Checklist for Filing a Hurricane Claim:

Below is a checklist for filing a Hurricane Claim:

  • Ensure the property is safe to enter prior to entering. If there is standing water still in the home, do not enter unless you have an electrician inspect and turn off all power.
  • Get in touch with your insurance agent and/or your insurance company to file a claim. Don’t delay. Even if you have not figured out exactly what your damage or property loss is, let your insurer (or authorized agent/broker) know right away that you have sustained a loss. Do this in writing.
  • Request a copy of your policy be sent electronically to you in pdf format.  You will need to review your entire policy for an understanding of what you are entitled to and what you are responsible for under your policy, including if the event is even covered.
  • Do not begin cleanup, repairs, or throw anything away until you notify your insurance company!
  • Take extensive photos and videos before and during the inspection of the building, damaged personal property, cleanable items, structural damage, and the standing flood levels of water in the house
  • Take detailed notes. Every time you call, write or speak to anybody affiliated with an insurance company, get their name and phone number. Write down the date and time of the communication, what you said, and what they said. Do not assume you will remember a conversation — or that they will.
  • Keep a copy of all paperwork. General rule: get everything in writing. Put everything in writing. Everything. Then make a copy of everything you sign and/or send (e-mail, regular mail, etc.).
  • Keep a receipt of every penny you must spend as a result of the disaster. For example, if you are forced to evacuate, keep records of purchases of food, lodging, clothing, etc.
  • If the roof is missing shingles, have qualified contractor mitigate the damage by installing tarps to protect the property from further damage.
  • Document the damage to the building as well as the personal property. List the dates of purchase, values, and receipts, if possible. Make a detailed list of every item damaged. Don’t leave anything out. File a claim for every item. You won’t get compensation for anything for which you do not submit a claim. Contact your credit card companies and retailers to help reconstruct purchases and identify costs for replacing lost items. Family members, friends and neighbors can help you create a full description of your loss.
  • Take plenty of photographs of everything, including discarded objects, structural damage, and standing floodwater levels.
  • If your home is uninhabitable, keep track of any living expenses that can be reimbursed.  Without receipts, you will not be able to collect any Additional Living Expenses (ALE) during the time the house is uninhabitable.
  • Only hire licensed contractors to do the work. Beware of signing a contract with an “assignment of benefits” (also referred to as AOB) clause which gives all the rights and proceeds of your insurance claim to the contractor.
  • The insurance company will appoint an adjuster to handle your claim. The adjuster is paid by the insurance company and works for the company, not for you. Moreover, the adjuster is not an expert on your policy, and may not know what it covers. If you think the adjuster is wrong, you may reject the adjuster’s estimates and demand a reconsideration. You can also hire a “public adjuster” to help you out.
  • Request copies of all estimates and reports from the insurance company adjuster.
  • Have your valuables appraised independently. For antiques, art and other valuable items, you should get your own appraisal to compare with the insurance company’s assessment.
  • Get insurance company approval for repairs. Don’t start repairing or replacing property, or throw away damaged property, without your insurance company adjuster’s approval.
  • Take your time. Don’t be pressured into agreeing to low-ball estimates, repairs or rebuilding. Give yourself time to review the proposed claims settlement and determine whether it is fair and acceptable to you.
  • Once the damage for the building/dwelling, the personal property and ALE is assessed, a “Proof of Loss”can be filed. This is your sworn statement of the amount you are claiming (along with any necessary supporting documentation) for your official claim for damages. Make sure to check for mistakes!
  • Do not sign releases or waivers until you know your rights. If you have an undisputed claim, you should not have to sign a release to settle. If you are asked to sign a release find out why and be cautious about signing away your rights.
  • Always be firm but polite. Know your rights and insist that the insurance company meet its legal obligations to you.

 

If you feel like the process of managing your insurance claim is to much to handle, intimidating, or if you feel your insurance company is not treating you fairly, you should consider contacting an attorney who will represent your interest. Your attorney will work directly for you, not the insurance company.  An attorney can handle every aspect of your claim and meet with your insurance adjuster, contractors, and anyone associated with the claim. The goal of your attorney is to negotiate the best possible settlement for your damaged property.

If a homeowner is forced to hire a lawyer to sue a homeowners insurer because the insurer did not pay enough for a claim, and the homeowner wins that lawsuit, then the homeowner is entitled to his or her attorney’s fees to be paid by the insurance company.

