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The Reality of the Insurance Contract
Most people view insurance simply as a safety net: you pay your premiums, and if disaster strikes, the insurance company writes a check. However, it is vital to remember that an insurance policy is legally a contract.
It is a bilateral agreement with specific responsibilities for both sides:
• Your responsibility: To pay for the policy and adhere to the conditions within it.
• Their responsibility: To indemnify (make you whole) should a covered loss occur.
While paying your premium is easy enough, the conditions required after a loss are where many policyholders unknowingly fail. The most critical of these is a document called the Proof of Loss.
It’s Not Just Paperwork—It’s Mandatory
Buried in the fine print of virtually every insurance policy is a requirement to submit a sworn Proof of Loss statement. This isn't a casual update; it is a formal legal document where you state the amount of money being requested.
The 60-Day Danger Zone
Many policies contain a strict clause requiring you to submit this document within 60 days of the date of the occurrence (or in some policies, upon the insurer's request).
This is not a suggestion. It is a deadline with teeth.
If you submit this document late, the insurance company often has the legal right to deny your claim entirely. This is not just a scare tactic; it has been the consistent ruling in courts across numerous states. If you miss the window, you may forfeit your right to payment, regardless of how legitimate the damage is.
The Legal Implications
The importance of the Proof of Loss extends beyond just the deadline. It is the cornerstone of your legal standing regarding the claim.
- Bad Faith Lawsuits: You generally cannot sue an insurance company for bad faith unless a Proof of Loss has been filed.
- Rejection Rules: Insurers may only reject a Proof of Loss for technical deficiencies—not disagreement.
- Statutory Interest: Filing the Proof of Loss often triggers interest penalties if payment is delayed.
What Should You Do?
If you are in a situation where you cannot turn the document in on time, you must ask the insurance company—in writing—for an extension. Do not rely on a verbal agreement over the phone.
However, the risk of technical deficiencies and the complexity of calculating the exact numbers required for a sworn statement make this a dangerous document to handle alone.
This is where a Public Adjuster becomes your best resource.
A Public Adjuster knows exactly how to fill out a Proof of Loss to avoid technical rejection. We understand the deadlines, statutory interest rules, and contractual obligations required to ensure your claim isn’t denied on a technicality.
Don’t let a missing piece of paper invalidate years of premium payments. Treat the Proof of Loss with the seriousness it deserves.
