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Insurance Contract
I need an insurance contract for a comprehensive health insurance policy that covers hospitalization, outpatient services, and critical illness, with a sum insured of INR 10 lakhs. The policy should include cashless treatment options, a no-claim bonus, and a family floater option for two adults and two children.
What is an Insurance Contract?
An Insurance Contract is a legally binding agreement between you and an insurance company where they promise to compensate you for specific losses in exchange for regular premium payments. In India, these contracts are governed by the Insurance Act of 1938 and follow the principle of 'uberrimae fidei' - meaning both parties must act with utmost good faith.
The contract spells out what's covered, how much you'll pay, and under what conditions the insurer will pay your claim. It must include essential details like policy duration, coverage limits, and exclusions. Indian law requires insurance contracts to be in writing and properly signed to be valid, with specific rules for different types of insurance like life, health, or property coverage.
When should you use an Insurance Contract?
You need an Insurance Contract anytime you want to protect yourself, your family, or your business from financial losses due to unexpected events. Common situations include buying a new home or car, starting a family, launching a business, or acquiring valuable assets that need protection under Indian law.
Getting insurance coverage is essential before major life events or business ventures where risk management becomes critical. For example, banks require property insurance before approving home loans, and the Motor Vehicles Act makes auto insurance mandatory. Business owners need coverage before operations begin, while professionals like doctors need liability insurance before practicing. The right timing helps avoid gaps in protection and ensures compliance with regulatory requirements.
What are the different types of Insurance Contract?
- Insurance Indemnity Contract: Basic agreement where insurer agrees to compensate for specific losses
- Deductible Indemnity Agreement: Specifies the amount policyholder must pay before coverage kicks in
- Subrogation Contract: Allows insurer to recover costs from third parties responsible for the loss
- Insurance Letter Of Agreement: Simplified contract outlining basic coverage terms and conditions
- Workers Compensation Hold Harmless Agreement: Protects employers from additional claims beyond worker compensation benefits
Who should typically use an Insurance Contract?
- Insurance Companies: Draft and issue policies, assess risks, process claims, and maintain reserves as per IRDAI regulations
- Policyholders: Individuals or businesses who pay premiums and receive coverage protection under the contract terms
- Insurance Agents: Licensed professionals who explain policy terms, help clients choose coverage, and facilitate contract execution
- Legal Advisors: Review and modify contract terms, ensure compliance with Indian insurance laws, and handle dispute resolution
- Claims Adjusters: Evaluate insurance claims, determine coverage applicability, and recommend settlement amounts
- Regulatory Bodies: IRDAI oversees contract compliance, protects policyholder interests, and enforces insurance regulations
How do you write an Insurance Contract?
- Basic Details: Gather full names, addresses, and contact information of all parties involved in the insurance agreement
- Risk Assessment: Document specific risks to be covered, property details, or business activities requiring protection
- Coverage Limits: Determine appropriate coverage amounts, deductibles, and premium payment terms
- Policy Period: Specify start and end dates, renewal terms, and any waiting periods
- Exclusions: List clearly what isn't covered to prevent future disputes
- Compliance Check: Ensure alignment with IRDAI guidelines and relevant Indian insurance laws
- Documentation: Collect supporting documents like identity proof, property papers, or business licenses
What should be included in an Insurance Contract?
- Insurable Interest: Clear statement of the policyholder's financial stake in the insured subject
- Premium Details: Payment amounts, frequency, and consequences of default under Indian contract law
- Coverage Terms: Specific risks covered, sum insured, and territorial limits of the policy
- Exclusion Clauses: Clear listing of situations and circumstances not covered by the policy
- Claims Procedure: Step-by-step process for filing claims and required documentation
- Dispute Resolution: Arbitration clause and jurisdiction details as per Indian law
- Termination Rights: Conditions for policy cancellation and refund terms
- Signature Block: Space for dated signatures of all parties with witness provisions
What's the difference between an Insurance Contract and an Insurance Policy?
While Insurance Contracts and Insurance Policy documents are closely related, they serve distinct purposes in Indian insurance law. An Insurance Contract establishes the legal relationship between insurer and insured, outlining fundamental rights and obligations. An Insurance Policy, however, is the operational document detailing specific coverage terms and conditions.
- Legal Framework: Insurance Contracts focus on establishing the binding agreement and legal basis for coverage, while Policies detail the practical implementation
- Scope and Detail: Contracts contain broader terms about the relationship, while Policies specify exact coverage limits, exclusions, and claim procedures
- Modification Process: Contracts typically require mutual agreement to modify, while Policies can be updated through endorsements
- Regulatory Requirements: Contracts must meet Indian Contract Act provisions, while Policies must comply with specific IRDAI guidelines for different insurance types
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