Florida law is not settled regarding noncompliance with conditions precedent to filing suit under an insurance policy, including whether a policyholder’s failure to submit a proof of loss bars the claim.
Under one theory, if a policyholder fails to submit the required proof of loss altogether and then files suit, the claim may be barred as a matter of law.
In Starling v. Allstate Floridian Insurance Company, the policyholder filed suit against the carrier after a claim was made for a house fire. The insured did not provide a proof of loss until after filing suit. The trial court granted summary judgment in favor of the carrier, and the Fifth District Court of Appeal affirmed. In Starling, the insured produced documents and even sat for an Examination Under Oath. During her examination, Ms. Starling explained that she did not submit a proof of loss because she did not have the information necessary to effectively value her claim. Despite the insured’s efforts, the court granted the insurer’s summary judgment.
Disagreeing with the majority opinion that the issue of compliance was is an issue of law, Judge Lawson cited the Fourth District Court of Appeal case, Haiman v. Federal Insurance Co., 798 So.2d 811 (Fla. 4th DCA 2001).
In Haiman v. Federal Insurance Company, the Fourth District Court of Appeal stated:
[A] total failure to comply with policy provisions made a prerequisite to suit under the policy may constitute a breach precluding recovery from the insurer as a matter of law. If, however, the insured cooperates to some degree or provides an explanation for its noncompliance, a fact question is presented for resolution by a jury.
Under the Fourth DCA’s approach, if a policyholder cooperates to “some degree or provides an explanation for its noncompliance,” the policyholder’s claim may not be barred as a matter of law for failure to submit a proof of loss.
As demonstrated, the law is different from jurisdiction to jurisdiction. To protect your interests under your policy, comply with all reasonable policy obligations, especially the proof of loss provision. If you have questions regarding a proof of loss, consult an insurance professional for help.
