directly from the polluter's liability insurer should be introduced. Currently, the focus appears to be more on protection and environmental remediation than on civil compensation. There is an urgent need for the development of statutory and civil liability compensation mechanisms and for an increased regulation of insurance policies and practices to ensure effective insurance cover to provide compensation for environmental damage. / Jurisprudence / LL.D.

Universally complications exist concerning insurance cover for the risks posed by pollution damage. Environmental insurance cover can be procured under first-party or third-party insurance. For the latter, the polluter's statutory or civil liability is required. The determination of liability for compensation, especially delictual liability, remains problematic. The right to the environment in section 24 of the Constitution creates a general duty of care. The introduction of a strict liability regime can be recommended to alleviate the burden of proving fault and contributory negligence. Where there is multiple or cumulative causation or the exact identity of the polluter is unknown, potential solutions regarding the allocation of liability include a pollution-share, joint and several, market-share or, as a last resort, a proportional allocation. Actionable damages should include property damage, pure economic loss, clean-up costs and natural resource damages, including compensation for reduced aesthetic value. Due to the uncertainty and potential magnitude of pollution-related claims, insurers have attempted to avoid or limit these risks by including specific pollution exclusion and limitation clauses in policies. Statutory regulation of policy content and prescribed wording for clauses could address problems relating to the interpretation of policy provisions. Various other issues such as the coverage of gradual pollution, the effect of the various triggers of coverage and the potential long-tail liability of insurer, the lack of information and the unpredictability of the risk cause further complications for both the insured and the insurer. Policies should preferably be issued on a `claims-made' basis linked to retroactive dates. Mandatory third-party insurance to the benefit of a third party should be required within specific high-risk industries, specifically for the benefit of the prejudiced person or an environmental remediation fund. The right of a prejudiced party to claim directly from the polluter's liability insurer should be introduced. Currently, the focus appears to be more on protection and environmental remediation than on civil compensation. There is an urgent need for the development of statutory and civil liability compensation mechanisms and for an increased regulation of insurance policies and practices to ensure effective insurance cover to provide compensation for environmental damage. / Jurisprudence / LL.D.

Les réclamations pour dommages punitifs en vertu de la Charte des droits et libertés de la personne se multiplient depuis plusieurs années devant les tribunaux. Pour être accueillie, cette réclamation implique la démonstration d’une atteinte illicite et intentionnelle à un droit ou une liberté protégé par cette charte. Les recours en responsabilité peuvent faire l’objet d’une couverture d’assurance. Or, le Code civil du Québec prévoit spécifiquement que l’assureur n’est pas tenu de couvrir la faute intentionnelle de l’assuré. Est-ce à dire que l’assureur n’a pas d’obligation envers son assuré lorsque des dommages punitifs sont réclamés? Il s’agit donc de déterminer si le concept de faute intentionnelle et celui d’atteinte illicite et intentionnelle sont des concepts qui s’équivalent ou qu’il est nécessaire de distinguer. Pour cette analyse, ces deux concepts seront abordés en profondeur. Il sera question de l’origine de ces deux notions, de leurs fondements et de leur interprétation pour finalement définir ces termes le plus précisément possible. Ces définitions permettront d’opposer ces deux notions et de déterminer au final qu’il existe plusieurs éléments qui différencient ces concepts, notamment à l’égard de l’intention requise, faisant en sorte qu’ils ne peuvent être assimilés. Cette conclusion aura un impact certain sur les obligations de l’assureur de défendre l’assuré et d’indemniser la victime pour ses dommages compensatoires lorsqu’il existe une réclamation en dommages punitifs et, par conséquent, l’assureur ne pourra faire reposer son refus de défendre ou d’indemniser sur la seule base de la preuve d’une atteinte illicite et intentionnelle. / Claims for punitive damages have proliferated over the years before the courts. For such claim to be granted, it is required to demonstrate an unlawful and intentional interference with any right or freedom protected by the Charter of Human Rights and Freedoms. Liability claims can be covered by insurance. However, the Civil Code of Québec specifically provides that the insurer is never bound to indemnify the insured’s intentional fault. Does this mean that the insurer has no obligation towards its insured when punitive damages are sought? The question is thus whether the concept of intentional fault and of unlawful and intentional interference are concepts that are equivalent or that need to be distinguished. For this analysis, the two concepts will be adressed in depth. The origin of these two concepts, their founding principles and their interpretation will be discussed to ultimately define these terms as precisely as possible. These definitions will then help to compare these two concepts and determine in the end that there are several elements that differentiate these concepts, particularly in regard to the required intent, with the result that they can not be assimilated. This conclusion will have a definite impact on the insurer’s obligations to defend the insured and to indemnify the victim for compensatory damages if punitive damages are also sought. Therefore, the insurer cannot justify its refusal to defend or indemnify solely on the basis of the evidence of an unlawful and intentional interference.

