Dallas Fort Worth Insurance Lawyer Blog
Dallas insurance attorneys must know that when a person makes a claim for coverage under his own insurance policy, that the person has a duty to co-operate with the insurance company in their investigation of the claim.
The insured is required by the policy to co-operate with the insurance company investigation by submitting the claim promptly, completing claim forms, providing access to damaged property and records, and signing sworn proofs of loss. As stated by the United States 5th Circuit Court of Appeals in the 1999 case, Griggs v. State Farm Lloyds, these requirements on the insured constitute a condition precedent to coverage under a policy of insurance. This means the insurance company has no duty to provide benefits under the policy until this co-operation has been given.
A typical homeowners policy would provide for these requirements:
1) give prompt written notice to the insurance company of the facts relating to the claim;
2) notify the police in case of loss by theft;
3) protect the property from further damage;
4) make reasonable and necessary repairs to protect the property;
5) keep an accurate record of repair expenses;
6) furnish a complete inventory of damaged personal property showing the quality, description, and amount of loss. Attach all bills, receipts and related documents which you have that justify the figures in the inventory;
7) as often as is reasonable required;
(a) provide the insurance company access to the damaged property;
(b) provide the insurance company with pertinent records and documents requested and permit the making of copies;
(c) submit to an examination under oath and sign and swear to it;
8) send, if requested, your signed sworn proof of loss within 92 days of being requested on a standard form supplied by the insurance company. The insurance company must request the signed sworn proof of loss within 15 days after receiving written notice, or that right is waived. But such waiver will not waive other rights under the policy;
(a) the proof of loss shall state, to the best of your knowledge and belief;
(i) the time and cause of loss;
(ii) the interest of the insured and all others in the property involved including liens on the property;
(iii) other insurance which may cover the loss; and
(iv) the actual cash value of each item of property and the amount of loss to each item;
(b) If you elect to make a claim under the Replacement Cost Coverage of the policy, this proof of loss shall also state to the best of your knowledge and belief;
(i) the replacement cost of the described dwelling;
(ii) the replacement cost of any other building on which the loss is claimed, and;
(iv) the full cost of repair or replacement of loss without deduction for depreciation.
An important note here — When or if an insurance company asks for and examination under oath — that is a red flag that the company is fixing to deny your claim and is looking to get further information in order to justify the denial. It is vital that an experienced insurance law attorney be involved if you are being asked to submit to an examination under oath.