Proof of Loss: Deadlines and What to Include

Of all the paperwork in a property claim, the sworn proof of loss is the one that carries teeth. It is a sworn statement. It fixes your number. And missing its deadline is one of the few unforced errors that can cost you a covered claim outright.

It is also widely misunderstood, mostly because people confuse it with reporting the claim. They are different documents with different clocks.

The deadline is set by your policy, not by statute

This is the part to get straight first. Florida statute sets the deadline for giving your insurer notice of a claim. Your policy sets the deadline for the sworn proof of loss, and it typically runs from the carrier’s request rather than from the date of loss.

Under the standard homeowners form, one of your duties after loss is to send to the insurer, within 60 days after our request, your signed, sworn proof of loss. Note the trigger: the clock starts when they ask, and if they never ask, the 60 days never starts. Note also that the same form says failure to comply with the duties after loss is prejudicial to the insurer, which is the language carriers rely on when they deny for a late or missing proof of loss.

The eight things it has to contain

The standard form is specific about what the sworn statement must set forth, to the best of your knowledge and belief:

• The time and cause of loss.
• The interests of all insureds and all others in the property involved, and all liens on the property.
• Other insurance which may cover the loss.
• Changes in title or occupancy of the property during the term of the policy.
• Specifications of damaged buildings and detailed repair estimates.
• The inventory of damaged personal property, showing quantity, description, actual cash value and amount of loss.
• Receipts for additional living expenses incurred and records supporting the fair rental value loss.
• Evidence or an affidavit supporting a claim under the credit card, fund transfer card, forgery and counterfeit money coverage, stating the amount and cause of loss.

Two of those items are where claims are won or lost. "Specifications of damaged buildings and detailed repair estimates" means a real scope, not a contractor’s one-page bid. "The inventory of damaged personal property" means a line-by-line list with values, and the same form requires you to attach all bills, receipts and related documents that justify the figures in the inventory.

Why signing early is expensive

A sworn proof of loss states your amount. Sign one before your scope is complete and you have sworn to a number that is lower than your loss, and you will spend the rest of the claim explaining why it went up.

The order that protects you is straightforward:

• Document everything before cleanup, including what is behind and above the visible damage.
• Get a complete scope priced line by line, not a repair quote.
• Build the contents inventory with values and supporting receipts.
• Then complete the proof of loss from finished documentation.
• If the deadline will arrive before the documentation does, ask in writing for an extension before the deadline passes, not after.

Carriers grant extensions more often than people expect, particularly after a major storm, but a request made after the deadline is a different conversation from one made before it.

What happens after you file it

Filing the proof of loss starts the carrier’s clocks. Florida requires an insurer to begin such investigation as is reasonably necessary within 7 days after receiving proof-of-loss statements, and to conduct any physical inspection within 30 days after receiving them. Separately, the insurer must pay or deny an initial, reopened or supplemental claim, or a portion of it, within 60 days after receiving notice of the claim. All of these bend for factors beyond the insurer’s control as the statute defines them, and for declared emergencies.

There is also a request you can make. Under the unfair claim settlement practices provisions it is a violation for an insurer to fail to affirm or deny full or partial coverage of a claim, and as to partial coverage the dollar amount or extent of coverage, or to fail to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. In plain terms: once your proof of loss is in, a written request forces a written position.

The examination under oath

The proof of loss often arrives alongside a request for an examination under oath. The standard form requires you, as often as the insurer reasonably requires, to show the damaged property, provide records and documents and permit copies, and submit to examination under oath while not in the presence of another insured, and to sign the same.

These are legitimate requests. They are also where an unprepared policyholder can damage a good claim by guessing at dates, values and causes under oath. Prepare from documents, not memory.

Getting the documentation right the first time

Central Florida claims run heavily to interior water and roof losses, and we prepare proofs of loss regularly in Orlando, Kissimmee and Winter Park, where a swelled contents inventory and a hidden-damage scope are usually the two documents nobody has built.

Preparing, completing and filing the claim documentation on your behalf is precisely what a public adjuster is licensed to do. If a proof of loss request has landed and you are not sure your scope is finished, talk to us before you sign it. Our claim process page walks through the sequence.

Your policy is the contract, and forms vary by carrier. The provisions described here come from the standard Homeowners 3 Special Form that most Florida homeowners policies are built on. Read your own declarations page and policy form, or send them to us and we will read them with you.

Sources

1. Homeowners 3 Special Form, ISO form HO 00 03 10 00 (sample published by the Insurance Information Institute)
2. Fla. Stat. s. 627.70131, Insurer’s duty to acknowledge communications regarding claims
3. Fla. Stat. s. 626.9541, Unfair methods of competition and unfair or deceptive acts
4. Fla. Stat. s. 627.70132, Notice of property insurance claim

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