Proximate cause is concerned with how the actual loss or damage happened to the insured party and whether it resulted from an insured peril. It looks for the reason behind the loss; is it an insured peril or not? The doctrine of proximate cause is one of the six principles of insurance.
Proximate Cause Principle of Insurance
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.
A policy may cover certain perils mentioned specifically therein (known as insured perils), whilst some perils may be specifically excluded (known as excepted perils), and some may still be neither included nor excluded (known as uninsured perils).
It is not always that 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.
Difficult situations occur where number of perils get involved simultaneously, some insured, some uninsured, and some still accepted.
More so, the position gets further complicated when an excepted peril follows up an insured peril, or an excepted peril is followed up by an insured peril, simultaneously getting mixed up by uninsured perils.
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.
What is this proximate cause, then? 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 that 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 maxim is, “Causa Proxima no remote spectator.” Immediate or proximate means Proximate inefficiency and not necessarily in time. The consideration is what has brought about the result.
A ship was severely torpedoed and was in the process of sinking. Almost immediately, there was a cyclonic storm, and the ship sank. It was held that the proximate cause of the sinking of the ship was a torpedo (Leyland Shipping Co. V. Norwich Union Fire Insurance Society, 1918).
Although the cyclone was nearer to sinking in time, a torpedo was the active, efficient cause because a torpedo so hard hit the ship that it would have sunk.
Maybe the cyclone has accelerated the sinking speed, and it can be regarded as a remote cause.
To take another example, a man falls from a ladder at a low height and scratches his leg a little. He is taken to a hospital, and in the hospital, he contacts cholera from the next bed patient and dies.
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 had he not had scratches on his leg, he would not have gone to the hospital and contracted cholera as such.
In this case, scratches may be a remote cause. Let us take another example. A man scratches his leg falling from a ladder. He is being taken to the hospital by ambulance.
On the way to the hospital, the ambulance meets a head-on collision with a lorry, and all persons on board the ambulance die, including our man.
The proximate cause of our man’s death is the collision and certainly no scratches. Collision being the cause of death is very efficient here whilst scratch is inefficient and remote.
Certain quotations may be beneficial to the students at this stage. They should try to realize the implications of such quotations, which would help them remove some confusion in their minds about the proximate cause.
- Lord Bacon, in his Maxims of Law, has said,
“it was infinite for the law to consider the cause of causes, and their impulsions one of another; therefore it contenteth itself with the immediate cause, and judgeth of acts by that, without looking to any further degree.” - In Leyland Shipping Co. V. Norwich Union Fire Insurance Society (1918), the maxim laid down was,
“To treat the proximate cause as if it was the cause which is proximate in time is out of the question. The truly proximate cause is that which is proximate inefficiency. That efficiency may have been preserved although other causes may meantime have sprung up, which have yet not destroyed it or truly impaired it, and it may culminate in a result of which it remains the real efficient cause to which the event can be ascribed”. - In YORKSHIRE DALE S.S. Co. V. MINISTER OF WAR TRANSPORT (1942), the statement made was,
“Choice of the real or efficient cause from out of the whole complex of the facts must be made by applying commonsense standards. Causation is to be understood as the man in the street and not as either scientist or the metaphysician would understand it”.
Proximate Cause Examples
It is only by considering some propositions and examples that the proximate cause doctrine can best be understood.
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.
The proximate cause of his death is stabbing and certainly not going to the cinema, although it may be wrongly argued that has he had not gone to the cinema, he would not have met the vandals and got killed in this way.
Here, going to the cinema may be simply a remote cause without proximately causing his death.
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. The following morning he is discovered by some people.
In the meantime, due to the severe exposure, he contracts pneumonia and dies.
Here the proximate cause of his death is an 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)
To find out the proximate cause, we shall have to watch the chain of events closely, 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.
So long as the first cause retains its identity and efficiency until we may say that it is the proximate cause.
If, however, the chain of causation is broken so that the first cause loses its identity, and a new cause develops, bringing about the result actively and efficiently. Then, we may tag the result to have been proximately caused by the new intervening cause.
To give an example, let us take 10 bricks arranged in a lined standing order one after another, keeping a gap of say, 6 Inches in between. Somebody gives a kick on the first brick, and gradually the last brick in the line also falls.
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.
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 bricks.
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.
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. Let us take another example.
A policy covers- accidental fire but specifically excludes earthquake fire. For example, there is an earthquake fire somewhere near the insured building. Due to the prevailing wind, the fire spreads gradually to neighboring buildings, ultimately setting the insured building on fire.
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 is so because throughout the spread and travel, with the help of natural wind, the fire retains its identity as an earthquake fire. The situation would have been different had the fire spread been interrupted by a new and independent cause.
Suppose in the same example, it so happens that from mid-journey of the fire, somebody lights a candlestick, carries this fire, and sets the property of somebody under fire.
