Taking a Look at a Common Proof of Loss Form
(Note: This Guest Blog is by Corey Harris, an attorney with Merlin Law Group in the Tampa, Florida, office. This is the ninth of a twelve part series he is writing on proof of loss).
I have spent the last few weeks writing about everything from what a Proof of Loss is to when one must be filed. As I was deciding on a topic for this week, I realized that while I had spent weeks talking about Proofs, I had yet to post an example. Since a picture is worth a thousand words, this week I am posting an example of a common Proof of Loss form.
As you can see, this form is very straight forward and seems simple enough to fill out. To fill out this form you will likely need to have a copy of your policy and declarations page in order to find the information such the policy number and limits, as well as the issue and expiration dates. You will also need to have specific information about the property, including specifics about occupancy and changes in title; abandoned property is not normally covered under standard policies and a change in ownership may affect whether coverage is available or if replacement cost or actual cash value is owed.
Finally, you will need to have information about the loss. As you can see below, the form requests a statement of the property which was damaged and its value. The amount of money claimed by the insured is also requested and should be as accurate as possible at the time that the Proof is submitted.
At the end of this form, as is standard in all Proofs of Loss, the insured must certify that the loss was not intentional and sign and swear that the information is accurate to the best of their knowledge.
While the format of some forms may differ, the information requested is usually the same. It is important to read the form thoroughly and be sure that the information is correct and complete before forwarding it to your insurer. As explained in previous posts, even a small mistake can cause a number of problems in getting your claim paid.
For the Policy Amount at Time of Loss, would this be the total of Coverage A & B? What does Actual Cash Value of Said Property refer to — the value of the home? According to whom — county appraiser or policy value or something else?
Corey
I am sure that the recent mandatory Florida fraud language will be included in your updated proof of loss forms for the consideration of the Florida subscribers to the blog.
Bill Cook
Bill,
Thanks for your comment. You are absolutely correct, there is now mandatory fraud language that imust be included in Florida Proof of Loss forms.
Specifically as of October 1, 2008, Florida Statute 626.8797 became effective and states:
626.8797 Proof of loss; fraud statement.--All proof of loss statements must prominently display the following statement: "Pursuant to s. 817.234, Florida Statutes, any person who, with the intent to injure, defraud, or deceive any insurer or insured, prepares, presents, or causes to be presented a proof of loss or estimate of cost or repair of damaged property in support of a claim under an insurance policy knowing that the proof of loss or estimate of claim or repairs contains any false, incomplete, or misleading information concerning any fact or thing material to the claim commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084, Florida Statutes."
The purpose of this series, and the sample Proof of Loss which I posted, is to give a general overview of the requirements. It is not intended to be state specific.
I appreciate you bringing this to my attention, however, as I know that many of our readers are in Florida and this language is applicable to their forms.
Gary,
The Policy amount at the time of loss may be the amount under Coverage A, Coverage, B, or both. It depends on what you are claiming and what Coverage is applicable.
As to the Actual Cash Value question, I will refer you to Michelle Claverol's series on valuation. She is currently explaining many of these issues in her posts.
Corey,
As most of Chip's posts suggest, clients should seek the use of counsel or a public adjuster in completing the POL. Doing so will go a long way to make sure the form is correctly and adequately filled out.
Bill
Bill,
I couldn't have said it better myself. While the form may seem pretty straight forward, the nuances behind these obligations can be extremely tricky and a small mistake can cause enormous problems with a claim.
I hope that this series will help give a general understanding of the Proof of Loss Requirement as well as show why people should have quality representation to make sure things go well.
My insurance company asked me to fill out the proof of loss form and requested my husband and I both's notary in the same form. However, the form only has enough space for one notary and I am the one who is making the claim (My husband lives in oversea). So I did the notary in the States and send it to the insurance company, and my husband did the notary at the US embassy oversea. Both notary have the same information although it is in a two forms that has the exact info. My question is: Is it neccessary for both insuerers to fill out the form or do you think the insurance company is trying to delay the process?
Thank you,
Carrie
My insurrance co. filled out my proof of loss form and I signed it (like a dummy) they faxed it to my husband and he signed it. Is this legal or just plain wrong. On the part where you list your loss they put see attached and they attached the list I gave them of damaged or stolen