An insurance company may have the right to examine its insured under oath in connection with its investigation and evaluation of an insurance claim. Most insurance policies impose an obligation on the insured to cooperate with the post-loss investigation. An insured’s failure or refusal to comply with an obligation to cooperate by submitting to an
Insurance policies impose a duty on insureds to cooperate with the insurer’s investigation of a claim. An insured’s duty to cooperate encompasses the insured’s obligation to appear for an examination under oath (“EUO”), if requested, and to provide documentation verifying the loss. “Cooperation clauses” generally have been held to be material provisions of insurance policies with compliance therewith a condition precedent to coverage.…
Continue Reading Can My Insurance Company Deny My Claim For Failure to Cooperate With Its Investigation?
Colorado passed very pro-consumer legislation stopping insurance companies from overusing the cooperation clause in property insurance policies.1 Denver based Merlin Law Group attorney Jon Bukowski explained that some insurance defense counsel have aggressively used the cooperation clause in property insurance policies as a sword in an attempt to obtain a forfeiture of insurance policy benefits.…
Continue Reading Forfeiture of Benefits For Failure To Cooperate Stopped Under New Colorado Law
After filing a claim, insurance companies will at times request a substantial amount of information, leaving many Coloradans feeling overwhelmed. However, a failure to respond to the requests (aka “failure to cooperate”), could cost an insured their owed insurance claim benefits. Recently the United States District Court, District of Colorado, discussed this issue in its review of a Motion for Summary Judgment in Cribari v. Allstate Fire & Casualty Insurance Company.1 …
Continue Reading Insurance Company Hassles? What Policyholders Need to Know About Insurer Requests For Documents and Information
Most policyholders usually do not know what to expect when they submit a claim to their insurance company. Some simply expect to fill out a claim form, maybe answer a few questions, and then receive a claim check from the insurer compensating them for the loss. Most policyholders are usually taken back when the insurance company asks for copies of their income tax returns, bank statements, bills, and other financial records.…
Continue Reading Do I Really Have To Provide My Insurance Company With My Financial Records After A Loss?
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.…
Continue Reading Refusing to Answer Questions at an EUO is Usually Not A Good Idea
Earlier this week, I was in Austin, Texas, attending a deposition with Chip Merlin on a hail damage claim. Texas is known for their barbeque so we decided to try out The County Line BBQ on Lake Austin. If you are in Austin, I highly recommend it.
This led me to today’s blog topic – a property insurance case involving damage to a barbeque restaurant.
When arguing with an adjuster over the value of your personal property claim, receipts can be an invaluable tool. But who keeps receipts? When dealing with theft or loss of property, you may actually have receipts; however in a total loss situation such as a fire, often the receipts are destroyed along with the property. Without fail, your adjuster will ask for receipts to determine the actual existence of lost property and the value. Under the basic homeowner’s policy, the insured has certain duties that must be complied with after a loss. Included in this is that the insured:
Continue Reading Receipts? Who Keeps Receipts For a Potential Insurance Claim?
Insurance policies have certain provisions that must be complied with in a property insurance claim. These are called duties after loss, and if reasonably requested by the insurer, they must be complied with. Recently, an insurer in New York became involved in litigation over whether the policyholder had shown it the damaged property following a claim.1 The insurer claimed the policyholder failed to show it the damaged property, which affected the insurer’s ability to determine whether there was a loss and the extent of any damages. There are often a couple policy provisions at play in this scenario. There is a duty to mitigate damages and perform necessary repairs as quickly as possible. On the other hand, there is a duty to show the insurer the damaged property.
"Maybe if we think and wish and hope and pray it might come true"
–The Beach Boys
A recent Florida case that involves examinations under oath demonstrates that insurers should cooperate with policyholders and not try to use technicalities to prevent payment. In First Home Ins. Co. v. Fleurimond, 3D09-2034, 2010 WL 2178839 (Fla. 3rd DCA June 2, 2010), policyholders were allegedly yelled at and badgered during an examination under oath. They left, obtained counsel, and the insurer then refused to reconvene the examination under oath. The policyholders filed suit, demanded an appraisal, and the insurer refused. The trial court ruled that the matter should proceed to appraisal, and the insurer appealed.