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High Court of Australia |
DISTILLERS CO. BIO-CHEMICALS (AUST.) PTY. LTD. v. AJAX INSURANCE CO. LTD.
[1974] HCA 3; (1974) 130 CLR 1
Insurance
High Court of Australia.
Menzies(1), Gibbs(2) and Stephen(3) JJ.
CATCHWORDS
Insurance - Public risks policy - Limitation of compensation payable to any number of "claimants in respect of or arising out of all occurrences of a series consequent on or attributable to one source or original cause" - Actions for damages by or on behalf of children born with deformities brought about by drug distributed by insured - Whether occurrences of a series - Prohibition on insured making admission in connexion with claim - Whether applicable where insurer declines to take over defence of action.
HEARING
Sydney, 1973, November 12;DECISION
1974, February 13."Claims arising directly or indirectly out of or caused by orThere is, however, an indorsement forming part of the policy which, so far as is relevant, is as follows :
in connection with goods sold, supplied or delivered or goods
upon which repairs adjustments or work has been carried out
or directed to be carried out, after such goods have passed
from the actual physical custody of the Insured or of any
person in the direct service of the Insured."
"Notwithstanding Exclusion (j) of the within Policy itThis indemnity, however, is subject to a number of limitations, including the following proviso :
is hereby expressly declared and agreed that this Policy shall
extend to indemnify the Insured in respect of all sums for
which he shall become legally liable arising out of death,
illness or bodily injury to any person occasioned during the
continuance of this Policy by negligence or by breach of any
condition or warranty as to absence of vice implied by law or
which would in the absence of express agreement be implied
by law in connection with goods sold, supplied or delivered by
the Insured, his servants or agents during any period of
insurance hereunder whether such goods were manufactured
by the Insured or not and whether such condition or warranty
is also expressed or not . . . "
"Provided further that the total liability of the Company
under this endorsement for all compensation payable
(a) to any claimant or number of claimants in respect of or
arising out of any one occurrence or in respect of or arising
out of all occurrences of a series consequent on or
attributable to one source or original cause
and
(b) during any one period of insurance shall, inclusive of all
costs, charges and expenses be limited to $100,000.
Subject also to the terms, limitations, exclusions and
conditions of this Policy." (at p4)
2. His Honour having construed this limitation made the following declaration
:
"Upon the true construction of policy of insurance PR/10319
granted by the defendant to the plaintiff the total of any
liability of the defendant to indemnify the plaintiff in respect
of all claims in respect of or arising out of death, illness or
bodily injury occasioned during any one period of insurance
by the ingestion of the drug 'Thalidomide' is limited to
$100,000." (at p4)
3. Condition 2 of the policy is as follows :
"(a) The Insured shall not without the consent in writing
of the Company make any admission, offer, promise or payment
in connection with any accident or claim, and the Company
if it so desires shall be entitled to take over and conduct in
the name of the Insured the defence or settlement of any claim.
(b) The Company shall be entitled to prosecute in the name
of the Insured, at its own expense and for its own benefit,
any claim for indemnity or damages or otherwise.
(c) The Company shall have full discretion in the conductp5)
of any proceedings in connection with any claim and the Insured
shall give all information and assistance as the Company may
require in the prosecution, defence or settlement of any claim."(at
4. His Honour having considered this condition made the following declaration
:
"Upon the true construction of the said policy the entry by
the plaintiff without the consent in writing of the defendant
into any settlement of the actions referred to in the Summons
filed herein which involves the making by the plaintiff of any
admission, offer, promise or payment would constitute a breach
of Condition 2 (a) of the said policy notwithstanding that the
defendant has elected not to take over and conduct the defence
or settlement thereof." (at p5)l 209240
5. These two declarations the insured challenges. It contends, as to the
first, that it is entitled to a declaration -
"that upon the true construction of Policy of InsuranceIt contends, as to the second, that it is entitled to a declaration -
PR/10319 and in the events which have happened the Plaintiff
is entitled to an indemnity in respect of One hundred thousand
dollars ($100,000.00) for each claimant who succeeds in an
action against the Plaintiff arising out of the use or ingestion
of the drug 'Thalidomide'."
"that upon the true construction of Policy of Insurance
PR/10319 the Plaintiff is not in breach of Condition 2 (a)
thereof if it settles without the consent of the Defendant
proceedings which the Defendant has elected not to take over
and conduct." (at p5)
6. The facts are that the insured supplied the market in New South Wales with
"Distaval" tablets which it imported from the overseas
manufacturer. These
tablets contained the drug "thalidomide". This drug, if ingested by a pregnant
woman, may or will have harmful
effects upon the foetus of her unborn child.
There are a number of actions pending against the insured for damages for
negligence
brought by or on behalf of the children born with deformities
alleged to have been brought about by the mothers' ingestion, while
pregnant,
of "Distaval" tablets distributed by the insured. The damages claimed in these
actions in one period of insurance exceed
$250,000. The manufacturer of the
"Distaval" tablets which the insured supplied - which is a co-defendant with
the insured in the
actions brought - has, it seems, offered to provide
$1,200,000 in or towards a settlement of all claims with which the insured is
concerned. (at p6)
7. It is in the setting which I have described that the contentions of the
insured in relation to the construction of the policy
fall to be considered.
(at p6)
8. The proviso in question in the indorsement limiting the total liability of
the insurer does not warrant the statement made in
the description of the
policy that the sum insured is 50,000 ($100,000). The relevant portion of the
provision means no more than
that the total liability during one period of
insurance is limited to 50,000 ($100,000) as compensation payable to
claimants in
respect of or arising out of any one occurrence or all the
occurrences "of a series consequent on or attributable to one source or
original cause". There could of course be a number of different occurrences to
each of which the limitation would apply but total
liability under the policy
could exceed 50,000 ($100,000) in a period. The question here is whether the
liability (if any) of the
insured to those claiming damages for the
deformities alleged to have been due to the thalidomide ingested by pregnant
mothers in
the form of "Distaval" tablets which the insured had put upon the
market is properly to be described as in respect of or arising
out of
occurrences "of a series consequent on or attributable to one source or
original cause". If so, the limit of liability in
any one period of insurance
for such occurrences is 50,000 ($100,000) as Helsham J. decided. (at p6)
9. In the circumstances stated the "occurrences" with which we are concerned
are, I am disposed to think each deforming of a foetus
so that the child was
later born with deformities. It may be, as counsel for the insured contended,
that the relevant occurrences
are the various births of deformed children.
Whichever view may be taken of the "occurrences" they were attributable to one
source,
namely, the thalidomide in the "Distaval" tablets supplied to the
market by the insured and taken by the mothers-to-be of the deformed
claimants. (at p6)
10. Is then each such occurrence (whether it be the deformation itself or the
birth with deformities) an occurrence "of a series"
attributable to one
source? The word "series" does, I think, normally carry with it the notion of
a sequence with some connexion
between the items in the sequence. Here
whatever connexion there is between the occurrences is to be found in what
constitutes the
further requirement, viz., that they are attributable to one
source. The problem is do they form a series? Prima facie I think not.
