In an unusual first-party insurance case we obtained a settlement of $32,000 for the client’s total loss of his motor vehicle.
The client’s SUV was stolen. It turned-up on the side of the road in Westchester County. It had been set on fire and was a total loss.
At first glance there appeared to be nothing unusal about the claim. The client called his insurer, Nationwide Insurance Company, and it inspected the burnt hulk. The client did not cause the loss and was innocent. Nationwide was getting ready to pay the claim.
Here is where it gets a little more interesting. The insurance company asked its insured, our client, to fill-out an accident loss affidavit setting forth the particulars of the loss. The client failed to send it. After numerous written requests by Nationwide the client still failed to file his report. Finally, Nationwide denied the claim on the ground that its insured failed to cooperate in the investigation.
Initially, the insurance company appeared to be right. An insured must cooperate with his insurance company in investigating and settling a loss. Nationwide’s requirement of a loss affidavit was not unreasonable. However, there was a reason why the client never filled-out the paperwork. The client suffered from extreme Attention Deficit Disorder. He was under medical care, and his psychiatrist said that he was unable to pay his bills and file his taxes. Also, the client was hospitalized for addiction rehabilitation for at least a month during this period.
We brought suit against Nationwide, and we were able to convince them the client’s failure to file the loss papers was not wilful and should be excused. Nationwide agreed to pay the actual cash value of the SUV.
If you have an unpaid first-party property insurance claim please call me at 800-581-1434.
Mark E. Seitelman, 12/8/08, www.seitelman.com.