{
  "id": "clause-claims-made-vs-loss-occurrence",
  "type": "clause",
  "languages": {
    "en": {
      "id": "clause-claims-made-vs-loss-occurrence",
      "lang": "en",
      "type": "clause",
      "title": "Claims-Made vs Loss-Occurrence Trigger Clause",
      "shortDefinition": "The contractual definition of the coverage trigger, determining whether the notification of the claim (claims-made) or the event causing the loss (occurrence) governs which policy period responds.",
      "synonyms": [
        "Claims-Made versus Occurrence Principle",
        "Coverage Trigger"
      ],
      "linesOfBusiness": [
        "Liability",
        "Financial Lines"
      ],
      "jurisdictions": [
        "Global"
      ],
      "tags": [
        "Liability Insurance",
        "Coverage Trigger"
      ],
      "relations": {
        "relatedTerms": [
          "cov-epli",
          "term-claims-made-principle",
          "term-claims-occurrence-principle"
        ],
        "partOf": [],
        "appliesTo": [
          "cov-do",
          "cov-vermoegensschadenhaftpflichtversicherung"
        ],
        "regulatedBy": [],
        "relevantFor": [],
        "insurableVia": [],
        "mitigatedBy": [],
        "comprises": [],
        "alternativeTo": [],
        "complementedBy": []
      },
      "attribute": null,
      "profile": null,
      "coverageProfile": null,
      "clause": {
        "kind": "definition",
        "origin": "international-programme",
        "favours": "neutral",
        "negotiability": "negotiable",
        "standardWordings": [
          "market-standard trigger definitions in D&O, professional indemnity and EPLI policies (claims-made with retroactive date, alternatively an occurrence trigger)"
        ]
      },
      "legalBasis": [],
      "standards": [],
      "reviewStatus": "expert-reviewed",
      "reviewedBy": "Guido Hesse, Hesse Group Holding AG",
      "lastReviewed": "2026-09-04",
      "version": "0.1.0",
      "updated": "2026-09-03",
      "generated": {
        "by": "cursor-agent/claude-sonnet-5",
        "at": "2026-09-03T00:00:00.000Z"
      },
      "verified": [
        {
          "by": "human:ghesse",
          "at": "2026-09-04T00:00:00.000Z",
          "method": null
        }
      ],
      "staleAfter": null,
      "url": "https://hgh.ch/lexikon/en/knowledge/clause/claims-made-vs-loss-occurrence-trigger-clause/",
      "alternateUrl": "https://hgh.ch/lexikon/de/wissen/klausel/claims-made-vs-loss-occurrence-prinzip/",
      "body": "## Purpose\n\nThe coverage trigger determines which policy year responds to a given loss. Under the loss-occurrence principle, which underlies classic DACH liability cover per AHB clause 1.1, the event causing the loss during the policy period is decisive, regardless of when the resulting claim is later made. Under the claims-made principle, by contrast, the moment a claim is first made against the insured during the policy period is decisive, usually limited by an agreed retroactive date.\n\n## Effect and limits\n\nOccurrence-based cover creates a natural \"tail\", since claims can be made years after the policy has ended, which matters for long-tail exposures such as environmental or asbestos losses. Claims-made cover instead requires a separate extended reporting period to protect claims made after expiry for wrongful acts committed during the policy period. In international programmes combining an occurrence-based local policy with a claims-made difference-in-conditions/difference-in-limits excess layer, trigger mismatches can create coverage gaps.\n\n## Negotiation and practice\n\nKey negotiation points include the retroactive date, the duration and pricing of the extended reporting period, and consistency of the chosen trigger across all layers of an international programme. Brokers and risk managers should check, in multi-layer programmes, whether the primary and excess layers use the same trigger, to avoid gaps for losses straddling the layer boundary."