It is
probably true that no two of the relevant occurrences happened at the one time
so that it may be taken for granted that they
occurred one after another, but
I do not regard that as itself sufficient to constitute them occurrences in a
series, see Attorney-General
v. Cohen (1937) 1 KB 478 . The numbers 1, 2 and 3
are a series of numbers because they are in a particular order, but I would
not
regard the numbers 7, 16 and 100 as a series of numbers because they are
in no discernible order. It seems to me that order is the
characteristic of a
series and there is no order in the occurrences here under consideration. The
difficulty with the phrase here
is to attribute any particular meaning to it,
other than the unlikely one, that it merely excludes occurrences happening at
the one
time. This is so because the element of connexion between occurrences
which could perhaps constitute them a series does not depend
upon the word
"series" itself, that is, that they are attributable to one source. This is
dealt with expressly. To reject the construction
that the phrase "occurrences
in a series" means no more than any number of occurrences not happening at the
one time does, it must
be conceded, leave the words "in a series" with
problematical positive significance. Nevertheless because I am not satisfied
that
the occurrences with which we are here concerned are occurrences in a
series simply because they happened one after the other, I
find myself unable
to agree with the first declaration made by Helsham J. Had the object of the
insurer been simply to limit its
liability to 50,000 ($100,000), except in
the event of contemporaneous occurrences attributable to one source and giving
rise to
claims against the insured, it could have done so very much more
simply than by the words which have been used. See the discussion
in Welford,
Accident Insurance 2nd ed. (1932), pp. 447-448, of the methods of limiting
liability. (at p7)
11. Accordingly, I consider that the insured is entitled to the following
declaration, viz. Upon the true construction of policy
of insurance PR/10319
the plaintiff is entitled to an indemnity for any sum not exceeding $100,000
for which the insured is liable
during any one period of insurance arising out
of the death, illness or bodily injury to any person occasioned by the
plaintiff's
negligence in or in connexion with its sale, supply or delivery of
"Distaval" tablets. (at p7)
12. The second declaration is based upon a construction of condition 2 (a) of
the policy, which may go beyond that condition. The
declaration relates to the
insured entering into a particular kind of settlement without the consent in
writing of the insurer, but
the condition relates simply to making, without
such consent, "any admission, offer, promise or payment in connection with any
accident
or claim". However the point of substance is clearly the construction
of the condition. (at p8)
13. The contention of the insured depends upon limiting the operation of the
first part of the condition by linking it to the second
in such a way that the
first part has no operation if the insurer declines to take over and conduct
the proceedings against the insured.
The basis for such a linking of the two
parts of the condition is perhaps best stated simply by asking why otherwise
do the two parts
appear as one condition. The validity of the contention,
however, must depend upon the language of the condition as a whole. (at
p8)
14. The second part of the condition is an authority not a requirement. It
assumes a claim against the insured by a third party
and authorizes the
insurer to take over and conduct either or both of two activities : (1) the
defence of the claim ; and (2) the
settlement of the claim. If the insurer
exercises the authority given to it there is conferred upon it "full
discretion in the conduct
of any proceedings in connection with" therewith
(cl. 2 (c)) and the insured is obliged to give "all information and assistance
as
the Company may require in the prosecution, defence or settlement of any
claim" (cl. 2 (c)). (at p8)
15. The first part of condition 2 (a) is expressed quite generally. It
clearly enough applies without any qualification as soon
as an accident, which
may give rise to liability, happens. It continues to apply when a claim is
made by a third party against the
insured and the insurer's election arises.
It obviously continues to apply if the election is exercised and the insurer
takes over
and conducts the defence or the settlement of the claim. At this
stage, however, some qualification is necessary in relation to the
making of
admissions for it would be beyond reason to read the condition as breached if,
in answering forensic questions either by
interrogatories or in the
witness-box, what the insured answered could be treated as an admission. Such
a qualification is, I think,
to be made whether or not the insurer has taken
over the defence of the claim. In short, there would be no breach of the
condition
in the answering of forensic questions. If there should be an action
upon the claim which results in a judgment against the insured
the condition
would cease to operate in respect of a claim resolved by that judgment and the
payment of the judgment could not be
in breach of the condition. The condition
is only against payments "in connection with any accident or claim". Upon
judgment the
third party's claim disappears. It seems to me, therefore, that
the first part of the condition is in terms applicable whether or
not the
insurer takes over the defence of a claim in respect of which an action is
brought and that there is no basis for restricting
its application if the
insurer does not take over and conduct the defence to a claim. (at p9)
16. The effect of such a construction is that the insurer not having taken
over the conduct of the defence of the actions brought,
the insured in
conducting the defence cannot do certain things without the consent of the
insurer. In General Omnibus Co. v. London
General Insurance Co. (1936) IR 596
Hanna J. regarded such an effect as "quite inconsistent with the circumstances
under which the
insured has to defend his own action" (1936) IR, at p 601 and
construed a similar condition to the one now before the Court as meaning
that
the consent of the insurer to acts such as admissions, promises or settlements
was not required where the insurer had elected
not to take over the defence of
an action. In my opinion, this decision fails to take into account the fact
that the action does
not concern the insured alone but also the insurer who
may be liable to indemnify the insured depending upon the outcome of the
action.
This interest exists whether or not the insurer takes over the
defence. There are many cases in which an insured may wish to settle
an action
but in which the insurer considers that no liability will arise because the
action can be successfully defended. Under
the contract between them, the
insurer can refuse to consent to the insured making payments in settlement of
claims. This condition
does not prevent an insured, at the risk of loss of
indemnity, from making a settlement independently of his contract of
insurance.
(at p9)
17. The condition is a common one upon which it might be expected that there
would be guiding authority. In America, the courts
have permitted an insured
to make a settlement without the consent of the insurer in spite of a policy
condition prohibiting such
a settlement in cases where the insurer has
declined to take over the defence, even though the insurer was under no
obligation to
take over the defence so long as the insured can establish that
the settlement was reasonable and that the insurer would otherwise
be liable :
see Corpus Juris Secundum vol. 45, 937b, Brinkman v. Western Automobile
Indemnity Association (1920) 218 SW 944 and
Bituminous Casualty Corporation
v. Walsh & Wells Inc. (1943) 170 SW 2d 117 . I can see no warrant in the terms
of this condition
for adopting such an interpretation. (at p9)
18. The insured may make a reasonable settlement where the insurer breaches
the contract by denying liability and refusing to defend
or settle : see
General Omnibus Co. v. London General Insurance Co. (1936) IR 596 and the
dictum of Lord Esher M.R. in Captain Boyton's
World's Water Show Syndicate
Ltd. v. Employers' Liability Assurance Corporation Ltd. (1895) 11 TLR 384 But
such is not the case here
for the insurer has not repudiated its obligations
and is not, so far as I can see, in breach of its obligations. By acting as it
has it may be that the insurer is forcing the insured to defend claims that it
would prefer to settle at the partial expense of the
insurer. However it seems
to me that the condition is directed to giving the insurer sutch an advantage
for its own protection. (at
p10)
19. In these proceedings there has been no argument upon the question whether
in the circumstances the refusal of the insurer to
give its consent in writing
to the insured making any admission, offer, promise or payment in connexion
with any claim lacks bona
fides or is unreasonable and, if so, whether the
insurer is under an obligation to consent. These are important questions of
law
depending upon findings of fact which have not been made and which require
full consideration after argument. In my opinion, the
declaration sought does
not raise these questions and upon them I express no opinion. I would vary the
second declaration to make
it clear that all that is being decided is that
condition 2 of the policy applies notwithstanding that the insurer has elected
not
to take over and conduct in the name of the insured the defence or
settlement of the claims made against the insured so that other
questions
relating to the construction of the condition will remain open if and when
they arise for decision. (at p10)
GIBBS J. I have had the opportunity of considering the reasons for judgment
prepared by my brother Stephen. I agree that the first
of the declarations
made by the learned primary judge should be affirmed. On the assumptions
properly made by the learned primary
judge, any compensation payable by the
appellant to the various claimants would be in respect of, or would arise out
of, a number
of occurrences of the one kind, which followed one another in
temporal succession, and which constituted "occurrences of a series"
within
the meaning of the policy notwithstanding that they did not take place in any
progressive order. I need add nothing to what
my brother has written on this
aspect of the case. (at p10)
2. The difficult question whether the second declaration was correctly made
depends on the proper construction of condition 2(a)
of the policy, which is
in the following terms :
"The Insured shall not without the consent in writing ofThe respondent contends that this condition contains two distinct provisions - a prohibition directed to the insured and the grant of a privilege in favour of the insurer - and that the prohibition continues to bind the insured whether or not the insurer avails himself of the privilege. It is unnecessary to consider what construction would be placed on the words of the first part of condition 2 (a) if they appeared in a policy which contained no provision equivalent to that which is made by the second part of the condition. The words must be construed in their present context, and the fact that the two parts of condition 2 (a) appear in one paragraph, and indeed in one sentence, strongly suggests that they are not unconnected, and that the former provision is intended to give efficacy to the latter. In other words, the very form of condition 2 (a) leads, in my opinion, to the conclusion that the object of prohibiting the insured from making any admission, offer, promise or payment without the consent in writing of the insurer is to prevent the insured from prejudicing the conduct by the insurer of the defence or settlement of any claim. If this is so it would appear to follow that it was not intended by the condition that the insurer, having declined to take over and conduct the defence or settlement of a claim, should nevertheless be able to control the manner in which the insured conducted its defence or settlement. (at p11)
the Company make any admission, offer, promise or payment
in connection with any accident or claim, and the Company
if it so desires shall be entitled to take over and conduct in the
name of the Insured the defence or settlement of any claim."
