Notice of Loss

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As the effects vary from state to state, it is important to be aware of what can happen if there is a delay in providing a proof of loss or notice to a carrier in an insurance claim. Some states are more lenient and follow the notice-prejudice rule.1 “The notice-prejudice rule requires that the insurance company can assert late notice as a defense to overage only if the late notice has caused actual prejudice to the insurer.”2 Some states, on the other hand, are much stricter on complying with any deadlines for notice or proof of loss. What can happen in Arkansas if a proof of loss is late?…

Continue Reading Late Proof of Loss in Arkansas

Insurance companies always seem to be at the ready with quite a few defenses up their sleeves, including – the technical defense of late notice. The traditional notice rule did not require the insurance company to show there was prejudice, it was simply enough for them to show the notice was untimely. Thankfully, many states now require the insurance company to show that the late notice was actually prejudicial to the investigation of the claim.…

Continue Reading Late Notice in Mississippi

Is it advisable to make a claim against the other person’s insurance carrier rather than your own insurance company? Maybe. But there is one big warning—you have a duty to notify your own carrier as soon as the loss happens. If you fail to promptly notify your insurance company of the loss, you may jeopardize your right to collect under your own policy. Notifying your own insurance carrier as soon as you have a loss is the safest way to protect yourself—even if you eventually collect everything from the responsible party’s insurance company.
Continue Reading My Property Damage Was Caused By a Third Party—Should I Wait to Notify My Own Carrier of the Loss Until I Collect From the Other Party’s Insurance?

Late notice of loss lead to denials in Florida at a very high rate. Insurers claim that they are prejudiced and that a presumption of prejudice arises from late notice. A federal trial court has questioned older legal authority about whether a presumption exists and whether the insurer bears the burden to prove prejudice based on policy language.1…
Continue Reading Is Your Denial Based on Late Notice of Loss—Who Has To Prove Prejudice?

Many insurance companies adjusting hail damage claims have a checklist of items that each adjuster must answer before payment of a claim. One of the items at the top of the list is whether there have been any prior hailstorms at the loss location. From a policyholder’s perspective, most do not go onto a roof nor call a roofer unless a leak occurs or there is obvious damage.
Continue Reading Hail Damage?—Not From This Hailstorm

With cold temperatures gripping my home State of New Jersey, my mind (and research) brings me to warmer locations. In a recent case,1 a federal court in Georgia held that an insured’s 11-month delay in filing a claim after a loss was not justified and provided the insurer with a reasonable ground to deny the claim.
Continue Reading Is Eleven Months Too Long a Delay in Filing a Claim with an Insurer After a Loss?

The International Roofing Expo in Las Vegas finished on Thursday. Roofers were asking me all kinds of questions. For example, they asked why insurance company pricing can be so low, could insurance companies ask for releases from their customers if the insurance company gave up its right to repair, and what they could do about mortgage companies holding onto their money after repairs were complete. The most controversial question was why Florida public adjusters supported Florida legislation that restricted roofers from being able to solicit business. I will let public adjuster leaders from FAPIA answer the last question.
Continue Reading A Question For Roofers and Public Adjusters—Should insurers deny claims for hail or windstorm damage if the damage is not discovered and reported within 6 months of the storm? Should insurers be able to prohibit lawsuits on this basis?

Last week the United States District Court for the Southern District of Indiana granted Travelers Indemnity Company’s Motion for Summary Judgment allowing them to dodge hail damage claims made by policyholder Mapleton at Countryside Condominium Association Inc. (“Mapleton”).1 Mapleton brought suit against Travelers for breach of contract and bad faith following two hailstorms impacting their buildings in June 2016 and April 2017. The hailstorms caused damage to the condominium’s siding estimated at $2.58 million.
Continue Reading Court Finds Hailstorm Claims Made “Unreasonably Late”

Defendant Insureds, Lonergan Law Firm, PLLC, et al. (“Lonergan”), recently appealed to the Fifth Circuit Court of Appeals a Northern District of Texas ruling against it, which found it failed to meet a material condition of the policy by not sending its Notice of Claim (“Notice”) to the Claims Department. Landmark American Insurance Co. (“Landmark”) filed suit against its insureds seeking to avoid liability for coverage by arguing that, even though it received notice via a Claim Supplement during the policy period, the insureds failed to send the notice to the location mandated by the Policy.1…
Continue Reading Notice of Claim: Precatory “Please” Does Not a Mandatory “Shall” Make