Commentary on Judgment Cass. civ., Section III, Ord., No. 11905 of 2020: Insurance and Professional Liability

Judgment No. 11905 of 2020 by the Court of Cassation offers important food for thought on professional liability in the medical field and the operation of insurance policies. In this case, a doctor was denied coverage by his insurance company after a patient sought compensation for damages resulting from a surgical procedure. The Court reiterated the importance of transparency and communication in the conclusion of insurance contracts.

The Case Subject of the Judgment

The doctor, D. P., was sued for an arthroplasty procedure that led to complications, including an infection. The patient therefore sought compensation for damages, alleging the doctor's and the healthcare facility's presumed liability. The central issue was whether the insurance policy taken out by the doctor covered such claims, considering that the infection had already manifested before the contract was concluded.

The Court ruled that the policy was not operative for facts already known to the insured at the time of conclusion.

Implications of the Judgment

This judgment highlights several fundamental aspects in the context of professional liability:

• Policy Operability: The Court clarified that the insurance policy was inoperative for liabilities of which the doctor was already aware at the time of conclusion.
• Duty to Disclose: The professional is obliged to disclose any claims for damages of which they are aware, in order to avoid issues related to the policy's non-operability.
• Claims Made Clauses: The judgment emphasizes the importance of clauses that limit coverage to facts not already known at the time of subscription.

Conclusions

In conclusion, judgment No. 11905 of 2020 represents an important milestone in the jurisprudence concerning professional liability insurance. It highlights the need for healthcare professionals to pay particular attention to the terms of their policies and to communicate clearly and promptly any issues that could affect their operability. Transparency and diligence are imperative not only for the protection of patients but also for the protection of the professionals themselves.