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Claims made and reported

Its 5 cross-references, woven across the glossary's 18 categories

A US variant of the claims-made basis requiring the claim to be both made against the insured and reported to the insurer during the policy period, or within a short window after.

Definition

A claims-made policy covers claims made against the insured during the policy period, whatever the date of the triggering event, subject to the retroactive date. The claims made and reported variant adds a second condition: the claim must also be reported to the insurer during that same period, or within a short window set by the policy, often thirty to sixty days after expiry. The aim is to close the insurer's exposure cleanly at the end of each period, and to prevent a claim received at year-end from being reported months later, after the policy has been renewed elsewhere. US courts generally apply this requirement strictly, even where the insurer suffered no prejudice from the delay, because it defines the scope of cover. Hence dramatic claim denials for mere late reporting. In France, the 2003 law regulated the claims-made basis in liability insurance and requires an extended reporting period of at least five years after termination, which limits the reach of a reporting-within-period condition. For an insured relying on an international program, the difference between the two bases is a classic trap: it is the internal procedure for escalating claims that protects the cover.

Example

Textbook case: a group's US subsidiary is served with a lawsuit on 20 December; the policy expires on 31 December with a thirty-day reporting window. The legal department forwards the suit to the broker only on 15 February. The insurer denies cover, and the court upholds the denial.

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