When your home is devastated by a severe windstorm, fire or some other peril, homeowner’s coverage provides the best means for securing necessary repairs.  While homeowner’s coverage can provide the basis to have your home rebuilt and your personal items inside the home replaced, there are prerequisites that must be fulfilled to ensure payment of your claim. 

The requirement that you provide your insurance carrier with a sworn proof of loss is one of the most important conditions imposed on property owners asserting a claim under their homeowner’s policy.  Failure to submit a sworn proof of loss in a timely manner can result in denial of your claim even if it is justified on its merits. 

A recent decision by a Michigan appellate court provides an example of the critical importance of submitting a sworn proof of loss within the designated time.  The policyholder’s home was damaged in a fire, but the insurer denied the claim because the insured failed to submit a sworn proof of loss within sixty days of the fire that damaged the property.  The insured filed a lawsuit for breach of contract after the insurer failed to pay the claim.

The insurer contended that it had no obligation to pay the claim because the sworn statement of proof of loss was not submitted within sixty days of the fire as required under the policy. The insurer also argued that the deadline for submitting the sworn proof of loss could only be extended in writing by the insurer.  The insurer also submitted evidence that the proof of loss was not submitted until many months after the fire even though the insurer had sent the insured a letter warning of the need to submit the form.  The insured testified that the letter was not received and that the insured was unaware of the requirement that the form be submitted within the sixty day deadline.

The trial court ruled in favor of the insurer, and the decision was upheld on appeal.  The appellate court indicated that the insured was obliged to comply with the express provision in the policy even if the warning letter was not received.

The decision provides a reminder that policyholders must carefully read the terms of their policy because they will be held accountable for the terms and conditions even if they are unfamiliar with the policy language.  Depending on state law, failure to submit a sworn proof of loss within the designated deadline will not result in a bar to claims unless the insurer suffers prejudice.  However, many jurisdictions do not impose a prejudice requirement.

Suggestions to Avoid Running Afoul of Proof of Loss Requirements

  • Since the sixty day requirement to submit a sworn proof of loss applies in most jurisdictions, you should not wait for a form to be sent to you by the insurer.
  • Read your policy because Florida courts enforce clear provisions.
  • Proceed cautiously when completing a sworn proof of loss because the document is completed under oath.  Inaccurate information in the proof of loss can provide a basis for denying a claim based on a material misrepresentation.
  • Request an extension, but you should not assume that it has been granted until you have something in writing that indicates the extension has been approved.
  • Retain an experienced insurance claims professional to assist you in preparing the sworn proof of loss.

You can reach Miami 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].

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