While the timeframe to file a legal action is generally defined under the Statute of Limitations, in some states an insurance policy can contractually establish a shorter period to file a legal action. In a recent California case, Keller v. Federal Insurance Company,1 the Ninth Circuit upheld a Legal Action Against Us clause, finding the … Continue Reading
In Florida, an insurer’s denial of coverage constitutes a waiver of its right to require an insured to comply with policy conditions before filing suit.1 But, what if insured requests an insurer to reconsider its coverage denial before filing suit? Does the request to reconsider nullify the insurer’s previous denial of coverage requiring the insured … Continue Reading
The purpose of a sworn proof of loss is to enable the insurer to properly investigate the circumstances of a loss while the occurrence is fresh in the minds of the witnesses, to prevent fraud, and to enable it to form an intelligent estimate of its rights and liabilities so it may adequately prepare to … Continue Reading
This blog has often discussed the importance of carefully reading your insurance policy. It is imperative to know of your rights should your insurance claim become problematic. It is crucial to know the policy’s suit limitation clause as well as your state’s statute of limitations, so you don’t miss the filing deadline. Once this period … Continue Reading
Insurers on occasion deny coverage or make claim decisions based on one ground, and then later, during litigation, seek to avoid liability based upon an entirely new defense theory. Although coverage decision letters regularly throw in boilerplate language seeking to avoid waiving coverage defenses, I was recently asked whether an insurer can deny coverage or … Continue Reading
Your first reaction to the question in the heading of this article might be an easy and obvious “Yes.” But you might want to reconsider after reading a recent case from Florida’s Fourth District Court of Appeal.1… Continue Reading
When submitting a claim to an insurance company, a policyholder has certain obligations that must be followed. The insurance policy contract lists the obligations. The policy document was written by the insurance company and approved (most of the time) by the insurance regulatory agency for the state where the property is located. Insurance contracts are … Continue Reading
Florida’s 4th District Court of Appeals (“4th DCA”), recently issued an opinion relating to compliance with post-loss duties in a property insurance case.1 The issue centered on whether the policyholder breached their duties under the insurance contract by not timely submitting a sworn proof of loss. The trial court decided that the policyholder could not … Continue Reading
If an insured fails to provide prompt notice of its property loss, it can often be grounds for denial of coverage. Most policies have a provision that notice be given promptly, immediately, or as soon as practicable. The question then becomes what is “prompt notice”? In PDQ Coolidge Formad, LLC v. Landmark American Insurance Company,1 … Continue Reading
Many moons ago (on October 26, 2012, to be precise), I blogged about compliance with examination conditions. That blog noted conflicting views as to what is required of a policyholder under the policy’s condition for examination under oath (in the property insurance context) or compulsory medical examination (in the health, disability, or long-term care insurance … Continue Reading
Last week, my post, Carolina Coverage – Are All These Documents Really Necessary, highlighted the Chavis case, in which the North Carolina Supreme Court ruled the Plaintiffs were justified as a matter of law in refusing to sign an overly broad release for records. But when it comes to producing documents requested by an insurance … Continue Reading
While working on a case for recovery after hail pummeled a homeowner’s roof, I found a recent case that discussed Texas law regarding Examinations Under Oath (EUO). In this case, the insurer demanded that the EUO be videotaped. When the insured refused to submit to a videotaped EUO, the issue of failing to comply with … Continue Reading
It is not uncommon these days to see an Examination Under Oath (“EUO”) provision (usually by way of endorsement) that reads along these lines: You, an ‘insured’ seeking coverage, must submit to recorded statements and examinations under oath, while not in the presence of any other ‘insured’, and sign the same. Also, your representative, including … Continue Reading
On October 26, 2012, I touched upon Examinations Under Oath (“EUO”). On June 19, 2009, Chip Merlin also touched upon EUOs. This post expounds upon both posts by responding to pointed questions we recently received in response to Chip’s June 19, 2009, post: (1) Why are some people chosen for EUOs? (2) Should I have … Continue Reading
This blog post is an extension of my December 14, 2012, post, which addressed damage mitigation provisions and a couple different ways that carriers try to wield the insured’s mitigation efforts against the insured. Here is some more food for thought.… Continue Reading
Most policies contain a post-loss condition requiring the insured to show the insurer damaged property “as often as [the insurer] reasonably require[s].” It is rare to find a policyholder bothered by the fact that an insurance company over-inspected damages during claim adjustment. Sure, sometimes insurers request one inspection after another in an effort to exhaust … Continue Reading
In my October 13, 2012, post, I gave an overview of an ongoing blog topic for me – post-claim / pre-suit insurance policy conditions. In my October 26, 2012, post, I gave some insight on compliance with an insurer’s request for examination. In my November 2, 2012, post, I wrote about proofs of loss. November … Continue Reading
In my October 13, 2012, blog post, I gave an overview of what will be an ongoing blog topic – post-claim / pre-suit insurance policy conditions. Today’s topic is compliance with examination requests. It is clear from the case law that examination policy conditions (e.g., Examination Under Oath (“EUO”) and Compulsory Medical Examination (“CME”) policy … Continue Reading
Did you, (the policyholder or the public adjuster), in the wake of a loss and in the midst of an insurance claim, feel like all but the insured’s firstborn child had to be pledged to the insurance company in order to receive the coverage the valuable premium was supposed to afford? If so, I promise … Continue Reading
A case issued yesterday shows when late notice is simply far too late. The policyholders lost in Kramer v. State Farm Florida Insurance Company,1 because they had no proof that the insurer was not prejudiced by the late notice of the loss. There should be an asterisk to this post because the lesson is that if … Continue Reading
According to a recent Florida appellate court, it has. What a great description of the strategic basis for the increasing litigation in Florida regarding compliance with examinations under oath. Attorneys, adjusters and others involved in the first-party property insurance claims industry are likely aware of the tactics some insurers use to pull the rug out … Continue Reading
During litigation, whether insureds complied with their duties to submit to requested Examinations Under Oath (EUO) can become a major issue. One way to combat an insurer’s accusation of non compliance is to research the actual “request” and determine whether it was sufficient. The sufficiency of the request will depend on the exact language in … Continue Reading
Over the last few years, I noticed a growing trend among my California clients. More insured clients who suffered a property loss are finding that they need to retain attorneys at an earlier stage in the claims process. Instead of seeking the advice of an attorney after their claims are denied, they need the help … Continue Reading
A few weeks back in Insurer Post-Loss Obligations and Appraisal – The Other Side of Romay, I wrote about compliance with post-loss obligations as preconditions to a demand for appraisal under a property insurance policy in Florida. In 200 Leslie Condo. Ass’n, Inc. v. QBE Ins. Corp., No. 10-61984, 2011 WL 2470344 (S.D. Fla. June … Continue Reading
