What is a Claim, Potential Claim, or Grievance

Defined in most policies as a demand for money or services related to remedying the alleged wrong. WILMIC’s policy defines a claim as:

  • “Claim” means your receipt of a demand for money or services,
    naming any of you and alleging a wrongful act. A claim is first
    made on the date any of you first receive a claim or any part of a
    claim. If a claim arises out of a series of wrongful acts, the claim
    is first made on the date any of you first receive any claim
    resulting from any of the wrongful acts in the series. 
  • “Wrongful act” is defined in WILMIC’s policy as:
    • Any act, error, or omission that is negligent in the
      rendering of or failure to render professional
      services to a client; or
    • While rendering professional services to a client,
      You commit personal injury. A wrongful act or a series of wrongful acts occurs on the date of the first act, error, or omission that is negligent or alleged to be negligent in that wrongful act or series of wrongful acts.
  • “Professional Services” is defined in WILMIC’s policy as:
    • Professional Services means the service you are legally obligated to render to a client in your capacity as a lawyer for the primary purpose of the client obtaining the benefit of your knowledge, skills, and experience in the law. Professional services may include other types of services only to the extent such services are identical and necessary to your performance of services to obtain the benefit of your knowledge, skills, and experience in the law. 
  • What is a “Potential Claim”
    • A “potential claim” is defined in WILMIC’s policy as:
      • A potential Claim exists when any of you first become aware of facts or circumstances regarding an act, error, or omission committed by any one or more of you that a reasonably prudent lawyer would expect to be or to become a basis for a claim, regardless of whether you believe such a claim will be made.
        • An example of a potential claim is a mistake you know about that the client may not yet know about, or the client may know about it but has not made a demand for you to fix it or pay for it. 
      • Potential claims must be reported during the policy period to ensure coverage. Failure to report a potential claim during the policy period in which the insured lawyer first becomes aware of the potential claim can result in a loss of coverage. 
      • Once a potential claim is reported, coverage is granted under the policy terms of the policy in effect at the time of the report, even if the subsequent claim is made after the policy period ends. 
    • Additional benefits may be available. For example, WILMIC’s policy provides coverage for legal counsel to represent the policyholder in proceedings involving a grievance before the Office of Lawyer Regulation. “Grievance” is defined as set forth in Wisconsin Supreme Court Rule 22.001(5) – “’ Grievance’ means an allegation of possible attorney misconduct or medical incapacity received by the office of lawyer regulation.”