La déjudiciarisation des litiges est un sujet actuel et fondamental pour les pouvoirs publics au regard de l’engorgement des juridictions françaises. Il s’agit d’une préoccupation que partage l’assureur en responsabilité civile médicale pour lequel faciliter le règlement amiable des conflits signifie diminuer ses coûts de gestion internes, avoir une meilleure maîtrise des sommes allouées au titre la réparation des dommages résultant de soins et valoriser son image d’expert de l’indemnisation auprès de ses assurés. Aujourd’hui, le monde de l’assurance du risque médical s’engage publiquement en faveur de la recherche d’une solution négociée des litiges. Il présente cette dernière comme étant un mode opératoire bénéficiant à toute la société et particulièrement aux patients (ou à leurs ayants-droit), lesquels peuvent obtenir une indemnisation plus rapidement que devant les juridictions et en limitant leurs frais. Pour mettre en œuvre cette démarche, l’assureur se dote de processus internes afin d’optimiser les chances de succès des réclamations présentées dans un cadre amiable. Il s’appuie également sur l’action des pouvoirs publics, lesquels ont, notamment, créé les commissions (régionales) de conciliation et d’indemnisation des accidents médicaux, affections iatrogènes et infections nosocomiales, qui permettent de faciliter les solutions négociées aux litiges. Pour autant, force est de constater qu’il existe des limites à cette entreprise. En effet, outre le fait que la victime demeure la principale décisionnaire du choix du mode opératoire de l’examen de sa demande, d’autres acteurs directs et indirects voire le professionnel de l’assurance du risque médical lui-même, peuvent être à l’origine de la judiciarisation du différend. En tout état de cause, le recours aux juges ne doit pas être entendu uniquement comme un échec de la solution négociée dans la mesure où la jurisprudence peut se révéler être un atout pour faciliter la déjudiciarisation des litiges ultérieurs. / Solving disputes outside of the judicial system is a contemporary and a fundamental challenge for public authorities given the current congested workload of Courts. Medical liability insurers obviously share that concern. Indeed, facilitating amicable settlements is a way to decrease internal administration costs, to have better control over the damages awarded, and to enhance their image as Experts in their field. Nowadays, medical risk insurance companies are publicly committed to negotiated solutions. According to them, the out of Court approach can benefit the entire society and particularly the patients (or their beneficiaries), who can reach compensation more quickly than they would in front of a court, while limiting their fees. In order to implement this procedure, the insurance companies provide themselves with new internal processes, to optimize the chances of finding amicable settlements for the claims they receive. The success of this strategy also relies on the action of public authorities, whose decision to create the C(R)CI (Commissions of conciliation and compensation for medical accidents, iatrogenic disorders and nosocomial infections), has eased access to negotiated solutions.Nevertheless, this approach cannot always lead to a successfull outcome. As a matter of fact, the victims remain the last to decide on the way they want the litigation to be settled. Some other direct or indirect actors, or even the medical liability insurer itself, can bring the action before the Court. Either way, recourse to a Judge does not have to be only seen as a failure, since it allows jurisdictions to give orientations that will help parties position themselves in the event of further cases.

Liability insurance concerns an insured’s insurance of its legal liability towards a third party for the latter’s loss. This specialised type of insurance is rather neglected in South African insurance law. There is a lack of understanding of the intricacies of liability insurance and its unique challenges. This flows primarily from its complex nature as third-party insurance, which involves legal obligations between multiple parties, and a lack of statutory regulation of the distinctive contractual aspects of liability insurance. Furthermore, limited authority exists on contentious legal aspects as a result of the relatively small number of judicial decisions in this field of law. It is also evident that liability insurance constantly evolves as new grounds of liability emerge and new insurance products develop in response to the changing demands of society. The rise of consumerism and the increase in third-party claims amplify the economic significance of the law of liability insurance in South Africa. A substantial knowledge gap remains in our jurisprudence, irrespective of the recent introduction of new statutory instruments aimed at regulating insurance practice in general. These reforms have not as yet been applied critically to liability insurance, and no specialised legislation in South Africa regulates aspects of this branch of insurance as is the case with microinsurance. The focus in this thesis is on two main issues: the insurer’s duty effectively to indemnify the insured, and the insurer’s defence and settlement of third-party claims brought against the insured. As a subsidiary theme, this thesis analyses legal uncertainties that may persist during pre-contractual negotiations, the liability insurance contract lifecycle, and even after the expiry of the contract. Legal challenges can be addressed by novel and creative application of the national law. Potential solutions can be gleaned from the other progressive jurisdictions reviewed – English and Belgian law. It is evident that this research may prompt Parliament to develop specific rules and regulations for liability insurance contract law. This thesis includes a check list of some of the most important disclosure duties for procuring liability insurance cover, its operation, and claims processes. / Mercantile Law / LL.D.