Made available in DSpace on 2015-12-03T18:35:28Z (GMT). No. of bitstreams: 1 Isabel_Cristina_Barbosa_Pinheiro.pdf: 2622902 bytes, checksum: 749431cab43b468b437e27cb0f5a0567 (MD5) Previous issue date: 2014-01-24 / The Brazilian public health system is deficient and doesn't fully meet the needs of the population. As a result, the private health care market has grown in recent years, which has changed the role of the state from executive to regulator of that sector. Regulation includes tackling the economic and financial issue. Our study aimed to identify the behavior of financing strategies adopted by medical cooperatives and group medicines to meet the regulatory benchmarks of the supplementary health care sector in Brazil. The survey results show that the mandatory Guaranteeing Assets (Ativos Garantidores, AG), 1st regulatory moment, resulted in a significant increase of both the overall and the long term indebtedness indexes, which reveals the use of Third-party capital instead of Equity capital. Only the Medical Cooperatives featured increased Overall Indebtedness, which means that the Medical Cooperatives, unlike Group Medicines, are capitalized by third party funds rather than by Equity Capital. Both modalities adopted the strategy of increasing their long-term debt and reducing their short term debt (debt composition). With the introduction of the Health Guarantor Fund (Fundo Garantidor da Sa??de, FGS), 2nd regulatory moment, the Overall and Current Liquidity indexes decreased, showing that the goal of the FGS program to reduce financial guarantees and to improve working capital wasn't met. Medical Cooperatives managed to reduce their overall debt, whereas the overall debt of Group Medicines increased. We conclude that there was a balance between the Indebtedness indexes and Liquidity over the period and that operators who wish to remain in the market must comply with the rules, adapting and improving the quality of their management / A rede p??blica de sa??de no Brasil ?? prec??ria e n??o atende de forma plena ??s necessidades da popula????o. Consequentemente, o mercado privado de assist??ncia ?? sa??de tem crescido nos ??ltimos anos e com isso a fun????o do Estado vem se alterando, passando de executor para regulador deste setor de atividade. Um alvo da regula????o ?? a quest??o econ??mico-financeira. Nesse sentido, este trabalho tem como objetivo identificar o comportamento das estrat??gias de financiamento adotadas pelas cooperativas m??dicas e medicinas de grupo frente aos marcos regulat??rios do setor de sa??de suplementar no Brasil. Os resultados da pesquisa indicam que com a obrigatoriedade dos Ativos Garantidores - AG, 1?? momento regulat??rio, os ??ndices de Endividamento, tanto geral quanto de longo prazo tiveram um aumento significativo, o que indica a utiliza????o de Capital de Terceiros ao inv??s do Capital Pr??prio. Observou-se que apenas as Cooperativas M??dicas apresentaram um aumento no Endividamento Geral. Isso indicou que as Cooperativas M??dicas, diferentemente, das Medicinas de Grupo, se capitalizaram com recursos de terceiros ao inv??s do Capital Pr??prio. Notou-se que ambas as modalidades adotaram a estrat??gia de aumentar a d??vida de longo prazo e reduzir as de curto prazo (composi????o do endividamento). Com a institui????o do Fundo Garantidor da Sa??de - FGS, 2?? momento regulat??rio, os ??ndices de Liquidez Geral e Corrente diminu??ram, indicando que a proposta do programa FGS, de reduzir as garantias financeiras e melhorar o capital de giro, n??o ocorreu. Observou-se que para as Cooperativas M??dicas o endividamento geral diminuiu e em contrapartida para as Medicinas de Grupo aumentou. Contudo, conclui-se que houve um equil??brio entre os ??ndices de Endividamento e Liquidez ao longo do per??odo e que para as operadoras se manterem no mercado ter??o que atender as regras, adaptando-se e melhorando a qualidade da sua gest??o

With the rapid development of the Islamic banking and finance in South Africa, the legal regime of South Africa, must be able to progress at the same rate of development. The recognition of a foreign legal system such as Islamic law in South Africa is challenging and difficult. South Africa, has an interest based insurance legislative framework and this is not aligned with the principles of the Islamic financial system. As a result of this, regulators have taken various measures to develop and promote the Islamic Industry. The amendment to the South African Tax legislation has created an equitable and level playing field for Islamic law. The South African government also has a further obligation which is to develop a legislative framework to govern Islamic law, as well as to enhance the regulatory and supervisory framework. The study of the development of the Islamic legal regime is an important area that aids legal practitioners in identifying and resolving legal disputes. The purpose of this paper is to examine the accommodation of the Islamic law of Takaful under the South African Insurance legal framework. / Public, Constitutional and International Law / LL. M. (Public, Constitutional and International Law)

