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).
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.
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?
On Wednesday, Florida’s Third District Court of Appeal issued an opinion affirming a trial court’s order compelling appraisal of a homeowners’ supplemental Hurricane Katrina claim.1 The insureds, the Cardelles, had filed claims with State Farm after Hurricanes Katrina and Wilma in 2005. After each hurricane the insureds reported property damage to State Farm. They obtained estimates from a contractor and their public adjuster and submitted sworn proofs of loss for each claim.
When a loss occurs, policyholders must always be mindful of their property insurance policy’s section titled “Duties after Loss.” A policyholder is required to perform specific duties after a loss and failure to meet the obligations may jeopardize a claim.
In a case recently decided in Texas, the insurance carrier prevailed against the policyholder when the appellate court found that the policyholder failed to adhere to its post-loss duties under a homeowner’s insurance policy.1 This blog entry examines the facts and holdings in the hope policyholders and professionals assisting them can avoid facing a similar situation.
In my last few posts, wrote about policyholders’ obligations and duties in notifying insurance carriers of a loss and the proof of loss obligations. I focused on New York in particular. What about the duties of insurance carriers once they are notified of a loss by a policyholder? I have heard people say insurance carriers have no duties after a loss. This cannot be farther from the truth. Let’s find out why…
Most policies contain language along these lines:
In case of a loss to covered property, you must see that the following are done: …
f. As often as we reasonably require: …
(3) Submit to examination under oath, while not in the presence of any other ‘insured,’ and sign the same.
A few of my previous posts in this blog series have squarely addressed or touched upon Examinations Under Oath (EUO). This post gets a bit more particular, focusing on the “while not in the presence” and “sign the same” language.
My previous seventeen posts in this blog series have discussed what you are required (or not required) to do under various post-loss / pre-suit insurance policy conditions. This post discusses the extent of “you.” Is “you” just you, or does “you” include your spouse, your family members, your public adjuster, and others? Who is “you” largely depends on the language of the insurance contract.
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?