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[1992] ZASCA 157
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S Z Tooling Services CC v South African Eagle Insurance Company Ltd. (53/1991) [1992] ZASCA 157; 1993 (1) SA 274 (AD); [1993] 1 All SA 217 (A) (18 September 1992)
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LL Case No 53/1991
IN THE SUPREME COURT OF SOUTH AFRICA APPELLATE DIVISION
In the matter between:
S Z TOOLING SERVICES CC Appellant
and
SOUTH AFRICAN EAGLE INSURANCE
COMPANY LIMITED Respondent
CORAM: VAN HEERDEN, NESTADT, EKSTEEN, NIENABER JJA et KRIEGLER AJA
HEARD: 8 SEPTEMBER 1992
DELIVERED: 18 SEPTEMBER 1992
JUDGMENT VAN HEERDEN JA:
2
The appellant was the insured in terms of a "Multi-Peril Policy" issued by
the respondent. During July 1988, when the policy was in
force, the appellant
allegedly suffered damage to certain equipment and submitted a claim which, if
valid, was covered by the policy.
The claim was, however, rejected by the
respondent on 24 November 1988.
During January 1989 the appellant commenced
motion proceedings in the Witwatersrand Local Division. It sought an order
declaring that
the respondent was obliged to indemnify it under the policy in
respect of the damage to the equipment. Kriegler J dismissed the application
which had been opposed by the appellant. He did so on two grounds, viz, i) that
the appellant had unjustifiably resorted to piecemeal
litigation and ii) that a
defence raised by the respondent could not, on the papers before him, be
rejected as unfounded. The gist
of that
3 defence was that the damage had
been caused intentionally by, or at the instigation of, the appellant's sole
shareholder.
During June 1989, some two months after the dismissal of the
application, the respondent instituted action against the respondent
in the same
Division. It again sought a declaratory order but also claimed payment of the
sum of R460 000. The appellant alleged
that that amount represented the cost of
repairing the damaged equipment and attendant expenditure. The respondent raised
various
defences, one of which was that all benefits under the policy had been
forfeited because of the appellant's failure to institute
the action within
three months after the rejection of its claim. In this regard the respondent
relied upon condition 6(c) of the
policy which is quoted below.
After the close of pleadings the parties
4 formulated a written statement of agreed facts. It was also agreed that at the trial only the following questions were to be resolved, viz, whether:
"3.1 As contended for by the Plaintiff [the appellant] that the commencement of the original action by way of motion proceedings, which was compliance with Condition 6 of the policy, had the effect that the provisions of Condition 6 thereafter ceased to apply to this claim;
3.2 As contended for by the Defendant [the respondent] that the running of the time bar period in terms of Condition 6 was not interrupted by the unsuccessful motion proceedings commenced by the Plaintiff as referred to therein."
The statement concluded as follows:
"4.1 If this Honourable Court rejects the Defendant's contentions, it will order that the action proceed against the Defendant and that the Defendant pay the costs of determining the issue of the time bar.
4.2 If this Honourable Court upholds the Defendant's contention, this Honourable Court will dismiss the Plaintiff's claim and order that the Plaintiff pay the Defendant's costs."
5
It is apparent that at the hearing of the trial Spoelstra J gave effect to
the parties' agreement. Having heard argument he found
in favour of the
respondent and consequently dismissed the action with costs.
Condition 6(a)
of the standard policy provides inter alia for the submission by the
insured of full details of a claim under the policy. The claim must be submitted
as soon as practicable
after the happening of the event giving rise to it.
Condition 6(b) and (c) read as follows:
"(b) No claim (other than a claim under the consequential loss section, if applicable) shall be payable after the expiry of twenty four months or such further time as the company may allow from the happening of any event unless the claim is the subject of pending legal action or is a claim in respect of the insured's legal liability to a third party.
(c) In the event of a claim being re-
6
jected and legal action not being commenced within 3 months after such rejection all benefit under this policy shall be forfeited."