If you have any questions regarding property damage caused by Hurricane Michael, and/or related insurance claims, please contact my office for assistance.

Helpful Link:

Your Guide to Understanding Florida Homeowners Insurance Claims

Standard Homeowners or Renters Insurance Coverage

Types of Perils Likely Covered:

Wind
Wind-driven water
Lightning
Fire
Loss of Utilities
Types of Losses Likely Covered:

Cost of preventative actions taken (e.g. boarding up windows)
Cost of temporary or emergency repairs
Cost of approved temporary lodging
Value of various personal property (subject to some limitations)
Value of refrigerator contents
Cost of authorized permanent repairs
Cost of damaged tree removal
Perils and Losses Likely Not Covered or Only Limited Coverage Available:

Damage due to flood water
Mold
Unauthorized permanent repairs
Travel costs
Ordinary living expenses
Sources of Additional Information:

EMERGENCY INFORMATION:

The American Red Cross: 1.800.RED.CROSS or www.redcross.org

Federal Emergency Management Agency (“FEMA”): 1.800.621.FEMA or www.fema.gov/hurricane-irma

FILING AN INSURANCE CLAIM:

ACE: 1.800.433.0385
AIG: 1.800.244.0304
Allstate: 1.800.255.7828
AMICA: 1.800.242.6422
Chubb: 1.800.252.4670
Continental (“CAN”): 1.877.CNA.ASAP
Farmers: 1.800.435.7764
Geico: 1.800.841.3000
Hartford: 1.800.843.7006
Liberty Mutual: 1.800.2.CLAIMS
Safeco Insurance: 1.800.332.3226
State Farm: 1.800.SF.CLAIM (1.800.732.5246)
Travelers: 1.800.CLAIM33
USAA: 1.800.531.8222
Florida Office of Insurance has a “Hurricane Season Resources” web page:

www.floir.com/Office/HurricaneSeason/hurricaneresourcepage.aspx

QUESTIONS AND COMPLAINTS:

Florida Department of Financial Services (“DFS”), Division of Consumer Services handles all consumer-related questions and problems concerning insurance: www.myfloridacfo.com

Florida contact information*: 1.877.MY.FL.CFO (1.877.693.5236)
*This is a toll-free helpline number and only available to consumers calling from a Florida number

Out of state contact information: 850.413.3089

Office of the Florida Attorney General: www.myfloridalegal.com

Price Gouging Hotline: 1.866.966.7226

National Flood Insurance Program Call Center: Specialists are available to assist with the servicing of a claim, provide general information regarding policies, and technical assistance to aid in recovery:

By phone: call toll-free 1.800.621.3362 (select option 2)
By e-mail: complete a “Request for Support” form and send to FEMA-NFIP-Support@fema.dhs.gov

How Are Marital Assets Divided During A Divorce?

Marital Assets

Marital Assets

How Are Marital Assets Divided During A Divorce?

Marital vs. Non-Marital Assets

1. Marital.

How are marital assets divided? Marital assets are assets gained during the marriage, whether by one spouse or both. Assets gained during the marriage and not specifically claimed as non-marital are presumed to be marital assets unless disproven. 

Marital assets also include any increase in value of non-marital assets from either the efforts of the spouses during the marriage or the spending of marital funds or marital assets. Mixing non-marital assets with marital assets (for example, in joint accounts), may cause the non-marital assets to be considered marital.

2. Non-Marital.

Non-marital assets are assets of either spouse from before the marriage. Non-martial assets also include inheritance or gifts from an individual other than a spouse. 

Additionally, assets obtained in exchange for non-marital assets and income from non-marital assets become non-marital. Assets can also be non-marital if both spouses agree in writing. Assets obtained after a divorce petition is filed or a divorce order is finalized are not considered marital assets. 

Marital Asset Division

1. Equitable Distribution.

Florida courts begin with the presumption of equitable distribution of marital assets. Equitable distribution means a fair, often equal, division of marital assets. 

