Insurance policies are long, convoluted, and abstruse documents. Santa Clara Law Review by an authorized administrator of Santa Clara Law Digital Commons. Proximate cause can be direct, dominant, effective, immediate cause. DOCTRINE OF PROXIMATE CAUSE REFERENCES: Luis B. Reyes and Judge Arthur L. Abudiente-----Proximate Cause - that cause, which, in natural … The proximate cause, whether an event covered by a policy (“peril”) or an event excluded from a policy (“exception”), “is the dominant or effective or operative cause.” So says MacGillivray and Parkington.1 So say the courts. Only premium paid or surrender value whichever is higher is payable and the total policy amount is not payable. A policy covers- accidental fire but specifically excludes earthquake fire. SOME IMPORTANT LEGAL JUDGMENTS HAVING BEARING ON THE PRACTICAL APPLICATION OF THE DOCTRINE, According to Section 55 (i) Marine Insurance Act,”Subject to the provisions of the Act and unless the policy otherwise provides the insurer is liable for any loss proximately caused by a peril insured against, but subject to as aforesaid he is not liable for any loss which is not proximately caused by a peril insured against.”, Section 55 (2) enumerates the losses which are not payable are. An insurer is liable for a loss of which a peril insured against was the proximate cause, although a peril not contemplated by the contract may have been a remote cause of the loss; but it is not liable for a loss of which the peril insured against was only a remote cause. That sinking feeling – proximate cause and insurance By Donald Dinnie on January 20, 2020 Posted in Insurance A German appeal court determined, in a marine claim, that the proximate cause of a vessel’s grounding and ultimate sinking after its main engine … The proximate cause rule applies here. Let us, however, assume that as a result of the kick only 6 bricks fall but suddenly a man throws a stone on the 7th brick and gradually falls the 7th, 8th, 9th, and 10th brick. 0
vi) Causa Proxima: In a contract of insurance, the governing rule is the proximate cause to fix the liability of the insurer. The insurance policy may cover the proximate cause, but not the event that actually causes the damage, so the policy holder will not be reimbursed for his claim. The concept of covered “perils” only exists in the property insurance context for the purpose of determining what causes of loss will be covered. To take another example, a man riding a horse in a lonely hilly place falls from the horseback, gets an injury and remains unconscious the whole night under exposure to severe cold. Certain states take into consideration the “but for” rule for proximate cause. Business Interruption Insurance Claims – Understanding the Doctrine of Proximate Cause and the Principles of Concurrent Causes. The proximate cause of his death is stabbing and certainly not going to the cinema, although it may be wrongly argued that has he not had gone to cinema he would not have met the vandals and got killed in this way. The efficient proximate cause is not necessarily the last act in a chain of events. marine insurance context and to explore how perils themselves would affect the formation and application of causation rules. Duffy is in the road construction business, and uses boiling enamel as part of the construction process. 423 (1989). Collision being the cause of death is very efficient here whilst scratch is inefficient and remote. startxref
So says MacGillivray and Parkington.1 So … (It is the proximate cause, not the remote cause that should be looked into is still the guiding principle. Co. v. Partridge (1973) 10 Cal.3d 94, which holds that, where an injury is proximately caused by two or more independent causes, the insurer is liable if any of those causes is covered under its policy. Proximate cause refers to a direct cause of loss, without which the loss would not occur; therefore, it is a highly relevant principle in the insurance industry. The insurer is not liable for any loss attributable to the willful misconduct of the assured, but, unless the policy otherwise provides, he is liable for any loss proximately caused by a peril insured against. Proximate Cause 11 5. Journal of Insurance Coverage. Proximate cause is a key principle of insurance and is concerned with how the loss or damage actually occurred and whether it is indeed as a result of an insured peril. By the Hon. Introduction. 0000001123 00000 n