3. This view of the effect of the condition is supported by a consideration
of the consequences that would flow from a construction
of the words of its
first part that placed no qualification upon their generality, for in the
event of an ambiguity in the instrument
it is proper to give it a construction
that would avoid irrational consequences that it is unlikely that the parties
intended. The
words of the first part of the condition, literally interpreted,
would forbid an insured to pay the amount of a judgment obtained
against him
upon a claim unless he obtained the written consent of the insurer to the
payment. Although the plaintiff's cause of
action against the insured would
merge in the judgment once it was obtained, the payment of the amount of the
judgment would remain
a payment "in connection with any accident or claim"
within the ordinary meaning of those words. But even if in some way it were
possible as a matter of construction to avoid this result, the words of the
first part of the condition, unless understood as ceasing
to have effect once
an insurer had elected to take no part in the conduct of the defence of a
claim, would operate so as most seriously
to hamper an insured in the defence
of a claim which the insurer had left him to conduct. In the ordinary course
of legal proceedings
it will often be prudent, and will sometimes be
necessary, for a party to make an admission, offer, promise or payment in
connexion
with the claim upon which the proceedings are based. A defendant,
acting reasonably, may make admissions in his pleadings or in response
to a
notice to admit, and may be obliged to make admissions in response to
interrogatories or to questions put in cross-examination.
Not infrequently a
defendant will regard it as wise to pay moneys into court or to make a payment
in settlement of a claim which
he has been advised is unanswerable. Sometimes
circumstances may call for a party to make an offer or promise as to the
future conduct
of the litigation. It would seem quite unlikely that the
parties to the policy intended condition 2 (a) to have so unreasonable an
operation as, for example, to prevent the insured from making an admission in
answer to an interrogatory without first obtaining
the written consent of the
insurer. No doubt the principle that the insurer could not refuse his consent
arbitrarily and in complete
disregard of the interests of the insured would to
some extent mitigate the inconvenience of the condition, but the insured would
remain in the position that he would be required from time to time to seek the
consent of the insurer to the taking of quite ordinary
steps in the action,
with damaging consequences if the insurer procrastinated in giving his
decision on a request for consent. However,
the only possible justification
for placing upon the words of the first part of the condition any construction
that would render
them inapplicable to admissions, offers, promises or
payments made in the course of legal proceedings is, in my opinion, that the
first part of the condition is in aid of, and ancillary to, the right given to
the insurer by the second part ; the only indication
in the policy that the
first part of condition 2 (a) has not a completely general operation is to be
found in the second part of
the condition. In other words, the condition will
apply to an admission, offer, promise or payment made in the course of legal
proceedings
unless the first part of the condition is understood as having no
operation once the insurer has elected to allow the insured to
conduct the
defence of a claim. This circumstance supports the view that the two parts of
the condition are not independent and distinct.
(at p12)
4. Although there have been decisions dealing with the position which arises
when an insurer in breach of his contract has refused
to take over the defence
of a claim or has denied liability under the contract, the only judicial
discussion which I have seen as
to the effect of a provision similar to
condition 2 (a) is in the Irish case of General Omnibus Co. Ltd. v. London
General Insurance
Co. Ltd. (1936) IR 596 . There the policy contained a
condition which read as follows :
"No admission, promise or payment shall be made by theIn that case the insurer having wrongfully repudiated liability under the policy, the insured, without the consent of the insurer, settled an action brought against him by a third party. It was held by Hanna J., and on appeal by the Supreme Court, that the above condition afforded no answer to an action brought by the insured against the insurer on the policy. The decision was rested on two grounds, one of which, that the insurer had repudiated liability under the policy, has no relevance to the present case. However, the majority of the Court also held, as a matter of construction, that the condition was inapplicable where the insurer had refused to take any part in defending the action. The trial judge, Hanna J., said (1936) IR, at p 601 :
insured without the written consent of the Company, which
shall be entitled, if it so desires, to take over and conduct in
the name of the insured the defence and settlement of any
claim, or to prosecute in his name for its own benefit any claim
or indemnity for damages or otherwise against any third party,
and shall have full discretion in the conduct of any proceedings
or in the settlement of any claim, and the insured shall give all
information and assistance as the Company may require, failing
which, benefit under this policy will be forfeited."
"Finally, what is the effect of condition 2 ? It is concerned,In the Supreme Court, Murnaghan J., with whose reasons Kennedy C.J. expressed agreement (1936) IR, at p 608 , said (1936) IR, at p 619 :
in my opinion, with the taking over by the Insurance Company
of the proceedings on behalf of the insured, and its intendment
is that nothing is to be done by the insured to prejudice the
main right of the insurer, so that, if the Insurance Company
has to contest the case, the insured is not to make any
'admission, promise, or payment without the written consent of the
Company'. I cannot accept the arguments contra, for this
condition is quite inconsistent with the circumstances under
which the insured has to defend his own action."
"In my opinion the meaning of the condition is that theThat decision is, of course, not binding upon this Court, but the remarks there made by the learned judges as to the effect of a condition which so far as material is indistinguishable from condition 2 (a) accord with my own views on the question. In my opinion the object of the first part of condition 2 (a) is to prevent the insured from doing anything that would prejudice the insurer in the conduct of the defence or settlement of a claim, or, in other words, is intended to protect the right given to the insurer by the second part of the condition. On the proper construction of the condition, where the insurer elects not to avail himself of that right, and repeatedly refuses to take any part in the conduct of the defence or settlement of a claim, the prohibition contained in the first part of the condition ceases to be applicable. With great respect to those who take a different view, I have therefore concluded that the second declaration was wrongly made and to that extent I would allow the appeal. (at p14)
insured must not do anything which will prejudice the Insurance
Company in conducting the defence of the action, if the
Company desires to take over the defence. In my opinion the
clause has no application to a case such as the present where
the Insurance Company has refused to take any part in
defending the action, and it does not debar the insured from
settling the case when it has come into Court for final
determination."
STEPHEN J. This is an appeal from the Equity Division of the Supreme Court
of New South Wales. The present appellant applied by
summons for declarations
as to its rights under a policy of insurance issued to it by the respondent
and on the hearing of that summons
Helsham J. made two declarations concerning
the construction of the policy ; it is with those two declarations that this
appeal is
concerned. (at p14)
2. The first declaration declared that the total of any liability of the
respondent insurer to indemnify the appellant insured in
respect of all claims
in respect of or arising out of death, illness or bodily injury occasioned
during any one period of insurance
by the ingestion of the drug "thalidomide"
was limited to $100,000. (at p14)
3. By the second declaration it was declared that the entry by the insured,
without the insurer's written consent, into any settlement
of certain actions
brought against it and which involved it in making any admission, offer,
compromise, promise or payment would
constitute a breach of condition 2 (a) of
the policy, notwithstanding that the insurer had elected not to take over and
conduct the
defence or settlement of those actions. The actions in question
are being brought on behalf of infant plaintiffs, alleging injury
following
their mothers' consumption of "thalidomide" during the pregnancy preceding
their respective births. (at p14)
4. Before turning to the facts it is necessary to describe the relevant terms
of the policy of insurance the subject of these declarations.
This policy,
originally issued in September 1960 and subsequently extended from time to
time, is entitled a "Public Risk Policy".
By its terms the insurer agreed to
pay to or on behalf of the insured-
"all sums for which the Insured shall become legally liableThe policy was also expressed to indemnify the insured in respect of legal costs which it might incur and this portion of the policy concluded by providing that "any sum to which the liability of the Company is expressed to be limited as hereinafter provided shall be inclusive of" the legal costs earlier referred to. (at p15)
by way of damages in respect of
Accidental death of or accidental bodily injury to any
person and/or accidental damage to property arising out
of an accident happening during the continuance of this
policy and caused as described in the Schedule under the
heading 'Events to which this policy applies'."