2. Unequal Distribution.

Florida courts can also allow unequal distribution of marital assets between the spouses based upon the following factors:

      • Contribution to the marriage, including child raising and home care
      • Financial situation
      • Length of the marriage
      • Interruption to a spouse’s career or schooling as a result of the marriage
      • Contribution to the other spouse’s career or schooling 
      • Interest in a business or professional practice free from the other spouse
      • Contribution to improving marital and non-marital assets
      • The child or another party’s interest in living in the marital home
      • Purposeful harm to marital assets since two years before the petition for divorce
      • Any other factor a court determines necessary to do justice 

Non-Marital Asset Division

1. Distribution of Non-Marital Assets.   

Non-marital assets are distributed to their respective spouses who controlled the assets prior to marriage or received the asset as inheritance or gift. 

However, the value of any enhancement to non-marital assets during the marriage or through other marital assets will be considered marital. 

Other Distributions

1. Cash Payments.

Florida courts can also require cash payments by a spouse as part of, or in replacement of, the distribution of marital assets. These cash payments can be one-time, lump sum payments or continuing installments. 

2. Alimony.

Alimony refers to support payments by one spouse to the other, whether a one-time payment or continuing payments. Alimony is determined separately from the division of assets. 

For more information contact Max Factor.  

Child Sharing – How Are Children Shared After Divorce?

Child sharing

Child Sharing

Minor Children

After a divorce, child sharing and support continue until the child’s 18th birthday. However, child sharing and support may extend beyond the child’s 18th birthday by agreement of both parents. Additionally, a court may extend child sharing and support if the child is still in high school and will graduate before turning 19 years old, or has a mental or physical incapacity.

Parental Responsibility 

The parents may establish a plan for parental responsibility through a Marital Settlement Agreement or through a court-ordered plan. Florida law tries to promote frequent and continuing contact of the child with both parents. There is no presumption for or against either parent. 

The parental plan describes what responsibilities each parent has regarding issues such as education and health care of the child. A court may consider each parent’s expressed interests regarding specific areas of the child’s upbringing. 

Parental responsibility will be shared by both parents unless the court finds that sharing parental responsibility would be detrimental to the child. A court may give sole parental responsibility to one parent if the court determines it to be in the best interests of the child.

Time Sharing

The parenting plan must also have arrangements for time sharing of the child. Time sharing can be split evenly between the parents or be unequal. Parents may alternate time sharing by certain days and weekends or on a week on/week off basis.

Important considerations for time sharing include the distance between the parents following their separation. Both parents must coordinate transportation for the exchanges of the child between parents. In fact, the Marital Settlement Agreement or court order must establish the location and time for exchanges of the child. 

Other time sharing issues include school breaks (winter break, spring break, summer break) as well as holidays (including Mother’s Day, Father’s Day, and the child’s birthday). School breaks and holidays can be shared evenly, given more to one parent if the other parent has more time sharing during the school year, or alternated with each parent having the child every other year.

Time sharing can also affect the amount of child support paid by the parents. Child support is a monthly financial obligation. Child support payments may be reduced when a parent has the child for at least 20% of nights during the year. This equals 73 nights per year. Every night beyond 73 nights provides for additional reduction in child support payments. 

Modifying A Parenting Plan

Once a parenting plan is in place, it may not be modified unless a court finds that there is a substantial, material, and unanticipated change in the circumstances from when the first parenting plan was originally agreed to or ordered. Any modification to a parenting plan must also be in the best interests of the child. Florida Statutes 61.13

For more information contact Max Factor. 

How Does Tax Reform Affect Alimony?

Tax Reform

Tax Reform and Alimony

What Is Alimony?

Tax Reform is going to affect Alimony. Alimony refers to payments from one former spouse to the other required by a divorce or other court-ordered separation instrument. For alimony to apply, one spouse must have an actual need for alimony and the other spouse must have the ability to pay. Courts then consider several factors, including the marriage length, standard of living, and both spouses’ income. Generally, alimony is provided by the higher earning spouse to the lower earning spouse.

Before Tax Reform

1. Payor.   The former spouse paying alimony (“Payor”) has been able to deduct alimony payments on his or her federal income tax return. For instance, a former spouse under a federal tax rate of 10% and paying $50,000 in alimony per year would save $5,000 each year in federal income taxes. 

2. Payee.   The former spouse receiving alimony (“Payee”) must list the alimony received as taxable income on his or her federal income tax return.

3. Recapture Rule.   If alimony by the Payor either significantly decreases or ends within the first three years of payments, the Payor must pay for the amount previously deducted, “recapturing”  that amount as taxable income. When this occurs, the Payee can deduct the same amount from taxable income, no longer paying taxes on the amount “recaptured.”

