Also known as: proofs of loss · proof-of-loss
Written by attorneys — see sources below.
A formal statement detailing the type and extent of a loss, submitted by an insured to an insurer as a condition precedent to recovering policy proceeds.
After a storm damaged her roof, Maria Lopez submitted a sworn proof of loss to Apex Insurance listing the cost of repairs and supporting documents. Apex refused payment because the form arrived after the 60-day policy deadline. The court held that timely proof of loss was a condition precedent, barring recovery.
Greenfield Bakery filed a detailed proof of loss with Harbor Mutual after a kitchen fire destroyed inventory and equipment. The insurer denied the claim for failure to include business-interruption calculations. Because the policy conditioned payment on complete proof of loss, the court upheld the denial.
Failure to submit a timely proof of loss can bar recovery under the policy. Courts have held that the requirement is a condition precedent, so an insurer may disclaim coverage when the insured misses the deadline without waiver or excuse.
Yes. When the policy expressly conditions payment on timely submission of detailed proof-of-loss documents, the insured must satisfy that condition before the insurer's duty arises. Partial or late submission means the condition fails and no payment obligation matures.
…is enforceable if it is reasonable in light of the anticipated or actual harm caused by the breach and the difficulties of proof of loss. A liquidated damages clause is not enforceable if it is a penalty, that is, if it is unreasonably large in relation to the anticipated or actual harm. The employee argues that the…