← University
Occurrence vs. Claims-Made: Why the Distinction Matters
0 of 4

A renewal proposal arrived at the offices of a mid-sized structural engineering consultancy in Calgary, and the coverage terms it contained differed substantially from anything the firm had carried in its 18-year operating history. The firm's professional liability insurer had indicated that occurrence-based coverage would no longer be available at renewal and that the firm would need to transition to a claims-made policy structure beginning in the upcoming policy year. The consultancy's managing partner, a professional engineer with 24 years of practice experience, understood that this shift represented more than an administrative change in policy language.

The firm employed 14 licensed engineers and 8 technical staff, providing structural design and building envelope consulting services to commercial developers, institutional clients, and residential builders across Alberta and British Columbia. Over nearly 2 decades of practice, the consultancy had completed engineering work on hundreds of projects, ranging from single-family residential foundations to multi-storey commercial developments and public infrastructure. Some of these projects dated back to the firm's earliest years, and the managing partner recognized that latent defects in structural work could surface many years after project completion—sometimes 10 or 15 years after the original design work was delivered.

The firm's current occurrence-based policy had provided coverage for claims arising from work performed during each policy period, regardless of when those claims were actually reported. This structure had allowed the consultancy to maintain continuous protection for its historical project portfolio without active management of prior policy periods. The proposed claims-made structure would tie coverage to the date a claim was first reported, introducing questions about retroactive dates, the treatment of prior acts, and the firm's exposure during any future transitions between insurers or upon the eventual retirement of the founding partners.

The managing partner had begun consulting with the firm's insurance broker about the implications of the transition, including the treatment of the firm's 18-year project history under the new policy structure, the potential need for extended reporting period coverage when partners retired, and the long-term cost implications of maintaining claims-made coverage through successive policy periods. Several of the firm's senior engineers were approaching retirement within the next 5 to 7 years, and the managing partner needed to understand how coverage would respond to claims that might emerge after those professionals had left active practice. The broker had outlined several coverage options and policy features that could address these concerns, but the managing partner sought a clearer understanding of how the fundamental differences between occurrence and claims-made structures would affect the firm's risk profile over time.

Claims-Made Coverage: The Policy Trigger and Why It Changes Your Risk Exposure

Claims-made coverage represents one of the most significant departures from traditional insurance principles that a risk professional will encounter in practice. Unlike occurrence-based policies, which anchor coverage to the moment when damage or injury actually happens, claims-made policies tie coverage to the date when a claim is first reported to the insurer. This fundamental shift in policy trigger has profound implications for how professionals and businesses must manage their insurance programs, particularly during transitions between insurers or when ceasing operations altogether.

The emergence of claims-made coverage in Canada traces back to the liability insurance crisis of the 1980s, when insurers faced mounting uncertainty about long-tail exposures. Under traditional occurrence coverage, an insurer could write a policy in 1985 and find itself paying claims related to that policy year decades later, once latent injuries or damages finally manifested. This proved particularly problematic in professional liability contexts, where errors in advice or design might not reveal themselves for years after the professional services were rendered. Insurers responded by developing claims-made forms that would give them greater certainty about their exposure windows, fundamentally altering the risk allocation between insurers and policyholders.

In Canada, claims-made coverage operates within the regulatory frameworks established by each province and territory. The Insurance Act of British Columbia, the Alberta Insurance Act, the Insurance Act of Saskatchewan, the Insurance Act of Ontario, and the Civil Code of Quebec all contain provisions relevant to liability insurance contracts, though claims-made forms are not explicitly addressed in most statutory frameworks. As of the date of authorship, provincial regulators have generally permitted claims-made coverage through market practice rather than specific legislative endorsement, allowing insurers to file and use these forms subject to standard contract law principles. The result is a patchwork where claims-made policies are widely available and commonly used for professional liability, directors and officers liability, errors and omissions coverage, and employment practices liability insurance, but where the specific interpretation of policy language may vary based on provincial common law or, in Quebec's case, the civil law principles governing insurance contracts under the Civil Code of Quebec.

That’s the free preview

You’ve reached the end of what’s open to read. The rest of this lesson is part of a $79 course — purchasing unlocks it, or sign in if you already have access.