It would be going to the cause of causes to say that this was an injury caused by property fire to the insured. Proximate Cause Principle of Insurance 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. 1 Proximate cause is not confined to insurance law but is important to most branches of law and. Insurers’ liability is excluded if the proximate cause was an excluded peril. In the insurance context the so-called proximate cause approach to legal causation is considered to be in accordance with the intention of the parties. The nearest cause of the damage caused … If the cause is an insured one, the claim is payable, if the cause is uninsured or excepted the claim is not payable. The Malaysian insurer argued that the proximate cause was the inherent vice in the inability of the legs to withstand the ordinary incidents of the voyage, meaning the loss was excluded from cover, or alternatively, that the loss was an inevitable consequence of the voyage embarked upon. Proximate cause is a legal concept that relates to the connection between an injury and the event that caused the injury. Under the policy, goods have been insured against damage likely to be caused by sea water. The proximate cause of the damage was the violence of the mob and the insurers were held to be liable under the policy. The drowning was nova causa.In Everett v London Assurance, a fire caused an explosion which in turn damaged property half a mile away. Proximate cause is used in civil and criminal cases, and are frequent in personal injury legal cases. The definition given in this case reads as follows:Proximate cause means the active, efficient cause that sets in motion a train of events that brings about the result, without the intervention of any force started and working actively from a new and independent source. Robert Vivian is Professor of insurance and risk management at the department of Business and Economics at the University of Witwatersrand.He continues with his monthly column on answering exam questions for the Insurance Institute of SA qualifications. It was occasioned by a concussion or disturbance of the air caused by fire elsewhere. For an act or event to be considered a proximate cause, it does not necessarily have to directly precede a loss or begin a chain of occurrences leading to the same. As recently noted … The doctrine of proximate cause is one of the six principles of insurance. Facilitator : Jan Schubart Description : This module deals with one of the 5 pillars of insurance, namely Proximate Cause.Essential to any claim in terms of an insurance contract, is to ratify that the cause of a loss is proximate to an insured peril. The doctrine of proximate cause, which is common to all branches of insurance, must be applied with good sense so as to give effect to and not to defeat the intention. ‘Proximate cause’ a source of conflict for ‘all risk’ policies- State and federal cases applying Illinois law conflict on whether proximate cause can be considered in deciding what caused a loss for purposes of all risk property insurance policies. Are chiropractic treatment expenses covered under medical insurance? Proximate cause.This may not be a “principle” of marine insurance but section 55 (1) of the U.K. Marine Insurance Act 1906 elevates it to a condition which must be fulfilled before the underwriter becomes liable to pay a claim. 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Courts employ a set of proximate cause rules to resolve causation disputes when a property policy states that it covers or excludes losses "caused by" a peril and there … (See for example Diacon and Carter, Success in Insurance, and Hansell, Elements of insurance, and IISA study notes for course 042)The South African writers prefer to pursue the idea of proximate cause from the maxim lure non remota causa sed proxima spectatur, which means that an insurer will only be liable if the ‘fact’ for which a claim is brought, is the result of a proximate cause.Whichever approach is used, in the insurance field proximate cause connects the insured peril to the loss or damage, either to prove a claim or the exception. Is there any minimum confinement period for operation? A judge once briefed a jury that had to determine cause by simply saying, “cause means what you twelve men and women sitting as a jury would regard it in a common- sense way as the cause.”1.2 The effect of the “last straw” casesThe last straw rule does not disturb the operation of the proximate cause rule.When, through an insured peril, a loss becomes inevitable, then even though the loss in caused in the final analysis by another peril, the original peril remains the proximate cause. Ms. Ho was admitted to hospital with lower back pain last month and was diagnosed with a prolapsed intervertebral disc which required a surgical operation to be performed. If the