Proximate Cause in Insurance

Proximate cause in insurance refers to the primary or predominant cause of a loss or damage that is covered by an insurance policy. It is a crucial concept used by insurance companies to determine whether a claim is eligible for coverage or not. Identifying the proximate cause is essential in insurance claims to establish a clear link between the covered event and the resulting loss.

To better understand the concept of proximate cause, consider the following example:

Let's say you have a homeowner's insurance policy that covers damage caused by lightning strikes. During a severe thunderstorm, lightning strikes a tree in your yard, and as a result, the tree falls and damages your house's roof, leading to water leaking into your home.

In this scenario, the proximate cause of the damage is the lightning strike, even though the immediate damage (the fallen tree and the water leak) might have occurred later. The insurance company will assess the claim based on the proximate cause, which is the lightning strike, and as it is a covered event, the damages to your home should be eligible for compensation under your homeowner's insurance policy.

However, if your homeowner's insurance policy specifically excludes coverage for damage caused by fallen trees and does not provide coverage for tree removal, the insurance company might deny the claim, despite the proximate cause being the lightning strike.

In summary, proximate cause in insurance is about determining the primary cause of a loss or damage, which may not always be the most immediate or direct cause. Insurance companies use this concept to evaluate claims and decide whether the loss falls within the scope of coverage provided by the policy. Understanding proximate cause can be essential for policyholders to know if their insurance will provide compensation for a specific event or incident.

‍