What Will Happen when Your Insurance Company Demands Your Examination Under Oath After You Have a Loss
After you have a loss and make a claim under your property insurance policy, several things are undertaken by the adjuster and other people on behalf of your insurance company.
Some of these things are easily understood:
- You are told to make an inventory of damaged property
- You are asked to provide proof of your ownership of items damaged in the loss
- A title search is performed on your house to be sure you are the registered owner
- Copies of Police or Fire reports are ordered
- You are asked to provide a recorded interview about the loss
However, in some circumstances, this preliminary investigation will lead the carrier to request that you provide much more documentation. Sometimes they will ask for tax returns, bank statements, and even ask that you sign an authorization for them to check your credit history or other financial information.
When the insurance company’s personnel become suspicious about any aspect of your claim, such as the cause of the loss, the amount of the loss, your financial condition as well as many other “red flag” issues, they will investigate even deeper into you and your claim.
After a loss, you will be required to file a Sworn Statement in Proof of Loss; that is the road map to your claim. This is a sworn document, so it is your testimony to the insurance company that you are claiming exactly what you put on that piece of paper. The insurance company will use that Sworn Statement in Proof of Loss as a foundation document in the later steps of their claim investigation.
Under the terms of your policy, the insurance company has the right to demand that you attend and testify at an examination under oath. This provision is found in the portion of your policy called “Section 1 Conditions (2) Duties to an insured(s)”. The insurance company will appoint an attorney and that person will send you a detailed letter stating, at length, what documents you are to provide and bring with you to the examination, and they will set a date and time, typically at the attorney’s offices. The examination is done in the presence of a court reporter who transcribes the entire proceeding, taking down every word of your testimony. This is done for potential purposes of later litigation, and your testimony must be as honest and accurate as you can recall, because it can be raised as an issue later and used against you should you contradict yourself.
The attorney can ask any questions he or she pleases, even those that seem meaningless to your insurance claim. Embarrassing personal questions are not off limits. No matter how troubling, you need to answer truthfully. The testimony you give is critical to your success in receiving payment for your loss.
As licensed Public Adjusters, we are not attorneys, and will not be allowed to attend your examination by the insurance company or their attorney.
When you receive your insurance company’s demand that you attend an examination under oath, you need to have your own attorney present during the exam. Despite this being an expense you might not believe you need to undertake, when the insurance company has a lawyer involved in your claim, you need your own attorney to even the playing field and to show the insurance company that you are taking this seriously.
The examination can sometimes take longer than one day, and you must cooperate and allow the exercise to conclude. If you must go back on a second or even third day, you have the obligation of cooperation as a condition of your policy, and if you fail to do so, you claim can be denied for non-cooperation alone and then you will have lost the ability to pursue your claim. You won’t even be able to sue for breach of contract by the insurance company, because you will be the one who breached it.
After the exam has concluded, the attorney will send a report and a copy of your transcript to the insurance company representative that is handling your claim. This report will indicate what the attorney believes should be done on your claim; acceptance with a recommendation that the claim be paid, or a denial for arson, fraud or misrepresentation. The claim adjuster may agree or disagree with the attorney, and the ultimate decision on your claim lies with the claim adjusters, supervisors and managers at your insurance company.
Should you need a referral to an attorney to represent you, Michigan Fire Claims can provide you with contact information for attorneys that specialize in litigation against insurance companies. These lawyers are highly effective and their success rate is unparalleled in this special field of litigation. They will consult with you at no charge in the initial stages to determine if they can assist you prior to taking on your case.
In the event that your claim is denied after you have given your examination under oath, you may still be able to sue the insurance company in court. Should litigation become a reality in your claim adjustment, Michigan Fire Claims Inc. will provide documents and testimony at deposition in support of the claim that was presented. Often the proof that we provide results is favorable settlements of suits against insurance companies.
Michigan Fire Claims Inc. is here to assist you every step of the way! Contact us today!