保險業資金運用的限制乃民國87年台灣保險界的熱門話題之一，不但有許多保險公司要求財政部放寬資金運用的限制，因為他們認為保險法中明文規定保險資金運用的範圍和比率，使保險資金運用相當僵化，且由於企業經營環境變化極大，因此法令的限制會影響保險公司的營運狀況；而財政部保險司成立的保險革新小組中，也對資金運用的限制有深入的探討，因為限制的範圍不但影響保險公司本身的投資情況，更因為保險公司有龐大的資金可運用，而可能牽動台灣的金融經濟情勢，因此值得深入的探討。 本研究的主要目的包括下列兩點： 1.研究保險公司資金運用績效在民國81年保險法大幅修訂，對資金運用加諸更明確的規定，與保險法修訂前的資金運用績效加以詳細比較，瞭解政府設定資金運用的限制對保險公司獲利率之影響，並針對投資風險進行實證分析，因為高風險伴隨著高報酬，故同時考慮風險與收益的影響程度。 2.初步分析本國保險公司7項經營上的比率例如流動比率是否因為保險法修訂之後而受到影響。 本篇論文的資料來源是來自台北市人壽保險同業公會所出版的『人壽保險業務統計年報』與保險事業發展中心所出版的『產物保險統計要覽』，並採用年報中的資產負債表、損益表與資金運用表加以實證分析。 研究時間以民國81年保險法修訂第146條之1到第146條之5為時間上的分界點，分析民國76年到民國80年資金運用的限制未修訂前的資金運用績效與民國81年到民國86年資金運用的限制修訂後的資金運用績效做比較，但因為依照法令規定發現保險公司有2年的調整期，因此研究時間分成3段（民國76-80年，民國81、82年，民國83-86年）。 本研究同時考慮投資收益率與投資風險，發現在兩迴歸模型中投資收益率與投資收益率變異數之係數均大於0，並且為顯著，代表兩者具有正相關的情形，符合高風險伴隨高報酬的理論；由Markowitz的『平均數-變異數投資組合模式』所求出的效率前緣發現加諸投資限制後，會使效率前緣向右下方移動，亦即同時使風險增加與投資報酬率減少；經由本研究的實證發現保險法的修訂對於保險公司投資績效與投資風險均造成顯著的影響，亦即保險法修訂後，使得保險公司的投資收益率減少，並增加保險公司的投資風險，因此本研究認為目前法令對於資金運用的限制的確有放寬的必要。 由於本研究發現投資上限對保險公司的投資績效會產生顯著的影響，並且會增加保險公司的風險，因此保險公司大聲疾呼再度修改保險法第146條之1到第146條之5與放寬投資限制的確有其必要性；另外本研究之實證可得知保險公司的經營性質會影響其投資收益率，並且因為產、壽險在資金結構與業務性質均有相當程度的差異，因此建議可將產、壽險的資金運用分別規範，由於我們發現限制會對保險公司的投資情形產生影響，加上壽險公司的投資收益率比較高，而投資風險比較低，因此本研究認為對於壽險公司的資金運用規範應該要比較寬鬆。 第一章 緒論 1 第一節 研究動機 1 第二節 研究目的 2 第三節 研究流程與架構 4 第二章 保險業資金運用介紹與文獻回顧 5 第一節 保險法第146條所規定資金運用途徑之介紹 5 第二節 衡量法令限制對企業造成影響之文獻 18 第三章 研究方法 27 第一節 資料來源 27 第二節 研究方法 29 第三節 兩段迴歸 36 第四章 實證分析 37 第一節 各種IRIS比率的實證結果 37 第二節 投資收益率的實證結果 42 第三節 投資收益率之變異數的實證結果 46 第五章 結論與建議 51 第一節 研究結論與建議 51 第二節 研究限制 54 參考文獻 55

