Insurance Co. Ltd. by .......... (Name and position of the signatory) Topspin Medical (Israel) Ltd. ( - ) A.M.
Insurance Co. Ltd., Bombay in the joint names of mortgagors and mortgagee and shall hand over the insurance policy to the mortgagee.
Insurance Co lTD. PROPOSAL FORM FOR DOCTORS' AND MEDICAL PRACTITIONERS' PROFESSIONAL INDEMNITY ----------------------------------------------------------------- This proposal must be signed. All questions must be answered. The completion and signature of this proposal does not bind the proposer or Insurer to complete a contract of Insurance. If there is insufficient space to answer questions, please use additional sheets and attach it to this form. The Company does not assume any liabilities until the Proposal has been accepted and premium paid. -----------------------------------------------------------------
1) Name of Proposer
2) a) Residential address
Insurance Co. LTD. PROPOSAL FORM FOR MEDICAL ESTABLISHMENTS ERRORS & OMISSIONS INSURANCE ----------------------------------------------------------------- This proposal must be signed. All questions must be answered. The completion and signature of this proposal does not bind the proposer or Insurer to complete a contract of Insurance. If there is insufficient space to answer questions, please use additional sheets and attach it to this form. The Company does not assume any liabilities until the Proposal has been accepted and premium paid. -----------------------------------------------------------------
Insurance Co lTD. PROPOSAL FORM FOR PROFESSIONAL INDEMNITY Applicable to Consulting Engineers, Architects and Interior Decorators ----------------------------------------------------------------- This proposal must be signed. All questions must be answered. The completion and signature of this proposal does not bind the proposer or Insurer to complete a contract of Insurance. If there is insufficient space to answer questions, please use additional sheets and attach it to this form. The Company does not assume any liabilities until the Proposal has been accepted and premium paid. -----------------------------------------------------------------
1) Name & Address of Proposer
2) When established
3) Description of the Business: (Please attach brochure, information booklet, etc.)
4) a) Names in full of all Qualifi- Date How long princi- Partners/Directors/ cations quali- pal in this Principals in full fied practice -------------------- ---------- ------ ----------------
Insurance Co lTD. PROPOSAL FORM FOR PROFESSIONAL INDEMNITY Applicable to ACCOUNTANTS/SOLICITORS/LAWYERS/COUNSELS/FINANCIAL CONSULTANTS ----------------------------------------------------------------- This proposal must be signed. All questions must be answered. The completion and signature of this proposal does not bind the proposer or Insurer to complete a contract of Insurance. If there is insufficient space to answer questions, please use additional sheets and attach it to this form. The Company does not assume any liabilities until the Proposal has been accepted and premium paid. -----------------------------------------------------------------
1) Name & Address of Proposer
2) When established
3) Full details of work carried on (Please attach brochure, information booklet, etc., if any & specimen copy of contracts entered into)
Insurance Co. All CGL - $75M x $25M Gtd. Cost $ 300,000 General and Hospital HPL - $75M x $25M Professional Liability McAllen Medical Center Texas Joint Texas HPL - $1M / $3M Gtd. Cost $ 2, 200,000 Edinburg Regional Medical Underwriting (separate limits each hospital) Center Association (JUA) McAllen Heart Hospital Fireman's Fund Texas CGL & HPL - $1M / $3M Gtd. Cost $ 250,000 Fort Xxxxxx Medical Center JUA Texas HPL - $1M / $3M Gtd. Cost $ 350,000 UHS of Puerto Rico, Inc. CGL - AIG Puerto Rico CGL - $1M / $3M* Gtd. Cost $ 75,000 San Xxxx Capestrano HPL - SiMed HPL - $100K / $300K* Gtd. Cost $ 1,250,000 *Limits excess of the primary limits shown above are self insured up to $10M per occurrence.
Insurance Co. Agent: Phone #: Accepted this day of , 20_ at Dayton, Ohio Owner/Agent UNDERSIGNED APPLICANTS AUTHORIZE ANY PERSON OR FIRM TO RELEASE INFORMATION CONCERNING THEIR CREDIT & PAYMENT HISTORY UPON PRESENTATION OF THIS FORM OR A PHOTO COPY OF THIS FORM AT ANY TIME. I hereby authorize Art Paradise/Art Paradise, Inc. or agents or representatives to obtain information concerning my past, current and future credit, rental, criminal and employment history. I hereby authorize any of the following sources, including but not limited to (1) credit reporting agencies (2) public or privately owned utility companies (3) government housing (4) current and past landlords, employers or creditors to release any said information to the above named party. I hereby authorize release of any of the above sources, their officers, agents or employees from any liability for damages of any kind whatsoever, either caused by negligence or not, which may at any time result in a decision not to rent this property now or in the future by reason of compliance with the above mentioned inquiry, which may included the answering of specific questions and the giving of information concerning my (applicant and co-applicants) present or past record.
Insurance Co of Hawai‘i, Ltd., 875 P.2d 894 (Haw. 1994), that the insured has the burden to prove a loss, does not speak to whether undated allegations of property damage may satisfy that burden. Second, AIG cites to an unpublished Ninth Circuit case predicting Alaska law would permit insurers to rely on extrinsic evidence “to prove that coverage is unavailable when the complaint is silent as to the existence of those facts and when the facts will not be determined in the underlying action.” Delta Airlines v. State Farm Fire, No. 95–35706, 95–35759, 1996 WL 511575, at *1 (9th Cir. 1996). Here, unlike in Delta Airlines, AIG is not introducing extrinsic evidence conclusively showing the absence of property damage during the AIG Policies’ periods. Regardless, AIG would need to show “that none of the facts upon which it relies might be resolved differently in the underlying lawsuit.” Dairy Rd. Partners, 992 P.2d at 117. AIG’s remaining arguments are simply irrelevant. Xxxxx is not contending that allegations of anticipated future xxxxx or allegations of property damage occurring outside of the policy periods satisfy the AIG Policies’ insuring agreements. Rather, because the Climate Lawsuits also allege undated property damage that may have happened during the AIG Policy periods, and because the complaints are read in the light most favorable to coverage, AIG cannot disclaim its defense duty on this basis.
3. It is possible for Aloha to be held liable for “damages because of” property damage
Insurance Co. 161 a secured party had a perfected security interest in the debtor’s equipment. The court ruled that the secured party had priority over the debtor’s attorney in the proceeds of the debtor’s insurance claim for damage to the equip- ment even though the attorney brought the action against the insurer and was entitled to a charging lien on the proceeds. The secured party’s security interest was first in time and the attorney had constructive and actual knowledge of that interest.162
