Claims-Made vs Occurrence: What's the Difference? (2024)

Not every commercial insurance policy is the same. When choosing business insurance, you can buy one of two types of coverage: claims-made or occurrence. While both protect against the same perils and offer the same coverage, when coverage is triggered varies. We’ll explain the distinction to make sure you’re properly protected.

What’s the difference between a claims-made and an occurrence policy?

A claims-made policy protects a business owner from incidents that occur and are reported during the policy’s term. An occurrence policy provides coverage during a specific term but will allow you to report claims after the policy term.

What is a claims-made policy?

Claims-made policies let you customize a coverage period. You’re protected from incidents during the policy’s term and during any added periods. Business owners can extend protection by electing retroactive coverage to a date before the policy was activated; they can also ask for an extended reporting period for more flexibility when filing a claim.

Retroactive coverage is determined by the retroactive date. This is when the policy’s coverage begins; coverage is in effect after this date. A retroactive date provides critical coverage for a business with an insurance gap, offering protection for a time when the business didn’t have a policy in place.

In a claims-made policy, claims must be made during the policy term to be covered. For this reason, business owners may feel restricted at the end of a policy’s term. This is why opting for an extended reporting period is helpful; it permits the filing of a claim after the policy is canceled. While this isn’t extended coverage, it allows delayed reporting up to a specific date.

What’s an example of a retroactive date?

Let’s say a small business owner purchases general liability insurance, which is a claims-made policy. The policy’s effective dates are Jan. 1 to Dec. 31, 2020. Because the business owner accidentally allowed their previous policy to lapse, they elect to implement a retroactive date of Oct. 1, 2019.

On March 1, 2020, the business owner files a claim about an incident that occurred on Dec. 5, 2019. Because the incident happened after the retroactive date, this is a covered claim. If the incident had occurred on Sept. 20, 2019, the insurer wouldn’t cover it.

Example of an extended reporting period

Let’s say a business owner purchased a claims-made business owners policy on Feb. 1, 2019, with a policy term ending Jan. 31, 2020. The company elects to add an extended reporting period of six months for a slightly higher premium.

On April 1, 2020, the company receives a claim for an incident that happened on Dec. 10, 2019. Because the incident happened during the policy’s term and is reported within the extended reporting period, it’s covered. It would not be covered if it were reported after July 31, 2020, because that date is past the extended reporting period.

Some business insurance costs are tax-deductible, including costs associated with workers’ compensation insurance and general liability insurance.

What’s an occurrence policy?

Occurrence policies are generally more expensive than claims-made policies because they let you report a claim at any time, unlike a claims-made policy, which specifies when you can report a claim. The occurrence policy allows for claim rights that extend well beyond the policy term as long as the coverage was in effect during the time the loss occurred.

This means a business owner with an occurrence policy doesn’t have to elect an extended reporting period; the policy automatically includes extended reporting. However, occurrence policies won’t allow you to put a retroactive period in place to get coverage for a time before the policy term.

What’s an example of an occurrence policy?

Let’s say a business owner purchases professional liability insurance that is set as an occurrence policy. The policy is purchased with a term of Jan. 1 to Dec. 31, 2015. The business owner retires after Dec. 31, 2015.

On Oct. 21, 2020, the retired business owner receives notice of a claim filed for an incident that happened on Aug. 12, 2015. Since the policy was in force at the time of the incident, the claim will be processed even though it wasn’t filed until years after the incident occurred.

What is tail coverage?

Tail coverage is another way to refer to the extended reporting period of a claims-made policy. Tail coverage is an added endorsem*nt to a policy that allows you to report and file claims that happened during the policy’s effective period.

Tail coverage is different from an occurrence policy, where reporting can happen at any time after the policy’s termination. Tail coverage is optional and an added cost.

FYI

An insurance policy endorsem*nt can extend the reporting period for errors and omissions coverage.

Which is the right type of coverage for you?

It can be challenging for business owners to know which type of business insurance coverage they need. As a general rule of thumb, if a business has coverage gaps, a claims-made policy is better. A claims-made policy affords coverage for incidents that might have happened while it didn’t have a policy in place.

Often, this situation affects new businesses, where insurance might not have been an immediate priority. Still, claims-made coverage is also useful for a business with an accidental coverage lapse.

Occurrence policies are a good option for professional service providers who may do the work in one period but have a claim filed much later. For example, if a tax preparer’s professional liability policy ended on April 30, 2012, and the client is audited four years later, the professional liability policy that was in place would offer coverage for any errors made.

Did You Know?

You can save money on business insurance by bundling policies into a single business owners policy, increasing your deductible and asking about group rates.

Can you switch from a claims-made to an occurrence policy?

It’s possible to change your policy type. This could happen when you change insurance carriers or as part of a renewal review when your policy is approaching expiration.

When switching from a claims-made to an occurrence policy, note that you may be creating a coverage gap. This gap can occur because you can’t make a claim on the new policy for a loss that occurred during the claims-made policy period.

For example, say a small business has a claims-made policy in effect with no tail coverage from Jan. 1 to Dec. 31, 2017. On Jan. 1, 2018, it changes the policy to an occurrence policy. A claim is made on Jan. 15, 2018, for a slip-and-fall injury that happened on Dec. 27, 2017.

While the business had coverage for the incident when the policy was in force, it no longer has coverage because there is no tail coverage extending when the claim can be reported. The new policy won’t cover the claim from a previous policy term. This means you may be liable for the loss and have to pay out of pocket.