On the other hand, a new and intervening force developed (throwing of the stone) which was active, efficient and potent enough to cause the result, i. e., falling off the last brick. While suing that individual, one will have to prove that the negligence was the actual or proximate cause of the injury. cit., p. 75. Here the proximate cause of falling off the last brick is certainly the kick because the strength of the kick was such that it could effectively make the last brick fall without the intervention of any new force started. Knowledge of Agent. The concurrent causation doctrine operates to hold as covered losses caused jointly by an excluded peril and some other peril that is not excluded. Insurance Contract: Elements and Clauses Insurance Contract (How it Works), Insurance: Definition, Features (Explained), Cargo Insurance: Definition, Importance, Types, Procedure, ← Utmost Good Faith in Insurance Contract, Marine Insurance, Life Insurance. Proximate Cause is an important principle of insurance, which helps in deciding how the loss or damage happen and whether it is the result of an insured peril or not. Further, this comment will analyze the Garvey case specifically and determine its validity and impact on insurance law. x�b```b``fa`a``�� �� �l@q������4�l��d�v�
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� Example: Boiling Enamel. Due to the prevailing wind, the fire spreads gradually to neighboring buildings one after another and ultimately sets the insured building into the fire. Let’s work through a fact pattern. Aspen Law and Business. For a more detailed discussion, you can read the proximate cause article by Professor Paul Hayden. By using these two words, the insurers have intentionally waived the application of the rule of proximate cause. The proximate cause itself may not do any direct damage. trailer
... instances where the doctrine of proximate cause can be applied to a patent infringement . The important point to consider here is that proximate cause is the only nearest cause and not the remote cause. The "efficient proximate cause" doctrine is often mistakenly referred to as the "concurrent cause" doctrine. Concurrent cause is actually a misnomer because it suggests that the events, actions, or forces must occur simultaneously. So long the first cause retains its identity and efficiency until the result we may say that it is the proximate cause. This section provides a definition of proximate cause and explains how it should be determined in practice. Proximate cause i s a common law doctrine was developed in the state courts within tort . Under this rule, in order to determine whether a loss resulted from a cause covered under an insurance policy , a court looks for the predominant cause which sets into motion the chain of events producing the loss, which may not necessarily be the last event that immediately preceded the loss. For more information, please contact sculawlibrarian@gmail.com. Dover says; “The causa Proxima of a loss is the cause of the loss, proximate to the loss, not necessarily in time, but inefficiency. Determining Proximate Cause Through Different Rules. 0000010936 00000 n
Mr. Johnson is resident in the firm's Orange County, CA office, and his practice includes representing insurers in insurance coverage disputes. The fact that one of these circumstances was abnormal or special does not necessarily deprive the master's act of the title of proximate cause: see Hart and Honored op. %%EOF
6d.) A man goes to a late-night cinema and whilst returning home from the show he is attacked by a group of vandals, stabbed and killed. Proximate cause is used in civil and criminal cases, and are frequent in personal injury legal cases. 0000005882 00000 n
The principle of proximate cause virtually revolves around the claims administration and, more precisely, diagnosing the playability or otherwise of a claim on the question of perils covered by a policy. Immediate or proximate means Proximate inefficiency and not necessarily in time. 0000001479 00000 n
While the efficient proximate cause is said to set into motion a chain of events, it is not necessarily the triggering cause, rather it is the predominating cause. Efficient proximate cause is the one that sets others in motion. The proximate cause of our man’s death is the collision and certainly no scratches. The concept of Proximate Cause was first distinctly stated as a legal doctrine by Bacon, and was embodied in the first of his max- ims in the phrase Iii ure non remola Causa, sedproxima spectatur. Essentially, the proximate cause in law should not remain as a mere open question of fact. nature of the insurance policy and whether a tort proximate cause analysis should be used in an insurance contract analysis. It is also hard to understand what it means and hence hard to apply it. In accident benefits policy, double of the policy amount is paid. While this has been insisted upon frequently in the past, to-day as never before there is a movement in all departments of knowledge, - in law, in metaphysics, in … A similar view was expressed in Incorporated General Insurances Ltd v Shooter 1987(1) SA842(A) at 862D: The Efficient Proximate Cause Doctrine in California: Ten Years After Garvey SCOTT G. JOHNSON - Scott G. Johnson is a partner with Robins, Kaplan, Miller & Ciresi L.L.P. xref