5. The reference to the heading "Events to which this policy applies" is to a
portion of the policy consisting of a short statement
of events, followed
first by a proviso limiting liability to specific sums in respect of specified
events and then by ten lettered
paragraphs containing exclusions from
liability on the part of the insurer, expressed to operate "except so far as
the Company shall
by endorsement hereon or by memoranda attached hereto have
agreed to extend the indemnity". (at p15)
6. One of those exclusions, that contained in par. (j), is one familiar in
the case of public risk policies ; it excludes liability
to indemnify in
respect of claims arising in connexion with goods sold or worked upon after
those goods have left the actual physical
custody of the insured. In other
words it excludes from indemnity the general area of products liability
insurance. (at p15)
7. However, the effect of this particular exclusion was then nullified by the
inclusion, before issue of the policy, of an indorsement
which was "to be
included in and read as part of" the policy itself. That indorsement read in
part as follows :
"Notwithstanding Exclusion (j) of the within Policy it isThe indorsement also contained a proviso excluding liability in certain instances and with that proviso this appeal is not concerned. The indorsement then concluded with a further proviso directly relevant to the first of the two declarations the subject of this appeal and which read as follows :
hereby expressly declared and agreed that this Policy shall
extend to indemnify the Insured in respect of all sums for
which he shall become legally liable arising out of death,
illness or bodily injury to any person occasioned during the
continuance of this Policy by negligence or by breach of any
condition or warranty as to absence of vice implied by law
or which would in the absence of express agreement be implied
by law in connection with goods sold, supplied or delivered
by the Insured, his servants or agents during any period of
insurance hereunder whether such goods were manufactured by
the Insured or not and whether such condition or warranty is
also expressed or not.".
"Provided further that the total liability of the CompanyThe indorsement was expressed to be subject to the terms, limitations, exclusions and conditions of the policy. (at p16)
under this endorsement for all compensation payable
(a) to any claimant or number of claimants in respect of or
arising out of any one occurrence or in respect of or arising
out of all occurrences of a series consequent on or
attributable to one source or original cause
and
(b) during any one period of insurance
shall, inclusive of all costs, charges and expenses be limited
to 50,000 pounds.".
8. Condition 2 of the policy, which was one of eight conditions in the
policy, all of which were in a form not unusual in the case
of indemnity
policies, is directly relevant to the second declaration made by Helsham J. It
read as follows :
"2. (a) The Insured shall not without the consent in writing
of the Company make any admission, offer, promise or payment
in connection with any accident or claim, and the Company
if it so desires shall be entitled to take over and conduct in the
name of the Insured the defence or settlement of any claim.
(b) The Company shall be entitled to prosecute in the name
of the Insured, at its own expense and for its own benefit, any
claim for indemnity or damages or otherwise.
(c) The Company shall have full discretion in the conduct
of any proceedings in connection with any claim and the
Insured shall give all information and assistance as the
Company may require in the prosecution, defence or
settlement of any claim.". (at p16)
9. The appellant, described in the policy as "Chemists and Druggists
(Wholesale)", distributed in Australia, from 1st August 1960
to the end of
November 1961, the drug "thalidomide" under the trade name "Distaval". It is
now, together with its parent company
in the United Kingdom, a defendant in a
number of actions brought on behalf of infants. Generally speaking, the
allegations disclosed
in those proceedings are that "Distaval" contains
ingredients having harmful effects on the foetus of unborn children if
consumed
by mothers during pregnancy, that the various grievous physical
disabilities of which each plaintiff complains are the result of
the mother
having consumed "Distaval" during pregnancy, that as the distributor of
"Distaval" the appellant knew or ought to have
known of its harmful effects
and that it negligently failed to warn those mothers, their medical advisers
and the chemists who supplied
"Distaval", of its harmful effects, whereby the
plaintiff infants have been permanently injured. (at p17)
10. It was following the institution of these actions against it that the
insured sought declarations against the insurer, which
had failed to admit any
liability to indemnify under the policy. (at p17)
11. The insured had, from May 1971 until July 1973, engaged in a lengthy
exchange of correspondence with the insurer, the details
of which need not be
recounted ; so far as presently relevant, the course of events was that the
insurer, having in May 1971 declined
liability in respect of the first claim
made by an infant plaintiff because of late notification of the claim, in July
1971 stated
that it was not prepared to accept any obligation to indemnify in
respect of other subsequent claims and, instead, and entirely without
prejudice, sought further information from the insured. Finally, after much
pressure from the insured, the insurer, in July 1973,
set out in some detail
its attitude to the claim for indemnity. It stated that it had not elected to
take over or conduct the defence
or settlement of any of the actions
instituted by infant plaintiffs and that it did not concede the insured's
legal liability nor
that conditions entitling the insured to indemnity had
otherwise been fulfilled. It refused consent to the insured making any
admission,
offer, promise or payment and warned that were it to do so it would
attract the operation of condition 2 (a) of the policy. It asserted
that only
if and when the insured became legally liable by way of damages to any
particular claimant would it consider whether indemnity
would be given ;
reference then followed to the resolution of differences as to indemnity by
arbitration under a clause of the policy.
(at p17)
12. It was necessary, in the proceedings before Helsham J., for certain
assumptions to be made concerning the circumstances of the
claims which have
been made against the insured but which have not, as yet, reached the trial
stage. His Honour accordingly assumed
for the purposes of his judgment that
all injuries complained of were due to the ingestion of "Distaval", that its
ingredients did
not alter, that the insured obtained all supplies of that
product from the same source, that all tablets were identical in their
characteristics and their effect was always the same, in all cases working to
bring about the mischief in the same way. (at p17)
13. Upon these assumptions his Honour concluded that the effect of the
indorsement to the policy was to limit the insurer's liability
to a total sum
of $100,000 in respect of the claims of all infant plaintiffs ; hence the form
of the first declaration. (at p18)
14. In the case of policies which provide indemnity over a period it has long
been the practice of insurers to impose an upper limit
upon their liability in
the case of each event which may occur, during the period of cover, giving
rise to a liability to indemnify.
Much litigation has ensued where one mishap
has resulted in injury to many, the question being whether, as the insurer
contends,
the one limit of liability to indemnify applies to the mishap as a
whole and, thus, to all claims flowing from it, or rather to each
individual
claim, as the insured would have it. This is just such a dispute but here the
limitation clause is expressed in terms
more detailed than in most reported
cases. (at p18)
15. The debate has, as a rule, concerned the meaning of the particular noun,
usually "accident" or "occurrence", employed to describe
that to which the
limit is to apply, and whether it refers to the mishap itself or to the injury
or death of each person involved
in it ; whether, in other words, it looks at
the matter from the viewpoint of the insured or of the injured victim. (at
p18)
16. In South Staffordshire Tramways Co. v. Sickness and Accident Assurance
Association (1891) 1 QB 402 a limit of "$500 in respect
of any one accident"
in a policy indemnifying against liability for "accidents caused by vehicles"
was held to apply to each of the
claims of some forty injured passengers in
one of the insured's trams which overturned ; it was not the overturning of
the tram but
the injury to each passenger to which the words "one accident"
applied ; as Bowen L.J. said (1891) 1 QB, at p 407 , "one accident"
meant one
accident to the person. (at p18)
17. In the recent case of Forney v. Dominion Insurance Co. Ltd. (1969) 1 WLR
928, at p 934 Donaldson J. attributes to this interpretation
given by the
Court of Appeal to "accident" what he describes as the subsequent use in
policies of the word "occurrence" rather than
"accident" when an insurer seeks
to limit liability in respect of any one mishap, regardless of the number of
persons injured thereby.
In Allen v. London Guarantee and Accident Co. Ltd.
(1912) 28 TLR 254 , the limitation of liability referred to claims "in respect
of or arising out of any one accident or occurrence" and Phillimore J.,
following the South Staffordshire Case (1) (1891) 1 QB 402
, held that where
two were injured in the one incident for which the insured was responsible
there were two "accidents"; however
there was, he said, only one "occurrence";
thus the limitation of liability applied to the total of the two separate
claims by those
who were injured as a result of that one occurrence. The many
decisions of United States courts on the subject are annotated in vol.
