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I'm trying to learn more about professional liability insurance and came across some terms regarding coverage triggers that seem identical to me, but I'm just not 100% sure because I see them used in different definitions and explanations. Looking for some help clarifying. Thanks.

- Claims Made

- Claims Made and Reported

- Occurrence

From my reading it seems to me that Claims Made and Occurrence are the same, and it's just a matter of semantics.

Nope...they're not the same. Bookmark IRMI.com.
Here's IRMI's description of Claims-Made - http://www.irmi.com/online/insurance-gl ... -made.aspx

...and Occurrence - http://www.irmi.com/online/insurance-gl ... olicy.aspx

Thanks. I understand there's a definite difference between Claims Made and Occurrence. I also see I should have been more specific in my query.

I was referring to the "Pure Claims Made" definition of a Claims Made policy. The standard term tossed around is is the generic "Claims Made", but more commonly it's meant to say "Claims Made and Reported".

The Pure Claims Made definition appears to be extremely similar to the Occurrence definition and so I wondered how does one properly distinguish between the two? More specifically, how would someone best relate the differences to someone new to the industry.

From IRMI:

pure claims-made policy
A type of claims-made policy requiring that a claim must be made against the insured during the policy period for coverage to apply. Unlike claims-made and reported forms, pure claims-made policies do not specify that the claim must also be reported to the insurer during the policy period. Instead, they indicate only that the claim must be reported to the insurer "immediately" or "as soon as practicable."

Occurrence
A policy covering claims that arise out of damage or injury that took place during the policy period, regardless of when claims are made.


There's a rather vague distinguishment between the two as to when the claim is to be reported.

Thanks for your help.

They're not similar. Here's an example.

Assume a claims made Products Liability policy has a policy period of 1/1/2011 to 2012 for a particular product. That product was manufactured on 5/1/2010, and the claimant purchased it on 8/1/2010. The product is DIRECTLY responsible for an injury to the person that purchased it, and this took place on 1/13/2011. The current claims made policy (i.e. 1/1/2011-2012) will respond.

Whereas....if they had an occurrence-basede Products Liability policy that had a policy period of 1/1/2010-2011 under the same scenerio (and...assuming this policy was also renewed 1/1/2011-2012), the 2010-11 policy would respond because this particular product was manufactured during that policy period, even though the claim occurred after its espiration.

Claims Made requires that a claim be made and reported during the policy period(or specified time following the policy period) and Occurrence form only means that a claim had to occur during the policy period. The Claims Made portion is where the differences are. This is very common on your Agent E&O insurance so you may be able to look over that policy for a good description. Good luck!

Worth noting that in an occurrence policy, the damage or injury must occur during the policy period. It does not matter when the claim is made. For instance an occurrence that injured a 1 year old child might not trigger a claim until the child attains majority 17 years later. The 18 year old occurrence policy would apply.

In an ISO CGL claims made policy with a retro date, the damage or injury date must occur after the retro date and before the end of the policy period AND the claim must be made during the policy period (with various requirements for reporting depending in part on whether the Extended Reporting Period is involved).

In most E & O claims made coverages, the focus is on the date of the wrongful act which must occur during the policy period or after the retro date.

Yeah, I know - oversimplified.