THE SUPREME COURT OF APPEAL
OF SOUTH AFRICA
CASE NO: 569/03
Reportable
In the matter between
HOLLARD LIFE ASSURANCE COMPANY LIMITED Appellant
and
G J VAN DER MERWE NO Respondent
Before: Scott, Mthiyane, Conradie, Van Heerden JJA et
Ponnan AJA
Heard: 19 November 2004
Delivered: 30 November 2004
Summary: Interpretation of exclusion clause in insurance policy –
whether accidental, wholly self-inflicted injury falling within
ambit of clause
JUDGMENT
VAN HEERDEN JA
2
[1] There were two main issues in the ac tion giving rise to this appeal:
firstly, the interpretation of an exclusio n clause in an insurance policy and,
secondly, the locus standi of the executor of an insured’s deceased estate to
claim benefits in terms of the policy in a situation where the insured had
ceded all his rights under the policy to a third party as secu rity for a debt
owed by him to the cessionary.
[2] The appellant is Holl ard Life Assurance Company Ltd (‘Hollard’),
the insurance company in question, while the responde nt is the executor of
the deceased estate of the insure d, Jean Pierre van der Merwe (‘the
deceased’).
[3] On 30 June 2001, the deceased c oncluded a written agreement of
insurance (‘the policy’) with Hollard, whereby the latter undertook to pay
the outstanding liability due by the deceased to Wesbank under an
instalment sale agreement (‘the cr edit agreement’) in the event of, inter
alia, the death of the deceased. The cr edit agreement between the deceased
and Wesbank, relating to a motor ve hicle, was concluded in early July
2001. In terms of the policy the de ceased ceded to Wesbank ‘all [his]
rights, title and interest in and to this Policy…as collateral security for the
outstanding debt in term s of the Credit Agreemen t entered into by [him]
with the Credit Grantor [Wesbank]’.
3
[4] A few weeks after the conclusion of these agreements, the deceased
accidentally shot himself with his ow n firearm and, in consequence, died.
At the time of his death, he was still indebted to Wesbank under the credit
agreement.
[5] The respondent and Wesbank duly notified Hollard of a claim in
terms of the policy, but Hollard reject ed the claim, relying on an exclusion
clause in the policy which reads as follows:
‘1. EXCLUSIONS APPLICABLE TO DEATH, DISABILITY AND DREAD
DISEASE
No amount shall be payable if in our [Hollard’s] Opinion:-
…
b) the claim is in any way due or traceable to, or arises directly or indirectly,
entirely or partially from:
…
(ii) suicide, self-inflicted injury or self-inflicted illness, whether intended or not,
or voluntary exposure to danger or obvious risk of injury.’
[6] When sued in the Pretoria High Court for the benefits allegedly
payable under the policy, Hollard pleaded that, as the cause of the
deceased’s death was ‘self-inflicted injury’, the abovementioned exclusion
clause applied and the claim was th us not covered by the policy. In
addition, so it was alleged, as the deceased had ceded all his rights under
4
the policy to Wesbank, the respondent had no locus standi to enforce any
claim against Hollard in terms thereof.
[7] In the court below, the matter wa s approached on the basis of a
stated case, the common cause facts simply being recorded prior to
argument. Prinsloo AJ held that, notwithstanding the cession in securitatem
debiti by the deceased to Wesbank, the respondent (as executor of the
deceased’s estate) could enforce the ceded rights against Hollard, despite
the fact that the debt secured by the cession had not been extinguished.
With reference to the decision of this court in Leyds NO v Noord-Westelike
Koöperatiewe Landboumaatskappy Bpk & andere , 1 the learned judge
construed the cession as a pledge of the rights unde r the policy to Wesbank
(the cessionary), the insured (t he cedent) retaining ownership ( dominium)
in the ceded rights. By analogy with th e ‘rule’ established in the case of
National Bank of South Afri ca Ltd v Cohen’s Trustee2 - namely that, on the
insolvency of the cedent in securitatem debiti , the trustee of his or her
insolvent estate is entitled to enforc e the ceded right a nd administer the
proceeds thereof as an asset in the insolvent estate, subject to the
preferential right of the cessionary as pledgee – Prinsloo AJ held that, on
the death of the cedent (the insured) , the executor of his deceased estate
1 1985 (2) SA 769 (A) at 780A-H.
2 1911 AD 235.
5
could enforce a claim under the policy against Hollard, subject to
Wesbank’s right to repayment of th e amount still owing to it under the
credit agreement.