After Tax Reform 

1. Payor.   The Payor cannot deduct alimony from his or her federal income tax return.   

2. Payee.   Alimony received by the Payee is no longer taxable. 

3. Recapture Rule.   For divorces finalized after January 1, 2019, the recapture rule no longer applies since the Payor cannot deduct any alimony payments. For modifications of divorces or other separation instruments before January 1, 2019, the recapture rule still applies. 

Have These Changes Occurred?

Alimony changes begin on January 1, 2019 and will apply to all divorces finalized on or after that date. The new alimony rules can also apply to changes to divorce or other court-ordered separation instruments before January 1, 2019, but only if the formers spouses expressly state in the change that they are applying the tax reform’s new alimony rules.

Significance of Changes

1. Payor.   Likely Payors (usually spouses with higher incomes) may have a financial incentive to finalize a divorce prior to January 1, 2019 in order to receive the yearly savings of alimony tax deductions. These deductions can provide significant savings as alimony payments can continue for the life of the spouses. 

2. Payee.   For likely Payees (usually spouses with lower incomes), waiting to divorce until January 1, 2019 or after will free those spouses from paying taxes on alimony received. However, the Payor may also have less money to provide to the Payee due to now paying taxes on alimony payments. Additionally, Payees will no longer be able to use alimony received to contribute to IRA accounts as IRA accounts require contributions from taxable income. 

3. Divorce Negotiations.   Tax reform’s alimony changes may remove an incentive for reaching settlements prior to trial. Deducting alimony payments on federal income tax returns often encourages the higher earning spouse to agree to pay more in alimony, leading the parties to settle more quickly and more often. 

For more information contact Max Factor. 

 

What You Need To Know When You File An Insurance Claim

Jeff Atwater is Florida’s Chief Financial Officer and one of Florida’s four Cabinet officials. He leads the Florida Department of Financial Services and also serves as Florida’s State Fire Marshal. He wrote the following article which was published by the Tallahassee Democrat on September 7, 2016.

Jeff Atwater Florida's CFO

Jeff Atwater
Florida’s CFO

Here’s what you need to keep in mind as you file insurance claims

Florida’s 10-year no-hurricane streak came to an end late Thursday night as Hurricane Hermine slammed into Florida’s coast and continued on a path that ultimately impacted most of our great state. In the days since, Tallahassee has started to pick up the pieces and return to regular routines.

I know it hasn’t been easy and we have all been working hard, but we are seeing significant signs of progress. In the last week, I have witnessed neighbors helping neighbors, and I have watched as people have stepped up to the plate to help their fellow Floridians. Nothing is more encouraging than to see the best come out of people during the worst of times.

Now that power has been restored across most of our capital city and the surrounding region, many of you must now shift focus and begin filing insurance claims to cover damage to your home or business. I encourage you to contact your insurance company, if you haven’t already, to file your claim. I have seen many insurance companies on the ground in impacted cities surveying damage and adjusting claims. Insurance can be confusing, which is why we have resources available to help.

Insurance can vary widely and every policy is different, but it’s my goal to provide you with the facts and information you need to complete your claim. Tropical Storm Hermine became Hurricane Hermine at 5 p.m. EST on Sept. 1. From the time a hurricane has been declared by the National Weather Service until 72 hours after the final hurricane watch has been lifted, damages incurred during that time are subject to a special hurricane deductible. Instead of your normal fixed-price deductible, a hurricane deductible is calculated as a percentage of the insured value of the home. Look for Coverage A on your policy documents; this could be more than your normal deductible.

As every home holds a different value, every deductible will be different, but your policy document should clearly your specific deductible amount.

As you document your losses, note that most homeowners’ insurance policies cover debris and tree removal if the downed tree damaged your residence or any adjacent structures, regardless of who owns the tree. Some policies also cover these services if the downed tree blocks the main entrance, but your insurance company will typically not cover a tree that falls to the ground but does not cause property damage.

Many policies also cover food spoilage, an unfortunate consequence of prolonged power outages. Certain limits do apply, but talk with your insurance agent about this if you are already filing a claim.

Flood damage is not covered under traditional homeowners’ policies. Flood coverage for your property and possessions must be purchased separately, and flood damage to your vehicle is covered under your automobile policy.

