Published on:

Understanding terms: “Direct Loss” and “Proximate Cause”

When dealing with insurance plans and the intricate clauses involved, it is important to fully understand the language used. In utilizing terms like these, insurance companies embed vague, variable levels of damage responsibility so as to skirt responsibility in the event damage comes to your home under what is supposed to be a covered incident. What exactly is a direct loss? What is the proximate cause of a damage? The following will hopefully help you better understand your policy and how to go about receiving the compensation you deserve when damage comes onto you:

Direct loss or proximate cause relates to the dominate and efficient cause of your property loss. In proving the proximate cause of a harm, the courts have held that, through eye witness and/or expert testimony, the insured must prove that the related incident the plan covers was the “dominate and efficient” cause of the loss. As such, it relates to a factual, not subjective, determination by the court or jury.

For example, should your claim relate to wind damage, it would be necessary to prove in court that the proximate cause of your damage to be the wind involved in the related storm. To proceed, you would then bring in an expert on wind damage to tell the court that, were it not for the extreme winds involved in the event that caused damage, your property would not be harmed.

Understanding proximate cause is extremely important because it can cause an extreme hardship to individuals who are unable to prove it when making their claim. For instance, if it can be proven that flood damage would have occurred even without the strong wins, the court or jury may deny the claim in court, alleging the damage would instead only be covered by flood insurance.

Because proximate cause is not a concrete idea and has vagueness that can lead to compelling arguments affecting the outcome of a case, it is essential to have legal representation that is able to effectively litigate in your favor. Proving proximate cause requires careful, well-developed arguments from your attorney and, perhaps most importantly, a compelling testimony from an expert on your side.

If you need to prove your claim and that your insurance provides coverage for the relevant proximate cause of your damage, call the Berniard Law Firm at (504) 527-6225 or Toll-Free at 1-866-574-8005 and an attorney will help you get the ruling you deserve.