Homeowners policies usually require policyholders to provide information supporting their claims and the amount of the loss, upon the insurer’s request. This document, referred to as a “proof of loss,” may require the policyholder, to set forth under oath the time and cause of the loss, identification of all who have an interest in the property, all the potential insurance that might be implicated from the loss, changes in title or occupancy during the policy’s term, specifications of damaged buildings and detailed repair estimates, an inventory of damaged personal property, and receipts for expenses incurred as a result of the loss. The information required will depend on the type of loss, damage sustained as a result of the loss, and the particular requirements of the policy.
The purpose of the “proof of loss” is to give the insurance company an adequate opportunity to investigate and to prevent fraud against the insurer before evidence of the loss becomes stale or unavailable. Lee v. Prudential Ins. Co., 812 F.2d 1344, 1346 (11th Cir. 1987).
Unless a policy explicitly states otherwise, the “proof of loss” provision is not automatically triggered in the event of a covered loss. Usually, an insurance company must request the “proof of loss” in order to enforce the provision. If a “proof of loss” is requested, policyholders must comply.
Some courts have reasoned that an insurer can waive its right to request a “proof of loss.” In Laird v. Chicago Insurance Company, Florida’s Third District Court of Appeal found that an insurance company may, by its conduct, waive its right to receive a timely “proof of loss.”
What conduct constitutes waiver?
In Keel v. Independent Life & Accident Insurance Company, the Florida Supreme Court held that an insurer that denies liability under a policy can waive its right to request a “proof of loss.”
Other circumstances may result in the insurer waiving its right to request a “proof of loss.” This blog is focused on Florida law, but every claim is factually unique and each jurisdiction is different.
As such, it is important for policyholders to consult experienced insurance professionals before submitting a “proof of loss” and in determining if they are required to comply with the particular policy provision.
Next week’s blog post will discuss whether a policyholder’s noncompliance with the “proof of loss” provision is a bar to his or her claim.