PROOF OF LOSS NOT SUBMITTED IN TIME, FLOOD LOSS NOT COVERED

PROOF OF LOSS NOT SUBMITTED IN TIME, FLOOD LOSS NOT COVERED 490_C011

PROOF OF LOSS NOT SUBMITTED IN TIME, FLOOD LOSS NOT COVERED

A standard flood policy had been issued to an insured couple on a property that was later damaged by a flood, within the policy period. The insureds notified the insurer of the loss. The claims adjuster representing the insurer reviewed the covered property and the subsequent water damage.

At that point, it appears that the insureds were displeased with the calculations and the amount of loss that the claims adjuster had determined. The insurer sent a formal proof of loss to the insureds to complete and sign. The insureds did not do so.

When the insurer did not receive the signed proof of loss, a letter was sent to the insured's reminding them of their contractual duty to do so within 60 days and informing them of the consequences if they failed to comply. 10 days later, the adjuster also sent a similar letter. The insureds asked for an additional 45 days, the insurer said in writing that they would consider doing so if the insureds responded with the signed proof of loss by a specific date. The insureds did not respond. So the insurer denied the claim for non-compliance with policy conditions and lack of interest, and then closed their file. The insurer so notified the insured, which then filed suit against the insurer, the provisions that then requested summary judgment.

The insured listed in their suit that although they had not submitted a formal proof of loss as required, they did give the insurer detailed lists of damaged items. Further, since the insurer had given extra time, this constituted a waiver of the time requirement.

In a decision by the New Jersey District Court, it was decided that the insureds had chosen not to comply with the conditions of the policy even after being notified of the consequences and thus, could not file suit. Further, that since the insurer did not agree to a waiver of the time requirement in writing, Summary Judgment was granted in favor of the insurer.

Gagliardi et. al Plaintiffs v. The Omaha Property and Insurance Company, Defendant New Jersey District Court, DNJ. No. 96-CV-1766. February 4, 1997. CCH 1997 Fire and Casualty Cases, Paragraph 6246.