The Claims Process

Claims Investigations, Post-Loss Conditions, Duties After Loss

Property insurance policies contain obligations for an insured who is making a claim for benefits after a loss—fire and smoke damage, water damage, theft, hurricane damage, etc. With regard to property insurance and many other types of insurance, these contract terms are generally referred to as “post-loss conditions” or “duties after loss,” and require the insured to cooperate with an investigation of the loss, as well as to do the following:

  • Give prompt notice of the loss
  • Protect the property from further damage, and make reasonable and necessary repairs to protect the property
  • Keep an accurate record of repair and expenses regarding the loss
  • Prepare an inventory of damaged personal property with bills and receipts
  • Notify the police and credit card companies in case of a loss by theft
  • Show the damaged property (sometimes multiple times)
  • Provide records and documents
  • Submit to an examination under oath
  • Provide a recorded statement
  • Send a sworn proof of loss within 60 days of request

Post-loss conditions are contained within the insurance policy contract in order to give the insurer the ability to investigate the validity of a claim before it must pay any loss benefits to its insured. Fair enough. Unfortunately, insurance companies all too often exploit this power to investigate by conducting a deliberately slow procedure that delays payment for a valid loss, harasses the insured, and focuses its efforts to search for ways to deny the claim or minimize the insurance carrier’s exposure at the expense of the claimant. An insurance company will frequently send its insured an exhaustive laundry list of categories of documents to be produced in connection with its investigation into the claim.

It may not be a coincidence if you feel that the entire process is designed to make you walk away from your claim.

Though it is intimidating to have your claim be the subject of such scrutiny, and daunting to comply with a confusing process, it is not a good idea to ignore the demands of the insurance company. The questions are: What is required to cooperate with the insurance company’s investigation of the claim? How far must a policyholder go in cooperating with a harassing insurer? Am I being taken advantage of? How long can this last? When are they supposed to pay? We can answer these questions.

Please do not hesitate to contact the Law Offices of Geoffrey Gilbert, P.A., insurance attorneys for insureds, claimants, and policy holders, for guidance on how to make the insurance carrier conduct a swift and fair investigation of the loss, and maximize your deserved recovery.