Delayed Notice: A Lesson in What to Avoid When Seeking Payment of a Homeowners Insurance Claim

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

When your home is damaged or destroyed by a hurricane, fire or other hazard, you will typically rely on your homeowner’s insurance to cover the loss.  However, insurance companies are adept at offering justifications for delaying or denying coverage or underpaying claims.  This means that policyholders need to have a clear grasp of the terms, exclusions, limitations, conditions and restrictions imposed by their policy. 

Generally, homeowners policies will include a requirement that an insured provide immediate notice of loss or a sworn proof of loss within a designated period.  Typically, a Florida homeowner will need to provide a sworn proof of loss within sixty days of the loss under the terms of their policy.  When an insured fails to comply with this pre-requisite for paying a claim, the consequences can be devastating.  A recent Florida 17th Circuit Court opinion, Hunt vs. State Farm, provides an example of critical mistakes homeowners seeking coverage should avoid when it comes to providing notice of a loss.

The Hunts’ home was damaged by Hurricane Wilma, but they did not notify State Farm of the loss until almost five years later.  The policyholders finally provided notice days before filing suit for breach of contract.  The trial court granted summary judgment in favor of State Farm because the Hunts failed to submit a timely proof of loss as required by their policy. 

The appellate court began its analysis by indicating that it is well settled in Florida that providing a sworn proof of loss as indicated in a policy is a condition precedent to coverage.  This means that the obligation to pay the claim never arises until the proof of loss is submitted to the insurance carrier.  When the insured files a breach of contract lawsuit without preparing and submitting a sworn proof of loss, the policyholder may be considered to have committed a material breach of contract, so the insurer has no duty to pay the claim.  When the sworn proof of loss is not submitted in a timely manner but is submitted prior to filing a lawsuit, there is a presumption that the insurer has suffered prejudice.  The insured then has a duty to provide evidence rebutting the presumption of prejudice by the insurer.

In the Hunts case, the court observed that the policyholders provided no evidence to rebut this presumption.  There are different way to establish no prejudice was suffered, including inspections and estimates obtained at the time the damage was incurred, expert testimony and other forms of evidence.  The most important lesson to be garnered from this case is that you should immediately notify your insurance carrier of a loss and provide a timely proof of loss within the timeframe indicated in your policy.  If you need advice or guidance in preparing a proper proof of loss, you might want to obtain professional assistance from an experience Miami insurance claims attorney.

If you have failed to provide notice or a proof of loss in a timely fashion, you will need legal assistance from professionals in insurance claims who can help you develop evidence to rebut the presumption of prejudice.  The insurance company has the advantage in this situation, so policyholders should never try to pursue a breach of contract lawsuit under these circumstances without an experienced Florida insurance dispute attorney in their corner.

If you have questions about your Florida property damage claim, we are here to help.  My law firm represents policyholders in claims disputes in Miami and throughout Florida.  The Law Firm of J.P. Gonzalez-Sirgo, P.A. offers free consultations and case evaluations.  No Recovery, No Lawyer Fees.  Call 305-461-1095 or Toll Free 1-866-71-CLAIM.

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