When it comes to insurance and the law, negligence is a term that has clearly defined meanings and strictures—at least when it comes to liability. In layman’s terms, insurance companies define negligence as a failure to act in a manner that a normal person would have, were they in a similar situation and circumstance and, importantly, those actions resulted in damages to either a person or property. Whether it was an accident or not, there is always risk of a lawsuit on the grounds of negligence.
But what does that mean, and what are the various types of negligence?
Negligence is an insurance term that is tied to various types of liability insurance such as home, life, health, business, and auto. Even if you’re found guilty of negligence, many of these policies would still cover a liability claim. That said, it’s decided on a case-by-case basis, and the level of negligence and the type of damage directly influence that decision when it comes to your claim. In regards to liability cases, your insurance policy may cover legal defenses in court but no further damage.
But simply making a negligence claim isn’t enough—it must be proven.
In order to prove a negligence claim, the law states that, the plaintiff (injured third party) or insurance company must demonstrate that the defendant (person allegedly at fault) satisfied the four elements of negligence:
- Cause in the fact
In terms of insurance, the “duty” refers to the legal obligation between either you and a client or you and your insurance company. And, for professionals, it has an additional element, which takes into account your duty as a professional to know the laws, safety measures, and best practices within your field.
For instance, imagine you’re a teacher at a private prep high school that often acts as a leap pad into Ivy League Universities. During a group assignment, you notice two students (who already have a prior fight on their record) bickering. It soon turns into a physical altercation. By the time you break it up, one of the students is knocked out and needs to go to the hospital. As punishment, both students are expelled, and now they’re going to miss out on going to their dream schools.
If the parents were motivated, they could sue you, claiming negligence for your failure to prevent the fight, which caused both medical damages and hypothetically hurt their financial futures. They blame you for putting them in a group together when you knew they had a previous history, and then, as the adult in the room, you didn’t step in before it escalated. In these cases, the parents will expect you to pay for the pain and suffering of their children.
Causation must be established in order to determine whether or not the defendant’s actions, or lack thereof, were responsible for the plaintiff’s damages. Often, this can be pretty confusing, particularly about who or what caused the personal injury. In order to make it somewhat easier to navigate, causation is typically split into one of two categories, and both must be satisfied for proof:
Actual Cause – Also referred to as “cause in the fact”—this states that if the action had not taken place, the personal injury wouldn’t have occurred. This is determined with a “but for” test—but for the cause, the incident wouldn’t have occurred.
Proximate Cause – Sometimes referred to as “legal cause,”this adds further dynamics to the case. It determines whether the defendant could have reasonably foreseen such an injury taking place due to their actions or lack thereof. So, even if you were the “but for” cause of an injury, if such a thing was unforeseeable, you may not be held liable.
For an example of how this situation can be confusing, let’s return to the prep school teacher and the students who got into a fight. After his expulsion, one of the students is upset and punches the wall, breaking his hand. The parents add this into their suit, alleging that, but for you not allowing the fight to occur under your watch, his hand wouldn’t be broken. Because of these circumstances, you are now being held liable for your negligent conduct.
However, this would be a flimsy case if it went to court. Although you can establish that cause existed, there’s no way that you, the teacher, could have predicted the fight or the emotional outburst that led to the student breaking his hand. So, while you may be held responsible for not breaking up the fight sooner, you likely wouldn’t be held responsible for the medical bills associated with the broken hand. However, if there was enough evidence that you were the one who failed to prevent the fight the injured person could still go after you.
Breach of duty
In order to prove negligence, you can’t simply state that a duty was owed, you must also show that they breached the duty. In other words, you have to clearly demonstrate that they didn’t take all reasonable precautions in order to avoid or mitigate the potential problem. In most cases, the plaintiff has to establish that rash decisions were made or that shortcuts were taken.
In the case of the teacher, a valid argument for breach of duty could involve a failure to recognize that putting two students with a past together was a bad idea, and then not stepping in sooner and separating the pair before the situation could devolve into fists being thrown.
The final criteria that must be satisfied is that actual damages, injuries, or harm occurred as a result of your negligence.
So, for the teacher, the parents of one boy could point to injuries sustained and the student’s medical bills and rehabilitation as evidence. Or, both could allege that missing out on their top choice colleges puts their once-bright financial futures in jeopardy.
Recap: elements of negligence
Four criteria for a claim of negligence:
These are the components of a valid negligence claim, but as you could probably guess, lots of claims are brought before a court to eventually be squashed. Whether or not you’re actually in the wrong, even the accusation of negligence could cost you a lot just to defend yourself. That’s where insurance can help.
Thimble: liability insurance coverage
Are you covered from liability, particularly that which is caused by negligence? If not, you’re taking a massive risk; one negligence lawsuit could tie you up and hamstring your business operations. No matter the circumstances, it’s always smart to stay protected with the proper legal resources. This is why it’s essential to have Thimble’s General Liability Insurance and Professional Liability Insurance policies. Such policies are intended to shield you from negligence and can help cover the costs of hiring a personal injury lawyer or legal team in these types of cases.
In less than 60 seconds, you can go from not being covered for negligence to having a Certificate of Insurance in your inbox, even on your way to a job site. Click “Get a quote” or download the Thimble mobile app to get started now.
Our editorial content is intended for informational purposes only and is not written by a licensed insurance agent. Terms and conditions for rate and coverage may vary by class of business and state.