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"Claims Made Policy" - The Insured is indemnified in case a claim arises during the policy period, no matter when a claim may arise, the Policy pays the insured for the Claim, provided the policy is active since its retroactive date(inception date).

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2009-12-07 09:04:41
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LaRae Sullivan

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2020-11-08 13:54:36

I need to file a claim

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Q: Claims made policy
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Why is tail coverage in a claims made policy important?

Claims made policies must have an occurrence occur and be reported to the carrier within the policy period. The tail protects against claims made subsequent to the effective termination date of the occurring policy period.


What is the difference between a claims made and occurrence general liability policy?

Occurrence policy key date is the date of the Occurrence or accident. If that date is during the effective policy period, that policy applies. On claims made policies, the trigger date is the date the claim is made or the policy holder becomes aware of a claim being made. If that date is during the effective policy period, that policy applies. Generally claims made policies are found in professional liability policies (doctors and lawyers) as well as errors and omissions policies. Claims made policies have what's called a Retroactive Date - This is gennerally the effective date of the first claims made policy writte. This date means that the insurance carrier WILL NOT pay any claims that occur prior to that date. Furthermore, once the policy expires, any claims that have not been reported during the policy term are not covered. You don't actually have any less coverage, but you have less time to report a claim. There are endoresments you can buy to extend the claim reporting time once the policy expires. An occurrence policy will let you report a claim today on a policy that was in force 5 years ago. You generally can't do that on a claims made policy unless you purchase endorsements. The claims made policy is becoming popular for fighting construction defect claims where builders are being sued today for something they did 7 years ago. If the contractor has a claims made policy now, that policy will not respond to the claim.


Explain the difference between a claims made policy and an occurrence policy?

Claims Made vs OccurrenceCommercial General Liability and other types of Personal Liability policies are generally "Occurrence" policies. This means "losses that occur during the policy term" are eligible for claims servicing. The policy active at the time of the loss is the policy that would address coverage. Professional Liability Policies are generally "Claims Made" policies. This type of policy offers coverage for "claims made during the policy term". An injury that occurred long before the policy became active could still be covered based on the retro active coverage date.


What is definition of retro date on insurance policy and prior and pending litigation date?

These are dates used in claims made insurance.Retro date - Policy covers any claim alleging facts occurring after this datePrior & Pending Date: Covers all claims made after this date (no coverage for claims known at policy inception)


What is tail coverage?

This supplemental insurance covers incidents that occurred during the "active" period of a claims-made policy but are not brought as claims against an insured, nor reported to the insurer, by the time the claims-made policy has been terminated. Needed at various times including when leaving a claims-made carrier, upon the decision to change claims-made carriers, at the time of retirement, or due to death or total disability of the member. Tail coverage is purchased from an insured's previous claims-made carrier.


What is the difference between a full occurrence policy vs a full occurrence with manifestation vs occurrence with manifestation and sunset clauses?

Claims Made Vs Occurrence Policies There are two primary forms of liability insurance policies - claims-made and occurrence policies. Most professional liability insurance, including directors and officers and employment practices liability insurance, is written on a claims-made basis.An occurrence policy obligates the insurance company to pay for claims arising out of occurrences during the policy period regardless of when the claim is reported. The policyholder is covered for any incident that occurs during the term of the policy regardless of when the claim arising from the incident is reported to the company. In some situations the claim might be made many years after the incident occurred. This leads to uncertainty for both the insured and the insurer.A claims-made policy protects an insured against claims or incidents that are reported while the policy is in force. Normally, a claims made policy provides coverage for acts occurring prior to the claims-made policy period. Coverage for acts occurring prior to the policy period is called "prior acts coverage," and the period prior to the policy period for which claims are covered is called the prior acts period. Prior acts coverage is usually only provided when a claims-made policy has been in force immediately prior to the current claims-made policy on a basis consistent with the prior policy. Prior acts coverage is defined as "full prior acts", covering acts occurring at any time prior to the current policy period, or is defined by a "retroactive date." When a retroactive date is used, prior acts coverage is provided from the retroactive date to the current policy period.


Do you need to have a retro date on Employee benefits Liability claims made policy?

Type your answer here... yes


After closing down a construction company.. do you need to continue to maintain liability insurance coverage for potential claims from the past?

The type of policy you have will determine if you need to keep coverage in place or not. There are occurrence forms, which cover situations that occur during the policy period, and there are claims made policies, which cover claims that are made during the policy period. Claims made policies may cover situations that happened before your policy started. Either way, there is a statute of limitations on how long someone has to make a claim against you. This statute varies from state to state, it is recommended that you check with the department of insurance. Usually it is 1 to 2 years.


What kind of medical malpractice insurance covers the insured only for those claims made while the policy is in force?

That is what Malpractice Insurance is.


What is a Claims made basis cover?

An insurance company is responsible to pay a claim up to the limits of the policy regardless of when the claim occurred if it is turned in during the policy period effective dates


Can an insurance provider drop your daughter from the policy and then request reimbursement for payouts made on her behalf?

Yes, if she did not have valid coverage at the time the claims were submitted.


Is there a statute of limitations on filing medical insurance claim in Georgia?

That will depend on your agreement with the insurance provider. Your policy will specify the times in which the claims must be made.

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