An Insurance declination due to late notice… Is it justied?

Robert Levine, Allied North America of New York, LLC

There are two parts to this issue. The first is should I report the incident and the second is when. In a standard General Liability policy the obligation of the policyholder is to “notify as soon as practicable of an “occurrence” .... which may result in a claim.” When deciding if you should report an incident, a decision needs to be made if the incident will generate a future claim. Someone falls in front of a job site, states they are O.K., and walks away. Is it safe to assume that no claim will occur from that incident?

The second issue is when to report. What is “as soon as practicable”? Immediately, one day, two days, a week, or a month? It definitely is a gray area. What if the owner learns of an incident at a different time other then when the incident occurred. Take the example above, your employee sees the fall, and does not inform you, the owner, of the incident. Does the clock start ticking when you find out or when your employee saw the incident?

This combination of issues can cause problems in reporting your Insurance claims. The carrier then has the right to decline your claim due to late notice. The carrier’s argument is that the late notice can prejudice their investigating, handling and amount paid on the claim. As a business, they want to minimize the total cost of their claims so they can be profitable. Your agent or agents also play a role in reporting claims. What policies or carriers are they reporting the claim to? It was a Workmen’s Compensation claim, should the Agent also report it to my General Liability carrier?

Your policy can be written to include stipulations that spell out what is a Notice of an Occurrence so the clock does not start too soon. Are you protecting yourself from receiving a declination due to Late Notice of Reporting? What is your claim handling or incident reporting process? What are you currently doing to protect yourself and your company? Reply back. Let me know what you are currently doing and how I can help.

Member Comments