first operation had not taken place, the second operation would not have been necessary. Principle of Proximate Cause - primary cause of a loss. 1590-1600 Latin proximatus (near, or approach) What is Proximate Cause. The question which arose was, did she sink as a result of the storm or as a result of the torpedoing?It was held that the proximate cause of the loss was the torpedoing rather than the storm, because the chain of causation was unbroken, and the proximate cause of the loss was still operating when the storm blew up. Proximate cause refers to the first event, or first peril, in a series of events that cause damage in an insurance claim. The second operation for remedying the puncture was caused by a potential operation risk arising from the first operation for her prolapsed intervertebral disc. Why will a claim for cancer discovered 10 days after the policy effective date be declined. The important point to consider here is that proximate cause is the only nearest cause and not the remote cause. The Principle of Proximate Cause in Medical Claims. Is hospitalisation mandatory for colonoscopy medical insurance claims? How does an insurance company evaluate medical insurance applicants with Hypertension? As a matter of urgency, she was transferred to another hospital to undergo a repair operation on her blood vessel. Through this hole, sea water has entered into the ship and damaged the goods insured. https://www.InjuryClaimCoach.com Proximate cause is an important part of personal injury claims. There is a long line of decisions which say that the cause is proximate if it can be described as the “dominant”, “direct”, “real”, “actual”, “determining”, “operative”, “predominant”, or “efficient” cause. Identifying the cause of loss in general insurance claims. In Washington, a judicial doctrine called the “efficient proximate cause” rule may apply and affect insurance coverage when multiple events combine to cause a loss. Proximate cause is a key principle of Insurance and is concerned with how the loss or damage actually occurred. The last straw which breaks the camel’s back, is not the proximate cause.2 ExamplesIn the case of Etherington v Lancashire and Yorkshire Accidental Insurance Company a man fell from his horse and sustained injuries which prevented him from moving. It is hard to disagree. The proximate cause itself may not do any direct damage. Proximate Cause — (1) The cause having the most significant impact in bringing about the loss under a first-party property insurance policy, when two or more independent perils operate at the same time (i.e., concurrently) to produce a loss. The direct cause of loss; exists if there is no unbroken chain of events leading from one act to a r 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. It is hard to disagree. This was in issue in a number of South African cases including Rabinowitz v Ned-Equity Insurance (1980).1.1 The effect of novus actus (or nova causa) interveniens.This has been defined as an abnormal event which breaks the chain of causation. The proximate cause of his death was the fall and not pneumonia.Pneumonia was thus not nova causa.In the case of Leyland Shipping Company v Norwich Fire Insurance Company 1918 a ship was torpedoed in the English Channel during the First World War. 8.1 Proximate Cause Definition Proximate cause was defined in the case of Pawsey v Scottish Union & National Insurance Company … Ms. Ho thought that her emergency confinement for the second operation, the aim of which was to remedy the blood vessel puncture that occurred during the first operation, was entirely unforeseen and unexpected. For an act to be deemed to cause a harm, both tests must be met; proximate cause is a legal limitation on cause-in-fact. As a result of lying on wet ground he contacted pneumonia and died. Medical Insurance Coverage for Public Hospital Confinement, Medical insurance plans with “Top-up” feature help customers to reduce insurance expenses, Medical insurance provides benefits for day care surgery, Medical Insurance Tips --- Public Hospital Cash Benefit, Mind the gap: don't get caught out by uninsured medical expenses, Multiple surgical procedures in one single incision, Pre-existing conditions exclusion of healthcare insurance, Relationship between Critical Illness Benefits and Medical Insurance Coverage, The importance of disclosing the complete truth, The Importance of Guarantee of Payment for Hospitalisation, The meaning of “Guaranteed Renewal” in medical insurance, Waiting period of critical illness insurance. ; the fire or the explosion ensure thriving ecosystems that underpin the well-being of millions of people pre-existing which! 1.0Medisure PlusHospitalCare, all causes preceding the proximate cause of causes to say that it was occasioned by potential! 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