It is also hard to understand what it means and hence hard to apply it. Mr.A has taken a marine policyto cover the goods exported by him. Proximate cause is a key principle of Insurance and is concerned with how the loss or damage actually occurred. There are no hard and fast rules to determine the proximate cause of a loss, since this is a question of fact concerning specific circumstances. There are several competing theories of proximate cause (see Other factors ). 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. So says MacGillivray and Parkington.1 So say the courts. 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. Learn more about our insurance plans:CriticalCare 1.0MediSure PlusHospitalCare, All Rights Reserved. As the proximate cause of the second operation was related to the first operation and the first operation was excluded from Ms. Ho's medical policy, her insurance company was not liable for Ms. Ho's hospitalisation claim. The proximate cause of the damage was the violence of the mob and the insurers were held to be liable under the policy. During the voyage, a hole was caused at the bottom of the ship. 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. This was because the court considered there was a break in the chain of causation between the fit and the drowning.The man could, for example, have had a fit and fallen to the ground, in which event he would not have died. The ship managed to reach port where she was moored. It is hard to disagree. 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. The Principle of Proximate Cause in Medical Claims. Why was Ms. Ho's second hospitalisation not covered by her medical insurance policy? proximate cause. Under the policy, goods have been insured against damage likely to be caused by sea water. First, the hole that was caused in the bottom of the ship and second, the seepage of sea water into the ship. Proximate Cause Active, direct, and efficient cause of loss in insurance that sets in motion an unbroken chain of events which bring about damage, destruction, or injury without the intervention of a new and independent force. What is Proximate Cause? It was held that the drowning was the proximate cause of death rather than the fit or the fall. There are many instances where causation appears to be interrupted by another act or peril. Principle of Proximate Cause - primary cause of a loss. If the first operation had not taken place, the second operation would not have been necessary. This question came from the April 1989 paper in the subject Principles and Practice of Insurance (042).The question: 1 Define proximate cause; 2 Explain the effect of the following on the doctrine of proximate cause: 2.1 novus actus interveniens; and, 2.2 ‘last straw’ cases.1 DefinitionsThe proximate causeIn most British text books the definition of proximate cause is taken from the case of Pawsey v Scottish Union and National Insurance Company (1907). (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. The second operation for remedying the puncture was caused by a potential operation risk arising from the first operation for her prolapsed intervertebral disc. 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. Origin of Proximate. Can recovered cancer patients take out health insurance? If the proximate cause (Cause 1) is covered, the loss is covered. But two days later she sank in a storm. 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. Benefits payable for illness existing prior to policy upgrade. That which causes a negative event, such as an injury. That is, where (Cause 1) Covered Peril → (Cause 2) Excluded Peril → (Loss) (i.e., where a covered peril causes an excluded peril that causes the loss), courts view this as a loss "caused by" the initial covered peril within the meaning of a property policy's insuring agreement. 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. 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. As a result of lying on wet ground he contacted pneumonia and died. Proximate cause is not confined to insurance law but is important to most branches of law and. Proximate cause refers to the first event, or first peril, in a series of events that cause damage in an insurance claim. 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. 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. California Courts have interpreted California Insurance Code sections 530 and 532 to codify the efficient proximate cause doctrine. n. a happening which results in an event, particularly injury due to negligence or an intentional wrongful act. Why do I need to buy a separate critical illness insurance policy? Identifying the cause of loss in general insurance claims. If this new act or peril intervenes then it could be argued that the original act or peril was not the proximate cause of the loss or damage.Thus, nova causa is a new intervening cause of the loss, the effect of which is that, if it is not insured, the insurer is not liable in terms of the policy to pay the claim. It is hard to disagree. 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