Insurance coverage Claims Should Be Timely Raised Even if Unknown
In October of 2005, the residence of Justin and Selma Soronson (“the Insureds”) was hit by land falling Hurricane Wilma. (“the Residence”). The Insureds did not notice any damage, nor was harm apparently visible from a reasonable and customary inspection. Far more than three years later, in 2009, an inspection was performed on the roof of the Home that revealed harm that appeared to be induced by a windstorm occasion. The Insureds immediately notified their insurance carrier and complied with the insurance policy’s requirement for submission of a sworn proof of loss. The insurance coverage company carried out its personal inspection, and denied coverage. The insurer claimed that no damage was verified, and the passage of time prior to notice of the claim getting produced prejudiced the insurance coverage company’s capacity to effectively establish the trigger of any such damage. Judgment was entered in favor of the insurance company and an appeal ensued.
The insurance business argued that the Insureds breached the insurance coverage policy that necessary a sworn proof of loss to be submitted inside 60 days right after a loss. The insurance business claimed that such a breach caused prejudice to the insurance coverage organization producing it impossible to establish the correct result in of any alleged harm. The Insureds argued instead that they furnished the sworn proof of los instantly upon mastering of the harm, and that since Hurricane Wilma, no operate had been performed on the roof, and no major wind events had impacted the residence. The insurance organization protected claiming that the language of the insurance policy was clear as to such a claim becoming created inside 60 days of the loss, and that to enable the Insureds to claim that expertise of the loss would be an unlawful rewriting of the insurance coverage policy.
Even though causes of actions for defects and losses usually can be brought inside a particular period of time after the same is known or must have been identified via a reasonable and customary inspection, the appellate court held that the terms of the insurance policy had been clear and unambiguous, and that the Court was not in a position to rewrite such a provision. Given that the insurance policy also stated clearly that no suit could be brought till compliance with all of the policy’s provisions, the appellate court agreed that the Insured’s claim was untimely and barred.
The appellate court stated that the only manner by which the Insureds could overcome such provisions would be to prove that the insurance business had not been prejudiced by the lack of timely notice. This is a tall burden to overcome as Florida law presumes that the insurance firm was in fact prejudiced if a policy condition precedent to suit, such as timely discover, has not been met. The Insureds were in a position to submit evidence that no perform had been performed on the roof considering that Hurricane Wilma and that no comparable windstorm events impacted the roof in that time. The appellate court held that this evidence merely amounted to “[a]t very best . . .that Hurricane Wilma damaged their roof and that their roof demands to be replaced as an outcome.” The Insureds were not, even so, in a position to supply proof that the insurance coverage company was not prejudiced in its potential to confirm such allegations and to appropriately assess the claim.
The appellate court affirmed the judgment in favor of the insurance firm holding that beneath the clear and unambiguous terms of the policy, the Insureds breached the policy for failing to provide timely notice of the loss, even even though it was undisputed that they did not know, nor had reason to know, of the loss, for more than 3 years. As a result, the burden fell upon the Insureds to prove that the insurance business was not prejudiced by the untimely notice. A burden which was also steep to meet.
The moral of this story is to remind everyone to read their insurance policies very carefully, and to obtain legal counsel as to their obligations beneath any such policy. One never ever wants to undertake an evaluation of their insurance policies after a loss. By then it might extremely nicely be also late. Anytime an event occurs that might trigger insurance coverage coverage, a timely inspection of the covered house really should be undertaken to preserve your rights.
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