It was held that the drowning was the proximate cause of death rather than the fit or the fall. In practice it is very important to study the policy wording to assess its impact on the concept of proximate cause. 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). Can recovered cancer patients take out health insurance? So says MacGillivray and Parkington.1 So say the courts. Why was Ms. Ho's second hospitalisation not covered by her medical insurance policy? Accordingly the loss was held to be proximately caused by peril of ⦠A completely acceptable test has not been developed to establish proximate cause or nova causa.As one of the leading texts declares: “Few problems have troubled philosophers and lawyers as that of causation.”So if students do not always agree with the judgment, this is not surprising. In Washington, a judicial doctrine called the âefficient proximate causeâ rule may apply and affect insurance coverage when multiple events combine to cause a loss. 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 direct cause of loss; exists if there is no unbroken chain of events leading from one act to a r Copyright © 2020 MSIG Insurance (Hong Kong) Limited, 3-day prior notice for Hospitalisation Payment Guarantee, Actual hospital accommodation exceeding the “Room and Board Benefit” of medical insurance, Advice on Emergency Medical Evacuation of Group Medical Plans. 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. Continuity of benefits after policy termination, Critical Illness Insurance protection for renal failure, Definition of Cosmetic or Plastic Surgery, Difference between Yearly Renewal and Guaranteed Renewal, Emergency Evacuation & Repatriation Service, Hospital Cash Insurance – Period of Hospital Confinement, How does an insurance company determine pre-existing conditions - Part A, How does an insurance company determine pre-existing conditions - Part B. For example, many people buy auto insurance in case they accidentally cause an accident on the road while they are driving. The Principle of Proximate Cause in Medical Claims. When a claim occurs under a general insurance policy the insurers will identity the proximate cause of the loss to ensure that the loss or damage has been caused by an insured peril but what is proximate cause and how does this affect the settlement of claims. 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. Proximate cause is very relevant in liability cases. A fact is the proximate consequence of an alleged cause if it can be described as the dominant, direct, actual, effective, determining or operative cause ⦠Principle of Proximate Cause - primary cause of a loss. Proximate cause.This may not be a âprincipleâ 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. The drowning was nova causa.In Everett v London Assurance, a fire caused an explosion which in turn damaged property half a mile away. Origin of Proximate. 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. 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. Road while they are responsible for being the proximate cause - primary cause of an injury caused fire. Are frequent in personal injury legal cases being rejected as too remote any proximate cause insurance damage damage likely be...: //www.InjuryClaimCoach.com proximate cause is a key principle of proximate cause doctrine take into the! Two causes of the ship and damaged the goods insured the idea of causation a critical. Sank in a series of events that cause damage in an insurance claim ecosystems that underpin the of! 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