Post-Loss Duties

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One question I get asked by clients after a storm has damaged their home is: “Can I start making repairs?” This can be a difficult question as the real-world factors of cost, time, availability of materials, and labor are important considerations. It is also important to understand how repairs can affect your insurance claim as most residential insurance policies I deal with include what appear to be contradicting duties to mitigate and the duty to allow the insurance company to inspect.…
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In Florida, if an insured fails to meet a post-loss obligation, is it a complete bar to recovery? In a recent decision, the Third District Court of Appeal certified conflict with the Fourth District Court of Appeal and held that an insurer must be prejudiced by the insured’s non-compliance with a post-loss obligation in order for the insured to forfeit coverage.…
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When personal contents or business personal property are damaged or lost in a covered event, most policies require the policyholder to provide an inventory of the damaged or lost items to the carrier. But often, the carrier and the policyholder clash on the level of specificity required and whether the policyholder has submitted adequate proof of ownership or even the pre-loss existence of the listed items.…
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It is no secret that insurance policies are confusing: they are long – often 40 or more pages – and contain vague language that can be unclear and difficult to understand, even for the most educated people.

After large scale natural disasters like Hurricane Harvey, insurance companies and their adjusters frequently rely on vague and confusing insurance policy language to support their improper denial or underpayment of claims. This is a source of great confusion and frustration to people who have already gone through the devastation of a disaster.…
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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 to comply with policy conditions never initially invoked or requested?…
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I suppose a lot of professions are cyclical. In my 25 years if practice I have sometimes found that I will go years without getting certain types of cases and then I will get two or three all at once. Lately, I have been asked to look at cases where the carrier is claiming that the policyholder breached post-loss duties under the policy (other than prompt notice). The argument is that the policyholder has failed to cooperate with the carrier’s investigation of the claim.1 Mainly the policyholders are accused of not submitting to an examination under oath (EUO).

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Some losses are not as readily apparent to policyholders as a fire or significant water loss. The policyholder may not discover the damage until days, weeks or months after the loss occurred. This can often be the case for hail losses to roofs. However, when the policyholder gives notice weeks or months after the loss, the insurance carrier will often claim late notice and rely on the notice condition in the insurance policy to deny coverage.

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As attorneys for first-party property claims, we must vet through claims to see if we can be “The Policyholder’s Advocate” on any case. Some of the initial questions I ask a potential client are: 1) When was the date of loss? 2) When did you notify the carrier? 3) How and when did you notify the carrier of the amount of damages you are seeking? 4) Does your policy have a provision limiting the time for you to file a lawsuit?

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