Administrative Code

Virginia Administrative Code
Title 14. Insurance
Agency 5. State Corporation Commission, Bureau of Insurance
1/27/2020

Chapter 335. Rules Governing Claims-Made Liability Insurance Policies

14VAC5-335-10. Scope.

The provisions of this chapter shall apply to all policies of liability insurance, as defined in §§ 38.2-117, 38.2-118, and subsection B of § 38.2-111 of the Code of Virginia, that limit the time allowed for reporting claims arising out of injury, damage, or wrongful act or omission covered by the policy. Any such policy shall be deemed to be a claims-made liability insurance policy for purposes of this chapter. The provisions of this chapter shall apply to claims-made liability insurance policies delivered or issued for delivery in the Commonwealth by an admitted insurer to become effective on or after October 1, 2018.

This chapter shall not apply to incidental claims-made liability insurance.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 20, Issue 21, eff. January 1, 2005; amended, Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-20. Definitions.

The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Admitted insurer" means an insurer licensed in the Commonwealth to engage in the business of insurance. An admitted insurer does not include any surplus lines insurer.

"Basic extended reporting period" means an automatic extended reporting period provided at no additional premium charge.

"Claims-made liability insurance" means an insurance policy providing coverage for the insured's liability for injury, damage, or wrongful act or omission occurring prior to the termination of coverage but subsequent to any applicable retroactive date, provided the claim for such injury, damage, or wrongful act or omission is first made during the policy period or any extended reporting period.

"Extended reporting period" means an extension of the time allowed for reporting claims, after termination of any claims-made liability policy for injury, damage, or wrongful act or omission that occurred prior to termination of the policy and that, except for the requirement to report claims during the policy period, was otherwise covered by the policy.

"Incidental claims-made liability insurance" means any claims-made liability coverage contained in or attached to a policy providing liability insurance on other than a claims-made basis.

"Medical professional liability insurance" means insurance coverage against the legal liability of the insured and against loss, damage, or expense incident to a claim arising out of the death or injury of any person as the result of actual or alleged negligence in rendering or failing to render professional service by any provider of health care.

"Policy" means a coverage part, form, or endorsement that is contained in a contract of insurance.

"Retroactive date" means the date on or after which injury, damage, or wrongful act or omission may occur and be covered under a claims-made liability insurance policy.

"Supplemental extended reporting period" means an extended reporting period that is available for the insured to purchase.

"Unimpaired limit of liability" means a limit equal to the dollar amount shown as the aggregate limit in the declarations (i) at the inception of the policy period or (ii) as amended in the policy thereafter, and in force at the time of the termination of the policy.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 20, Issue 21, eff. January 1, 2005; amended, Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-23. Required notice.

The following notice, or a notice that is substantially similar, shall be provided in writing with each new and renewal claims-made liability insurance policy:

You have purchased claims-made liability insurance. When this insurance terminates, the insurer will send an offer with the available options for purchasing the supplemental extended reporting period. You may be entitled to receive information on claims under this policy. If you have any questions regarding your claims-made coverage or the importance of purchasing the supplemental extended reporting period, please contact your insurance company or your insurance agent.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-27. Standards for basic extended reporting period.

An insurer may offer a basic extended reporting period. If a basic extended reporting period is offered, it shall be included in the policy.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-30. Requirement to offer supplemental extended reporting period.

A. Every claims-made liability insurance policy shall include a provision that the named insured may purchase a supplemental extended reporting period in accordance with the provisions of 14VAC5-335-40 upon policy termination. To the extent that policy limits apply separately to each named insured, each named insured shall be separately entitled to purchase a supplemental extended reporting period. Policy termination of claims-made coverage shall include:

1. Cancellation or nonrenewal of the policy by the insurer or the insured;

2. Advancement of any applicable retroactive date; or

3. Renewal of the policy on other than a claims-made basis.

B. No offer of a supplemental extended reporting period is required if cancellation or nonrenewal of a claims-made liability insurance policy is due to:

1. Nonpayment of premium;

2. Failure to comply with terms or conditions of the policy; or

3. Fraud.

C. Each claims-made liability insurance policy shall contain provisions that clearly state when the supplemental extended reporting period will and will not be offered.

D. Upon a policy termination as set forth in subsection A of this section, the insurer shall offer in writing to the named insured a supplemental extended reporting period. The offer shall include the duration and premium of the required supplemental extended reporting period coverage in 14VAC5-335-40 and any other available duration and premium options. The offer shall be sent no earlier than the date of notification of termination of the policy and not later than 15 days after the termination of the policy. The named insured shall have a minimum of 30 days from policy termination to purchase the supplemental extended reporting period.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 20, Issue 21, eff. January 1, 2005; amended, Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-40. Supplemental extended reporting period requirements.

A. Each insurer shall offer a supplemental extended reporting period to allow an extension of the time to report claims as follows:

1. For medical professional liability insurance, an unlimited supplemental extended reporting period shall be offered with unimpaired limits of liability and shall be effective the same day as the termination of the policy; or

2. For all other claims-made liability insurance policies, a supplemental extended reporting period of at least one year shall be offered.

In addition, the insurer may also offer greater or more limited extensions of time in which to report claims.

B. A supplemental extended reporting period purchased with unimpaired limits of liability in whole or in part shall be effective the same day as the termination of the policy. In all other instances, the policy provisions shall establish the effective date of the supplemental extended reporting period as (i) the same day as the termination of the policy if no basic extended reporting period applies, or (ii) the same day the basic extended reporting period expires if a basic extended reporting period applies.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 20, Issue 21, eff. January 1, 2005; amended, Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-45. Requirement to provide loss information.

A. If the policy is issued with an aggregate limit:

1. The insurer shall provide loss information to the named insured with the notice of cancellation or nonrenewal of the policy; or

2. The named insured may request loss information within 120 days from the date of policy renewal. The insurer shall provide such loss information within 15 calendar days of the insured's request.

B. The loss information shall be sufficient to inform the named insured regarding the remaining or potentially remaining limits of coverage available under the terminating policy.

C. This section shall apply to medical professional liability insurance only if the insurer offers an extended reporting period with other than unimpaired limits of liability.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-50. Prohibitions.

A. The supplemental extended reporting period coverage shall not be canceled by the insurer without the consent of the insured except for nonpayment of premium or fraud.

B. No insurer shall deny coverage under a supplemental extended reporting period on the basis that other applicable insurance coverage is in effect. An insurer may apply the supplemental extended reporting period coverage as excess over other insurance.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 20, Issue 21, eff. January 1, 2005; amended, Virginia Register Volume 34, Issue 16, eff. October 1, 2018.

14VAC5-335-60. Severability.

If any provision of this chapter or its application to any person or circumstance is for any reason held to be invalid by a court, the remainder of this chapter and the application of the provisions to other persons or circumstances shall not be affected.

Statutory Authority

§§ 12.1-13 and 38.2-223 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 20, Issue 21, eff. January 1, 2005; amended, Virginia Register Volume 34, Issue 16, eff. October 1, 2018.



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