Reinsurance - M97（Dip级30学分，选修）-《再保险》
往期精选：
（前述章节【Dip系列课程】M97-第八章-再保险相关的法律问题C2下）
C3 Aggregation clauses（汇总条款）
A common issue for the parties to a reinsurance contract is whether original claims may be aggregated for the purposes of a claim under that contract. The issue may be addressed specifically by aggregation clauses, such as the hours clause, or alternatively, the parties must look to the reinsuring clause and to the basis of the limit and retention (e.g. each and every loss).
再保险合同双方常见的一个问题是，是否可以将原始索赔汇总起来，以便根据该合同提出索赔。该问题可以通过汇总条款（例如时间条款）专门解决，或者，双方必须考虑再保险条款以及限额和保留的依据（例如每次损失）。
Typically, that basis is defined by reference to event or occurrence and, in recent years, the courts have been granted many opportunities to decide quite what is meant by those particular terms. An occurrence is synonymous with an event, unless the context dictates otherwise. You should be aware that the basis of aggregation may also be defined by reference to a common cause rather than a common event.
通常，该依据是根据事件或发生情况定义的，近年来，法院有很多机会来决定这些特定术语的含义。除非上下文另有规定，否则发生情况与事件同义。您应该知道，汇总依据也可以通过参考共同原因而不是共同事件来定义。
In Caudle v. Sharp (1995), the reinsured provided errors and omissions cover to various Lloyd’s underwriting agents, including the managing agency for syndicates 317 and 661 and the members’ agents which had placed Names on those syndicates. The syndicates sustained terrible losses when the active underwriter wrote 32 run-off contracts attached to a single (1982) year of account, aggregating significant long-tail asbestos-related liabilities. The Names on that year sued the agents for the alleged negligence of the underwriter and, when the matter settled, the reinsured sought recovery under various reinsurance contracts. The retention under the reinsurance contract was expressed as ‘each and every loss’ which, in turn, was defined as ‘each and every loss and/occurrence … or series of losses and/or occurrences … arising out of one event’.
在 Caudle 诉 Sharp 案（1995 年）中，分保人向劳合社的各承保代理提供了错误和遗漏保 险，其中包括 317 号和 661 号辛迪加的管理代理，以及向这些辛迪加投保的成员代理。当主动承保人在一个单一的账户年度（1982 年）内承保了 32 份附有大量与石棉有关的长尾责任的冲销合同时，这些辛迪加遭受了严重损失。该年度的名字公司以承保人疏忽为由起诉了代理商，当事情解决后，再保人根据各种再保险合同寻求赔偿。再保险合同规定的自留额被表述为 “每一项损失”，而 “每一项损失 ”又被定义为 “一次事件引起的每一项损失和/或事件……或一系列损失和/或事件……”。
At first instance, the arbitration award was upheld on the basis that the underwriter’s continuing failure to take the steps he should have in the circumstances (or ‘blind spot’) was a state of affairs that amounted to one ‘event’, out of which the losses eventually arose. The Court of Appeal disagreed. The ‘blind spot’ was not a single event. It was not limited in time nor was it causative of a loss, save on each of the 32 occasions when the underwriter’s failure manifested itself and his ignorance gave rise to an occurrence of negligence, leading to a claim and a loss under the original policy.
一审维持了仲裁裁决，理由是承保人在当时的情况下一直没有采取他应该采取的措施（或称 “盲点”），这种情况相当于一个 “事件”，而损失最终就是由这个 “事件 ”引起的。上诉法院不同意这一观点。盲点 “不是一个单一的事件。它在时间上没有限制，也不是损失的原因，除非在 32 次事件中，承保人的失误表现出来，他的无知导致了疏忽的发生，从而导致了原保单下的索赔和损失。
Evan, LJ, proposed his three-prong test for determining an event:
• a common factor which could properly be described as an ‘event’;
• which satisfied the test of causation; and
• was not too remote for the purposes of the clause.
Evan 法官提出了确定事件的三项标准：
• 可以恰当地描述为“事件”的共同因素；
• 满足因果关系标准；并且
• 就该条款而言，事件并非遥不可及。
In Kuwait Airways v. Kuwait Insurance (1996) the loss of 15 aircraft belonging to Kuwait Airways, following the invasion of Kuwait, was held to be a single event as there was unity of time, location, cause and intent.
在科威特航空公司 诉 科威特保险公司案（1996 年）中，入侵科威特后科威特航空公司 15 架飞机的损失被认定为单一事件，因为时间、地点、原因和意图是统一的。
Rix, J, said that: an ‘occurrence’ (which is not materially different from an event or happening, unless perchance the contractual context requires some distinction to be made) is not the same as a loss, for one occurrence may embrace a plurality of losses. Nevertheless, the losses’ circumstances must be scrutinised to see whether they involve a degree of unity to justify their being described as, or as arising out of, one occurrence. The matter must be scrutinised from the point of view of an informed observer placed in the position of the insured…In assessing the degree of unity regard may be had to such factors as cause, locality and time and the intentions of the human agents.
