What Constitutes a Sufficient Proof of Loss When Making a Claim for Flood Damage?

J.P. Gonzalez-Sirgo
Founder of J.P. Gonzalez-Sirgo, P.A.

While homeowner's insurance or flood insurance can provide valuable financial protection in the event of a storm, policyholders need to be careful when complying with the terms of their policy.  Most policies require policyholders to provide a proof of loss with supporting documentation.  Insurance companies often dispute the sufficiency of the information or documentation provided.  This tactic can justify denial of the claim based on the insured’s failure to comply with the policy terms in providing a proof of loss. 

A federal case provides an example of the level of scrutiny that may be focused on the proofs of loss provided by policyholders under the Standard Flood Insurance Policy (SFIP).  In the case of Young v. Imperial Fire and Casualty Insurance Company, the policyholder initially submitted a proof of loss for the policy limit of $175,100 minus the deductible.  The policyholder did not provide values for depreciation, actual cash value or the cost of repair or replacement.  The proof of loss indicated that these items were undetermined.

After the policyholder hired a public adjuster, the adjuster submitted a revised estimate of the flood-related damages that indicated a total of $260,635, which was intended to supplement the policyholder’s proof of loss.  Eventually the adjuster sent a revised proof of loss that indicated the cost of repair or replacement was $260,235, but the proof of loss also indicated that the value of depreciation and actual cash value remained undetermined.  The proof of loss submitted by the adjuster included documents substantiating the value.  A final proof of loss was subsequently submitted by the adjuster with substantially the same information as the 2nd proof of loss but without the supporting documents.

The policyholder sued the insurer after rejection of their proofs of loss.  The insurance company sought summary judgment based on the failure of the insured to submit a timely proof loss that met the terms of the Standard Flood Insurance Policy.  The judge rejected the claim of the insurance company and indicated that the proof of loss forms, public adjuster estimate, and supporting documentation was sufficient to comply with the proof of loss requirement.

In this case, the insured essentially submitted 3 proofs of loss, the public adjuster's estimate and supporting documents only to have the insurance company indicate that this did not constitute a sufficient proof of loss.  This case demonstrates the extent that insurance companies that participate in the National Flood Insurance Program will go to when trying to justify not paying a claim.  If you are having challenges getting your flood damage insurance claim paid, you might want to seek the advice of an experienced flood damage insurance attorney.

You can reach Miami Flood Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

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