In summary, there is much to be considered even though you still have a lot on your mind. If you have questions about how to file a claim, if you need help finding contact information for your insurance company, or if you are not sure if your losses will be covered under your insurance policy, give my Consumer Insurance Helpline a call. You’ll get direct access to insurance experts who can help with all of these questions and more. We serve all Floridians in every county. 

The number is 1 (877) 693-5236, and the line is open 8 a.m. to 5 p.m. Monday through Friday. We hope to hear from you if you have insurance-related questions, concerns, or needs. You can also call this number to report any suspicious or suspected fraudulent activity, and we will refer the information to our insurance fraud investigators for follow up.

Hurricane Hermine was strong, but the state of Florida and its people are stronger. Full recovery efforts will take time, but we will get there. If you need help, don’t hesitate to ask — ask your neighbors, ask your community leaders, give us a call, too. We’re here for you.

You may office call the office of Max Factor Law. We will be happy to assist you with your claim. My telephone number is (850)577-1699. My email address is Max@MaxFactorLaw.com. You can also contact me through the contact page.

Top Seven Issues for Flood or Water Damage

Flood Damage

Flood Damage

When a house is damaged by flooding and/or water which leaks into the structure, the property owner may encounter some problems in making an insurance claim for the cost of repairing the damaged property. It is important for you to remember that all homeowner’s insurance policies are not identical. Therefore, it is important for you to review the terms and conditions of your insurance policy so that you will know what your homeowner’s policy covers and what is not covered. An insured can usually check with his insurance agent or a representative from his insurance company to find out exactly what is or is not covered by the insurance policy.

The following is a list of some of the more frequent questions which are raised when a homeowner encounters flooding and/or water damages to a home:

Coverage Issue 1

Water damage because a water pipe inside the house freezes because the temperature falls below zero and the water pipe burst, allowing water to leak inside the house. Normally this type of water damage is covered by the homeowner’s insurance policy. However, some policies will not cover this type of loss if house was left unoccupied and without heat, because the insured failed to perform the necessary upkeep that would have prevented this water damage.

Coverage Issue 2

Water leaks from your backyard swimming pool, damaging your lawn and flooding your basement. Under most policies, the water damage to your basement and the personal property inside the basement would be covered under your policy. However, the damage to your lawn would not be covered because most insurance policies exclude coverage for damage to land, including the lawn on which the house is located. Furthermore, some policies do cover certain “named perils” such as fire, explosion, vandalism and vehicles not owned by the insured, so if your lawn was damaged by one of the “named perils”, then there would be coverage for the loss. Swimming pools are not usually listed as a “named peril.” However, if a tree falls on the swimming pool and causes the water to leak from the pool, then there would probably be coverage under the insurance policy.

Coverage Issue 3

Your washing machine overflows, flooding part of the house. The key issue of coverage would be whether the overflowing of water was caused by your failure to properly maintain the washing machine or did sudden accidental damage cause the water overflow. Whenever there is damage to the home caused by the homeowner’s failure to properly maintain the property, then this can be excluded from coverage.

Coverage Issue 4

A sewer backs up, causing water to flood the basement of your house. Most insurance policies do not provide coverage for sewer backups. However, it usually is possible to add sewer back up coverage to your policy, which will increase the amount of premium you pay for your homeowner’s insurance.

Coverage Issue 5

Water seeps into your basement, causing damage. Seepage is considered a maintenance problem, and is normally excluded from homeowner’s insurance.

Coverage Issue 6

During a heavy rainstorm, water leaks through your roof causing damage to your roof and to your furniture inside the home. Most policies will not reimburse you for the roof repairs which are necessary because this will be viewed as a house maintenance issue. However, the interior water damages will normally be covered, as will any damage to your furniture. If a neighbor’s tree falls on your roof, the damage to your roof and your interior damages will normally all be covered by the homeowner’s policy.

Coverage Issue 7

If your house is damaged by a flash flood from the overflowing of a nearby rive or lake, this type of damage will typically not be covered by the homeowner’s policy. Flood damage is not covered by homeowner’s insurance. But if your house is in a location where flooding is a concern, you can always buy flood insurance to protect against that type of damage.

In summary, it is important for you to know what your policy covers and what it does not cover, and to understand that lack of maintenance can cause to loss to be excluded from coverage. For more information contact Max Factor.

