In Allstate Floridian Insurance Company v. Farmer, 38 Fla. L. Weekly D75a, (Fla. 5DCA 2012), a Florida insurance law case, the Florida Fifth District Court of Appeal held that the trial court did not commit error by allowing the homeowner to prove that the insurance company was not prejudiced by the homeowner’s failure to timely submit a sworn proof of loss for the insurance claim.
Florida Insurance Law: Conditions Precedent
In this case, the homeowner had two unrelated insurance claims within one month of another. The insurance company required that three claims be filed for the two incidents and requested numerous documents, recorded statements, examinations under oath, and a sworn proof of loss. The insurance company received everything but the sworn proof of loss and conceded at trial that it had everything it needed to process the claims. Notwithstanding that fact, the insurance company did not resolve the claims and the homeowner filed a lawsuit. At trial, the insurance company moved for a directed verdict on the basis that the homeowner did not substantially comply with the requirement to submit a sworn proof of loss. The insurance company argued that the homeowner breached the insurance policy by not complying with all conditions precedent including the filing of a sworn proof of loss. Florida law requires at least substantial compliance with conditions precedent in order to recover under an insurance contract.
Florida Sworn Proof of Loss
All insurance policies require a homeowner to submit a sworn proof of loss when requested by the insurance company. The purpose of the sworn proof of loss is to advise the insurance company of the facts of the loss, what was damaged, and the approximate cost of damages. The sworn proof of loss enables the insurance company to complete its investigation of the claim. In this case, the insurance company argued that the failure of the homeowner to submit the sworn proof of loss was a breach of the conditions precedent and therefore it was relieved from having to provide insurance benefits.
Florida Presumption of Prejudice
At trial, the jury found that the homeowner did not substantially comply with submitting a proof of loss form but that there was no prejudice to the insurance company since it apparently had all the other information that it needed in order to complete its investigation. The insurance company argued that the jury should not have been permitted to make the finding of no prejudice and that the case should have been over once it was determined that the homeowner had failed to substantially comply with a policy condition. When there is a failure to comply with conditions of the insurance policy, Florida law provides that there is a presumption of prejudice to the insurance company. The presumption of prejudice is however rebuttable, meaning that the homeowner has the opportunity to prove that there was no prejudice. If the homeowner cannot prove that there was no prejudice, the insurance company prevails and is relieved of any obligation to pay the claim. The reason for this harsh rule is that prejudice means the insurance company did not have the ability to properly investigate the loss and determine either its cause or damages. The appellate court simply applied the foregoing principles and allowed the homeowner the opportunity to prove that even if the homeowner did not give the requested form to the insurance company that it did not affect the investigation and therefore it should not bar the claim.
Florida Insurance Claim Lessons
The lesson to be learned from this case is to not tempt fate. So long as the requests of the insurance company are reasonable and provided for by the insurance policy, the homeowner should make every attempt to timely and reasonably comply with those requests. There is no reason to inject another issue into the case or give the insurance company another reason to get out of paying for an otherwise valid claim.
Related Topics: Miami Insurance Lawyer, Florida insurance law, Florida insurance claim, Florida sworn proof of loss
