Proof of Loss Timeframes and Compliance Can Be Waived
The Michigan appraisal case discussed in “What is Michigan Appraisal Law?” also had an important discussion and finding about proof of loss requirements under Michigan law. The insurer, once the policyholder demanded appraisal to determine the amount of loss, raised the late filing of a proof of loss as a complete defense.
The Michigan court noted that insurance company actions can result in waiver of proof of loss requirements:
Defendant first argues that plaintiff’s claim for recovery is barred because plaintiff failed to submit its sworn proof of loss within 60 days from the date of the loss. Defendant correctly points out that in general, an insured is precluded from filing a claim under the applicable insurance policy if it fails to submit a proof of loss within 60 days from the date of the loss, absent waiver of the 60-day requirement by the insurance carrier. Auto-Owners Ins Co v Gallup, 191 Mich App 181, 183-184; 477 NW2d 463 (1991). ‘Waiver is defined as the intentional and voluntary relinquishment of a known right.’ Moore v First Security Cas Co, 224 Mich App 370, 376; 568 NW2d 841 (1997) (citations omitted). A waiver may be ‘evidenced by a party’s decisive, unequivocal conduct reasonably inferring the intent to waive.’…
On this record, we conclude that defendant waived any defense barring plaintiff’s claim for failure to submit a proof of loss within 60 days. The loss at issue here occurred in July 2021. Although plaintiff did not formally submit the proof of loss at issue in this case until October 27, 2021, defendant advanced partial payments on the claim in August 2021, impliedly waiving the 60-day requirement. By our calculations, the initial deadline to submit a proof of loss was September 7, 2021.1 However, defendant extended the deadline for submission twice: first on September 17, 2021, when defendant informed plaintiff that its investigation of the claim was complete, and for a second time on October 13, 2021, when defendant told plaintiff to submit the additional proof of loss by November 12, 2021. By communicating that it would continue to accept the statement of loss past the deadline in the contract, defendant expressly waived the 60-day requirement. 1
The partial payments satisfied the waiver of the proof of loss requirements.
Arguing there was a waiver of the proof of loss requirements is not the position a policyholder wants to be in. Instead, comply with the proof of loss requirements or get a written extension as a best practice.
Thought For The Day
Get up, stand up, Stand up for your rights. Get up, stand up, Don’t give up the fight.
—Bob Marley
1 Cantina Enterprises II v. Property-Owners Ins. Co., No. 363105 (Mich. App. Jan. 18, 2024).