It will have been observed that the motion proceedings were initiated within
three months of the date of rejection of the appellant's
claim by the
respondent, but that the action was instituted only some seven months after that
date. Spoelstra J was of the view that
proceedings in which only declaratory
relief is sought do not constitute "legal action" within the ambit of condition
6(c). His reasoning
ran along these lines: The only claim that the appellant
could have made under the policy in respect of damaged equipment, was one
for
payment of compensation. Clause 6(c) envisages only one action, and that is an
action for the enforcement of the claim lodged
with the insurer under clause
6(a). That being so, only a process by which compensation
7 for the loss
suffered by the insured is claimed, i e, payment of a monetary amount, can be a
"legal action". Hence the launching
of proceedings for declaratory relief only
did not satisfy condition 6(c).
In this court counsel for the respondent
rightly conceded that, as was apparently common cause in the court a quo,
"legal action" can be commenced by way of notice of motion (cf Collett v
Priest 1931 AD 290, 300; Kempton Park Bombay (Pty) Ltd v Kempton Park
Municipality 1956 (1) SA 643 (T) 647, and Danzas Trek (Pty) Ltd v Du
Bourq and Another 1979 (4) SA 915 (W) 919) . He did, however, contend that
it was only during June 1989, when it was too late, that legal action within the
meaning
of condition 6(c) was instituted.
I am prepared to accept that condition 6(c) is open to the construction put
on it by the trial
8 judge. In my view, however, it also admits of another
interpretation. There can be no doubt that, generally speaking, a party
commences
legal action when he issues summons, or starts motion proceedings, for
the purpose of obtaining a declaratory order, whether or not
he also seeks
consequential relief. Supporting the reasoning of Spoelstra J, counsel for the
respondent submitted, however, that
the phrase "legal action" should not be
construed in isolation. Those words, so it was argued, have reference to the
enforcement
of the rejected claim, and a claim in respect of damage to equipment
must necessarily be a claim sounding in money. Hence condition
6(c) envisages
the institution of legal proceedings for the recovery of a sum of
money.
Counsel went on to draw a distinction between property and liability
insurance. He pointed out that the policy in question provides
cover in
9
respect of both types of insurance and submitted that it is only when the
liability section is invoked that a claim for an indemnity,
unaccompanied by a
claim for payment of a specific amount, may be made. But, it was also submitted,
if a claim is preferred under
the provisions relating to property insurance - as
happened in the instant case - it must be a demand for compensation for damage
caused to the property concerned.
The flaw in this line of argument is the
presupposition that there cannot under condition 6 be a claim in respect of
damage to property
unaccompanied by details of the monetary extent thereof, and
that hence only a claim sounding in money can be rejected by the respondent.
Condition 6(a)(iii) does provide, it is true, that the insured must as soon as
practicable after the happening of an event which
may result in a claim under
the policy "submit ... full
10 details in writing of any claim". It is quite
feasible, however, that an insured may submit a claim for an unspecified amount
because
he is not at that stage in a position to quantify his loss. The insurer
may then immediately repudiate liability and thus reject
the claim, because, e
g, of material misrepresentations made by the insured in the proposal form. It
appears to me that if in such
a case the insured should fail to commence legal
proceedings within three months after the date of rejection, he would be hard
pressed
to contend that condition 6(c) did not become operative because there
had not been a claim for payment of a specific amount. (Cf
Thompson v Goold
and Co (1910) AC 409 (H L) 410-11, 416, 419 and 420.) On the other hand, if
in the postulated case the insured had to institute action for payment of
a sum
of money within the stipulated period he could well be compelled to claim a
fictional amount of
11
which no particulars could be provided by him. All this provides a strong
pointer to the conclusion that the "legal action" contemplated
by condition 6(c)
need not necessarily be proceedings for the enforcement of a claim sounding in
money.
Counsel for the respondent also submitted that the overriding purpose
of condition 6(c) is to make time of the essence in the lodging
of claims and
the prosecution of actions against the respondent. The obvious reasons for the
incorporation of the relevant provisions,
so the argument continued, are to give
the respondent early notice of legal proceedings against it, and to enable it to
investigate
claims as soon as possible, to preserve evidence and to allocate
funds for a contingent liability. All this is true, but in my view
it does not
have a decisive bearing on the construction of condition 6(c). If, as happened
in the present case, proceed-
12
ings for declaratory relief only were to be instituted against the
respondent, it would know that those proceedings, if successful,
would almost
inevitably lead to an action for payment of a specific amount. It would
therefore be alerted to the need to preserve
evidence and to conduct such
further investigation of the validity of the claim as might be deemed necessary.