    },
    "de": {
      "id": "clause-claims-made-vs-loss-occurrence",
      "lang": "de",
      "type": "clause",
      "title": "Claims-made- versus Loss-occurrence-Prinzip",
      "shortDefinition": "Vertragliche Definition des Deckungsauslösers, die bestimmt, ob die Erhebung des Anspruchs (Claims-Made) oder das schadenverursachende Ereignis (Loss-Occurrence) für die zeitliche Zuordnung zum Versicherungsjahr massgebend ist.",
      "synonyms": [
        "Anspruchserhebungsprinzip versus Schadenereignisprinzip",
        "Coverage Trigger"
      ],
      "linesOfBusiness": [
        "Haftpflicht",
        "Financial Lines"
      ],
      "jurisdictions": [
        "Global"
      ],
      "tags": [
        "Haftpflichtversicherung",
        "Deckungsauslöser"
      ],
      "relations": {
        "relatedTerms": [
          "cov-epli",
          "term-claims-made-principle",
          "term-claims-occurrence-principle"
        ],
        "partOf": [],
        "appliesTo": [
          "cov-do",
          "cov-vermoegensschadenhaftpflichtversicherung"
        ],
        "regulatedBy": [],
        "relevantFor": [],
        "insurableVia": [],
        "mitigatedBy": [],
        "comprises": [],
        "alternativeTo": [],
        "complementedBy": []
      },
      "attribute": null,
      "profile": null,
      "coverageProfile": null,
      "clause": {
        "kind": "definition",
        "origin": "international-programme",
        "favours": "neutral",
        "negotiability": "negotiable",
        "standardWordings": [
          "marktübliche Trigger-Definitionen in D&O-, Vermögensschaden- und EPLI-Policen (Claims-Made mit Rückwirkungsdatum, alternativ Occurrence-Trigger)"
        ]
      },
      "legalBasis": [],
      "standards": [],
      "reviewStatus": "expert-reviewed",
      "reviewedBy": "Guido Hesse, Hesse Group Holding AG",
      "lastReviewed": "2026-09-04",
      "version": "0.1.0",
      "updated": "2026-09-03",
      "generated": {
        "by": "cursor-agent/claude-sonnet-5",
        "at": "2026-09-03T00:00:00.000Z"
      },
      "verified": [
        {
          "by": "human:ghesse",
          "at": "2026-09-04T00:00:00.000Z",
          "method": null
        }
      ],
      "staleAfter": null,
      "url": "https://hgh.ch/lexikon/de/wissen/klausel/claims-made-vs-loss-occurrence-prinzip/",
      "alternateUrl": "https://hgh.ch/lexikon/en/knowledge/clause/claims-made-vs-loss-occurrence-trigger-clause/",
      "body": "## Zweck\n\nDer Deckungsauslöser (Trigger) legt fest, welches Versicherungsjahr für einen Schaden zuständig ist. Beim Loss-occurrence-Prinzip, wie es der klassischen DACH-Haftpflicht nach AHB Ziff. 1.1 zugrunde liegt, ist das schadenverursachende Ereignis während der Vertragslaufzeit massgebend, unabhängig davon, wann der Anspruch später erhoben wird. Beim Claims-made-Prinzip ist demgegenüber der Zeitpunkt der erstmaligen Anspruchserhebung gegen den Versicherten während der Laufzeit entscheidend, meist begrenzt durch ein vereinbartes Rückwirkungsdatum.\n\n## Wirkung und Grenzen\n\nOccurrence-Deckungen erzeugen einen natürlichen „Tail\", da Ansprüche noch Jahre nach Vertragsende erhoben werden können, was für Langzeitschäden wie Umwelt- oder Asbestfälle bedeutsam ist. Claims-made-Deckungen benötigen demgegenüber eine gesonderte Nachmeldefrist (Extended Reporting Period), um nach Vertragsende erhobene Ansprüche für während der Laufzeit begangene Pflichtverletzungen abzusichern. In internationalen Programmen mit einer occurrence-basierten lokalen Police und einer claims-made-basierten DIC/DIL-Exzedentendeckung können Trigger-Inkongruenzen zu Deckungslücken führen.\n\n## Verhandlung und Praxis\n\nZentrale Verhandlungspunkte sind das Rückwirkungsdatum, die Dauer und Prämiengestaltung der Nachmeldefrist sowie die Konsistenz des gewählten Triggers über alle Schichten eines internationalen Programms hinweg. Makler und Risikomanager sollten bei mehrschichtigen Programmen prüfen, ob Grund- und Exzedentendeckung denselben Trigger verwenden, um Lücken bei Schadenfällen an der Schichtgrenze zu vermeiden."
    }
  }
}