Motion for Contempt and Enforcement

Contempt of Court can occur when someone fails to obey an existing Court Order. For a person to be in “Contempt of Court”, there must be: (1) a Court Order that clearly imposes an obligation, (2) an ability by that person to comply with the Court Order, and (3) a willful refusal by that person to obey the Court Order.

In a family law situation, there are times when one of the parties (either the former husband or the former wife) fails to comply with an Order issued by the family law court. When these circumstances occur, the other party may want to take some type of action which will make the uncomplying party obey the existing court Order. One of the options available for the party seeking compliance with the existing Order is the filing of a Motion for Contempt and Enforcement.

Requirements of a Motion for Contempt and Enforcement

A. Requirements for Motion for Contempt/Enforcement. Before a Motion for Contempt and Enforcement can be successfully filed, the following requirements must be satisfied:

1. Existence of a Court Order that clearly defines an obligation that the other party must comply with. For example, if the Court Order states that the Father must pay the Mother $100 in child support on or before the 10th day of each month until the child reaches the age of 18, then the Father’s obligation to make monthly child support payments appears to be clearly defined.

2. Ability of the Obligated Party to Comply with the Court Ordered Requirement. This means that if the Court ordered the Father to make monthly child support payments to the Mother, then the Court must receive evidence shows that the Father has the financial ability to make those monthly payments.

3. Evidence which shows that the Obligated Party has willfully refused to comply with the existing Court Order. For example, if the Father sill has the income and/or assets which would enable him to make the monthly child support payments, then this requirement would be satisfied. On the other hand, if the Father is no longer employed and/or no longer has the assets necessary to pay child support; and can show the Court that he has diligently sought other employment or other options which can help pay the child support, but has been unsuccessfully, then this requirement may not be satisfied.

Contempt/Enforcement

Contempt/Enforcement

Sanctions resulting from a Motion for Contempt and Enforcement

B. Sanctions Court May Impose If A Party Has Ability To Comply With Existing Order But Refuses To Do So. If the Court determines that the noncompliant Party has the ability to comply with the existing Order but intentionally refuses to do so, then Court may impose one or more of the following sanctions:

1. Incarceration. If the Court determines that the noncompliant party has intentionally refused to comply with the Court’s Order and has the ability to comply with the Order, then the Court has the authority to incarcerate the non-compliant party. The purpose of the incarceration is to put pressure on the non-compliant party and try to force them to comply with the Order. If the noncompliant party initiates action to comply with the Order, then the incarceration will end.

2. Fines. Another means for the Court to address the contempt issue is to Order the noncompliant party to pay a fine as a penalty for their noncompliance.

3. Other Sanctions. Depending on facts and circumstances regarding a Party’s noncompliance, the Court may order other sanctions. For example, if a Party is employed but refuses to pay child support, then the Court may order a wage garnishment.

For more information contact Max Factor.

What is an Examination Under Oath?

Examinations Under Oath

Almost every insurance policy (“policy”) requires an insured to comply with certain requirements if there is any loss or damage to property which is covered by the policy. These requirements are usually identified as “Duties After Loss.” One of the most important Duties After Loss is an Examination Under Oath (“EUO”).

An EUO is a formal proceeding during which an insured, under oath and in the presence of a court reporter, is questioned by an insurance company representative regarding the issues related to the insurance claim. An insurance company representative can be an insurance company adjuster, an independent adjuster, an attorney who represents the insurance company or any other representative. The purpose of the court reporter is to transcribe all of the questions and answers during the EUO and then prepare a transcript of the EUO. The EUO transcript is then given to the insured and any other persons questioned during the EUO for their review. Each person who testified during the Examination Under Oath will be asked to read the Examination Under Oath transcript and make any necessary changes to their testimony so that the transcript is true and correct. Each person who testified during the EUO will then be asked sign the EUO to verify the truthfulness of their testimony and any changes made to the EUO transcript.

Examination Under Oath

Examination Under Oath 

The requirement that an insured submit to an Examination Under Oath is a contractual obligation that is based on policy language. This language normally requires an insured to: “submit to an EUO while not in the presence of another insured …and to sign the same.” An EUO can be one of the most useful tools available to an insurance company in determining whether a loss is covered under the policy and the amount of the loss covered by the policy.

Generally, the policy language will allow the insurance company to take an EUO of the named insured, any insured seeking coverage under the policy, and any persons assisting the insured in submitting the claim. Under this provision, if a public adjuster has assisted the insured in submitting a claim, then the public adjuster may be requested to submit to an EUO. The specific policy language will normally determine the persons who are required to submit to an Examination Under Oath.

