Analysis of Judgment Cass. Civ., Section III, no. 12908 of 2022: Validity of the Claims Made Clause

The very recent judgment of the Court of Cassation, Third Civil Section, no. 12908 of April 22, 2022, addresses a crucial issue concerning the validity of claims made clauses in civil liability insurance contracts. Following an appeal filed by the Religious Province of S. Pietro, the Court confirmed the legitimacy of such clauses, clarifying their impact on the rights of policyholders and the obligations of insurance companies.

Context of the Judgment

The dispute originated from a claim for damages suffered by a patient, in which the Religious Province and the healthcare professionals involved were ordered to compensate for the damage. The insurance company, however, objected to payment, invoking the claims made clause, which limits indemnity to claims made during the policy's term. The Court of Appeal of Naples, in the appealed judgment, had deemed this clause valid, justifying its decision with jurisprudential precedents.

The Court of Cassation has reaffirmed the validity of the claims made clause, emphasizing its compatibility with current legislation.

Reasons for the Decision

The Court of Cassation, examining the grounds for appeal, rejected the arguments of the Religious Province, confirming that:

• The claims made clause is not to be considered unfair if there is no evidence of imbalance between the rights and duties of the parties.
• The trial judge has the power to interpret contractual clauses, and the validity of the clause in question had already been established in previous judgments.
• The burden of proving the nullity of the clause falls on the policyholder, not on the insurance company.

This approach reflects the principle of evidentiary acquisition, according to which evidence must be evaluated based on its content, regardless of who presented it.

Implications of the Judgment

Judgment no. 12908 of 2022 has significant repercussions in the field of insurance and civil law. Claims made clauses, although criticized in the past, have now been confirmed as legitimate tools for defining insurance coverage. This means that policyholders must pay particular attention to the contractual conditions, especially regarding the terms for reporting claims.

Furthermore, the Court clarified that insurance companies can legitimately limit their exposure to risks, provided that this is done in compliance with regulations and without creating excessive imbalance in the rights of the parties involved.

Conclusions

Judgment Cass. no. 12908 of 2022 represents a significant step in defining the relationship between policyholders and insurance companies, consolidating the legitimacy of claims made clauses. Parties must be aware of the legal and contractual implications, and it is advisable to consult legal experts before entering into complex insurance contracts.