The plaintiff in Evanoff v. The Standard Fire Ins. Co., 2008 U.S. App. LEXIS 15261 (6th Cir. July 18, 2008) suffered flood damage at his condominium. He had purchased a Standard Flood Insurance Policy from Standard Fire for his condominium and its contents. The terms of the policy were governed by 44 CFR 61.4. The policy and regulations required that within 60 days of a loss, the insured submit a proof of loss form signed and sworn to.
Excess rain flooded the insured's property, causing excessive damage to his condominium. He notified Standard Fire and forwarded a Loss notice and a damage estimate of $39,752 from a contractor. Standard Fire's adjuster recommended payment of only $3,440. The adjuster sent the insured a proof of loss form for this amount, but the insured refused to sign and return the form. The sixty day deadline imposed by the policy and federal regulations for submitting a proof of loss expired. Standard Fire then denied the claim based on failure to submit a timely proof of loss.
The insured sued. He argued he had provided every item required by the policy, including a letter that contained his signature. The district court granted summary judgment to Standard Fire because there were no genuine issues of material fact regarding whether a proper proof of loss form had been submitted as required by the policy and 44 CFR 61, App. A (2)(J)(4). The 6th Circuit affirmed, noting federal courts have consistently held that the proof of loss requirements must be strictly enforced. Therefore, the court rejected the insured's argument that he had substantially complied with the terms of the policy.
The Hawaii Supreme Court addressed complying with proof of loss requirements in The Best Place, Inc. v. Penn Am. Ins. Co., 82 Hawai`i 120, 920 P.2d 334 (1996). The policy in Best Place also required submission of a proof of loss within 60 days, which the insured failed to do. Nevertheless, the insurer implicitly waived the 60-day provision by seeking more information regarding the insured's claim. Under these circumstances, the Court held that the insurer's post-deadline request for additional information constituted an implied waiver of any defense based on the 60-day time limitation. Id. at 123, 920 P.2d at 337.
