Insured's Failure to Adhere to Policy Conditions

April 29, 2013

Insured delayed providing the proof of loss to the carrier on a theft claim. Carrier submitted an email to the insured indicating it never received a correct proof of loss, so they are denying the claim. Insured provided an accurate proof of loss and the carrier still denied the claim based on the non-receipt of the proof of loss within sixty days, a condition of the policy. Can the carrier deny based upon a condition of the policy being delayed?

Kentucky Subscriber

If the insured procrastinated and did not submit the proof of loss to the carrier within the specified amount of time, then yes, the carrier can deny the claim. If there are extenuating circumstances, the carrier may be willing to take that into consideration, but it does not have to. Insureds have duties to the carrier that must be fulfilled in order for losses to be paid.

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