Insurance company attorneys can be tricky because they try to “set up” defenses in the investigation of a claim and then claim non-cooperation or fraud if the requests are not fully responded to. It is almost as if the insurance defense bar is playing a “gotcha” game. On the other hand, not cooperating on an obvious and material issue will spell doom for the policyholder. This was the case in a matter decided last week.1Continue Reading The Duty to Cooperate—What Happens If You Do Not Fully Respond and the Insurance Company Says Nothing About It?

Every once in a while, Colorado federal district court judges decide to provide more clarity on legal defenses asserted by insurers. One such recent case is a great case study regarding the evolving standard relative to an insurer’s ability to assert a failure to cooperate defense in litigation. In Excel Construction Group v. GuideOne Mutual Insurance Company,1 the trial court recently evaluated the failure to cooperate defense for defenses asserted before the enactment of C.R.S. § 10-3-1118. Excel was filed by a contractor by assignment of an insurance claim. Excel filed a lawsuit against a church facility’s insurer for breach of contract damages and a violation of Colorado’s insurance bad faith statute, C.R.S. § 10-3-1115 and 1116, in the federal district court of Colorado on December 31, 2020.   Continue Reading Does an Insured Have to Respond to an Insurer’s Document Request or Else Risk Legal Action Asserting a Failure to Cooperate as an Absolute Bar to Insurance Recovery?

Property insurance companies have a good faith obligation to promptly investigate facts related to coverage and evaluate amounts of damage for a covered loss following notice of loss. If there is coverage and the loss exceeds the deductible, property insurers should promptly issue payment explaining how the amounts were determined. What happens if the policyholder thinks more is owed? Continue Reading Policyholders Need to Cooperate, Prove Damage From the Loss, and Value the Damage

Examinations under oath are important to recovery. Reasonable production of relevant documents that are part of a cooperative investigation is important as well. Failure to provide an examination under oath and documents is a one-way street to help an insurer deny recovery.
Continue Reading Failure to Provide an Examination Under Oath and Documents Can Result in Lost Benefits

Almost all property insurance policies require that the insured “assist and cooperate” in an insurer’s investigation. If an insured fails to “cooperate,” an insurer may have the right to deny a claim. However, the insurer cannot demand that an insured cooperate with every request. This blog discusses what requests you should ensure an insured cooperates with, what lack of cooperation may be grounds for a denial, and how to manage an insurer’s overbroad and unreasonable request. Most of the principles here are not unique to California and can serve as a general guide almost everywhere else.
Continue Reading What Constitutes Cooperation with an Insurer’s Claim Investigation in California – Ensuring Compliance and Avoiding Unnecessary Harassment

“Please do this, tell us that and please send us these documents.” Every day I hear this from potential clients, public adjusters representing policyholders, and restoration contractors asking what they have to do and provide. I often end up litigating the same issues in court. Insurance companies often leave the “please” out of the never-ending letters they send following a loss demanding information before paying money. Many insurance company adjusters seem a lot more allegedly concerned about thoroughly investigating a loss than they do about providing prompt payment.
Continue Reading California Policyholders Need to Cooperate with Their Insurers Following a Property Loss. What Does That Mean?

An insurance company may have the right to examine its insured under oath in connection with its investigation and evaluation of an insurance claim. Most insurance policies impose an obligation on the insured to cooperate with the post-loss investigation. An insured’s failure or refusal to comply with an obligation to cooperate by submitting to an

Insurance policies impose a duty on insureds to cooperate with the insurer’s investigation of a claim. An insured’s duty to cooperate encompasses the insured’s obligation to appear for an examination under oath (“EUO”), if requested, and to provide documentation verifying the loss. “Cooperation clauses” generally have been held to be material provisions of insurance policies with compliance therewith a condition precedent to coverage.
Continue Reading Can My Insurance Company Deny My Claim For Failure to Cooperate With Its Investigation?

Colorado passed very pro-consumer legislation stopping insurance companies from overusing the cooperation clause in property insurance policies.1 Denver based Merlin Law Group attorney Jon Bukowski explained that some insurance defense counsel have aggressively used the cooperation clause in property insurance policies as a sword in an attempt to obtain a forfeiture of insurance policy benefits.
Continue Reading Forfeiture of Benefits For Failure To Cooperate Stopped Under New Colorado Law

After filing a claim, insurance companies will at times request a substantial amount of information, leaving many Coloradans feeling overwhelmed. However, a failure to respond to the requests (aka “failure to cooperate”), could cost an insured their owed insurance claim benefits. Recently the United States District Court, District of Colorado, discussed this issue in its review of a Motion for Summary Judgment in Cribari v. Allstate Fire & Casualty Insurance Company.1
Continue Reading Insurance Company Hassles? What Policyholders Need to Know About Insurer Requests For Documents and Information