Per Occurrence and Annual Aggregate Limits

The per-occurrence limit is the most the policy pays for any one claim. The annual aggregate is the most it pays for all claims in the policy year combined. Senior care is usually written on a combined general and professional liability form, so both bodily injury from a slip on a wet floor and professional negligence in a wound care plan draw on the same limits.

The aggregate is where senior care programs quietly fail. A single facility with a bad year can generate multiple claims from the same underlying condition, understaffing, for example, which produces falls, pressure injuries, and medication errors at the same time. Those are separate occurrences drawing on one aggregate. An operator who sizes the per-occurrence limit against a worst-case single claim, then accepts an aggregate at three times that number, has bought protection against one bad claim rather than one bad year. Look at your own claim frequency over the last five years, not just severity, when sizing the aggregate.