The Claims Made Clause in the Judgment of Cass. Civ. No. 8894 of 2020: Implications and Reflections

The recent ordinance No. 8894 of 2020 from the Court of Cassation offers an important reflection on the validity and consequences of claims made clauses in insurance contracts, particularly for healthcare facilities. This clause, which requires the insured to report the loss within one year from the termination of the contract, has raised significant questions regarding the fairness and potential abusiveness of contractual conditions.

The Case and the Court's Decision

In the case at hand, the Hospital (OMISSIS) was ordered to compensate for damages suffered by a child during a hospitalization. The hospital requested to be indemnified by its insurance company, Generali Italia S.p.A., which refused the request citing the presence of the claims made clause. The Court of Appeal upheld the first instance decision, emphasizing that the clause was not abusive and pursued legitimate interests.

The claims made clause does not affect the typical characteristic of the insurance contract, but regulates the role of the compensation request in relation to the insured fact.

Critiques of the Claims Made Clause

Despite the decision of the Court of Appeal, the Cassation accepted the third ground of appeal from the Hospital. In particular, the Court found that the clause in question could create a significant imbalance between the parties, as the reporting of the loss was contingent upon receiving a compensation request from the third party affected. This aspect creates a difficult condition for the insured, who must respond to uncontrollable time constraints.

  • The clause can make it excessively difficult for the insured to exercise their rights.
  • The deadline for reporting is not related to the behavior of the insured, but depends on the
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