Seguro y Responsabilidad Patrimonial de la Administración presenta un detallado estudio del derecho de seguros y de la responsabilidad de la Administración Pública por las acciones y omisiones de funcionarios en la prestación de servicios públicos. Su objetivo es ilustrar cómo el seguro trabaja en el ámbito de la Administración Pública. La tesis se divide en tres partes y combina la exposición con el análisis crítico. En la primera parte, la tesis analiza brevemente el contrato de seguro y proporciona argumentos económicos para defender que el seguro es socialmente más beneficioso en Administraciones Públicas pequeñas que en Administraciones totalmente solventes. En la segunda parte, la tesis doctoral proporciona soluciones a los problemas que surgen entre la Ley de Contrato de Seguro y la regulación de la responsabilidad patrimonial de la Administración Pública. Finalmente, examinamos estas soluciones en un particular contexto: el seguro de responsabilidad civil por mala praxis médica que proporciona protección en el caso de que actos negligentes den lugar a algún daño o lesión a los pacientes en el ámbito de la Administración Pública. / Seguro y Responsabilidad Patrimonial de la Administración presents a detailed examination of the law of insurance and the Liability of Public Administration for the actions and omissions of civil servants in the provision of public services. Its objective is to illustrate how insurance works in the Public Administration. The thesis is divided into three parts and combines exposition with critical analysis. In the first part, the thesis briefly analyzes the insurance contract and provides economic arguments that the insurance is more socially beneficial in small Public Administrations than completely solvent Administrations. In the second section, the doctoral thesis provides solutions to the problems between Spanish law of insurance contracts and the regulation of Liability of Public Administration. Finally, we examine these solutions in a particular context: the medical malpractice liability insurance that provides protection in case of acts of malpractice that result in harm or injury to patients in the Public Administration.

Under senare tid har allt fler företag börjat utöva verksamhet där mark nyttjas för olika aktiviteter med stöd av allemansrätten. HD har bedömt att sådant nyttjande; kanalisering, är tillåtet med stöd av allemansrätten, men uttalade i NJA 1996 s. 495 (”Forsränningsmålet”) samtidigt att nyttjandet bara är tillåtet så länge marken inte skadas. Eftersom skadeståndsfrågan aldrig har prövats i samband med allemansrätten har föremålet för denna uppsats varit att utreda möjligheterna att utfå ersättning för skador via allmänna skadeståndsrättsliga regler, skadestånds- och avhjälpandeansvaret i miljöbalken samt för intrång i äganderätten via expropriationslagen och möjligheten att få ersättning ur en försäkring. Expropriationsalternativet kan inte användas idag, eftersom marknyttjande med stöd av allemansrätten är ett icke ersättningsgillt intrång i äganderätten. Möjligheterna till att betrakta en skada på marken som en sakskada är stora. Det finns emellertid omständigheter som skapar komplikationer för båda skadeståndsansvarsformerna. En allmän skadeståndstalan kräver att culpa hos skadevållaren kan bevisas, vilket kan vara svårt när många människor vistas på en plats samtidigt. Kanalisatören kan betraktas som culpös enligt principerna om kumulativ eller anonym culpa, enligt vilka en principal blir ansvarig, trots att de individer han ansvarar för inte, var och en för sig, varit culpösa. Det miljörättsliga skadeståndsansvaret bygger på ersättning för störningar som inte är orts- eller allmänvanliga. När det gäller allemansrättsligt nyttjande torde många störningar betraktas som just orts- eller allmänvanliga. Avhjälpandeansvaret i miljöbalken bygger på ersättning för miljöfarlig verksamhet, och det är tveksamt om det kan tillämpas på kanalisatörens verksamhet. Expropriationsersättning på grund av allemansrättsligt nyttjande tillerkänns inte markägaren enligt gällande rätt, vilket kan tyckas märkligt eftersom många nyttjandeformer som påminner om allemansrätten, t.ex. servitut, medför sådan ersättningsrätt. Det finns vissa möjligheter att ersätta markskador ur försäkringar. Dock är de flesta skador följden av invasionsproblematik, som är mycket svårt försäkra. Samtliga ersättningsformer har visat sig otillräckliga för att ersätta skador som är estetiska och ideella, eftersom sådana skador inte kan beräknas i pengar. Beroende på hur marknyttjande med stöd av allemansrätten betraktas har man olika åsikt om i vad mån kanalisatören borde ersätta markägaren för skador på marken. Om nyttjandet uppfattas som någonting som finns vid sidan av markäganderätten är endast konkreta skador ersättningsgilla. Om man anser att nyttjandet är ett intrång i äganderätten och en förmögenhetsöverföring från markägaren till kanalisatören bör emellertid redan rätten att nyttja marken föranleda ersättning. Den ersättningsform som bäst tillgodoser markägarens intresse av att få skador på marken åtgärdade och få ersättning för ekonomisk förlust är avhjälpandeansvaret. Endast det ansvaret reparerar till fullo skador på miljön. Det krävs emellertid ett domstolsavgörande för att slutligen klargöra avhjälpandeansvarets tillämplighet. / Recently, more and more companies have come to exercise activities under the right of public access on land that belongs to whomever. The High Court has assessed that such use of land; channeling, is permitted, but in NJA 1996 s. 495 (“The Rafting Case”) also announced that this use is only allowed as long as the land remains unharmed. Since the question of damages in the context of the right of public access has not yet been treated in jurisprudence, the object of this thesis has been to investigate the possibilities to obtain restitution for damages via tort law, liability under the environment act as well as for proprietary intrusions under the expropriation act and restitution via insurance. Expropriation, however, cannot currently be made use of, since the right of public access is an intrusion which does not entail restitution. There are extensive possibilities for considering damage to the land as damage to property. However, there are ramifications for both the legal options for damages: the tort law and the environmental act. The tort law requires tortuous behaviour from the tortfeasor to be established, which is difficult when several persons stay at one place simultaneously. The canalizer may be considered tortuous under the principle of vicarious liability and cumulative or anonymous tort. According to these principles, the canalizer is responsible for the actions of certain individuals, even though they have not, individually, been negligent. The environmental liability for damage is based on restitution for disturbances that are not common to the place nor to the general public. This fact is difficult to establish in the context of the right of public access. The remedial responsibility of the environmental act is constructed for operations that are harmful to the environment, which is why it is dubious whether the responsibility is applicable to the canalizer’s activities. Currently, compensation for expropriation cannot result of use of land under the right of public access. This is peculiar, since many usufructs reminiscent of the right of public access, i.e. the easement, result in such compensation. Some forms of damage to the land can be insured. Although, most damage in this context arise from invasion, a cause of damage which is nearly impossible to insure. All forms of restitution have proven insufficient for compensating damage that is esthetic or otherwise non-pecuniary. Depending on if the right of public access is regarded as proprietary intrusion or something that exists alongside the right to property, one comes to different conclusions about the extent of compensation for damage. In the former case, only substantial damage is compensable. In the latter case, even the right to use the land occasions compensation. The liability which best meets the needs of the proprietor: compensation and restoration of damage to his property, is the remedial responsibility of the environmental code. This responsibility alone fully restores harm to the environment. However, the applicability of the remedial responsibility needs to be established in jurisprudence.

