Relevant principles
6This case requires consideration of the principles which underlie the proposition that the High Court (French CJ, Gummow, Hayne, Heydon and Kiefel JJ) described in Wallaby Grip Ltd v QBE Insurance (Australia) Ltd [2010] HCA 9; 240 CLR 444 at [25] as "well accepted", namely that "the insurer must prove that a loss falls within an exception".
7A contract of insurance may make express provison as to who bears the burden of proving the existence or non-existence of a particular fact for the purpose of establishing an entitlement to indemnity. In Levy v Assicurazione Generali [1940] AC 791 the contract of insurance provided that where the insurer relied upon a condition excluding loss or damage occasioned by specified occurrences, which included "civil commotion", the "burden of proving that such loss or damage is covered shall be upon the insured". Citing the judgment of Scrutton LJ in Re Hooley Hill Rubber and Chemical Co and Royal Insurance Co [1920] 1 KB 257 at 272-273, the Privy Council said at 798:
"... [the onus of proving that one or other of the occurrences specified in sub-clause 2 of condition 6] was placed upon the appellant [insured] by the express terms of the contract. There can be no doubt that as a matter of agreement between parties the onus of proof of any particular fact, or of its non-existence, may be placed on either party in accordance with the agreement made between them."
8In Spinney's (1948) Ltd v Royal Insurance Co Ltd [1980] 1 Ll Rep 406, Mustill J described a clause in the same terms as that in Levy as a "reverse burden clause" (411 (col 1); 412 (col 1)). Whilst accepting that its validity was "not in doubt" (426 (col 2)), Mustill J read the clause down and held that it did not apply unless the insurer had first established that it was arguable that the exclusion on which it relied might apply. There is no such clause in the present policy although, as will be seen, there is an evidentiary provision which qualifies the cover provided in relation to the risk of Explosion.
9In the absence of a provision expressly dealing with the question of onus, the principles which apply are those referred to by Jordan CJ (delivering the judgment of the Court) in Kodak (A/asia) Pty Ltd v Retail Traders Mutual Indemnity Insurance Association (1942) 42 SR (NSW) 231. In that case there was an issue as to whether the insured bore the burden of proving fulfilment of a condition necessary to the accrual of the insurer's liability. A distinction was drawn between such a condition and one which created a particular exception to the insurer's obligation to indemnify. When considering that question of onus, his Honour observed (at 237) in relation to a condition of the latter kind:
"Again, a plaintiff seeking to enforce an obligation qualified by a general exception which is applicable to all cases must negative the exception; but if the obligation is general and qualified only by particular exceptions, a person seeking to rely on an exception must prove himself within it: Munro Brice & Co v War Risks Association; Pye v Metropolitan Coal Co Ltd; Willeston on Contracts (1936) III, p. 1939. Similarly a person who seeks to escape an accrued liability by a claim that it has been discharged by breach of a condition subsequent must prove the breach; and a person who contends that a contract has been rescinded in pursuance of a resolutive condition must produce evidence in support of his contention ..." [Footnotes omitted]
10His Honour had earlier considered and applied the same principles to an issue as to onus arising in relation to the application of a provision allowing for the termination of a contract of employment: see Gordon v Australian & New Zealand Theatres Ltd (1940) 40 SR (NSW) 512.
11In Munro, Brice & Co v War Risks Association Ltd [1918] 2 KB 78 the sailing ship Inveramsay was insured under a marine policy which excepted the risks of "capture, seizure, and detention, and the consequences thereof". The issue was whether the insured, having established that the vessel was lost at sea, also had to show that the sea peril was not the result of a cause excluded by this 'free of capture and seizure' clause. Bailhache J held that it did not. After reviewing a number of authorities, including Gorman v Hand in Hand Insurance Co (1877) IR 11 CL 224, his Honour formulated (at 88-89) what he described as the "rules now applicable for determining the burden of proof in such a case as the present".
12Those principles, in their application to the onus of proof in contracts of insurance, are summarised in the following passage from Williston, A Treatise on the Law of Contracts (rev ed 1936, Baker, Voorhis & Co) III at 1939, which is cited by Jordan CJ in Kodak at 237:
"The test [as to which party bears the burden of pleading and proving a qualification or proviso in an insurance or transportation contract] no longer depends upon whether the limitation upon the promise is to be found in a separate clause or not, but, instead, on whether the exception is as wide as the promise and thus qualifies the whole promise, or whether it merely excludes from the operation of the promise particular classes of matters which but for the exception would fall within it, leaving some part of the promise unqualified and absolute. In the case of a qualified promise, that is, where the exception would defeat the whole promise, a plaintiff cannot make out a prima facie case unless he alleges the promise and negatives the exception as of old, whereas, if the promise is simply subject to some exceptions, it is sufficient for the plaintiff to bring himself within the general terms of the promise, leaving it to the defendant to allege and prove that the plaintiff's claim in fact falls within an excluded exceptional class." [Footnotes omitted]
13This summary follows the language of the second and third of Bailhache J's propositions which draw a distinction between a provision that qualifies the whole scope of a promise and one that excludes from the operation of the promise particular classes of case which, but for the provision, would fall within it: Munro, Brice & Co at 88. Reference also must be made to Bailhache J's fourth proposition that whether "a promise is a promise with exceptions or whether it is a qualified promise is in every case a question of construction of the instrument as a whole" (at 89).
