Order no. 19071 of 2024: The Burden of Proof in Reporting Insurance Claims

The judgment of the Court of Cassation no. 19071, issued on July 11, 2024, offers an important reflection on the issue of reporting claims in the context of insurance. The decision focuses on the insured's obligation to promptly notify the insurer of the claim and the consequences related to non-compliance with this obligation.

Regulatory Context

According to Article 1913 of the Civil Code, the insured has the obligation to notify the insurer of the claim. However, non-compliance with this obligation can have different consequences depending on the nature of the violation, which can be intentional or negligent. In fact, if the non-compliance is intentional, the insured loses the right to indemnity, as established by art. 1915, paragraph 1. In case of negligence, however, the insurer may reduce the indemnity in proportion to the damage suffered, as provided for by art. 1915, paragraph 2.

The Ruling's Maxim

OF THE INSURER Obligation - Non-compliance - Intentional and negligent nature - Consequences - Burden of proof on the insurer - Content - Case law. For the insured to be considered in breach of the obligation, imposed by art. 1913 of the Civil Code, to notify the insurer of the claim, it is necessary to ascertain whether the non-compliance is intentional or negligent, given that, while in the first case the insured loses the right to indemnity, pursuant to art. 1915, paragraph 1, of the Civil Code, in the second case the insurer has the right to reduce the indemnity due to the prejudice suffered, pursuant to art. 1915, paragraph 2, of the Civil Code; in both cases, the burden of proof rests on the insurer, who is required to demonstrate, in the first case, the fraudulent intent of the insured and, in the second, that the insured voluntarily failed to comply with the obligation and the prejudice suffered. (In this case, the Supreme Court quashed the lower court's judgment which had denied the right to compensation for late reporting of the claim without providing reasons regarding the imputability of the delay to the insured's intent or negligence).

Practical Implications of the Ruling

This order, therefore, clarifies the importance of the burden of proof on the insurer. In particular, the insurer must demonstrate:

• That the insured's non-compliance with the reporting obligation was intentional, meaning there was fraudulent intent;
• That the non-compliance is negligent, i.e., that the insured voluntarily failed to comply with the obligation and that this caused damage to the insurer.

This distinction is fundamental, as it determines whether the insured can receive the indemnity or have it reduced. The Court, in the specific case, quashed a lower court ruling that had not adequately assessed these aspects, emphasizing the importance of a thorough analysis of the claim situation.

Conclusions

In summary, ruling no. 19071 of 2024 represents an important step forward in protecting the rights of the insured, drawing attention to the burden of proof on the insurer. It is essential that insurance companies carefully assess the causes of any delays in reporting claims, so that the rights of the insured are always respected and adequately protected.