Liability insurance concerns an insured’s insurance of its legal liability towards a third party for the latter’s loss. This specialised type of insurance is rather neglected in South African insurance law. There is a lack of understanding of the intricacies of liability insurance and its unique challenges. This flows primarily from its complex nature as third-party insurance, which involves legal obligations between multiple parties, and a lack of statutory regulation of the distinctive contractual aspects of liability insurance. Furthermore, limited authority exists on contentious legal aspects as a result of the relatively small number of judicial decisions in this field of law. It is also evident that liability insurance constantly evolves as new grounds of liability emerge and new insurance products develop in response to the changing demands of society. The rise of consumerism and the increase in third-party claims amplify the economic significance of the law of liability insurance in South Africa. A substantial knowledge gap remains in our jurisprudence, irrespective of the recent introduction of new statutory instruments aimed at regulating insurance practice in general. These reforms have not as yet been applied critically to liability insurance, and no specialised legislation in South Africa regulates aspects of this branch of insurance as is the case with microinsurance. The focus in this thesis is on two main issues: the insurer’s duty effectively to indemnify the insured, and the insurer’s defence and settlement of third-party claims brought against the insured. As a subsidiary theme, this thesis analyses legal uncertainties that may persist during pre-contractual negotiations, the liability insurance contract lifecycle, and even after the expiry of the contract. Legal challenges can be addressed by novel and creative application of the national law. Potential solutions can be gleaned from the other progressive jurisdictions reviewed – English and Belgian law. It is evident that this research may prompt Parliament to develop specific rules and regulations for liability insurance contract law. This thesis includes a check list of some of the most important disclosure duties for procuring liability insurance cover, its operation, and claims processes. / Mercantile Law / LL.D.

Medical expenses refer to all medical and related expenditure reasonably incurred in respect of bodily injuries sustained. This then constitutes the primary loss in incidences of bodily injuries. However, it is accepted that bodily injuries infringe in the main the non-patrimonial aspects of the individual’s bodily integrity which is a personality right. Notwithstanding this trite provision of our law, the dissertation contends that medical expenses as a head of damages is inherently patrimonial. In essence, the true nature of medical expenses as a loss that ultimately affects both the patrimonial and non-patrimonial interests of the individual, is considered. Furthermore, the dissertation analyses the assessment and quantification mechanisms in our law, and makes a comparative study with the corresponding positions in England and Australia. The intended outcome of this dissertation is to provide clear guidelines for the award of damages, particularly where future loss is involved. / Private Law / LLM