55 of
the American Law Reports, 2nd ed. (1957), p. 1300. (at p19)
18. In the present case the relevant limitation of liability clause,
contained in the proviso to the indorsement, refers to "occurrence"
and not to
"accident", the latter being more likely to operate favourably to the
interests of an insured. Moreover the maximum amount
is not expressed to be
applicable merely to "any one occurrence"; instead still further protection is
afforded to the insurer, first
by the reference to several claimants in
respect of the one occurrence and secondly because claims in respect of two or
more occurrences
are nevertheless made subject to the one maximum amount of
$100,000 so long as they form a series and are consequent on, or attributable
to, one source or original cause. (at p19)
19. The proviso must, of course, be read in its context in the indorsement;
the compensation payable to claimants of which it speaks
must refer to sums
for which the insured becomes legally liable arising out of death, illness or
bodily injury to any person and
which is occasioned as set out in the opening
words of the indorsement. So the limit of liability which the proviso creates
is one
applicable to sums of that nature which become payable to one or more
claimants in respect of or arising out of either one occurrence
or all
occurrences of a series if those occurrences be consequent on or attributable
to the one source or original cause. (at p19)
20. Quite apart from authority I would not regard the word "occurrence" in
this context as apt to refer to the death of a victim
or to his illness or
injury but rather to the mishap causing such death, illness or injury and this
is borne out by the contemplation
of the proviso that there may be a number of
distinct claimants although only one occurrence. In Forney's Case Donaldson J.
regarded
the policy's contemplation that a number of claims might arise out of
one occurrence as indicating that "occurrence" there meant
the mishap, not its
consequences (1969) 1 WLR, at p 934 . So do I ; although in the case of a
victim's death there may be several
dependant claimants yet, generally
speaking, the existence of several claimants will predicate the existence of
several persons injured,
made sick or killed, and is thus inconsistent with an
interpretation of "occurrence" in the singular as referring to these
happenings
rather than to the mishap which gave rise to them. Moreover the
contrary construction ignores the effect which the opening words
of the
indorsement give to the words "all compensation" in the proviso. If expanded
in the light of those opening words "all compensation"
must mean "all sums for
which the insured shall become legally liable arising out of death, illness or
bodily injury to any person
occasioned by negligence or by breach of condition
or warranty as to absence of vice in connection with goods sold supplied or
delivered".
If "all compensation" bears this meaning the words of the proviso
which follows, "in respect of or arising out of any one occurrence",
will not
refer back to a victim's death, injury or illness but rather to the event
causing that death, injury or illness. (at p20)
21. I accordingly conclude that the occurrence or occurrences spoken of in
the proviso refer to mishaps in which victims suffer
death, injury or illness
and not to that which they suffer. (at p20)
22. This conclusion is at variance with the view of Helsham J. who regarded
the infant victims' deformities as relevant occurrences.
However, as will
appear, I nevertheless arrive at the same conclusion as did his Honour,
although by a different road. (at p20)
23. Whether or not an occurrence is the mishap or its consequences, as
manifested in the victim's injuries, it seems clear that
in the present case
there was no one occurrence in respect of which or arising out of which
compensation may become payable to all
these infant claimants. Only if the
links in the chain of causes be traced as far back as the act on the part of
the insured in distributing
"Distaval" can one event common to each claimant
be found and the proviso should not, I think, be construed as including such a
remote
cause within the meaning of "occurrence". (at p20)
24. Accordingly the insurer must seek to rely upon that part of the proviso
which extends its operation to several occurrences,
which, if they form a
series having one source or original cause, will still serve the insurer's
purpose in confining the extent
of its liability to the one sum of $100,000.
(at p20)
25. The facts of the present claims are, as yet, largely conjectural ; it was
this that gave rise to the need, felt by Helsham J.,
to proceed upon the basis
of certain assumptions. Even those assumptions fall short of supplying the
necessary factual basis in the
very special facts of this case. If this were a
vehicle indemnity policy the occurrence would be the collision as a result of
which
the third party victim suffered his injuries. I find elusive the
equivalent of a collision in the present case. Is it the ingestion
of the drug
by the pregnant woman, the accumulation within her body of harmful
constituents of the drug, the taking effect of these
constituents upon the
foetus, the subsequent malformed development of the foetus within the womb,
the birth of the malformed infant
or some combination of two or more of these
events? Merely to state these possible factors as I have may be to reveal a
lack of understanding
of the operation of the drug and its effects; that would
not be surprising in view of the absence of evidence on the topic. These
difficulties are, of course, not unexpected when, before the facts are known,
it is sought to determine how a written instrument
may operate in relation to
those as yet undetermined facts. The difficulties can, I think, in this
instance, be avoided, if not overcome.
Whatever may prove ultimately to be the
relevant "occurrences" in these cases they will, I think, because of the
nature of the assumptions
made by Helsham J., be found all to be attributable
to the one "source of original cause". Whether that be a quite remote one,
such
as the distribution of a drug containing a dangerous ingredient, or some
more proximate one (and this will, of course, depend upon
the prior
identification of what is the relevant occurrence), it will, I think,
necessarily prove to be the same cause in the case
of each injured infant. No
other outcome appears possible, given the assumptions which are to be made.
Thus whatever the "occurrences"
may prove to be, the proviso will apply if
they be occurrences "of a series". (at p21)
26. The meaning of "series" in the proviso is, I think, that of a number of
events of a sufficiently similar kind following one
another in temporal
succession. By the express words of the proviso, relevant occurrences must
have "one source or original cause"
and must, by the operation of par. (b) of
the proviso, occur within a relatively short time span. Since any number of
distinct events
will, unless by coincidence they occur simultaneously,
necessarily occur in a temporal sequence, the only remaining attribute of
the
concept of a "series" to be satisfied is that the events should be, in a
sufficient degree, similar in nature. (at p21)
27. The characteristic of the similarity of events which may form a series I
take from those dictionary meanings of series which
refer to the concept of
being "of one kind" or of having some "characteristic in common" - Shorter
Oxford English Dictionary ; in
Attorney-General v. Cohen (1937) 1 KB 478, at
pp 483, 491 , it was said of the term "series of transactions" in revenue
legislation
that mere contiguity of time or place was not enough, some
"integral relationship" between the transactions must exist ; and see
Reg. v.
Kray (1970) 1 QB 125 and Reg. v. Ludlow (1971) AC 29 . (at p21)
28. In the present case it seems that although the precise nature and extent
of the injuries of the various infants may differ,
the precedent events were
in each case the same ; all involved the ingestion by a pregnant woman of
"Distaval", of which the insured
was the wholesale marketer in Australia,
with, it is to be assumed, consequent harmful effects upon the foetus,
produced in each
case in the same way by its content of "thalidomide",
resulting in deformity on birth of the infant. The assumptions required to
be
made themselves produce, to my mind, the necessary similarity called for in
any "series" of events. (at p22)
29. In at least one reported decision upon the construction of an insurance
policy the question of the existence of a "series" of
events has arisen
directly for decision. In Richardson Construction Co. v. London and Lancashire
Guarantee and Accident Co. (1939)
2 DLR 738 a liability indemnity policy
contained a limit of $1,000 "for any one accident or series of accidents
arising out of one
cause". Pile-driving operations extending over three months
had caused damage to four dwellings each in different ownership and the
owners
of each recovered, either by judgment or by settlement out of court,
substantial sums against the insured. The insured contended
that the limit was
to be applied to each claim against it, each being a distinct accident, and
not to the total of those claims.
In the Ontario Supreme Court, Mackay J.
considered a number of English decisions, including the South Staffordshire
Case (1891) 1
QB 402 and Allen's Case (1912) 28 TLR 254 , and, finding that
there had occurred four separate and distinct accidents occurring
at different
times and all from the one cause, vibrations, concluded that they constituted
a "series of accidents" so that the limit
of $1,000 was applicable to the
total. (at p22)
30. Two decisions of the U.S. Court of Appeals for the Fifth Circuit, Anchor
Casualty Co. v. McCaleb [1950] USCA5 37; (1950) 178 F (2d) 322 and
Saint Paul-Mercury
Indemnity Co. v. Rutland [1955] USCA5 520; (1955) 225 F (2d) 689, esp at p 693 , while concerned
with the construction of a clause
in a liability indemnity policy setting
a
maximum liability for "each accident" without reference to the word "series",
do provide
instances, in a similar context, of the
judicial use of the word
"series" and "series of events" in the same sense as I would give
to it in the
present instance. (at p22)
31. In my view the first declaration was correctly made by Helsham J.,
although I would regard the occurrence or occurrences to
which the proviso
refers not as the injuries suffered by the infant claimants but rather as the
relevant events precedent to that
injury, each of which had the same source or
original cause and formed, with the others, a series of occurrences such as is
referred
to in the proviso. (at p22)
32. In conclusion on this aspect I note that E.A. Heppell in a passage of his
work Products Liability Insurance (1967), a text principally
directed to the
British insurance industry, refers to what he describes as the usual form of
clause limiting liability in respect
of any one accident as containing the
phrase "any occurrence or series of occurrences arising from one source or
original cause".
