Additional duty imposed upon insured

With respect to property and life insurance, the insured is required to file a formal proof of loss in order to receive payment. For life insurance, the company only needs proof of the death of the cestui que vie (cqv) and usually a death certificate is sufficient. If no certificate is available, a formal statement of the attending physician or an obituary notice will suffice. More detail may be required in two situations: (a) where the policy provides double indemnity benefits in the case of accidental death, or (b) where the cqv has disappeared and no body has been found. For property insurance, the proof of loss must set out the details of the claim – the time and cause of loss, estimates of the cost of repair or replacement and documentation of other expenses. Failure to file the required proof of loss is usually not a good defense for the insurance company, but intentional concealment or misrepresentation will invalidate the policy.

There is an additional duty imposed upon insured who wish to file claims under property or liability insurance and that is the duty of cooperation. So far as property insurance is concerned, the insured is expected to cooperate in all investigations of the claim, to show the damaged property, submit to examination under oath and produce all relevant books and records. In liability insurance, the duty to cooperate obligates the insured to forward all demand letters and litigation documents to the insurer, attend depositions and hearings, furnish information for answering interrogatories, supply evidence and assist defense counsel. The duty also includes some negative obligations: the insured must not admit liability, make payments to or engage in settlement discussions with third-party claimants or assist the third party in pursuing an action against the insured or the insurer.