In that case, that resultant fire shall be accidental fire or malicious fire and certainly not earthquake fire as the chain of events has been broken by a new and independent force, which is active, efficient, and potent enough to bring about the result. (This example is based on a Morgan Owen prize paper, C. 1.1, journal No. 42, 1939)
From all the examples explained hereinbefore, the readers would appreciate that it is indeed Common Sense that is required most to find out the proximate cause of a result. We should not try to find out the cause of causes, thereby getting mixed up and complicating the issue.
A learned judge, therefore, rightfully commented with confidence, “If you want to find out the proximate cause, do not ask a scientist or a lawyer; ask a man from the street. Probably his answer will be the correct one”.
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.
Rule of 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.
These are;
Single Cause
When a single cause gives rise to a claim, the issue is simple. If the cause is an insured one, the claim is payable. If the cause is uninsured or excepted, the claim is not payable.
Concurrent Causes
It becomes a difficult proposition when a loss is caused by the operation of many perils, some insured, some uninsured, and some excepted. If no excepted peril is involved, then provided that there is at least one insured peril involved, the claim becomes payable by disregarding others.
However, suppose excepted peril is involved with insured peril. In that case, if the effects of excepted peril can be separated from that of the insured peril, there is a liability for the loss caused by the insured peril. But, on the other hand, if it cannot be so separated, there is no liability whatsoever.
Unbroken Sequence
If an insured peril follows excepted peril, there is no claim. If, on the other hand, an insured peril is followed by an excepted peril, there is a claim for the loss caused by the insured peril.
When several events occur in an unbroken sequence than provided, there is no excepted peril involved, and the whole claim is payable only if an insured peril is involved.
Broken Sequence
If an insured peril follows excepted peril as a new and independent cause, then there is a liability for the loss caused by the insured peril. If, on the other hand, an insured peril is followed by an excepted peril as a new and independent cause, there is also a liability for the loss caused by the insured peril.
WAIVER OF THE DOCTRINE
Sometimes the application of the rule of proximate cause may be waived by insurers through policy conditions. The best example here is probably the standard fire policy. The policy does not cover loss due to “spontaneous fermentation,” but any resultant fire damage is covered.
This is because the insurers have used the word “its own” before “spontaneous fermentation,” which means that only the property subjected to spontaneous fermentation is excluded, but any resultant fire damage is covered.
Had the words “its own” not been there, the resultant fire damage would not have been covered under the rule of proximate cause.
By using these two words, the insurers have intentionally waived the application of the rule of proximate cause.
SOME IMPORTANT LEGAL JUDGMENTS HAVE A BEARING ON THE PRACTICAL APPLICATION OF THE DOCTRINE
- GASKARTH V. LAW UNION (1876)
- ROGERS V. WHITTAKER (1917)
- COXE V. EMPLOYERS LIABILITY ASSU. (1916)
Proximate Cause in Marine Insurance
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
(i) misconduct of the assured,
(ii) delay, although the delay be caused by a peril insured against,
(iii) ordinary wear and tear, ordinary leakage and breakage inherent vice or nature of the subject matter insured, or any loss proximately caused by rates or vermin or any injury to machinery not proximately caused by maritime perils.
- The insurer is not liable for any loss attributable to the willful misconduct of the assured. Still, unless the policy otherwise provides, he is liable for any loss proximately caused by a peril insured against.
- The insurer will not be liable for any loss caused by delay unless otherwise provided.
- 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.
Dover says, “The causa Proxima of a loss is the cause of the loss, proximate to the loss, not necessarily in time, but inefficiency. Thus, while remote causes may be disregarded in determining the cause of a loss, the doctrine must be interpreted with good sense.”
To uphold and not defeat the intention of the parties to the contract. Thus the proximate cause is the actual cause of the loss.
There must be a direct and non-intervening cause. The insurer will be liable for any loss proximately caused by a peril insured against.
For marine insurance to be observed, understanding how the proximate Cause principle is applied in marine insurance must be understood.
Proximate Cause In Life Insurance
The efficient or effective cause which causes the loss is called the proximate cause, and it is the actual cause of loss.
If the cause of loss (peril) is insured, the insurer will pay. Otherwise, the insurer will not compensate.
In life insurance, Causa Proximo’s (Proximate Cause) doctrine is not applied because the insurer is bound to pay the amount of insurance, whatever may be the reason for death. For example, it may be natural or unnatural.
So, this principle is not of much practical importance in connection with life assurance, but in the following cases, the proximate causes are is observed in life insurance.
War-risk
The policy is issued on the exclusion of War and aviation risks. The proximate cause of death is important because the insurer waives its liability if death occurred, in this case, while the insured was in the field or is engaged in the operation of war and aviation.
Only the premium paid or surrender value, whichever is higher, is payable, and the total policy amount is not payable.
Life Insurance and Suicide
If a suicide occurs within one year of the policy, or there was an intention to commit suicide arid, the policy payment would be restricted only to the third party’s interest in the policy, provided the interest was expressed at least one month before the suicide.
Accident Benefit
A problem arises when an insured under an accident policy is killed or suffers an injury with an immediate cause and a remote cause.
In the accident benefits policy, double the policy amount is paid. Therefore, the cause of death in this policy is of paramount importance.
