The Court found coverage was properly denied due to the insured's failure to strictly comply with the requirements of the National Flood Insurance Act. Hughes v. Am. Nat'l Prop. & Cas. Co., 2013 U.S. Dist. LEXIS 99071 (E.D. La. July 16, 2013).
The insured's home was damaged by Tropical Storm Lee in September 2011. The insured's policy was a Standard Flood Insurance Policy under the "Write Your Own" program with the insurer.
An adjuster was assigned to the claim and gave the insured a claims handbook, which included the requirements for proof loss. The total damage to be paid was $2,586.14. The adjuster sent a proof of loss to the insured for his signature, but never received the form back. The insured claimed he signed and returned the form along with eight documents. The insured also argued he met with the adjuster on numerous occasions at the property. Further, Exhibits 1-8, which included filled out worksheets of the losses, estimates, the NFIP "Final Report," photographs showing the damaged property and its repairs, and his contractor's estimate, were sent to the insurer and should constitute legal proof of loss.
The insurer closed the file without payment because a sworn proof of loss was never provided. The insured sued, and the insurer moved for summary judgment.
The court granted the motion for summary judgment. Because an NFIP participant could not file a lawsuit without having complied with all policy requirements, summary judgment had to be granted if the insured failed to perform the legal obligations outlined in the regulations. These included sending the proof of loss within 60 days after the loss. The proof of loss was to include, among other things,the date and time of the loss, a brief explanation of how the loss happened, and an inventory of damaged personal property.
The documents submitted by the insured were not sworn statements. Because the information required by the proof of loss provision were not supplied, no rational trier of fact could find that he was entitled to receive payment for his SFIP claim.