Over the last twelve weeks I have covered many of the issues regarding Proofs of Loss, and I wanted to end the series by covering some of the common mistakes and thoughts for avoiding them.
First, I cannot stress enough how important it is to read and understand the rights and duties under each individual policy. Some policies may only require a Proof be submitted after an insurer demands it, while others may require the Proof to be submitted within a certain time after the loss occurs, even without being requested to do so. If you do not read and understand the policy provisions, a Proof may not be submitted on time or in accordance with the obligations outlined in the policy and could delay recovery.
Also, it is important to know and understand the laws of your particular jurisdiction. While the policy provisions may be clear as to what the obligations of each party might be, the laws of each jurisdiction generally supersede the policy language. If, for instance, a policy requires the Proof to be submitted within 30 days of an insurer’s demand but a state statute provides that a Proof must be submitted within 60 days, the state statute will control. Keep in mind that normally an insurer may not limit the timeframe for submitting a Proof of Loss more than is outlined in the jurisdiction’s statutes, however, they are free to extend that timeframe. Thus, in the example above, if the policy allowed 90 days for submission, the policyholder would be able to take advantage of the extra 30 days afforded by the policy.
Next, if the Proof cannot be filled out within the timeframe requested by the insurer, the insured should not hesitate to ask for an extension. Sometimes estimates have not been fully completed or the damage has not been fully realized, therefore obtaining extensions may be the only way for the correct information to be submitted in the Proof.
It is also important for the policyholder to communicate with the insurer and confirm any verbal conversations in writing. Having a written communication will cut down on the “he said, she said,” which can occur later in the claim if issues about a waiver or extension come up.
As with many other aspects of insurance claims, the details are important. Many times, the insured fails to sign and/or notarize the Proof and .by doing so. may provide the insurer an opportunity to reject it. Each time a Proof of Loss is submitted, make sure that these technical requirements are fulfilled in order to move the claim along.
When an insurer requests a Proof of Loss, a policyholder should seriously consider retaining professional representation if they have not already done so. Insurance claims are not a normal part of most people’s life, and small mistakes may cause large problems in the future. By seeking help from a licensed public adjuster or attorney early in the process, mistakes can be avoided and an amicable resolution can come more quickly.