Occurrence vs. Claims Made

What is the difference between Occurrence and a Claims-made Policy?

Occurrence Policy

An occurrence policy provides coverage for a claim based on when treatment occurred. The claim can be reported at any time as long as the policy was in effect when the claim or incident occurred. For example, if a claim is made in 2012 based on treatment rendered in 2009, the 2009 policy responds.

Claims-Made Policy

In contrast, a claims-made policy provides coverage for a claim that occurs during the policy period and is reported during the policy period. For example, if a claim is made in 2012, based on treatment in 2009, the 2012 claims-made policy covers it, as long as the incident occurred after the policy’s retroactive date. The retroactive date is the date which treatment must occurred to trigger coverage.

Claims-Made Policy Considerations

As many allied healthcare professionals have claims made policies, it is important to make sure you have continuous coverage so you will not have a gap in coverage. For no additional premium charge, the Lloyd’s policy will honor the retroactive date specified on your insurance policy as long as you have had continuous coverage from the first date you purchased your claims made policy. You would not be required to purchase “Tail Coverage” or an Extended Reporting Period Endorsement from your previous carrier as long as you have had continuous coverage with no gaps.

Which policy is better?

Both claims made policy and occurrence policies are transferring your risk and giving you a peace of mind in the event you are named in a malpractice lawsuit. With the claims made policy, you will need to be cognizant of the tail and nose coverage options and just make sure you are adequately covered. Your insurance broker will advise you on your options for tail and nose coverage.