Certain states take into consideration the “but for” rule for proximate cause. H��V�j1��Wx]ǖ�Ǭ�誅�E? This is because the insurers have used the word “it’s own” before “spontaneous fermentation” which means that only the property subjected to spontaneous fermentation is excluded but any resultant fire damage is covered. This means understanding if the injury would occur but for the action or lapse of the defendant. While remote causes may be disregarded in determining the cause of a loss, the doctrine must be interpreted with good sense.”. Here the proximate cause of his death is accident or falling from the horseback, the reason being that injury leading to unconsciousness, exposure to severe cold and then pneumonia are all-natural events developing gradually one after another without really being intervened by a new or independent source (The example is based on a judgment given in ETHERINGTON V. LANCASHIRE AND YORKSHIRE ACCIDENT INSURANCE Co., 1909). Certain quotations may be very helpful to the students at this stage and they should try to realize the implications of such quotations, which would help them in removing some confusion that might occur in their mind about the proximate cause. Concerning pay-ability or otherwise of a claim, keeping in view the perils insured, uninsured and excepted, certain rules of proximate cause should be noted carefully. The efficient proximate cause is not necessarily the last act in a chain of events. Subrogation Principle in Insurance: How it Works? 0000001592 00000 n
In MacGillivray on Insurance Law (11th Ed, 19-001, page 513) it is said that “A proximate cause is not the first, or the last or the sole cause of the loss: it is the dominant or effective or operative cause”. (Price 2s. Rev. It was held that the proximate cause of the sinking of the ship was torpedo (Leyland Shipping Co. V. Norwich Union Fire Insurance Society, 1918). A problem arises when an insured under an accident policy is killed or suffers an injury, which has an immediate cause and a remote cause. 0000004739 00000 n
To take another example, a man falls from a ladder at a low height and scratches his leg a little. 0000014929 00000 n
12.Fire Insurance 1. Almost immediately there was a cyclonic storm and the ship sank. Types of Policies 34 6. 0000007930 00000 n
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Insurance Glossary Defines: Proximate Cause — (1) ... As a principle of tort law, proximate cause refers to a doctrine by which a plaintiff must prove that the defendant’s actions set in motion a relatively short chain of events that could have reasonably been anticipated to lead to the plaintiff’s damages. The proximate cause rule applies here. In insurance cases the policy enumerates and thus highlights the possible causes to which attention should be given. It is only by considering some propositions and examples that the doctrine of proximate cause can best be understood. 0000007678 00000 n
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Proximate cause refers to the first event, or first peril, in a series of events that cause damage in an insurance claim. The Risk 13 6. The policy does not cover loss due to “spontaneous fermentation”, but any resultant fire damage is covered. In W. Nat'l Mut. There must be direct and non-intervening cause. Efficient Proximate Cause Law and Legal Definition. The insurance policy may cover the proximate cause, but not the event that actually causes the damage, so the policy holder will not be reimbursed for his claim. doctrine of proximate cause has to be applied for the purpose of ascertaining which of the successive causes is the cause to which the loss is to be attributed within the intention of the policy.1 Doctrine of Proximate Cause Proximate cause refers to an action that leads to an unbroken chain of events; events that end with someone suffering a loss. “Proximate cause has been defined as “that cause, which, in natural and continuous sequence, unbroken by any efficient intervening cause, produces the injury, and without which the result would not have occurred.” In the above-mentioned case, the high court citing the case of Urbano vs. There might be multiple causes for the delay but the aptest cause must be looked into. Meaning 18 2. ����z�r�{A:�#��C������R�dSG!�|ٮ��@;6p3������@��E�X��y��Q � ��MR
The insurer will be liable for any loss proximately caused by a peril insured against. Therefore, the cause of death in this policy is of paramount importance. Efficient proximate cause is the one that sets others in motion. This comment certainly conveys the feeling of the learned judge as to how he feels the importance of common sense in finding out the proximate cause. 0000001047 00000 n
