We have previously discussed the importance of complying with post obligations here. We have also discussed why an insured MUST comply with a sworn proof of loss request in a prior post. In short, if you have an insurance claim for your home or business in Florida, you need to make sure you follow all post-loss conditions in the policy, including submitting a sworn proof of loss to the insurer, in a timely fashion. Otherwise, your claim could be denied.

Florida’s Fourth District Court of Appeals recently handed down a decision that dealt with this issue. In Dias v. Universal Property & Casualty Insurance Company, Mr. & Mrs. Dias suffered water damage to their property. They filed a claim with Universal, who requested a date and time to inspect and for them to submit a sworn proof of loss, a repair estimate, and other documents. The inspection did take place, but no sworn proof of loss or other documents were sent. Universal made two subsequent requests, which went unanswered. The insurance company then denied the claim. A sworn proof of loss was submitted six weeks after the denial and additional documentation was provided later. Universal still did not pay on the claim.

The Dias family sued, and Universal moved for summary judgment because thy Diases did not satisfy all conditions precedent to recover under the policy. Summary judgment was granted on this issue to Universal and the case went to the Fourth District Court Appeals.

The Court held that, when an insured does not provide a sworn proof of loss and other documentation pursuant the policy, there is a presumption that the insurance company has been prejudiced. Likewise, when documents are submitted untimely, there is a presumption that the insurance company has been prejudiced. However, it is possible to rebut that presumption.

In this case, the Diases were able to show that an issue of fact remained as to whether they had rebutted the presumption of prejudice. Particularly, the insureds had deposed the adjuster from Universal who did the inspection. He testified that he needed no further information to prepare an estimate. Additionally, the insureds had submitted a sworn proof of loss before filing the lawsuit and had submitted additional documentation. 

It should be noted that the Diases are not out of the woods yet. It is possible that, at trial, Universal will be able to show it was prejudiced. So, if you file an insurance claim in Florida, make sure you timely submit your sworn proof of loss and any other required documentation in a timely fashion. If you need assistance complying with your policy obligations, contact the attorneys at Alvarez Law Group for a free claim review and to determine your rights.

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