A claim denial, especially of what could be determined an otherwise covered claim, can be devastating. One reason an insurance claim can be denied is due to the failure to provide “prompt notice.” The insurance policy requires that notice of the loss or an event that has caused damage be provided to the insurer, and most policies require “prompt notice.”
What constitutes “prompt notice”, however, can be confusing. Some policies do not define the term. The issue of whether an insured provided “prompt” notice generally presents an issue of fact. Laquer v. Citizens Prop. Ins. Corp., 167 So. 3d 470, 474 (Fla. 3d DCA 2015). “Prompt notice do[es] not require instantaneous notice.” Guzman v. Southern Fidelity Insurance Company, 332 So.3d 67, 70 (Fla. 2d DCA 2021). “Rather, ‘[n]otice is said to be prompt when it is provided ‘with reasonable dispatch and within a reasonable time in view of all of the facts and circumstances of the particular case.” Guzman, 332 So.3d at 70. Prompt notice is also typically a question of fact for the jury to determine. (“All of the Florida cases bearing upon the question of the requirement of notice being given to the insurer seem to be uniform in the proposition that what is a reasonable time depends upon the surrounding circumstances and is ordinarily a question of fact for the jury.”). Guzman, 332 So.3d at 71 (internal citations omitted).
Not having a definitive timetable can understandably cause confusion. Here are some tip to help ensure that you are complying with the prompt notice requirement.
Why is Prompt Notice Required?
Before getting into when prompt notice is required, it is important to talk about why this rule exists in the first place. The prompt notice requirement does not exist to disadvantage homeowners. Rather, it is there to provide some protection for insurance providers.
Insurance providers are required to be given prompt notice for a variety of reasons. If a homeowner tells an insurance provider that wind damage happened from a storm many years ago, it may be hard for the insurance provider to confirm the cause of damage due to the time that had elapsed. Under the terms of the policy, the insurance provider is required to reimburse damages for certain reasons. With so much time having elapsed and no insurance investigation happening in time to verify the cause of damage that has occurred, it may be difficult to review the damage, evaluate it, and propose a fair number for the damage.
When is Notice Required?
Here are a couple of guidelines that can help determine when notice is required in some circumstances:
Consider What Is Reasonable Under The Circumstances
If a tornado knocks out a wall in one’s living room, it will be instantly evident that there was damage. But what if the damage is not so obvious? Suppose that there is water damage from a storm that damages the underside of a roof. Without taking the roof off, it may be impossible for the homeowner to know that the roof damage was there. Or what if a pipe burst while you were on vacation? Prompt notice does not require instantaneous notice but should be provided with reasonable dispatch and within a reasonable time in view of all of the facts and circumstances of the particular case.
Consider When It Is Safe to Do So
Extenuating circumstances such as dangerous weather or lack of power may be reasonable explanations for why there may be a delay between damage and notification to the insurance carrier. Once it is safe to do so, begin the process of contacting the insurance provider so that they are aware of the loss.
What Happens if You are Late Letting an Insurance Provider Know?
Late reporting, in itself, does not necessarily mean that a claim will be denied. It depends on whether the insurance carrier is prejudiced by the delay. To establish a defense based upon an insured’s failure to satisfy post-loss obligations that lead to a forfeiture of coverage, Florida law adopts a two-part test. First, “the insurer must plead and prove that the insured has materially breached a post-loss policy provision.” Am. Integrity Ins. Co. v. Estrada, 276 So.3d 905, 912 (Fla. 3d DCA 2019).(emphasis added). Second, if the insurer establishes the first element, “the burden then shifts to the insured to prove that any breach did not prejudice the insurer.” Id. (emphasis added).
How to Avoid Prompt Notice Issues
Here are some steps to help avoid prompt notice issues:
Notify the Insurance Carrier As Soon as Possible
Try to let the insurance provider know about the damage as soon as possible. Consider doing this even if you are not completely sure that there is a claim. If you think you need an attorney to help you with submitting a claim, contact one.
Document and Follow Up on the Notification
When you report the loss and file a claim, consider keeping a record of the notification. It may be helpful to log every communication, send emails if possible, and if you send anything through the mail, make sure it is certified.
Ideally, before damage has happened, consider taking photographs of your property in its condition before damage has occurred. This will be very helpful for an insurance adjuster to compare the damaged property against and it may bolster your claim that there has been damage. When safe to do so, take photos or video of the damage. If anyone has witnessed the damage, be sure to get the witness to make a statement or at least get their contact information.
Preserve Evidence of Damage
In addition to having photos, it may be helpful to keep a small sample of the property damage to show to the insurance adjuster.
Get Documentation from Professionals
When contractors come in to repair the property damage, they will take notes of what is damaged and what they are repairing. It may be helpful to get a copy of their documentation to submit with the claim.
What to Do if a Claim is Denied for Lack of Prompt Notice
If an insurer has denied your claim by taking the position that there has been a failure to provide prompt notice, we may be able to help you.
Do not delay. Contact 321-283-5888 to speak to a Florida insurance attorney today.