14That proposition means, as the Court observed in Wallaby Grip Ltd at [27], that "the matter of proof follows largely upon the construction of the terms of the contract of insurance and the insurer's promise contained within it". The result is that much may turn on how the insurer's promise is formulated (Wallaby Grip Ltd at [29]) because, as Bailhache J pointed out, "a promise with exceptions can generally be turned by an alteration of phraseology into a qualified promise" (at 89).
15This is well illustrated by Welford and Otter-Barry in their work The Law Relating to Fire Insurance (3rd ed 1932, Butterworth & Co). The authors refer (at 124-125) to conditions in a policy, the object of which "is to exempt the insurers from liability in certain cases where the assured sustains a loss which would be prima facie covered by his policy". They note that such conditions "are usually called exceptions" and that, subject to the language of the policy, "it is for the insurers to show that they are protected by an exception". They continue (at 125):
"A different method may be adopted and the exemption from liability, instead of being framed as an exception, may be expressed as a qualification or limitation upon the undertaking of the insurers ... The contract of the insurers then ceases to be a general undertaking to indemnify the assured, subject to exceptions, in which case the insurers are liable, unless the exception applies: the contract is a qualified undertaking only, and no liability arises, unless the loss falls within the qualification. The distinction may be illustrated thus. If the insurers wish to exclude liability for incendiary fire, they may do so by either method. If the method of using an exception is adopted, their undertaking will be expressed in general terms as a contract to insure against 'loss by fire, except incendiary fire.' By the second method the undertaking will be qualified: it will be an insurance against 'loss by non-incendiary fire.' Though both methods accomplish the same result, namely, the exclusion of liability for incendiary fire, the distinction between them is not merely one of expression, it is a distinction of substance having an important bearing upon the onus of proof, since, by the second method, the onus is placed upon the assured to prove that the loss falls within the undertaking as qualified ..."
16The principles formulated by Bailhache J have been said to turn on a distinction which is not logically defensible because every qualification of a class can equally be stated, without any change of meaning, as an exception to the class: see Professor Stone, "Burden of Proof and Judicial Process: A Commentary on Joseph Constantine Steamship Ltd v Imperial Smelting Corporation Ltd" (1941) 60 LQR 262 at 279-281. However, as the above discussion shows, where the legal burden of proof lies is not determined by the overall effect of the policy provisions when read as a whole. It turns on the content and scope of the insurer's promise and what facts the insured must prove to bring its claim within the terms of that promise. Those matters depend on the proper construction of the contract of insurance. The parties to that contract may expressly agree as to who has that burden or leave that question to be determined in accordance with principles which have been regarded as settled for nearly 100 years.
17An early example of the application of the principles summarised by Bailhache J may be seen in the decision of Palles CB in Gorman v Hand in Hand Insurance Co. Bailhache J considered that case to have been correctly decided. Palles CB's reasoning was as follows:
"The policy is not in its terms limited to damage by accidental fire: 'the Society agrees (subject to the conditions indorsed, which are to be taken as part of the policy) that if the property described shall be destroyed or damaged by fire ... they will ... pay or make good all such loss and damage.' The third indorsed condition provides that the policy shall not cover, inter alia, loss or damage caused by the act of an incendiary; and reading this condition, as we are bound to do, as part of the policy, the contract is that the Defendants shall be liable for loss by fire, provided it be not the act of an incendiary. When, therefore, it is once shown that the loss resulted from fire, the Plaintiff has established a prima facie case, and the onus is thrown upon the Defendants to prove that the act which caused the fire was within the proviso. The defence is not in any sense a traverse of an allegation comprised within the general averments of the plaint; it is a plea in confession and avoidance, and the proof of it is upon the Defendants."
18As the decision of the High Court in Pye v Metropolitan Coal Co Ltd [1934] HCA 9; 50 CLR 614 shows, albeit in a statutory context, the application of these principles depends on the construction of the provisions to which they are being applied. The matter in issue was whether a worker claiming to have suffered an "injury" under s 6(1) of the Workers Compensation Act 1926-1929 (NSW) bore the onus of establishing that his pulmonary fibrosis was not "a disease caused by silica dust". The majority (Rich J, Evatt J and McTiernan J) construed those words as introducing a limited exception to the circumstances in which the employer was liable and held that the employer bore the onus of proving that exception; whereas the minority (Gavan Duffy CJ and Starke J) considered that those words were part of the description of the ambit of the disease for which the employer was responsible. Accordingly the minority considered that the worker had to prove that the qualification did not apply.
19Professor Clarke, in The Law of Insurance Contracts (6th ed 2009, Informa) refers to an exception which qualifies the insurer's promise in all of the circumstances in which it applies as a general exception and one which does not as a specific exception. At par 16-3C1, he gives the following examples of specific exceptions:
"For example, it is usually enough for the insured to show that his property was damaged by fire; it is for the insurer to show that the fire damage was caused by an exception, such as riot or inherent vice in the subject-matter of the insurance. The scope of the exception (fire damage caused by riot or inherent vice) is narrower than the scope of the cover (fire from whatever cause). Again, it is enough for the insured to prove that his ship was lost by perils of the sea; it is for the insurer to prove that it was sunk by enemy submarines and thus within a war risk exception. The scope of the exception (sinking by war risk) is narrower than the cover (loss at sea from any cause)."