He attributes to that phrase the effect of limiting to the
specified maximum sum the insurer's liability for all compensation payable
in
respect of injury and damage resulting from one act of negligence by the
insured : at p. 33. The passage is of interest as showing
that elements of the
wording of the present proviso are of current common use in products liability
insurance. (at p23)
33. The second declaration is concerned with the interpretation of condition
2 (a) of the policy. The appellant insured contends
that the declaration is
erroneous and that the restraints imposed upon it by the condition do not
apply if the insurer elects not
to take over the conduct of the defence to
claims against the insured ; alternatively it is contended that the
withholding of consent
by the insurer must be subject to an implied term that
it may not be withheld unreasonably. (at p23)
34. Condition 2 (a) appears to be a clause in common use in insurance
policies but its operation and effect, although much litigated
in the United
States, is the subject of very little English or Australian authority. Any
declaration as to its construction is likely
to affect indirectly persons
other than those who are parties to this appeal. (at p23)
35. In these circumstances it is not irrelevant to note some features
peculiar to insurance against risks of third party liability
and in relation
to which condition 2 (a) is of special significance. Policies insuring against
such risks and which combine an upper
limit of indemnity with a prohibition
upon settlement of claims by the insured without the insurer's concurrence, as
does the present
policy, are very likely to give rise to conflicts of interest
as between insurer and insured whenever a claim is made against the
insured in
excess of that upper limit of indemnity. The insured will be anxious to settle
the claim at a figure within that limit
; the insurer, however, will gain
little from a settlement close to the limit and may prefer to have the case
fought out rather than
have it settled on such terms. An immediate conflict of
interests then arises. (at p23)
36. Where settlement for less than the upper limit of indemnity appears
unattainable and the third party's case is a strong one
the insurer's
immediate financial interests would be better served if he could successfully
resist the insured's claim to indemnity
instead of accepting liability to
indemnify and conducting an inauspicious defence. Condition 2 (a), as
interpreted in the present
declaration, may afford to an insurer a means of
attaining this result ; if the insured is anxious to settle and the insurer,
while
refusing to take over the conduct of the defence, withholds its consent
to a settlement, a breach of the condition against settlement
without consent
may be procured and subsequent liability to indemnify may be avoided. An
insured's anxiety to settle will, of course,
be acute if his entitlement to
indemnity is in doubt and will in any event be substantial if the likely
amount of any judgment against
him far exceeds the limit of his entitlement to
indemnity under the policy. (at p24)
37. To appreciate that by the present declaration there is conferred upon an
insurer, who has declined either to defend a claim
or to acknowledge any
liability to indemnify in respect of that claim, a power arbitrarily to
withhold consent to a settlement is
to be struck by the far-reaching
consequences of the construction of condition 2 (a) which the present
declaration involves. Those
consequences are, if anything, exacerbated when
the particular policy, unlike the prevailing forms of American and Canadian
policies
- see Williston on Contracts, 3rd ed., vol. 7, p. 422, and Harvard
Law Review, vol. 67 (1954), p. 1137, n. 1 - does not oblige the
insurer to
defend actions against the insured. The present policy, like other policies
which have come before English courts, allows
the insurer to stand by, neither
accepting nor declining liability ; it also casts upon him no obligation to
defend claims made against
the insured. The terms of the declaration would
permit it at the same time to refuse consent to any proposed settlement, while
warning
the assured that to settle would constitute a breach of condition. (at
p24)
38. This construction of condition 2 (a) is prone to leave the insured in a
dilemma ; if he defends the action brought against him
a verdict much in
excess of the insurer's limit of liability may result and the insurer may
ultimately turn out not to be liable
to indemnify ; if he settles the action,
albeit for a reasonable sum, the insurer may then rely, as the present insurer
has said
it will, upon the fact of that unauthorized settlement as a breach of
condition excusing it from all liability to indemnify. (at
p24)
39. This, then, is the insured's dilemma in the present case. It is by no
means an uncommon one and variations of it have been the
subject of many
decided cases in the United States. Ever since the leading case of St. Louis
Dressed Beef and Provision Co. v. Maryland
Casualty Co. [1906] USSC 62; (1906) 201 US 173 (50
Law Ed 712) in which Holmes J. delivered the judgment of the Court, it has
been well established
that where
an insurer wrongfully denies liability to
indemnify and fails to defend the action brought against the insured the
latter
may make
a reasonable settlement of that action and then recover
against the insurer - later cases appear in the annotation in American
Law
Reports, vol. 142 (1943), p. 812 and its supplements. A like view was taken by
the Appellate Division of the Alberta Supreme
Court
in Chamberlain v. North
American Accident Insurance Co. (1916) 28 DLR 298 ; the judgments in the
Appellate Division refer to
both
English and American authority for the
proposition that the insurer's repudiation of liability to indemnify prevents
it from
relying,
by way of defence to the insured's action against it, upon
the insured's prudent settlement of the third party's claim against
him.
In
Stevenson v. Reliance Petroleum Ltd. (1956) 5 DLR (2d) 673 , a decision of the
Supreme Court of Canada, only one member of
the
Court, Locke J., found it
necessary, because of the view he took on other aspects of the case, to
consider the effect of the
insured's
conduct in agreeing to consent judgments
in settlement of certain of those claims despite the insurer's specific
warning
that to
do so would contravene the conditions of the policy
prohibiting settlement by the assured. He treated the insurer's failure
to
investigate
the claims, to conduct the defence and to pay resultant judgments
as breaches of the contract of insurance: these
breaches he described
as
amounting to waiver of its right to insist upon compliance by the insured with
the relevant conditions of
the policy and relied
for that purpose on the
authorities upon which the judgments in Chamberlain's Case (1916) 28 DLR 298
were founded.
(at p25)
40. These United States' and Canadian decisions were concerned with policies
which obliged the insurer to defend claims made against
the insured; the
insurer's failure to do so was found to be a clear breach of an important
contractual obligation. The position in
this case is otherwise. By the present
policy the insurer undertakes to indemnify the insured only in respect of "all
sums for which
the Insured shall become legally liable by way of damages" in
respect of specified happenings; not until the insured becomes subject
to a
relevant liability will the insurer, for the first time, be subject to any
obligation to indemnify the insured under the policy
and at no time will it be
under an obligation to defend actions brought against the insured by third
parties. It has a right, but
no obligation, to undertake the defence of such
actions. In Post Office v. Norwich Union Fire Insurance Society Ltd. (1967) 2
QB
363 , the policy was in terms somewhat similar to those of the present
policy; by it the insurer agreed to "indemnify the insured
against all sums
which the insured shall become legally liable to pay as compensation in
respect of loss of or damage to property.
It was held that the right to
indemnity only arose upon the liability of the insured to the injured person
being established by judgment
of the court, award of an arbitrator or by
agreement between the insured and the third party - per Lord Denning M.R.
(1967) 2 QB,
at pp 373-374 and per Salmon L.J. (1967) 2 QB, at pp 377-378 ,
each approving of a statement to the like effect by Devlin J. in
West Wake
Price & Co. v. Ching (1957) 1 WLR 45, at p 49 . The Post Office was the
injured third party and Potter & Company
Ltd. the
insured and of the rights of
the insured Salmon L.J. said (1967) 2 QB, at p 377 :
"It is quite true that if Potters in the end are shown to have
been legally liable for the damage resulting from the accident
to the cable, their liability in law dates from the moment
when the accident occurred and the damage was suffered. But
whether or not there is any legal liability and, if so, the amount
due from Potters to the Post Office can, in my view, only be
finally ascertained either by agreement between Potters and
the Post Office or by an action or arbitration between Potters
and the Post Office. It is quite unheard of in practice for any
assured to sue his insurers in a money claim when the actual
loss against which he wishes to be indemnified has not been
ascertained. I have never heard of such an action and there is
nothing in law that makes such an action possible." (at p26)
41. In the present case the insurer is thus on good legal ground in
asserting, as it has in correspondence, that as yet no obligation
to indemnify
has arisen; no event against which it is to indemnify has occurred, the
insured not yet having become legally liable
for any sum by way of damages.
