Search results for: thirteen part series on examination under oath

Starting next Wednesday, we will start a weekly series regarding examinations under oath which are sometimes called sworn statements under oath.

Continue Reading The Examination Under Oath: A Thirteen Part Series on Everything You Need (and Would Ever Want) to Know About Examinations Under Oath and Sworn Statements Under Oath Given Pursuant to a Property Insurance Claim

(Note: This is the thirteenth of a thirteen part series on examination under oath).

“You know the insurance company is going to cut the estimate in half, so you have to pump it up.”

I can’t tell you how many public adjusters have expounded this philosophy to me. As I tell them all: do not go down that road, as it is a slippery slope. First, if the estimate is significantly higher than the carrier’s evaluation of the claim, SIU (Special Investigative Unit, the fraud division) becomes involved. This will now offer your client the unique opportunity to undergo a fraud investigation. What will this entail? Well, the policyholder is guaranteed to be asked to sit for examination under oath and all of the fun that goes along with that endeavor. So, this begs the question: what may the policyholder expect at the EUO of a suspected inflated claim?

Continue Reading Typical Questions Asked During an Examination or Sworn Statement Under Oath of a Disputed Structural or Personal Property Valuation Claim Suspected of Being Inflated, Exaggerated or Made Up

(Note: This is the tenth of a thirteen part series on examination under oath). 

 “How did I do?” and “What happens next?” are the two predominant questions posed to me after my clients finish examinations under oath. Both are very good questions. In fact, what does happen with the claim after an EUO? What actions should policyholders and public adjusters take after an EUO? First, oftentimes during the examination, information such as the names and numbers of handymen or documentation, like an invoice for a handyman, is brought up for the first time. In that case, the public adjuster’s and policyholder’s task is the same: gather the information or documents and forward to defense counsel immediately! And I can not stress this enough: PAs should consider it one of their primary responsibilities to navigate through the post-loss obligations as quickly as possible. For in order to get a claim paid, invoke appraisal, or file a lawsuit, there must be an adequate exchange of information through the post-loss obligations for the carrier to make an independent assessment of the loss. Hence, wading through the quagmire of post-loss requirements is of utmost importance.

Continue Reading The Examination Under Oath is Over: What Now?

(Note: This Guest Blog is the ninth of a thirteen part series on examination under oath).  

“What should I say to a client before an EUO?”

This question is often posed to me by public adjusters. First, I always tell them to have the policyholder hire an attorney, as I can not stress enough that an examination under oath is a very critical point in the proceedings. Insureds may be easily tripped up by a savvy defense attorney, placing their claim in jeopardy. With that being said, there are several forms of review by which a PA may assist his/her policyholder in preparing for an EUO.

Continue Reading What Public Adjusters Need to Tell Their Clients About Examinations Under Oath and Why Public Adjusters Need to Be Careful About Giving Legal Advice

(Note: This is the eighth of a thirteen part series on examination under oath).  

“I’ve never taken a deposition, what kinds of questions are they going to ask me?”

This is a question posed to me most often by policyholders when they receive that dreaded notice for an examination under oath. As most people have never had the pleasure of sitting under a bare bulb being browbeaten by an overzealous insurance defense attorney, insureds usually have no idea what is in store for them at an EUO. First, as I usually explain EUOs are NOT depositions. As the court distinguished in Goldman vs. State Farm, 660 So2d 300 ( Fla. 4th DCA 1995), depositions are products of law suits, inherently adversarial, while EUOs are part of the policy’s post-loss obligations, where the policyholder has a duty to cooperate and assist the insurer in their investigation and evaluation of the claim. Therefore, as the insured has a duty to cooperate, yet most have never been involved in the EUO process, how should a policyholder prepare for an EUO? 

 

Continue Reading How to Prepare for an Examination or Sworn Statement Under Oath if You are a Policyholder or Public Adjuster

(Note: This Guest Blog is by Robert Reynolds, an attorney with Merlin Law Group in the Coral Gables, Florida, office. This is the seventh of a thirteen part series he is writing on examination under oath). 