It’s important to review the risks of changing coverage forms when renewing or getting a new insurance policy. You must be certain you have adequate coverage for anything that might come up as a claim. Plus, claims are not always filed in a timely manner. The best business insurance carriers will work with you to ensure you’re not leaving your company vulnerable.

Claims-Made vs Occurrence: What's the Difference? (2024)

FAQs

Claims-Made vs Occurrence: What's the Difference? ›

Essentially, for a claim to be considered for coverage, an occurrence-based policy needs to be active when the act or incident occurs; claims made policies have to be active when the claim is made.

What is better, claims made or occurrence? ›

Claims-made coverage is portable. You can take the coverage from one insurance company to another. The advantage to an occurrence policy is its permanence. The period of time you are insured under an occurrence policy is protected forever by the policy you had that year.

What triggers a claims made policy to respond to an occurrence? ›

In the case of a claims-made policy, however, determination of coverage is triggered by the date you first became aware and notify the insurer of a claim or potential claim. The insurer's policy in force on the date you became aware and give notice is the insurer who must defend and settle the claim.

What is the difference between claims made and claims occurring policy? ›

A “Claims Made” policy provides coverage for claims when the incident is reported. A “Claims Occurring” policy provides coverage for when the incident occurred. An example would be if there was fault in work that you carried out ten years ago, but it has only just been reported today.

What is the difference between claims made and claims reported? ›

A claims-made policy only requires you to report the claim promptly, or “as soon as practicable.” This does not necessarily require the notification to occur during the policy term whereas the claims made and reported policy requires both to occur within the same policy period.

What are the advantages of claims-Made? ›

Pros:
  • Simple to own and maintain (including switching insurers or plans)
  • Provide more coverage since aggregate limit renews each year.
  • Accommodate claims that don't produce lawsuits right away.

What are the benefits of occurrence? ›

The most obvious benefit of an occurrence policy is that it offers long-term protection. As long as coverage is in place when the incident occurred, it's possible to make a claim on that period years into the future. Another advantage is that occurrence policy costs tend to be fixed.

Can you switch from claims made to occurrence? ›

1. Keep in mind that as soon as you buy a Claims-Made insurance policy the clock starts ticking for that tail insurance. If you only carry the Claims-Made policy for 1 year and then want to switch to Occurrence, you can do so – but you have to buy tail for that 1 year that you carried the Claims-Made policy.

How do you explain a claims-made policy? ›

What Is a Claims-Made Policy? A claims-made policy refers to an insurance policy that provides coverage when a claim is made against it, regardless of when the claim event occurred. A claims-made policy is a popular option for when there is a delay between when events occur and when claimants file claims.

What is the purpose of the claims made form? ›

Insurance companies commonly write policies on a claims-made form. This means your insurer helps cover claims filed during your policy period. There are two features of a claims-made policy that can affect coverage: Retroactive date: Your policy provides coverage if an incident occurs on or after a specified date.

What is an example of per occurrence? ›

For example, say your policy's per-occurrence limit was $1 million and the aggregate limit was $2 million. Your company gets sued on two separate occasions in the same year, each time for $1 million. Because your per-occurrence limit is $1 million, both lawsuits will be covered.

Do all claims made policies have a retroactive date? ›

A retroactive date is a provision found in many (although not all) claims-made policies that eliminates coverage for claims produced by wrongful acts that took place prior to a specified date, even if the claim is first made during the policy period.

What is the difference between claims made and modified claims made? ›

Modified Claims Made Policy – Same as claims made, except coverage will continue for claims made after the Insured terminates the policy that arose out of a medical incident that happened during the coverage period (Retroactive Date through termination date.

What is the difference between occurrence and claims made? ›

A claims-made policy only covers those that occur and are reported within the policy's timeframe, unless tail coverage is also purchased. An occurrence policy provides lifetime coverage for incidents that take place during a policy period, regardless of when the claim is reported.

What happens after a claim is made? ›

The insurers and attorneys of both parties will investigate the accident, determine the amount of fault each driver holds, and then come to a settlement agreement based on their assessment.

What are 2 types of claims? ›

There are three types of claims: claims of fact, claims of value, and claims of policy. Each type of claim focuses on a different aspect of a topic. To best participate in an argument, it is beneficial to understand the type of claim that is being argued. There are two sides to an argument, the pro-side and con-side.

What is the purpose of the claims Made form? ›

Insurance companies commonly write policies on a claims-made form. This means your insurer helps cover claims filed during your policy period. There are two features of a claims-made policy that can affect coverage: Retroactive date: Your policy provides coverage if an incident occurs on or after a specified date.

Can you switch from occurrence to claims Made? ›

Claims-Made policies provide coverage for 'claims' only when BOTH the alleged incident AND the resulting 'claim' happen during the period the policy is in force! Switching from an "Occurrence" to a "Claims Made" form is the least perilous change.

What is the difference between per occurrence and per claim deductible? ›

A per occurrence deductible is like most auto or homeowners insurance you might be familiar with; you pay the $500, and that's the max you'll pay when something happens. But if your deductible is per claim, that means a separate deductible gets applied to every claim filed in a single occurrence.

What does occurrence insurance cover? ›

An occurrence-based policy covers losses that happen during the time you have the policy, regardless of when you file a claim. It is designed to protect you against long-tail events – incidents that could cause injury or damage years after they occur.

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