It might not always
be possible to calculate the amount which should be
allocated for the contingency of an ultimate judgment debt, but if the insured
failed to provide full details of the measure of his claim as soon as
practicable after the relevant event occurred, the respondent
could obviously
rely on non-compliance with clause 6(a)(iii).
A further contention of counsel
for the respondent was that no purpose would be served by condition 6(c) if it
does not require an
insured to
13
initiate proceedings which, if successful, will result in judgment for a
specific amount. I cannot agree. If the insured fails to
commence any
proceedings within the three month period such liability as the insurer may have
incurred under the policy will obviously
come to an end. The condition will in
such a case constitute a complete bar to further proceedings.
I should
mention that counsel for the appellant placed some reliance on condition 6(b). I
agree, however, with counsel for the respondent
that that condition does not
throw any meaningful light on the import of condition 6(c).
In the final
analysis the appellant sought to enforce its alleged rights under the policy
when it instituted the motion proceedings.
True, it could not in those
proceedings obtain an executable judgment in its favour. But, had it obtained
declaratory
14 relief the liability of the respondent under the policy - as
opposed to the extent thereof - would no longer have been in issue
(cf Cape
Town Municipality and Another v Allianz Insurance Co Ltd 1990 (1) SA 311 (C)
331). In a very real sense, therefore, the initiation of those proceedings
constituted the commencement of legal action directed
at enforcement of the
rejected claim. Put differently, the proceedings constituted a step formally
involving the respondent in a
preliminary process aimed at the eventual recovery
of compensation for the loss to which the appellant's claim related.
I should
also point out that acceptance of the respondent's contention could in
casu have produced a curious result; viz, that even if the appellant had
obtained the declaratory relief sought in the motion proceedings,
it could not
institute action for consequential relief if more than three months
15 had
lapsed since the date of rejection of the claim.
I am accordingly of the view
that, at best for the respondent, the language of condition 6(c) is open to two
more or less equally
plausible constructions. The first is the one favoured by
the court a quo, and the second an interpretation that legal action may
also be commenced by the institution of proceedings for a declarator that
the
insurer is liable under the policy to compensate the insured for such loss as he
may have suffered. That being so, this court
"should incline towards upholding
the policy and against producing a forfeiture" of the appellant's alleged rights
under it. An application
of the rule verba fortius accipiuntur contra
proferentem obviously leads to the same result: Pereira v Marine and
Trade Insurance Co Ltd 1975 (4) SA 745 (A) 752H.
The final, and alternative, submission of
16 counsel for the respondent was that condition 6(c) barred the appellant from bringing fresh proceedings after the dismissal of its application and the lapse of three months from the rejection of its claim. I cannot agree. Condition 6(c) does not peremptorily stipulate that any legal action against the respondent must be commenced within the said period; it merely prescribes the consequence of a failure to bring such action timeously. The condition therefore ceases to be of application once legal action has been commenced within that period. In particular it does not profess to deal with the situation brought about by a failure of the action. Hence, unless such failure gives rise to a plea of res judicata, the insured is at liberty to institute fresh proceedings. The only limitations on this right flow from the provisions of the Prescription Act 68 of 1969, and of clause 6(b) which becomes determinative only after
17
the expiry of 24 months from the happening of the event in question.
It
may be that the phrase "legal action" in condition 6(c) should be construed as
"valid legal action", and that e g a process brought
in the wrong forum or which
does not disclose a cause of action, does not serve to satisfy condition 6(c).
It is, however, unnecessary
to express a view in that regard. I say so because
it has rightly not been suggested that as a matter of law the declaratory relief
sought in the motion proceedings could not have been granted on the strength of
the averments in the founding afidavit.
The appeal is allowed with costs,
including the costs of two counsel, and the following is substituted for the
order of the court
a quo:
"(1) It is declared that the plaintiff may proceed with its action against
18 the defendant. (2) The defendant is ordered to pay the costs occasioned by the determination of the issue set out in para 3 of the statement of agreed facts."
H J O VAN HEERDEN JA
NESTADT JA
EKSTEEN JA
CONCUR NIENABER JA
KRIEGLER AJA