We’re asked questions all the time. Policyholders, Agents, Adjusters, Attorneys…everyone has questions about the insurance claims process. We love questions, because it means you’re actively engaged in the claims process.

Here are some of the questions that we’re asked most frequently. This FAQ page is tailored towards the Claimant, so most Agents, Adjusters, and Attorneys contact CDR directly with their most complicated questions.

Claim Deadlines

Examination Under Oath – EUO
An insurer shall furnish, upon request of any person claiming to have a loss under any insurance contract, forms of proof of loss for completion by such person. But such insurer shall not, by reason of the requirement so to furnish forms, have any responsibility for or with reference to the completion of such proof or the manner of any such completion or attempted completion. If a person makes a claim under a policy of insurance, the insurer may require that the person by examined under an oath administered by a person authorized by state or federal law to administer oaths. This provision is included in most insurance policies, although some of the specific wording may vary depending upon the insurance company and/or policy of insurance.

One Year Suit Provision
Suit Against Us. No action shall be brought unless there has been full compliance with all of the policy provisions and the action is started within one year after inception of the loss or damage. This provision is included in most insurance policies, although some of the specific wording may vary depending upon the insurance company and/or policy of insurance. Some policies allow two year deadlines.

Insurance Fraud
Insurance fraud means an act or omission committed by a person who knowingly, and with intent to defraud, commits, or conceals any material information concerning, on or more of the following:

1.    Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, broker, or its agent, false information as part of, in support of, or concerning a fact material to one or more of the following:

• An application for the issuance or renewal of an insurance policy;
• The rating of an insurance policy or contract;
• A claim for payment or benefit pursuant to an insurance policy;
• Premiums paid on an insurance policy;
• Payments made in accordance with the terms of an insurance policy; or
• The reinstatement of an insurance policy;

2.    Willful embezzlement, abstracting, purloining, or conversion of moneys, funds, premiums, credits, or other property of an insurer or person engaged in the business of insurance; or
3.    Attempting to commit, aiding or abetting in the commission of, or conspiracy to commit the acts or omissions specified in this subsection.

This provision is included in most insurance policies, although some of the specific wording may vary depending upon the insurance company and/or policy of insurance.

Insurance Policy Declarations Page
The Declarations Page contains all of the critical information about YOUR particular insurance policy.  It is the page which tells WHO is the named insured, WHAT is being insured (property address, automobile identification, description of property, etc.), HOW MUCH it is being insured for (policy limits), WHEN the insurance policy is in force (inception and expiration dates), WHO ELSE is named on your policy (mortgage information, additional insureds, etc.), DEDUCTIBLES, COVERAGES, and lots of other information which determines what the actual insurance policy covers.

Proof of Loss
The Proof of Loss is the form upon which you formally submit your claim to the insurance company.  Your Proof of Loss will tell the insurance company how much you are asking them to pay you for your loss.  Along with your Proof of Loss you will attach any repair estimates, contents inventories, summaries of expenses, and any other documents which help prove your claim.  By filing a Proof of Loss you are telling the insurance company that you expect to be paid for your loss.  Your Sworn Statement in Proof of Loss is exactly that- a sworn statement that your claim is legitimate.  (Anything less than legitimate could be considered fraud, and defrauding an insurance company is a crime.)

What can I do if I’m unhappy with the claims settlement?
What is an Appraisal?
How long does Appraisal take?
What Appraisal format is best for me?
How do I get started?

What if my claim is going badly?
What is a Public Adjuster?
Should I hire an Attorney? If so, who/when?
How can CDR help me resolve my claims problems?
What should I be doing to resolve my claim?

What should I pay attention to as regards my claim?
Claims Deadlines
Insurance Fraud
Insurance Policy Declarations Page
Proof of Loss
Examination Under Oath-EUO
Appraisal Provision
One Year Suit Provision