Accordingly, its failure to admit liability to indemnify can in no view amount
to any breach of contract.
Moreover, since it is under no obligation under the
policy to take over and conduct the defence of any claim against the insured
its failure to do so is likewise no breach of the policy capable of excusing
the insured from observance of the terms of condition
2 (a). (at p26)
42. Does it then follow that the effect of the first limb of condition 2 (a)
is that assigned to it by the second declaration, the
insured being left to
make the best way it can out of its dilemma? Since the declaration deals only
with the construction of condition
2 (a) the answer must, I think, be "Yes".
However in my view the declaration tells but half the story; the consent to
which condition
2 (a) refers is not one which the insurer may arbitrarily
withhold. Its power of restraining settlement by the insured must be exercised
in good faith having regard to the interests of the insured as well as to its
own interests and in the exercise of its power to withhold
consent the insurer
must not have regard to considerations extraneous to the policy of indemnity.
(at p27)
43. It will be necessary to say more concerning this duty of good faith and
its consequences and to indicate the authorities which
support its existence.
Before doing so I should state briefly my reasons for rejecting a construction
of the first limb of condition
2 (a) which would make it inapplicable where
the insurer elects not to defend a claim against the insured. (at p27)
44. The body of United States' and Canadian case law to which I have referred
is distinguishable ; those cases on examination all
turn upon the fact that
under the form of policy there in question a refusal to defend is a breach of
contract, variously characterized
as a repudiation entitling the insured to
disregard the condition against settlement or as a waiver of that condition or
as giving
rise to an estoppel. As already mentioned, such a contention is not
open in the case of the present policy, which does not impose
any obligation
upon the insurer to defend. It is noteworthy that none of the North American
authorities which I have read seeks to
justify an unconsented-to settlement by
the insured on any ground of construction of the policy ; the prohibiting
condition is assumed
to be applicable whether or not the insurer defends and
only by recourse to the consequences of the insurer's breach of contract
is
the insured's settlement justified. (at p27)
45. There is only one authority of which I am aware which lends some support
to a construction of condition 2 (a) favourable to
the insured. In General
Omnibus Co. Ltd. v. London General Insurance Co. Ltd. (1936) IR 596 it was
held that a condition very similar
to condition 2 could not be relied upon by
an insurer who had denied liability in respect of a particular third party
claim which
the insured had subsequently settled on reasonable and proper
terms. The policy, unlike the common North American form, imposed no
obligation upon the insurer to defend ; the primary judge, Hanna J., read the
relevant condition as being concerned
"with the taking over by the Insurance Company of theHowever the judgment goes on to describe the insurer, which had not only refused to take over the defence of an action but had also specifically denied any liability to indemnify, as being "debarred from relying on such a condition as a condition precedent" and the decision must, I think, be understood in the light of the breach of contract on the insurer's part in denying liability to indemnify. On appeal to the Supreme Court of the Irish Free State Kennedy C.J. and FitzGibbon and Murnaghan JJ. delivered separate judgments ; each affirmed this aspect of the decision of Hanna J. Murnaghan J. said (1936) IR, at p 619 :
proceedings on behalf of the insured, and its intendment is
that nothing is to be done by the insured to prejudice the main
right of the insurer, so that, if the Insurance Company has to
contest the case, the insured is not to make any 'admission
promise, or payment without the written consent of the
Company'. I cannot accept the arguments contra, for this
condition is quite inconsistent with the circumstances under
which the insured has to defend his own action." (1936) IR, at p 601
"In my opinion the meaning of the condition is that theHis Honour drew no distinction between a wrongful refusal to indemnify, which is what in fact occurred, and an election not to exercise its right to take over the insured's defence, nor was it, in the circumstances, necessary for him to do so. The Chief Justice (1936) IR, at p 608 , adopted these views of Murnaghan J. ; FitzGibbon J. on the other hand relied upon what he regarded as the insurer's waiver, by its conduct in declining liability to indemnify, of its right to be consulted in the settlement of any claim. It was, he thought, the clearest case of waiver by conduct. This case cannot, in my view, provide any authority in a case where the insurer is not in breach of contract. (at p28)
insured must not do anything which will prejudice the Insurance
Company in conducting the defence of the action, if the
Company desires to take over the defence. In my opinion the
clause has no application to a case such as the present where
the Insurance Company has refused to take any part in
defending the action, and it does not debar the insured from
settling the case when it has come into Court for final
determination."
46. The terms of condition 2 (a) appear to me to be unambiguous in their
imposition of an unqualified restraint upon specified acts
by the insured
unless consented to by the insurer ; among these acts is "payment in
connection with any accident or claim" and, although
it is possible to
conceive of a settlement which does not involve a defendant in any "admission,
offer, promise", "payment" must
needs be involved in any settlement. It was
argued that "payment" cannot refer to satisfaction of a judgment by an insured
who, following
his insurer's election not to defend, has had judgment entered
against him. While this may be so it does not justify the giving of
no meaning
to "payment" ; the term is appropriate to apply to payment under a settlement
and should be so interpreted. (at p28)
47. The fact that "settlement" does not occur in the first limb of condition
2 (a) but does appear in the second limb affords no
aid to the appellant
insured ; the first limb is concerned with particular acts by the insured
rather than with transactions ; the
"conduct of the defence or settlement of
claims" is in marked contrast to the prohibited single acts, to "make any
admission" etc.
It would seem to me to have been inappropriate as a matter of
drafting to have added to these four prohibited acts the entire transaction
comprehended by "settlement". Its omission is readily explained by the fact
that a prohibition of the four acts will also effectively
prohibit a
settlement. (at p29)
48. The position of the first limb of condition 2 (a), preceding the
subsequent grant of power to the insurer to take over the defence
of a claim,
is in itself an obstacle to any construction limiting its operation. The
prohibition must clearly apply to the initial
period after a claim is made and
before the insurer has had the opportunity of deciding whether or not to take
over the defence ;
it must also apply if the insurer does elect to defend. I
can discern no ground, whether based upon the giving of business efficacy
to
the contract or upon the contra proferentes doctrine, for restricting it to
these two cases ; it will, I think, apply equally
when the insurer elects not
to take over the defence, whatever may be the position should the insurer go
further and wrongfully repudiate
liability to indemnify. (at p29)
49. It is for these reasons that I have concluded that the second declaration
appearing in the order of Helsham J. should not be
disturbed on appeal. (at
p29)
50. However it is important that the making of this second declaration should
not be thought to confer any arbitrary power of refusal
of consent upon the
insurer. On the contrary I regard the power of the insurer as so hedged around
with safeguards for the legitimate
interests of the insured as to result in a
situation in which the insured may be little worse off as a result of the
declaration
than it would have been had it been held that it might settle
claims without the insurer's consent. (at p29)
51. Where conflicts of interest arise as between an insured and an insurer,
as they frequently will where an indemnity against liability
to third parties
is limited to a maximum amount, the insurer must exercise its powers under the
policy with due regard for the interests
of the insured. Perhaps because of
the rather different way in which the granting of cover for third party
automobile claims has
developed in the United States as compared with the
United Kingdom or Australia, there appear to be very few instances in the
latter
jurisdictions in which the courts have had to consider this aspect of
liability insurance. One is, however, provided by Groom v.
