The Importance of Timely Notice Under Claims-made Liability Policies

Claims-made liability policies require timely notice of claims or circumstances that could lead to a claim for an insured to qualify for coverage. This allows insurers to properly investigate and respond to claims, 哪一个 helps control costs and determine the legitimacy and extent of the claim. Businesses need to be aware of this aspect of these policies, 因为延迟通知的规定是严格执行的, 可能会导致拒绝报道. This means an insured might have to bear the full cost of the claim.

This article provides an overview of claims-made policies, discusses common reasons for late notice and offers strategies to mitigate late notice risks.

了解理赔保单

A claims-made policy generally provides coverage if a claim is made when the policy is active, regardless of when the underlying incident that gave rise to the claim took place. Many claims-made policies include a “retroactive date” that specifies how far back the underlying incident can have occurred for the policy to cover the associated claim. Incidents occurring before this date are typically not covered.

另外, claims-made policies require a claim to be made and reported to the insurer during the policy period or within a specified extended reporting period (ERP), 也被称为“尾部覆盖”.” Timely reporting is crucial because late claims can prejudice the insurer, making it more difficult to investigate the claim and collect evidence. It is important to note that most professional liability, 错误和遗漏, 董事及高级职员, and employment practices liability insurance policies are written on a claims-made basis. 

迟到的常见原因

Considering the significance of timely reporting under a claims-made policy, it’s helpful for businesses to be aware of some of the common reasons for late notice in order to prevent them. 这些原因包括:

• 不了解报告要求—If the insured does not adequately review the policy’s terms and become familiar with the reporting requirements, 这种不熟悉可能会导致通知晚了.
• 被保险人组织内部沟通不畅—Reporting delays may occur when the insured’s organization does not have specific procedures that designate who is responsible for reporting claims and establish timelines for doing so.
• 对该主张的重要性有不正确的看法—Misconceptions of a claim’s importance can occur from a lack of understanding of the underlying incident or the claims process. Some insureds might even hope that ignoring a claim will make it disappear. Such misunderstandings may lead to a lack of urgency in claims reporting.
• 人为错误—Insufficient training or oversight in the reporting process can result in mistakes or oversights, 哪一个, 反过来, 是否会导致延误通知保险公司.

降低延迟通知风险

To prevent late notice, insureds can take the following actions:

• Thoroughly and regularly review the insurance policy 了解报告要求和时间表. This ensures the insured knows what needs to be done to comply with the policy terms.
• 执行内部程序 for promptly reporting claims or circumstances that could give rise to claims. These procedures should detail who in the organization is responsible for this reporting and to whom the report must be made to satisfy the policy’s requirements.
• 及时报告潜在索赔 这样保险公司就有事故记录了, even if it is not apparent if the underlying incident will result in a claim. 如果最终出现索赔，这可能是至关重要的.
• 培训员工 on their responsibilities to document and communicate about circumstances that could lead to claims. Adequate training ensures that everyone understands the importance of timely reporting.
• 保持理赔保单的持续更新 为了避免覆盖缺口. If a claim arises during a lapse between policies and outside of any applicable ERP, 保险公司将不提供保险.
• 与持牌专业人士合作; 包括代理, 经纪人和律师, for guidance on properly submitting claims under the business’s insurance policy. Professional advice can help ensure that all procedural documentation requirements are met.

结论

Adhering to the timely reporting requirements of a claims-made policy is necessary for the insured to receive proper coverage. To protect themselves from the impacts of late-notice denials, businesses can take several preventive actions to reduce the risk of them occurring.

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This 覆盖的见解 is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice. ©2024 Zywave, Inc. 版权所有.