Marine Insurance: The Doctrine of Proximate Cause and Insurance against War Risks at Sea. "doctrine of efficient proximate cause." 1 It is the immediate cause and not the remote cause. 34 0 obj
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Proximate cause i s a common law doctrine was developed in the state courts within tort . The principle of proximate cause has been established to solve such a cumbersome situation and to enable a claims manager to decide whether a claim is at all payable or not and if payable, then to what extent. Washington courts had never previously engaged in an efficient proximate cause analysis outside the context of property insurance policies, and with good reason. This is so because throughout the spread and travel, with the help of natural wind, the fire retains its identity as an earthquake fire. Proceeding on that basis, the function of the Court is to identify the proximate cause of the damage. He is being taken to the hospital by an ambulance. So, this principle is not of much practical importance in connection with life assurance, but in the following cases, the proximate causes arc observed in the life insurance, too. 8.1 Proximate Cause Definition Proximate cause was defined in the case of Pawsey v Scottish Union & National Insurance Company … 15 Insurance Premium. Total & Constructive loss 30 4. 0000012280 00000 n
Until recent past the Principle of proximate cause was not used to be considered as a principle as such. Because proximate cause is the darling of law professors and bar examiners! It contained a provision exempting the insurer from liability for “loss or damage by fire which may happen or take place by means of any invasion, insurrection, riot or civil commotion, or of any military or usurped power.” One of the leading and often quoted cases on the doctrine of proximate cause is Insurance Company v. Boon . 0000009660 00000 n
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(This example is based on a Morgan Owen prize paper, C. 1.1, journal No. Although, the cyclone was nearer to sinking in time, nevertheless, a torpedo was the active efficient cause, because the ship was so hard hit by a torpedo that it would have sunk. Proximate cause refers to the first event, or first peril, in a series of events that cause damage in an insurance claim. 7. Proximate cause is an act, whether intentional or negligent, that is determined to have caused someone else’s damages, injury, or suffering. u�X$�n��m���1��T0R�Kg�r�Y|�7a��s;���ql6�e�3`��-
(�,�,7�d%�b�NI>���>狼.q� Salient features 27 3. INSURANCE: THE PROXIMATE CAUSE IN ENGLISH LAW Malcolm Clarke The proximate cause, whether an event covered by a policy (" peril") or an event excluded from a policy (" exception "), " is the dominant or effective or operative cause." The Court then opined that because nothing in the Policy undermined application of concurrent cause doctrine and no efficient proximate cause could be determined, concurrent cause doctrine applied in favour of coverage for the loss. (ii) delay although the delay be caused by a peril insured against. Ins. For finding out the proximate cause we shall have to watch closely the chain of events, leading ultimately to a result, and out of such events whether in a broken or unbroken sequence, interrupted or uninterrupted, the cause proximate to the result must be established. 34 20
Sometimes the application of the rule of proximate cause may be waived by insurers through policy conditions. Proximate cause is used in civil and criminal cases, and are frequent in personal injury legal cases. It is important that courts establish proximate cause in personal injury cases because not everyone nor everything that causes an injury can be held legally liable. The proximate cause of his death is cholera and not falling from the ladder, or for that matter scratches on his leg, even though it can be wrongly argued that has he not had scratches on his leg he would not have gone to the hospital and contacted cholera as such. Definition 26 2. The efficient or effective, cause which causes the loss is called proximate cause, it is the actual cause of loss. It is hard to disagree. It may be natural or unnatural. Marine Insurance Transhipment 1. The situation would have been different had the spread of fire been interrupted by a new and independent cause. Copr. MrJustice Wright. However, the present school of thought has given this doctrine the status of a principle and, therefore, now-a-days it is considered to be one of the six principles of insurance, backed up by … In the meantime, due to the severe exposure, the contracts pneumonia and dies. It has been well defined in the leading case of Pawsey V. Scottish Union and National (1907) as follows : “Proximate cause means the active, efficient cause that sets in motion a train of events which brings about a result, without the intervention of any force started and working actively from a new and independent source”,’ It is the immediate cause and not the remote cause. It was decided by per Bingham L J in T M Noten BV v Harding that the proximate cause of the damage is determined by the application of common sense od a business. 53 0 obj