[8] Shortly before the commencement of the trial, the respondent took
cession of any claim Wesbank may have had against Hollard under the
policy and amended the particulars of claim accordingly. In a consequential
amendment to its plea, Hollard allege d that any claim Wesbank may have
had under the policy had prescribed by the time of the attempted cession,
Wesbank not having complie d with a provision in the policy requiring the
institution of legal proceedings agains t Hollard within a specified period of
time. The court below rejected Holla rd’s allegations in this regard,
construing the time bar pr ovision in the policy as being applicable only to
the insured.
[9] As regards the reliance by Ho llard on the abovementioned
exclusion clause, 3 Prinsloo AJ was of the view that ‘the most reasonable
and logical …interpretation is that all the acts, namely suicide, self-
inflicted injury, self-inflicted illn ess and voluntary exposure to harm
presuppose the common element of de liberate intent.’ On a ‘strict
interpretation’, the phrase ‘whether intended or not’ in the exclusion clause
3 See para 5 above.
6
should apply only to the immediately preceding words, ie ‘self-inflicted
illness’, and not to the words ‘self- inflicted injury’. According to the
learned judge-
‘Bearing in mind the dictionary meaning of “ inflict” and the fact that all the other
actions in the exclusion clause pres uppose intent, an interpretation that “ self-inflicted
injury” can be contrived without intent, would appear to be incongruous. If one then
relies on the assistance of the contra proferentem and eiusdem generis constructions,
such an interpretation becomes far-fetche d and unacceptable. Quite apart from the
question of interpretation…the notion of excluding liability on the ground of “ self-
inflicted injury which is not intended ” can lead to absurd results. It would mean that the
innocent insured who falls into an uncovere d manhole at night and injures himself will
not be protected by the policy. The same applies to the innocent insured who eats a
contaminated can of sardines or drives into an invisible stationary object at night on the
highway. In my view, such an interpretation will not be tolerated in the light of the
principles referred to above.’
[10] The court concluded that the inci dent in which the deceased shot
himself ‘by accident and without inte nt or any other form of fault or
unreasonable exposure to danger’ did not fall within the ambit of the
exclusion clause relied on by Hollard. Mo reover, even if this interpretation
of the exclusion clause was not correct, the court found that Hollard’s
‘attempt to avoid liability by going to the preposterous extreme of
including the words “whether intended or not” in a general exclusion of
7
this nature is contra bonos mores so that the exclusion, to that extent, is
rendered unenforceable.’ The res pondent’s claim under the policy thus
succeeded. With the leave of the cour t below, Hollard appeals against all
these findings.
[11] In view of the conclusion to wh ich I have come regarding the
interpretation of the exclusion clause, it is unnecessary to deal with any of
the other issues canvassed in the court below. I de liberately refrain from
expressing an opinion as to the correctne ss or otherwise of the findings of
Prinsloo AJ on those issues It was comm on cause that Hollard was of the
opinion that the respondent’s claim fell within the am bit of this clause. The
respondent did not attack the reas onableness of this opinion as such, 4 but
contended that it was based on an incorr ect interpretation of the clause in
question. Obviously, if on a proper inte rpretation of the clause – which is a
matter of law 5 – the exclusion of Hollard’ s liability does not apply to
unintentional self-inflicted injuries of the kind which caused the death of
the deceased, then Hollard’s opini on was wrongly formed and is
consequently of no effect.
4 It would seem that, in forming an opinion on whether or not the factual circumstances allegedly giving
rise to a claim under the policy fell within the ambit of the exclusion clause, Hollard was obliged to act
reasonably (see, for example, RH Christie The Law of Contract in South Africa 4 ed (2001) 114-115 and
the cases there cited; cf also Damsell v Southern Life Association Ltd (1992) 13 ILJ 848 (C) at 851G-
852C and 859G).
5 See Van Zyl NO v Kiln Non-Marine Syndicate No 510 of Lloyds of London 2003 (2) SA 440 (SCA) para
11 at 447H.