Two weeks ago the issue of a policyholder refusing to answer questions was discussed in this blog. Hand-in-hand with that topic is: What if an insured renders an inaccurate answer during an examination under oath? This analysis should begin with the policy language. Every insurance policy I have ever read includes a fraud, misrepresentation, and concealment provision. Fraud is the willful intent to deceive. Misrepresentation is the willful act of presenting knowingly incorrect information. Concealment is the willful act of hiding facts or circumstances. The one common thread to this unholy trinity is that all three acts must be willful. That is, the policyholder must be participating in these acts intentionally. To be clear, over time just about everyone’s memory tends to fade. Hurricane Wilma occurred just over 4 years ago, and I’m quite sure a policyholder misremembering some of the facts of a claim that happened over 4 years ago will not lead to denial.

Continue Reading What is the Impact of a Wrong Answer at an Examination Under Oath? Do all Incorrect Answers Lead to Denial?

(Note: This is the sixth of a thirteen part series he is writing on examination under oath). 

“We are here today for your examination under oath. It is being taken subject to the policy’s terms and conditions to illuminate all facts and circumstances surrounding your claim so the insurer may make an informed decision about your claim.” This is the little speech I would give before taking a policyholder’s examination under oath back in the days when I carried the insurers’ water like Gunga Din. Of course, today I often make light of such statements. That is, it seems like the only reasons insurers demand an EUO are: claim delay, intimidation of the policyholder, and looking for reasons to deny the claim. But where does the truth lie? What are the practical reasons insurers demand an examination under oath?

Continue Reading The Practical Reasons Insurers Take Examinations Under Oath and Why Policyholders Need Representation By Legal Counsel

(Note: This Guest Blog is the fifth of a thirteen part series on examination under oath).

“Do I have to answer that?” Occasionally, one of my clients will turn to me during an examination under oath and query that very question. In turn, 999 times out of a 1000, I answer, “Yes,” or have the questioner clarify a poorly-worded question. The reason I usually counsel clients to answer has several elements, but most importantly: if a fight may be easily avoided and you are conferred no benefit by fighting, why fight? That is, I know if the policyholder refuses to answer a question at EUO, defense counsel will immediately suspect fraud, thinking, “Why else would someone refuse to answer questions unless they were hiding something?” But further, and, more importantly, I know defense counsel’s eyes will start rolling around like a slot machine until they land on DENIAL because they believe they have right to ask anything and the insured has to answer, otherwise the policyholder is violating the policy’s duty to cooperate. Is this true? May defense counsel ask the policyholder literally anything at an examination? Must the insured answer or risk violating the cooperation clause?

Continue Reading Under What Circumstances Can a Policyholder Refuse to Answer a Question at an Examination Under Oath and Not Lose Policy Benefits?

(Note: This Guest Blog is the third of a thirteen part series on examination under oath).

“Sunshine State hereby requests you to submit to an examination under oath which will be held at the residence premises of the insured.” This is a common request to policyholders by Sunshine State. Of course, as a former insurance defense attorney I know that the carrier’s intention is to turn the EUO into a dog and pony show. That is, they will have the policyholder take defense counsel on a guided tour of the damage to the property, and if the policyholder fails to point out any of the covered loss, the carrier will hold that against the policyholder as if it were an intentional act of concealment.

Continue Reading Where Do and Can Examinations Under Oath Be Held? Does a Policyholder Have to go to Timbuktu?

(Note: This Guest Blog is the second of a thirteen part series on examination under oath).

“I don’t want to sit for an examination under oath…” If I had a nickel for every time a client said that to me, I’d probably own my own plane. For policyholders who have never been involved in a deposition or EUO, the proposition of sitting in a room, swearing an oath to tell the truth, and being questioned by an attorney while a court reporter writes down every word can be very daunting. So this begs the question—“Is it possible to avoid an EUO?”

Continue Reading What Happens if A Policyholder Does Not Attend an Examination Under Oath?