Order No. 19071 of 2024: The Burden of Proof in Insurance Claims Notification

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

Regulatory Context

According to Article 1913 of the Civil Code, the insured is obliged 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 wilful or negligent. In fact, if the non-compliance is wilful, the insured loses the right to compensation, as established by Article 1915, paragraph 1. In case of negligence, however, the insurer may reduce the compensation in proportion to the damage suffered, as provided for by Article 1915, paragraph 2.

The Ruling's Maxim

OF THE INSURER Obligation - Non-compliance - Wilful and negligent nature - Consequences - Burden of proof on the insurer - Content - Factual circumstances. For the insured to be considered in breach of the obligation, imposed by Article 1913 of the Civil Code, to notify the insurer of the claim, it is necessary to ascertain whether the non-compliance is wilful or negligent, given that, while in the first case the insured loses the right to compensation, pursuant to Article 1915, paragraph 1, of the Civil Code, in the second case the insurer has the right to reduce the compensation in proportion to the damage suffered, pursuant to Article 1915, paragraph 2, of the Civil Code; in both factual circumstances, the burden of proof lies with the insurer, who is required to demonstrate, in the first case, the insured's fraudulent intent and, in the second case, that the insured voluntarily failed to comply with the obligation and the damage suffered. (In this case, the Supreme Court quashed the lower court's judgment which had denied the right to compensation due to late notification of the claim without providing reasons regarding the imputability of the delay to the insured's wilful 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 notification obligation was wilful, i.e., that there was fraudulent intent;
• That the non-compliance is negligent, meaning 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 compensation or have it reduced. The Court, in this 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, judgment 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 claims notification, so that the rights of the insured are always respected and adequately protected.