- Failing to timely report your loss.
- What is timely reporting? Insurance policies do not give a specific time period to report a loss. However, case law provides a standard as to whether notice of a loss was given promptly to your insurance company. “’Prompt’ is undefined in the policy. It is well settled, however, that ‘prompt’ and other comparable phrases, like ‘immediate’ and ‘as soon as practicable,’ do not require instantaneous notice.” Cont’l Cas. Co. v. Shoffstall, 198 So.2d 654, 656 (Fla. 2d DCA 1967). Instead, Florida courts have interpreted these phrases to mean that notice should be provided “with reasonable dispatch and within a reasonable time in view of all of the facts and circumstances of the particular case.” Yacht Club on the Intracoastal Condo. Ass’n, Inc. v. Lexington Ins. Co., 599 Fed.Appx. 875, 879 (11th Cir.2015) (citation omitted). “Notice is necessary when there has been an occurrence that should lead a reasonable and prudent [person] to believe that a claim for damages would arise.” Waldrep, 400 So.2d at 785. Thus, the issue of whether an insured provided “prompt” notice generally presents an issue of fact. LoBello, 152 So.3d at 600. So, in summary, whether a claim has been timely reported is an issue of fact that must be determined by a court taking into consideration all of the circumstances the insured encountered during the loss occurrence, and would they be sufficient to make a reasonable and prudent person in the insured’s shoes believe they have a claim for damages under their policy. If so, they should have reported the loss around that time and if not they did not need to report anything at that time.
- Even if it is determined to be untimely then this only creates a presumption that the insurance company has been prejudiced, which is rebuttable by the insured. [T]he proper interpretation of the effect of prejudice in delayed notice cases was that while prejudice to the insurer is presumed, if the insured can demonstrate that the insurer has not been prejudiced thereby, then the insurer will not be relieved of liability merely by a showing that notice was not given “as soon as practicable.”
Tiedtke v. Fidelity & Cas. Co. of N.Y., 222 So. 2d 206, 209 (Fla. 1969) (emphasis added). This too is a question of fact that must be determined by a court weighing how any delay in claim reporting has in fact caused harm to the insurer.
- Failing to mitigate or prevent further damage after the loss.
- An insured has a duty under their policy to protect their home from further damage after they become aware of a loss. Example: failing to cover your roof to prevent future rain from entering via hurricane created openings in your roof.
- Failing to disclose information on your property insurance application.
- An insured has obligation to be truthful and candid in their property insurance application so that the insurance company has a fair opportunity to evaluate the risk of loss and risk of incurring a claim on the insured property. This includes being allowed to limit liability to only future damage that occurs from a covered peril after the policy has been bound. Example: failing to disclose prior claims or pre-existing damage on your application can negate an insurance company’s liability on a future claim.
- Failing to cooperate with the claim investigation.
- Policies are often written obligating the insured to cooperate with the insurance company’s investigation of a claim or risk the insurer not being held liable by a court to pay for the claimed damages. Example: This includes things like failing to allow an insurance company adjuster to inspect your home upon request or failing to perform an examination under oath requested by your insurance company.
- Failing to provide documentation or a sworn proof of loss when requested
- Insurance company adjusters will frequently request numerous documents to investigate the loss and damages being claimed requiring the insured to search for and provide documents and information. Example: Insurance carriers often have a contractual right to request a sworn proof of loss document detailing the dollar amount of your claimed damages and sworn to by you in front of a notary.
If you have questions or concerns, at Watson Et Barnard Law we can handle your Hurricane claim from beginning to end. We explain the claims process to you, what to expect, and how to avoid things that could impact your ability to get paid on your claim. Give us a call or send us a message to put our expertise to work for you in getting the money you need to restore your home to its pre-loss condition. Remember we only get paid if you get paid on your claim.
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