Analysis of the Judgment of the Court of Cassation, Civil Section III, No. 12908 of 2022: Validity of the Claims Made Clause

The very recent ruling of the Court of Cassation, Civil Section III, No. 12908 of April 22, 2022, addresses a crucial issue regarding the validity of claims made clauses in liability insurance contracts. Following an appeal filed by the Religious Province of St. Peter, the Court confirmed the legitimacy of such clauses, clarifying their impact on the rights of the insured and the obligations of insurance companies.

The Context of the Judgment

The dispute originates from a claim for damages suffered by a patient, in which the Religious Province and the healthcare professionals involved were ordered to compensate for the damage. The insurance company, however, opposed the payment, invoking the claims made clause, which limits indemnity to claims presented during the validity of the policy. The Court of Appeal of Naples, in the contested ruling, considered this clause valid, justifying its decision with previous case law.

The Court of Cassation reaffirmed the validity of the claims made clause, emphasizing its compatibility with current regulations.

Reasons for the Decision

The Court of Cassation, examining the grounds for the appeal, rejected the arguments of the Religious Province, confirming that:

  • The claims made clause is not to be considered unfair if there is no evidence of imbalance between the rights and duties of the parties.
  • The judge of merit has the power to interpret contractual clauses, and the validity of the clause in question had already been established in previous rulings.
  • The burden of proving the nullity of the clause falls on the insured, not on the insurance company.

This approach reflects the principle of evidential acquisition, according to which evidence must be assessed based on its content, regardless of who presented it.

Implications of the Judgment

Judgment No. 12908 of 2022 has important repercussions in the field of insurance and civil law. Claims made clauses, although criticized in the past, have now been confirmed as legitimate tools for delimiting insurance coverage. This means that insured parties must pay particular attention to the contractual conditions, especially regarding the terms for reporting claims.

Furthermore, the Court clarified that insurance companies may legitimately limit their exposure to risks, provided this is done in compliance with regulations and without creating excessive imbalance in the rights of the parties involved.

Conclusions

The judgment of the Court of Cassation No. 12908 of 2022 represents a significant step in defining the relationship between insured parties and insurance companies, consolidating the legitimacy of claims made clauses. Parties must be aware of the legal and contractual implications, and it is advisable to consult legal experts before entering into complex insurance contracts.

Bianucci Law Firm