8
[12] The principles governing the interp retation of an insurance policy
were set out by this court in Fedgen Insurance Ltd v Leyds6 as follows:
'The ordinary rules relating to the interpretation of contracts must be applied in
construing a policy of insurance. A court must therefore endeavour to ascertain the
intention of the parties. Such intention is, in the first instance, to be gathered from the
language used which, if clear, must be given effect to. This involves giving the words
used their plain, ordinary and popular mean ing unless the context indicates otherwise…
Any provision which purports to place a li mitation upon a clearly expressed obligation
to indemnify must be restrictively interpreted…; for it is the insurer's duty to make clear
what particular risks it wishes to exclud e…. A policy normally evidences the contract
and an insured's obligation, and the extent to which an insurer's liability is limited, must
be plainly spelt out. In the event of a real ambiguity the contra proferentem rule, which
requires a written document to be construed against the person who drew it up, would
operate against Fedgen as drafter of the policy…'
In the Van Zyl NO case (supra), this court also quoted with approval from
the judgment by King J in Barnard v Protea Assura nce Co Ltd t/a Protea
Assurance7 to the following effect:
'Now it is an accepted principle in interpreting insurance contracts that it is the duty of
the insurer to make it clear what particular risks he wishes to exclude. The principle is
stated by May in the following terms: ''No rule in the interpretation of a policy is more
fully established, or more imperative or controlling, than that which declares that, in all
cases, it must be liberally construed in favour of the insured so as not to defeat without a
plain necessity his claim to an indemnity which in making the insurance it was his
object to secure.'''
6 1995 (3) SA 33 (A) at 38B-E (other case references omitted); recently re-affirmed by this Court in Van
Zyl NO v Kiln Non-Marine Syndicate No 510 of Lloyds of London 2003 (2) SA 440 (SCA) para 6 at
445H-446G.
7 1998 (3) SA 1063 (C) at 1068B-C.
9
And (at 1068D):
'From this it would follow that if a term in a policy (''term'' in the sense of designation)
is capable of both a broader and narrower meaning it is that which is favourable to the
insured, in other words to the upholding of the policy, which must be employed.'
[13] With regard to the onus, the position is as follows:8
‘The ordinary rule is that the insured must prove himself to fall within the primary risk
insured against, whilst the onus is on the insurer to prove the application of an
exception: Eagle Star Insurance Co Ltd v Willey 1956 (1) SA 330 (A) at 334A - 335F.’
[14] In view of the reasoning followed by the court below, the following
dictum of this court in the even more recent case of Metcash Trading Ltd v
Credit Guarantee Insurance Corporation of Africa Ltd9 is apposite:
‘“According to our law … a policy of insurance must be construed like any other
written contract so as to give effect to th e intention of the parties as expressed in the
terms of the policy, considered as a whole. The terms are to be understood in their plain,
ordinary and popular sense unless it is evident from the context that the parties intended
them to have a different meaning, or unless they have by known usage of trade, or the
like, acquired a peculiar sense distinct from their popular meaning”
(Blackshaws (Pty) Ltd v Constantia Insurance Co Ltd 1983 (1) SA 120 (A) at 126H–
127A). If the ordinary sense of the words necessarily leads to some absurdity or to some
repugnance or inconsistency with the rest of the contract, then the Court may modify the
8 Van Zyl NO v Kiln Non-Marine Syndicate No 510 of Lloyds of London, above para 7 at 446F-G.
9 [2004] 2 All SA 484 (SCA) para 10 at 488b-f.
10
words just so much as to avoid that absurdity or inconsistency but no more ( Scottish
Union & National Insurance Co Ltd v Native Recruiting Corporation Ltd 1934 AD 458
at 464–6; Fedgen Insurance Ltd v Leyds 1995 (3) SA 33 (A) at 38B–E). It must also be
borne in mind that:
“Very few words … bear a single meaning, and the ‘ordinary’ meaning of words
appearing in a contract will necessarily depend upon the context in which they are used,
their interrelation and the nature of the transaction as it appears from the entire contract’
(Sassoon Confirming and Acceptance Co (Pty) Ltd v Barclays National Bank Ltd 1974
(1) SA 641 (A) at 646B). It is essential to have regard to the context in which the word
or phrase is used with its interrelation to the contract as a whole, including the nature
and purpose of the contract ( Coopers & Lybrand and Others v Bryant 1995 (3) SA 761
(A) at 768A–B; Aktiebolaget Hässle and Another v Triomed (Pty) Ltd 2003 (1) SA 155
(SCA) para 1).”’
[15] Contrary to the view of Pr insloo AJ in this regard, 10 the ordinary
rules of grammar dictate that the co mma before and after the phrase ‘self-
inflicted injury or self-inflicted dise ase’ in the exclusion clause makes the
qualification ‘whether intended or not ’ (appearing immediately after such
phrase) applicable to both instances and not only to ‘self-inflicted disease’.
