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Claims Made Policy

A Claims Made policy responds to a claim if two requirements are simultaneously met. The claim must be reported during the policy period AND the claim must be triggered by an event that occurred on or after the policy Retroactive Date. The retroactive date will continue to appear on each successive Claims Made policy, thus making these types of policies portable. The net result of this portability is coverage for what is known as Prior Acts by the new insurance company. A Claims Made policy with a retroactive date that is earlier than its inception date demonstrates how the transfer of potential prior unknown liabilities from one insurance carrier to another carrier can occur. This is a feature unique to the Claims Made policies. However, it is important to keep in mind that it is up the discretion of the insurance carrier’s underwriter to determine which retroactive date will be utilized for the current policy to be written. One important aspect of a Claims Made policy, providing the two requirements stated above are met, is that regardless of when a claim is made, the Claims Made policy you currently have in force will respond to that claim. Whenever you are deciding between an Occurrence policy and a Claims Made policy, you should consider all of this information and speak with your Broker about your options.

Example:
Claims Made policy effective date: August 1, 2001
Coverage continuous for 6 years: August 1, 2001 to August 1, 2007
Claim submitted: in February 2007
Event occurred: in 2003
Claims Made Policy that responds: Policy in force in February 2007 up to limits of that policy

 

*The information found within this website is not deemed to be complete for every situation and is not a substitute for professional legal or insurance advice. It is an overview of some of the more common insurance terms and scenarios that may arise in certain instances regarding Medical Professional Liability insurance. The examples and models set forth in this website are for illustrative purposes only; to address specific concerns, please contact PLIG of SJ. Please be advised that you should always consult with the appropriate professionals to fully evaluate your individual situation as it pertains to insurance coverage. No reliance should be placed on the information contained on this website unless independently verified by PLIG of SJ. PLIG of SJ cannot, and does not, offer legal advice of any kind.

PLEASE NOTE: The Professional Liability Insurance Group of South Jersey is licensed in the state of New Jersey only and any and all content found within this website are intended solely for viewers who are licensed Health Care Providers in the state of New Jersey.

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