Recently, it seems like I have been privy to a relatively high number of insureds asked by their carrier, following a loss, to submit to an examination under oath (commonly referred to as an EUO). The most common question I received was, “Can I just choose not to answer or attend?” Although the choice is ultimately the insureds and the ramifications of refusal vary by justification, when dealing with Arizona insureds, I generally advise against such blanket refusals.
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Public adjuster and policyholder advocates often get questions from insureds about the extent that insureds must cooperate with insurers during the investigation stage of a claim. As an example, some insureds have asked me whether they really must produce financial documents and receipts in a theft claim. Insureds often ask why the insurer is making their lives so difficult during the investigation.

These questions have prompted me to write this blog addressing a clause in most property insurance policies known as the “Cooperation Clause.”


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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 usually “take it or leave it” when it comes to the wording of the provisions. An insured can buy endorsements to the policy, add additional insurance, and change deductibles but the language about the coverage and the explanation of what is excluded is not something an insured can make edits or changes to for the insurance company to consider and make part of the contract.


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The lack of cooperation defense seems to be raised more often than it probably should in first-party property insurance claims. In Florida, and many other states, the insurance carrier has the burden to prove any lack of cooperation by the policyholder in a first-party property insurance claim substantially prejudiced it before any such breach would prevent recovery under the policy.


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At this point in their Hurricane Sandy insurance claims, many in New Jersey are being noticed to sit for an Examination Under Oath (EUO). Many wonder what an EUO is and if it is necessary for them to participate. An EUO is essentially a question and answer session where an attorney for the insurance carrier will ask you questions concerning your property and the loss claimed to that property. Virtually all insurance policies have a clause that requires you to cooperate with the insurance carrier’s investigation of your claim, which includes sitting for an EUO as often as they reasonably require. That begs the question, how do the courts of New Jersey deal with failure to participate in a requested EUO?


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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 an insured out of pursuing a claim; but, more commonly, insurers do not inspect damage enough during claim adjustment and attempt to unwind lackluster claim adjustment inspections with post-denial inspections.

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In my October 13, 2012, blog post, I gave an overview of an ongoing blog topic for me – post-claim / pre-suit insurance policy conditions. In my October 26, 2012, blog post, I gave some insight on compliance with an insurer’s request for examination. In my November 2, 2012, blog post, I gave some insight on proofs of loss. Today’s topic is the paper cut – the insurance company’s myriad document requests.

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Most – if not all — insurance policies contain a cooperation provision stating that a policyholder must cooperate when making an insurance claim. I have often found that insurance companies like to argue that they cannot properly evaluate the damages because a policyholder has violated the policy by not cooperating during the investigation. In fact, I am currently responding to that very claim in a case where the policyholder has allowed the carrier access to its property more than 50 times! So that got me thinking, under Texas law, what does it mean to cooperate with respect to insurance claim investigations?


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