This is an extensive group of conditions comprising eight sections, that further encompass thirteen subparagraphs. All of these are highly important policy provisions standard to all homeowners policies and merit your attention.
The introductory paragraph to this section states that the insurer has no duty to provide coverage for an otherwise covered loss if the insurer is prejudiced by the failure of the named insured, another insured, or a representative of an insured, to comply with the list of duties that follows.
- Give the insurer or the insurer's agent prompt notice of the loss.
- Notify the police in the event of a theft loss.
- Give the issuer of a credit card, electronic fund transfer card, or access device notice of loss or of unauthorized use of same as required by the provisions of the agreement between the issuer and the insured.
- Protect the property from further damage. If repairs to property are required, the insured must:
- make reasonable and necessary repairs to protect the property and
- keep an accurate account of repair expenses.
- Cooperate with your insurer in its investigation of the claim. This means returning phone calls, and responding to correspondence promptly. If you do not understand what a communication or an information request from your insurer means or why it is important, promptly call the claim representative or your agent and ask for an explanation so that you can provide an appropriate response. Any delay on your part that reflects mere silence in response to an insurer's request for information (in appropriate cases) can be taken as evidence of a failure to cooperate.
- Prepare an inventory of damaged personal property which shows:
- the quantity;
- the description;
- the actual cash value; and,
- the amount of loss of all items for which loss is claimed.
Areas that can be problematic here are where the insured may have extensive collections of books, or audio recordings. Other items, such as furniture that has been passed along through a family with no clear record of the value or acquisition cost, can also be problematic. The valuation issues can be even more difficult - few of us retain the receipts for everything we buy.
The requirement that the insured submit an inventory of the damaged, destroyed, or lost property is one of the reasons that it is frequently suggested that insureds videotape or photograph the interior of their homes with closets and cabinets open from time to time. This will create at least a partial visual record of their belongings and that videotape or set of photographs should be stored in a safe place, such as a safe deposit box.
Allow the insurer to examine the insured property as often as the insurer reasonably requests; provide the insurer with records and documents upon its request and permit the insurer to make copies; submit to an examination under oath, outside the presence of any other insured; and, sign a, transcript of the examination under oath.
Examinations under oath are often, but not always, requested by insurers in cases in which the insurer perceives the insured to be uncooperative with the investigation of the claim. Examinations can also be requested when there are aspects of the claim that suggest that there may be a fraudulent aspect to the claim. Refusal to submit to an examination under oath can afford the insurer a basis for refusing to pay a claim in its entirety.
The examination is conducted before a court reporter, who takes down all the questions and answers, and transcribes them into a booklet form after the examination has concluded. The person who conducts the examination is usually a lawyer retained by the insurer.
Under the laws of most states, the insured who is being questioned has the right to be represented by counsel at his or her own expense at the examination. The degree to which the insured's lawyer can object to questions varies from state to state.
Usually, when an insurer demands an examination under oath it also demands a lengthy list of documents for the insured to produce for inspection and copying at the examination. These document inspection requests in conjunction with examinations under oath can be duplicative of previous demands by the insurer, which is the insurer's prerogative.
Due to concerns that some insurers exercise their rights to demand an examination under oath unreasonably, some states have enacted some restrictions, For example, the California Insurance Code now provides that insurers may conduct an examination under oath only to obtain information that is relative to and reasonably necessary to process or investigate the claim. This, however, is a rather nebulous standard. How To Claim Insurance For Home
Examinations under oath may be conducted only on reasonable notice, at a reasonably convenient place, and for a reasonable period of time. The insured has the right to have counsel present, who can assert any objection to a question that would be permissible in a deposition under state or federal law.
The insurer must provide the insured with a free copy of the transcript of the examination under oath after it is transcribed and must permit the insured to make sworn corrections to the transcript.
Meet the proof of loss requirements that are preconditions to claim payment by the insurer. The signed and sworn proof of loss must be submitted to the insurer by the insured within sixty days of the insurer's request. It is common for the insurer and the insured to agree to extensions of the sixty-day deadline for submission of the proof of loss.
You should confirm any such agreement in writing. The proof of loss must set forth, to the best of your knowledge and belief, the following information:
- the time and cause of loss;
- the interest of all insureds, all others on the property involved, and all liens on the property;
- any other insurance that may cover the loss;
- any changes in the title to or occupancy of the property during the term of the policy;
- specifications of damaged buildings and detailed repair estimates;
- the inventory of damaged, destroyed, or lost (in the ease of theft) personal property;
- receipts for any additional living expenses incurred and records that support the fair rental value loss if a claim is being made for same; and,
- evidence or an affidavit that supports a claim under the credit card electronic fund transfer card coverage, stating the amount and cause of loss, if such a loss is being claimed.