While an Examination Under Oath is similar to a Deposition, one of the significant differences is that the insured’s attorney should not object to a question and instruct the insured not to answer that question. If the question relates to material information regarding the claim, then the insured’s refusal to answer the question can be sufficient grounds for the insurance company to deny the claim.

Another issue which is sometimes raised regarding an Examination Under Oath is whether an insured must submit to an EUO if the insured has already given a recorded statement to a representative of the insurance company. Most courts hold that a recorded statement is not a substitute for an EUO. Consequently, if an insured, who has previously given a recorded statement, is asked to submit to an EUO, the better choice would be for the insured to submit to an Examination Under Oath.

In conclusion, an Examination Under Oath can be a very useful tool for an insurance company to use in investigating an insurance claim. Most courts have held that an insured’s refusal to submit to an EUO is an absolute bar to coverage. Therefore, it is in the best interest of the insured to comply with a request from the insured company to submit to an Examination Under Oath.

If you need assistance with an Examination Under Oath please contact Max Factor.

Insurance Duties After Loss for Storm Claims

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Insurance Issues Related To Storm Claims

With Hurricane Season now upon us, it is important to be aware of some of the basic issues which can arise from the insurance coverage applicable to storm damages. Look for the duties after loss requirements in the insurance policy.

Duties After Loss:

Most insurance policies have a section which requires an insured to comply with certain requirements if there is any loss or damage to property which is covered by the insurance policy. These requirements are usually identified as “Duties After Loss.” While each insurance policy may contain a different list of “Duties After Loss”, the requirement for an insured to comply with these “Duties” is usually the same. Most insurance policies will contain language which states that a legal action cannot be brought against the insurance company unless there has been full compliance with all of the “Duties After Loss”.

Typical Duties After Loss:

The following is a list of some of the “Duties After Loss” which may create problems for an insured claiming storm damage:

1. Prompt Notice of the Loss. This duty requires an insured to give notice to the insurance company within a reasonable time after the insured is aware of damage to the property insured by the insurance policy. The reason for this duty is so that the insurance company can inspect the loss and take the necessary action to repair the damages and prevent additional damage to the insured property. For example, if a windstorm causes damage to the roof of a house, prompt notice will allow the insurance company to make temporary or final repairs to the roof which will prevent or limit any interior damage from water leaking into the interior of the building due to the roof damage. If the insured fails to give prompt notice of the loss, then the insurance company may deny a claim for some or all of the interior water damage.

2. Sworn Proof of Loss. This duty requires the insured to submit a sworn document (“Proof of Loss”) containing the information requested by the insurance company. Normally the insurance policy will give a time limit for the insured to submit the sworn proof of loss, such as 60 days. This means that the insured will have 60 days after the insurance company request that a POL be produced to submit a signed and sworn document. The insurance company will normally provide the insured with the forms which need to be filled out, signed and sworn to.

3. Examination Under Oath. An Examination Under Oath (EUO) requires the insured to appear before a representative of the insurance company (usually the insurance company’s attorney) to answer questions under oath about any matter related to the loss or claim, including any records or documents related to the loss or claim. A court reporter will normally be present to record each question and answer during the EUO. After the EUO is completed and transcribed by the court reporter, then the insured will have the opportunity to review the transcript and make any corrections which are necessary to make the transcript true and correct.

Failure To Comply With Duties After Loss:

Most insurance policies contain a provision which states no one may bring a legal action against the insurance company unless there has been full compliance with all of the policy’s Duties After Loss. For example, this requirement means that if an insured is requested to submit a Sworn Proof of Loss and fails to do so, or is requested to submit to an Examination Under Oath and fails to do so, then the insured will probably not be allowed to file a lawsuit against the insurance company until these duties are satisfied. Another issue which may arise from an insured’s failure to comply with the Duties After Loss, is whether the insurance company was prejudiced by the insured’s failure to timely perform the Duties After Loss. For example, if the insurance company can show that the insured’s delay in performing its Duties After Loss resulted in the insurance company being unable to determine the type and amount of damage caused by the storm and the cost of repairing those damages, then the insured may be prevent from filing a lawsuit to collect the damages caused by the storm. Consequently, the insured should be diligent in complying with the Duties After Loss. Contact Max Factor for more information.