Crocker (1939) 1 KB
194 . In that case the policy, by condition 2, entitled the insurer to
"absolute conduct and control" of proceedings
against the insured. Sir Wilfred
Greene M.R. said in the course of argument (1939) 1 KB, at p 198 that the
insurer had a duty to
each person it insured ; this was, in the context, a
reference to a duty unrelated to its duty to indemnify. Then in his judgment
(1939) 1 KB, at p 203 his Lordship said that insurers must throughout act "in
what they bona fide consider to be the common interest
of themselves and their
assured" and may not allow their judgment to be influenced by the hope of some
ulterior advantage. This was
a case in which the insurer, for reasons of its
own flowing from an agreement it had reached with another interested insurer,
had,
while fully indemnifying the assured, committed him to an admission of
negligence without consulting him. It had done so knowing
that the insured was
justified in his denial that he had been negligent and it did so with the
intention that judgment should be
given against him, as it was. This was all
part of its agreement with the other insurer. Scott L.J. examined the true
measure of
the insurer's right under the policy to control proceedings and
said of condition 2 that the right of absolute control which it conferred
upon
an insurer was (1939) 1 KB, at p 223 :
"subject to certain implied boundaries and limitations. ItMacKinnon L.J. referred to possible conflicts of interests as between insurer and insured when employing the one solicitor to defend a third party's claim and, in that context, described condition 2 as (1939) 1 KB, at p 226 :
was not one which they would be entitled to exercise arbitrarily.
They were bound to exercise a real discretion upon each question
as it arose in the conduct of the defence, making each decision
after due consideration of the circumstances of the particular
case ; not, of course, consulting the wishes of the assured as if
he were an uninsured person, but taking their decisions with
their minds on the facts of the particular allegations made
against him, whilst not forgetting their own rights arising from
the bargain expressed in the policy . . . ".
"subject to an implied term that the solicitor who is selectedReference may also be made to Beacon Insurance Co. v. Langdale, per Slesser L.J. (1939) 4 All ER 204, at p 206 . (at p30)
by the society" (the insurer) "shall act reasonably in the
interests both of the assured and the society."
52. In Hansen v. Marco Engineering (Aust.) Pty. Ltd. (1948) VLR 198, at pp
207-208 , Fullagar J. had occasion to refer to Groom
v. Crocker (1939) 1 KB
194 and to the different measure of the insured's interest as compared with
that of the insurer where a policy
is subject to a limit of indemnity. In Club
Motor Insurance Agency Pty. Ltd. v. Swann (1954) VLR 754, at pp 761-762 , Dean
J. referred
to the duty of an insurer to safeguard the interests of the
insured as well as its own, also referring to Groom v. Crocker (1939)
1 KB 194
. (at p31)
53. The implied obligation imposed upon the insurer to have regard to more
than its own interests when exercising its rights and
powers under the
contract of insurance is perhaps most clearly to be seen in the well
established doctrines of the United States
courts. Those courts have for many
years had to deal with cases arising under automobile third party risks
insurance policies conferring
upon the insured indemnity only for a limited
amount and have had before them questions of conflicts of interest, especially
where
failure to make a settlement with a claimant at a figure near the upper
limit of the insurer's liability to indemnify has arisen.
It has been held
that an insurer must act in good faith towards the insured and must have
regard to his interests both in the defence
of actions against the insured and
in their settlement. As the Court of Appeals of New York, then presided over
by Cardozo C.J.,
said in Best Building Co. v. Employers' Liability Assurance
Corporation (1928) 247 NY 451, at p 453 ; 160 NE 911, at p 912 :
"That the insurance company in the handling of the litigationand see generally annotation in American Law Reports, 2nd ed. (1955), vol. 40, at p. 168, Williston on Contracts 3rd ed., vol. 7, par. 914, the review of cases contained in Cardinal v. State (1952) 304 NY 400, at pp 410-411; 107 NE 2d 569, at p 573 , the recent case of Gordon v. Nationwide Mutual Insurance Co. (1972) 30 NY (2d) 427; 334 NYS 2d 601 , in which the insurer's duty of good faith and fair dealing is closely analysed in the judgments. (at p31)
or in failing to settle is liable for its fraud or bad faith is
conceded and has been repeatedly stated in all the cases
bearing on the subject."
54. This duty of good faith and fair dealing must, I think, not only control
the actions of an insurer who has taken over its insured's
defence but will
apply equally to the insurer's exercise of its power of granting or
withholding consent to the making of admissions
etc. even if it elects not to
take over the defence. (at p31)
55. The nature of the proceedings before Helsham J., concerned as they were
only with a point of construction and not involving
any investigation of the
merits of the particular settlement which the insured was anxious should be
effected with infant plaintiffs,
makes it quite inappropriate on this appeal
to seek to judge the insurer's refusal of consent to settlement. It would I
think be
improper for the insurer to refuse its consent to an otherwise proper
and reasonable settlement if it did so not because there were
reasonable
prospects of a defence to claims succeeding but rather because, remote as
those prospects might appear, they seemed to
it preferable to a settlement
involving it in payment up to the full amount of its limit of liability. To
refuse consent in such
a case, thereby exposing the insured to the probability
of a judgment against it for an amount much in excess of the limit of
liability,
would be substantially to disregard the proper interests of the
insured. On the other hand the insurer might quite properly refuse
consent to
a settlement which was attractive to the insured not because of an objective
evaluation of the prospects of a successful
defence but rather because it
would avoid the adverse publicity of a trial or would enable the insured to
share in, and require its
insurer to share in, a liability which properly
should be wholly borne by its parent company, the supplier of the allegedly
harmful
drug. (at p32)
56. No doubt the limit of liability to indemnify and its relationship to the
amount likely to be awarded against an insured will
be an important factor in
considering the propriety of any refusal of consent to a settlement. The
insurer necessarily ceases to
have any interest in that part of an award in
excess of the limit of liability but the insured is vitally interested in that
excess.
In the form of policy in use in the United States, which appears
commonly only to prohibit settlement by the insured at the cost
of the
insurer, it has been held in a number of cases that the insured may, without
breach of condition, settle that portion of a
claim in excess of the limit of
liability : Traders & General Insurance Co. v. Rudco Oil & Gas Co. (1942) 142
Am LR 799,
at p 806
and the annotation (1942) 142 Am LR, at pp 809-812 as
later supplemented. (at p32)
57. The second declaration produces, I have said, a result little less
favourable to the assured than would a declaration that the
consent of the
insurer to any settlement was unnecessary ; in the latter event the insured
would nevertheless be required to have
regard to the proper interests of the
insurer and could not claim indemnity under the policy in respect of amounts
payable under
a settlement which did not reflect, by its terms, a reasonable
evaluation of the prospects of a successful defence to a third party's
claim.
Such a settlement might also be attacked upon the distinct ground that the
amount payable under it by the insured was not
within the cover of the policy,
not being an amount for which the insured became legally liable within the
terms of the indorsement
to the policy but being rather, at least to a
significant extent, moneys paid for reasons extraneous to the risks insured
against.
Thus, by way of illustration only, the facts might justify a
conclusion that the moneys had been paid to avoid adverse publicity
or to
relieve the insured's parent company of part of its liability for manufacture
of a dangerous product, neither of which would
be within the risks insured
against. (at p33)
58. In its letter of 27th July 1973 the insurer has used language which may
suggest, perhaps unintentionally, that it has decided
to withhold consent to
any form of settlement whatever of the claims of the infant plaintiffs; if
this is in fact the insurer's attitude
it would seem to be inconsistent with
its duty to have due regard to the interests of the insured and thus properly
to evaluate each
proposal of settlement that may be made to it in the light of
the prospects of a successful defence against the claims. (at p33)
59. I would add that in considering the terms of the second declaration I
have confined my attention to those claims against the
insured for which the
insurer has not denied liability to indemnify. One claim, relating to the
child, Laura Anne Thompson, has been
the subject of a specific denial of
liability upon the ground of late notification of the claim but the summons in
these proceedings
does not seek any declaration in respect of that claim. Were
it ultimately to be established that the insurer was not entitled to
deny
liability in respect of that claim and was in breach of contract in doing so I
would not necessarily regard the terms of the
present declaration as
applicable to her case. It would, in any event, be inappropriate to deal, on
this appeal, with this quite
speculative aspect; what might be the
consequences of a bona fide and reasonable settlement by the insured of that
one claim without
the insurer's consent is a question for another day. (at
p33)
60. I would dismiss this appeal subject to a variation of the form of the
second declaration as indicated in the judgment of Menzies
J. (at p33)
ORDER
Order of the Supreme Court of New South Wales variedby omitting the second declaration therein contained
"Upon the true construction of the said policy the
making by the plaintiff of any admission, offer,
promise or payment in the actions referred to in the
summons filed herein would constitute a breach of
condition 2 (a) of the said policy notwithstanding that
the defendant has elected not to take over and conduct
the defence or settlement thereof".
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