Examinations under oath are important to recovery. Reasonable production of relevant documents that are part of a cooperative investigation is important as well. Failure to provide an examination under oath and documents is a one-way street to help an insurer deny recovery.
Continue Reading Failure to Provide an Examination Under Oath and Documents Can Result in Lost Benefits

Almost all property insurance policies require that the insured “assist and cooperate” in an insurer’s investigation. If an insured fails to “cooperate,” an insurer may have the right to deny a claim. However, the insurer cannot demand that an insured cooperate with every request. This blog discusses what requests you should ensure an insured cooperates with, what lack of cooperation may be grounds for a denial, and how to manage an insurer’s overbroad and unreasonable request. Most of the principles here are not unique to California and can serve as a general guide almost everywhere else.
Continue Reading What Constitutes Cooperation with an Insurer’s Claim Investigation in California – Ensuring Compliance and Avoiding Unnecessary Harassment

“Please do this, tell us that and please send us these documents.” Every day I hear this from potential clients, public adjusters representing policyholders, and restoration contractors asking what they have to do and provide. I often end up litigating the same issues in court. Insurance companies often leave the “please” out of the never-ending letters they send following a loss demanding information before paying money. Many insurance company adjusters seem a lot more allegedly concerned about thoroughly investigating a loss than they do about providing prompt payment.
Continue Reading California Policyholders Need to Cooperate with Their Insurers Following a Property Loss. What Does That Mean?

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.

Continue Reading An Insured’s Duty to Cooperate in Pennsylvania