Counsel for the respondent conceded as much. Moreover, as counsel for
Hollard correctly contended, Prinsloo AJ’s conclusion that the kind of
unintentional self-inflicted injury which ha d caused the death of the
10 See para 9 above.
11
deceased in this case was not cove red by the wording of the exclusion
clause effectively negates the words ‘whether intended or not’ in that
clause, contrary to the general ru les governing the interpretation of
contracts.11
[16] Counsel for the respondent conte nded that, should the exclusion
clause be interpreted so as to apply to the circumstances of the deceased’s
death in the present case, this would lead to absurd results. As indicated
above,12 the court below accepted this ar gument. I disagree. If the words
‘self-inflicted injury or sel f-inflicted disease’ are interpreted restrictively,
as they must be,13 then only injuries or diseases which are entirely inflicted
upon himself or herself by the insured will be covered. An injury or disease
which is caused partly by the actions or omissions of the insured, but in
conjunction with the action or omission of some other part y or some other
contributory factor, will fall outside th e ambit of the exclusion clause. In
the examples of absurd consequences given by Prinsloo AJ (falling into an
uncovered manhole, eating contaminated sa rdines, driving into an invisible
stationary object at night), the injury or disease is inflicted on the insured
11 See, for example, Wellworths Bazaars Ltd v Chandlers Ltd 1947 (2) SA 37 (A) at 43, where Davis AJA
quoted with approval the following passage from Ditcher v Denison 11 Moore PC 325 at 357: ‘ It is a
good general rule in jurisprudence that one who reads a legal document, whether public or private,
should not be prompt to ascribe – should not without necessity or some sound reason, impute – to its
language tautology or superfluity, and should be rather at the outset inclined to suppose every word
intended to have some effect or be of some use. ’ See also Portion 1 of 46 Wadeville (Pty) Ltd v Unity
Cutlery (Pty) Ltd & others 1984 (1) SA 61 (A) at 70C-D.
12 See para 9.
12
only partly by his or her own actions. Without the intervention, whether by
act or omission, of some other party or some other contributory factor (the
removal and non-replacem ent of the manhole cove r, the manufacture
and/or sale of contaminated sardines, the leaving of the offending object in
the path of traffic), the injury or disease would not have occurred.
[17] Whether or not a particular inju ry or disease is entirely ‘self-
inflicted’ will obviously depend on the f acts of that particular case and, in
forming its opinion in this regard , Hollard will be obliged to act
reasonably. 14 The court below held, in effe ct, that because in certain
hypothetical instances, it may be doubtful whether or not the injury or
disease was ‘self-inflicted’, the word s ‘whether intended or not’ in the
exclusion clause should simply be i gnored. In the present case, the injury
was clearly ‘self-inflicted’ in the sense discussed above and the approach of
the court below, in my view, exceeds the bounds of interpretation of
contracts.
[18] I also do not agree with the cour t below that ‘including the words
“whether intended or no t” in a general exclusi on of this nature is contra
bonos mores so that the exclusion, to that extent, is rendered
unenforceable.’ Although the qualific ation might be an unusual one, an
13 See Van Zyl’s case ( para 12 above) para 6 at 445J-446B.
13
insurer is entitled to circumscribe th e risks which are covered by the policy
and to determine the insu rance premium accordingly. 15 It certainly cannot
be said that the respondent discharged the onus of showi ng that the ‘clear
effect’ of the exclusion clause, restri ctively interpreted as set out above, is
contrary to public policy or that ‘there is a probability that unconscionable,
immoral or illegal conduct will resu lt from the implementation of the
[exclusion clause] according to [its] tenor’.16
[19] It follows from the abov e that the death of th e deceased fell within
the ambit of the exclusion clause and hence did not give rise to a claim in
terms of the policy.
Order
[20] In the circumstances, the following order is made:
(a) The appeal succeeds with costs.
(b) The order of the court below is set aside. In its place is
substituted:
14 See footnote 4 above.
15 See Fedgen Insurance Ltd v Leyds 1995 (3) SA 33 (SCA) at 38G-H.
16 Juglal NO & another v Shoprite Checkers (Pty) Ltd t/a OK Franchise Division 2004 (5) SA 248 (SCA)
para 12 at 258D-G, referring to Sasfin (Pty) Ltd v Beukes 1989 (1) SA 1 (A) at 8C-9G. Cf also Afrox
Healthcare Bpk v Strydom 2002 (6) SA 21 (SCA) para 9-10 at 34D-E.
14
‘The plaintiff’s claim is dismissed with costs, including the
qualifying fees of the defendant ’s expert, Professor HJ
Scholtz.’
B J VAN HEERDEN
JUDGE OF APPEAL
CONCUR:
SCOTT JA
MTHIYANE JA
PONNAN AJA