FIRST PARTY PROPERTY

HURRICANE & WINDSTORM NOTICE REQUIREMENT

SUMMARY: The insured must give notice of a claim for hurrican or windstorm damage within 3 years of the incident. After a claim has been made, adjusted, and paid on any request for additional money must be submitted within three years of the hurricane or windstorm.

FIRST PARTY PROPERTY BURDEN OF PROOF

SUMMARY: The insured has the initial burden to show there was damage to the property during the policy period. After the insured meets this initial burden, the burden shifts to the insurer to show an exclusion applies under the policy. If the insurer can show an exclusion applies under the policy the burden will shift back to the insured to show there is an exception to the exclusion.

CONCURRENT CAUSE DOCTRINE VS EFFICIENT PROXIMATE CAUSE

SUMMARY: The concurrent cause doctrine states that if a covered and a non-covered peril contributes to a loss, then the loss is covered. Under the efficient proximate cause doctrine, loss is only covered if the event that set the loss into motion is covered under the policy. If the policy does not contain an anti-concurrent clause then the concurrent cause doctrine applies.

ASSIGNMENT OF BENEFITS VS. DIRECTION TO PAY

SUMMARY:If the insured transfer all his rights under the policy it is an assignment of benefits. If the insured maintains some rights then it is a direction to pay. After the insured assigned away their rights, they may not bring a suit under the policy.

LACK OF PREJUDICE INVESTIGATING A LOSS

SUMMARY:There is no lack of prejudice where the insurance company can evaluate the claim. The mere speculation that prejudice exist will not relieve the insurer of its liability. Whether or not the insurer is prejudiced is a question of fact.