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n. a happening which results in an event, particularly injury due to negligence or an intentional wrongful act. At common law the general principle then was that if there are two or more proximate causes, but that one of those causes was excluded under the policy then the insurer is not liable to indemnify the insured for the loss, notwithstanding that the other cause of the loss is not an excluded loss and falls within the ambit of the policy coverage. - … The law is comprised of doctrines that are incompatible, vary from jurisdiction to jurisdiction, and lend themselves to “logic chopping.” Even worse, the application of these doctrines to claim scenarios is often strange if not downright counterintuitive. Thus the proximate cause is the actual cause of the loss. The claim is not payable because the proximate cause of loss is earthquake fire and not ordinary fire even though the earthquake had nothing to do with the insured building. This must be direct, dominant, operative & efficient. Example: Boiling Enamel. Proximate cause is concerned with how the actual loss or damage happened to the insured party and whether it is a result of an insured peril. The survey of some law cases is helpful in demonstrating the court approach in determining the proximate cause. Under this rule, in order to determine whether a loss resulted from a cause covered under an insurance policy , a court looks for the predominant cause which sets into motion the chain of events producing the loss, which may not necessarily be the last event that immediately preceded the loss. We should not try to find out the cause of causes thereby getting mixed up and complicating the issue. The proximate cause itself may not do any direct damage. A related doctrine is the insurance law doctrine of efficient proximate cause. Let’s work through a fact pattern. (Price 2s. It is not always that much straightforward that a loss would be caused by a singular insured or uninsured or an excepted peril so that a claim would be either payable or not payable. 2 In Boon , the policy covered certain goods in a store building. Single Event. If a suicide occurs within one year of the policy, or there was an intention to commit suicide arid the payment of policy would be restricted, only up to the interest of the third party in the policy provided the interest was expressed at least one month before the suicide. Proximate cause, or the Latin Causa Proxima, relates to the cause of the loss in that the event of the peril insured against must be covered under the insurance contract (policy), and the dominant cause of the event must not be excluded. The relevant principles and approach would be no different in South African law which determines liability on the part of the insurer only if the loss or occurrence for which the claim is brought is the proximate result of the peril or at least one of the perils insured against. He is taken to a hospital and in the hospital, he contacts cholera from the next bed patient and dies. Auto. Proximate cause in insurance law: Fire following earthquake Alistair McDonald* Insurers use exclusions in material damage policies to define or limit their exposures to losses to commercial property* 1 resulting from earthquake and fire following earthquake. Let us take another example. A related doctrine is the insurance law doctrine of efficient proximate cause. 6d.) INSURANCE: THE PROXIMATE CAUSE IN ENGLISH LAW Malcolm Clarke The proximate cause, whether an event covered by a policy (" peril") or an event excluded from a policy (" exception "), " is the dominant or effective or operative cause." The insurer is not liable for ordinary wear and tear ordinary leakage and breakage, inherent vice or nature of the subject-matter insured, or for any loss proximately caused by rats or vermin, or for any injury to machinery not proximately caused by maritime perils. At common law the general principle then was that if there are two or more proximate causes, but that one of those causes was excluded under the policy then the insurer is not liable to indemnify the insured for the loss, notwithstanding that the other cause of the loss is not