Proof of Loss

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A recent case1 shows that every technical step regarding proof of loss requirements in the flood claims process has to be followed, even if the steps are meaningless. Federal law regarding flood claims is draconian. It is the worst law against policyholders. Attempts at legal reform of the claims processes have fallen on deaf ears. It is a “heads I win, tails you lose” situation if a flood policyholder challenges any claims decision.
Continue Reading Federal Flood Claim—File a Timely Proof of Loss Even If Claim Denied

Federal common law interpreting the rules and regulations of the National Flood Program is usually not helpful to policyholders. It has truly become a situation where technical, literal rules are followed to the letter of the law rather than any intent or spirit for why the rule was written. In this “form over substance” common law, which federal judges feel compelled to follow, an important lesson is to follow those rules in an exacting manner or risk losing insurance benefits. One recent case held that an attorney at law, while acting with authority for the client, cannot sign the proof of loss form for the policyholder client.1…
Continue Reading Policyholders and Not Their Attorneys Need to Sign Flood Proof of Loss Forms

One of the basic duties which public adjusters are supposed to accomplish for their policyholder clients is to evaluate the amount of damage and properly file a proof of loss if one is required. I was thinking about this while reading a fairly recent Florida case1 where a public adjuster failed to file a proof of loss on behalf of the policyholder despite the insurance company demanding one in writing. This failure to file a proof of loss cost the policyholder an otherwise valid claim.
Continue Reading Public Adjusters Owe a Duty to Properly Comply with Proof of Loss Requirements

In a Puerto Rico Hurricane Michael case involving a Zurich Insurance Company providing a policy to a Louisiana policyholder, an alleged delayed payment resulted in attorneys for Zurich arguing that they could delay owed payments for various excuses. The first issue was what a proof of loss meant under Louisiana law.
Continue Reading Proof Of Loss is Different Under Louisiana Law—Should You Be Insured by a Slow and Underpaying Insurance Company?

After having suffered a dish washer leak to their home, policyholders submitted a claim to their insurance company. The insurance company sent the policyholders a Reservation of Rights letter requesting a signed, sworn proof of loss within 60 days. The homeowners failed to meet this deadline and submitted their sworn proof of loss after the insurance company filed a complaint for declaratory judgment and material breach. The trial court entered a final summary judgment for the insurance company based upon the failure of the insureds to comply with their obligation to provide a sworn proof of loss, and the policyholders appealed.1…
Continue Reading Late Filed Proof of Loss – Does Delay Result in Denial?

In the many catastrophes in which we have educated and assisted policyholders in understanding their rights, obligations, and benefits under their policies, we have never seen or heard of insurer non-response like we have in Louisiana after Hurricanes Laura and Delta.
Continue Reading Louisiana Policyholders Have a Right to Obtain a Complete Copy of Their Policy

Last October we pointed out the alarming number of Louisiana insurers adding to the grief of Hurricane Laura insureds by requesting Proofs of Loss within 60 days and repairs to be completed within 180 days in order to receive replacement cost benefits under their policies. We also sent correspondence to Louisiana’s Insurance Commissioner, James J. Donelon, requesting an Advisory Letter be sent to Louisiana insurers reminding them of Louisiana’s statutory extensions for Proofs of Loss and Replacement Cost Coverage deadlines. On February 11, 2021 Louisiana’s Insurance Commissioner issued Bulletin 2021-02:1…
Continue Reading Louisiana Insurance Commissioner Issues Bulletin on Statutory Extensions for Proof Of Loss And Replacement Cost Coverage Deadlines

My Red Bank colleague, Dan Ballard, and I recently gave a presentation about Misrepresentations & Mistakes at the 2020 Fall Conference of the Professional Public Adjusters Association of New Jersey (PPAANJ). During that presentation, I discussed New York case law providing that a homeowners insurance policy may be voided if the insured willfully and fraudulently places in the proof of loss a statement of property lost which the insured did not possess, or places a false and fraudulent value upon the articles which the insured did not own.
Continue Reading Incorrect Information Within Proof of Loss Not Enough To Void Insurance Policy

Hurricane and Tropical Storm Eta has left a flood claims hangover from Florida throughout the Carolinas. Since the National Flood Insurance program administrators appear to be stingy and failing to watch out for their fellow Americans by not granting flood proof of loss extensions, policyholders need to get started properly filing their claims right away.
Continue Reading Storm Eta Leaves a Flood Claim Hangover and Do Not Forget Lake Charles — Tune In For Friday at 2 PM