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Notice-of-Circumstances Provisions in Claims-Made Policies

By Victor F. Mustelier
June 27, 2008

As insurers under D&O policies respond to the claims activity likely to be generated by the subprime mortgage crisis, they should consider whether their policyholders are complying with notice provisions commonly found in 'claims-made' policies dealing with notice of potential claims and the submission of claims outside of the current policy period. This easily overlooked issue has potentially serious consequences for an insurer ' affecting the scope of its coverage obligations and the exposure of its limits. In coverage litigation, courts have often found that policyholders who fail to comply with these 'notice-of-circumstances' clauses are not entitled to coverage.

Generally, D&O, bankers' liability, and other claims-made insurance covers the liability of professionals to third parties only for claims that are both made (against the insured) and reported (to the insurer) in the same policy period. A limited exception to this rule, however, is carved out by notice-of-circumstances clauses typically found in claims-made policies. These clauses enable policyholders to obtain coverage for claims made against them after the policy's expiration but only if, before the policy period ends, they notify the insurer in writing of specific facts and circumstances they reasonably expect to lead, after the expiration of the insurance, to a claim against them. As to subsequently-made claims which actually do arise from the circumstances of which the insured notified the insurer, notice-of-circumstances provisions essentially enable insureds to keep any policy limit remaining on their expiring coverage in place during the succeeding policy period. Clearly, in the wake of the subprime crisis, policyholders with subprime exposures may seek to give notice of circumstances regarding their activities that may give rise to claims.

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