“claims-made” policy 是什么意思啊?

“claims-made” policy 是什么意思啊?

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“claims-made” policy指的是索赔提出制保单,它属于产品责任保险保单(product liability insurance policy)的一种。产品责任保险保单格式分为索赔提出制和事故发生制,索赔提出制要求产品销售日期、事故发生时间、索赔提出时间均在保险期间内,保险公司才可以按照保单内容进行赔付。其英文释义如下:A claims-made policy is a type of insurance policy most commonly used to cover the risks associated with business operations. For example, these policies are often used to cover the potential for mistakes associated with errors and omissions (E&O) in financial statements. They are also used to cover businesses from claims made by employees, including wrongful termination, sexual harassment, and discrimination claims. (From Investopedia)


如果要采用以索赔提出为基础的方式,保险人则会规定追溯期(retroactive period),即在追溯期开始后发生的产品责任事故并在保单有效期内提出索赔,保险人才承担责任,且追溯期一般规定不超过5年。一般情况下,保险人出具第一张以索赔提出为基础的保单时,不给追溯期。现实承保中,采用此条款,被保险人通常可有一定宽限期,即便保单到期或注销,只要被保险人在条款中规定的发现期中提出索赔,这个索赔仍旧有效。


产品责任保险保单的另一种为事故发生制保单(occurrence policy)。事故发生制要求产品销售日期、事故发生时间在保险期间内,而不要求索赔提出的时间,即只要产品销售日期、事故发生时间在保险期间内,保单已经过期且不论过期多久,只要被保险人提出索赔,保险公司依然需要按照保单内的赔偿限额进行赔偿。The occurrence policy is based on the time in which the claim event occurred since the occurrence policy trigger only covers claims that come from incidents that fell during a specified period. Occurrence policies don’t specify when the accident must take place, as long as the injury or damage it causes occurs during the policy period.


总而言之,两者的最大区别在于一个重点在于索赔时间,而另一个则是事故发生时间。


以下为相关双语示例,供参考:

If any insurance policy is a “claims-made” policy, then such “claims-made” policy shall be kept in force for not less than six (6) years immediately following termination or expiration of the Agreement.

如果任何保险单为索赔提出制保险单,该索赔提出制保险单的效力至少应持续至协议终止或到期后满六(6)年之日为止。

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