The Claims Made Clause in the Supreme Court Ruling No. 8894 of 2020: Reflections and Implications

The recent ruling of the Supreme Court No. 8894 of 2020 offers significant insights regarding the validity of the claims made clause in a liability insurance contract. In this decision, the Court established that this clause, while not abusive, may present issues of merit, especially in situations where the timing of the claim may disadvantage the insured.

The Context of the Ruling

The case in question involved a hospital sued by the parents of a child for damages incurred during a hospitalization. The hospital, ordered to compensate, sought to be indemnified by the insurance company Generali Italia S.p.A., which raised the applicability of the claims made clause, requiring the claim to be reported within twelve months of the contract's termination.

The Supreme Court ruled that the claims made clause is not inherently abusive, but may become unworthy of protection when it creates a significant imbalance between the parties.

The Implications of the Claims Made Clause

The claims made clause, as highlighted by the Court's decision, can create a significant imbalance between the parties. It obliges the insured to report the claim within a stipulated timeframe, which may be critically linked to the timeliness of the claim made by the third party. This aspect raises questions about the actual protection offered to the insured, as their right to assert the insurance benefit depends on external and uncontrollable events.

  • The validity of the clause depends on its compliance with the limits imposed by law.
  • The judge of merit must evaluate whether the clause creates an imbalance between the parties.
  • It is necessary to consider how the clause affects the insured's right to exercise their action.

Conclusions

In conclusion, the Supreme Court ruling No. 8894 of 2020 emphasizes the importance of a balanced assessment of contractual clauses in the insurance sector. The claims made clause, while not inherently abusive, must be carefully scrutinized to avoid creating a disadvantageous condition for the insured. It is essential that the parties involved understand the legal and practical implications of such clauses to ensure adequate protection of their rights.

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