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Misconceptions Regarding Policy Conditions: Insurer’s Request for a Signed, Sworn Proof of Loss

When an insured makes a property claim to their insurance carrier, the insurer has the right to investigate that claim prior to an insured filing a lawsuit. One of the common pre-suit policy conditions contained in an insurance policy is an insurance company’s right to request a signed, sworn proof of loss is provided within a specified period of time from the Insured, generally 60 days. A signed, sworn proof of loss is a document prepared by or on behalf of the insured providing the amount of damages being claimed under the policy, which is signed by the insured under oath and notarized. The purpose of this document is to provide that insurance company with notice of the type and scope of the damages being claimed.

Common misconception insureds and their representatives believe, is that providing a signed, sworn proof of loss upon request by the insurance company is merely that: a request. However, once specifically requested by the insurance company, a signed, sworn proof of loss becomes a condition precedent prior to the insured filing a lawsuit to provide the same. Should an insured not provide a signed, sworn proof of loss (after a request for same), and within the time set forth by the contract or statute, and then choose to file a lawsuit, recent Florida case law supports the Insurer’s position that such premature lawsuit is barred.

The second misconception insureds and their representatives have is that it is the insurance company’s burden to prove that it was prejudiced by the Insured’s failure to provide it a signed, sworn proof of loss prior to an insured filing a lawsuit. Indeed, Rodrigo v. State Farm Florida Ins. Co. aptly provides clarification on these common misconceptions regarding the duties of the Insured and the Insurer regarding a request for a sworn proof of loss.

In Rodrigo v. State Farm Florida Ins. Co., 144 So. 3d 690 (Fla. 4th DCA 2014), Rodrigo (Plaintiff Insured) filed a claim with State Farm (Defendant Insurer), whereby State Farm requested a signed, sworn proof of loss within 60 days. Rodrigo failed to provide the same and filed suit. State Farm’s Amended Answer to Rodrigo’s complaint asserted that Rodrigo materially breached the policy by failing to satisfy conditions precedent, failed to satisfy all policy provisions prior to filing suit, and failed to comply with his contractual obligations. See Id. State Farm moved for summary judgment on the insured’s failure to comply with a condition precedent (failure to submit a sworn proof of loss). See Id. The court held (1) that failure to furnish a signed, sworn proof of loss prior to filing a lawsuit was a material breach of the policy, and granted State Farm’s Motion for Summary Judgment regarding the same. See Id. The court also found (2) that the “insurer need not show prejudice when the insured breaches a condition precedent to suit.” See Id (citing to Goldman v. State Farm Gen. Ins. Co., 660 So. 2d 300, 303 (Fla. 4th DCA 1995).

It’s safe to say that these small misconceptions can have a large impact on a claim. Whether you are an insured or an insurer, it’s important that both parties understand their respective duties and obligations under the policy.

Presented (on behalf of the Firm) by

Joanna Bragman

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