After an examination under oath, many clients ask how they did or what happens next. Both are very good questions. In fact, what does happen with the claim after an EUO? What actions should policyholders and public adjusters take after an EUO? First, it is common during the examination for information such as the names and numbers of handymen or documentation, like an invoice for a handyman, to be brought up for the first time. In that case, the public adjuster’s and policyholder’s task is the same: gather the information or documents and forward to defense counsel immediately! I can not stress this enough: PAs should consider it one of their primary responsibilities to navigate through the post-loss obligations as quickly as possible. In order to get a claim paid, invoke appraisal, or file a lawsuit, there must be an adequate exchange of information through the post-loss obligations for the carrier to make an independent assessment of the loss.
Assuming there are no outstanding requests from the carrier when the EUO concludes, the PA has one course of action: encourage the carrier to make a fair decision and pay the claim. There are certain time limitations governing how quickly an insurance company must make a decision on a given claim. By the time the EUO has occurred, all requested documentation should have been provided and a re-inspection at least offered by the PA and policyholder. Thus, upon the EUO’s conclusion, there should be no excuses by the carrier. Remind them of this and of the time limitations. Demand a decision. But always do so professionally.
If the carrier does demand a re-inspection post-EUO or more documentation, coordinate the re-inspection or gather the documents immediately. If you suspect that the insurer is asking for more information as a delay tactic, review the matter with an attorney and see if there is a statutory remedy available. In Florida, a civil remedy notice may be filed with the Department of Financial Services to formally place the carrier and the state on notice of the carrier’s bad faith actions. In Florida, if the carrier refuses to pay within 60 days of filing the CRN, it may be liable for bad faith at the conclusion of the underlying claim for direct damages.
Whatever jurisdiction in which you work, use all methods at your disposal to encourage the carrier to render a fair decision post-EUO. Reminding a carrier that extra-contractual damages may result from actions taken in bad faith can sometimes make all the difference.