an excluded loss and falls within the ambit of the policy coverage. A model of causation more rational than the "doctrine of efficient (2) As a principle of tort law, proximate cause refers to a doctrine by which a plaintiff must prove that the defendant’s actions set in motion a relatively short chain of events that could have reasonably been anticipated to lead to the plaintiff’s damages. The modern legal doctrine seems to be narrower and more definite in its application than some of the older expressions of the con- C ONSISTENT advance in the development of legal doctrines and in their application is impossible without a clear under-standing of elementary definitions and concepts. The law of causation is a prime example of the information few people know about and even fewer use when purchasing insurance. Somebody gives a kick on the first brick and gradually the last brick in the line also falls. What is Proximate Cause. Probably his answer will be the correct one”. Notably, proximate cause in the marine insurance law is the dominant cause of the damage. In MacGillivray on Insurance Law (11th Ed, 19-001, page 513) it is said that “A proximate cause is not the first, or the last or the sole cause of the loss: it is the dominant or effective or operative cause”. Because proximate cause is the darling of law professors and bar examiners! A man scratches his leg falling from a ladder. California Courts have interpreted California Insurance Code sections 530 and 532 to codify the efficient proximate cause doctrine. It is not a model of clarity. 0000001157 00000 n
What is this proximate cause then?
The definition of the “cause” was under test in many cases and was mentioned clearly in the Marine Insurance Act 1906 in its section 55 that the cause should be proximate, as follows: 1. More so, the position gets further complicated when an insured peril is followed up by an excepted peril or an excepted peril is followed up by an insured peril, simultaneously getting mixed up by uninsured perils. "doctrine of efficient proximate cause." This means understanding if the injury would occur but for the action or lapse of the defendant. In order to achieve the merits, this dissertation scrutinises the causation theory itself and It is hard to disagree. The consideration is what has brought about the result? Marine losses 32 5. Therefore, Evanston argued coverage was triggered under the “concurrent proximate cause” doctrine established by the California Supreme Court in State Farm Mut. the doctrine of Causa Proximo (Proximate Cause) is not applied because the insurer is bound to pay the amount of insurance whatever may be the reason of death. DOCTRINE OF PROXIMATE CAUSE In case an individual is injured due to someone else’s negligence, one can easily claim damages due to the negligence at the end of that individual. A similar view was expressed in Incorporated General Insurances Ltd v Shooter 1987(1) SA842(A) at 862D: “No difficulty arises when only one cause has to be considered. The maxim "causa proxima non rempota spectature." The concurrent causation doctrine operates to hold as covered losses caused jointly by an excluded peril and some other peril that is not excluded. While suing that individual, one will have to prove that the negligence was the actual or proximate cause of the injury. - Volume 3 Issue 2 - W. L. M. Average clause 23 4. Section 55 (2) (b) with clarity excuses the insurer from any loss caused due to delay even if the delay is caused by an act insured against. It is also hard to understand what it means and hence hard to apply it. From all the examples explained hereinbefore the readers would possibly appreciate that it is indeed the Common Sense that is required most to find out the proximate cause of a result. Three unruly doctrines—proximate cause, concurrent cause, and efficient proximate cause—cause an inordinate amount of litigation. Beale, 33 Harv.L.R. Difficult situations do occur where numbers of perils get involved simultaneously, some insured, some uninsured and some still accepted. For a more detailed discussion, you can read the proximate cause article by Professor Paul Hayden. Reinsurance & Retention 25 8. We would be well served by getting rid of these terms and other jargon as a prologue to the development of a set of simple and cogent doctrines. %PDF-1.6
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The "efficient proximate cause" doctrine as developed by the courts in Garvey and Sabella, SOME OBSERVATIONS ON THE DOCTRINE OF PROXIMATE CAUSE. In this case, the proximate cause of falling the last brick is throwing the stone and not the kick because the kick was not efficient enough to cause the last brick to fall. 0000002527 00000 n
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