Rix 法官说：“发生”（与事件或发生并无实质性区别，除非合同上下文要求作出某种区分）与损失不同，因为一次发生可能包含多项损失。尽管如此，必须仔细审查损失的情况，看其是否具有一定程度的统一性，以证明有理由将其描述为或产生于一起事件。在评估统一程度时，可以考虑原因、地点和时间以及人为因素的意图等因素。
Later, in Scott v. Copenhagen Re (2002), attempts to aggregate that loss with a British Airways aircraft, which was grounded on invasion but destroyed during allied bombing the following year, failed on the basis of lack of unity of time and cause.
后来，在 Scott 诉 Copenhagen Re (2002) 案中，试图将该损失与一架英国航空公司的飞机合并计算，该飞机在入侵时停飞，但在次年盟军轰炸中被摧毁，由于时间和原因不统一而失败。
In Mann v. Lexington (2001), rioting took place at a number of locations in Indonesia over the course of a couple of days in May 1998, and it was held that damage to various stores proceeded from separate occurrences and not from a single occurrence.
在 Mann 诉 列克星顿案（2001 年）中，1998 年 5 月的几天里，印度尼西亚的一些地方发生了骚乱，法院认为，对不同商店造成的损害是由不同事件引起的，而不是由单一事件引起的。
In American Centennial v. INSCO (1996), the latter sought to aggregate losses arising from claims against the auditors, and 14 directors and officers, of a failed US Savings and Loan company (S&L). The collapse of S&L was held not to be a relevant ‘event’. It was not causative of INSCO’s losses which arose out the acts or omissions of the auditors, directors and officers, rather than the subsequent collapse of S&L.
在 American Centennial 诉 INSCO 案（1996 年）中，后者寻求将对一家倒闭的美国储蓄和贷款公司 （S&L）的审计员以及 14 名董事和高级职员提出的索赔所产生的损失合计起来。储蓄和贷款公司的倒闭被认为不是一个相关的 “事件”。它不是 INSCO 损失的原因，因为 INSCO 的损失是由审计员、董事和高级职员的作为或不作为引起的，而不是由 S&L 随后的倒闭引起的。
In Axa Re v. Field (1996), the main issue was whether ‘one originating cause’ in errors and omissions policies should be construed as being synonymous with ‘one event’ in an excess of loss reinsurance contract, which potentially responded to losses arising under the original policies.
在 Axa Re 诉 Field（1996 年）一案中，主要问题是错误和遗漏保单中的 “一个起因 ”是否应解释为与超额损失再保险合同中的 “一个事件 ”同义，后者可能会对原始保单下产生的损失做出反应。
Lord Mustill observed that: in ordinary speech, an event is something which happens at a particular time, at a particular place, in a particular way… A cause to my mind is something altogether less constricted. It can be a continuing state of affairs; it can be an absence of something happening.
穆斯蒂尔勋爵认为：在普通的语言中，事件是指在特定时间、特定地点、以特定方式发生 的事情……在我看来，原因是一种完全不受限制的东西。它可以是一种持续的事态，也可以是没有发生的事情。
In summary, the meaning of event or occurrence is as follows:
• A unifying factor allowing a number of individual losses to be aggregated and treated as a single happening.
• An event is what has happened as opposed to the reason for what has happened. It is something that happens in a particular time, at a particular place and in a particular way.
• The individual losses must be sufficiently closely connected to the event by reference to the unities of time, locality, cause and motive.
• The individual losses must have a causal connection to and must not be too remote from the aggregating event.
• The assessment is objective, to be made from the perspective of the informed observer and is a matter of intuition and common sense.
总之，事件或发生的含义如下：
• 一个统一因素，允许将多个单个损失汇总并视为单个事件。
• 事件是发生的事情，而不是发生原因。它是在特定时间、特定地点和以特定方式发生的事情。
• 单个损失必须与事件在时间、地点、原因和动机方面有足够紧密的联系。
• 单个损失必须与汇总事件有因果关系，并且不能太遥远。
• 评估是客观的，从知情观察者的角度进行，是直觉和常识的问题。
Before leaving this section, we should mention the ‘sole judge’ clause as another route to aggregation. In this clause the reinsured reserves the right to decide, or is expressed as the sole judge of what constitutes, e.g. each and every loss and/or one event.
在离开本节之前，我们应该提到 “唯一判断 ”条款，它是另一种合计的途径。在这一条款中，再保险人保留决定权，或被表述为构成每项损失和/或一个事件的唯一判断者。
In RE Brown v. GIO Insurance (1998) and at a time when the law equated ‘event’ with ‘originating cause’, the reinsured sought to aggregate claims arising from each (negligent) underwriter for the purposes of claiming under its ‘event’-based reinsurance. It was held open to the reinsured to decide mixed questions of fact and law and, as the reinsured had directed itself to the correct question and the answer was neither perverse nor in bad faith nor otherwise manifestly unreasonable, the decision was not open to question by reinsurers.
在 RE Brown 诉 GIO Insurance（1998 年）一案中，当时的法律将 “事件 ”等同于 “起因”，分保人试图将每个（疏忽的）承保人引起的索赔合并起来，以便根据其基于 “事件 ”的再保险提出索赔。据认为，分保人可以对事实和法律的混合问题做出决定，由于分保人已经找到了正确的问题，而且答案既不反常，也没有恶意，也没有其他明显不合理的地方，因此分保人不能对这一决定提出质疑。
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