NOTICE OF LOSS

NOTICE OF LOSS Sec. 90. In case of loss upon an insurance against fire, an insurer is exonerated, if written notice thereof be not given to him by an insured, or some person entitled to the benefit of the insurance, without unnecessary delay. For other non-life insurance, the Commissioner may specify the period for the submission of the notice of loss.

Sec. 91 When a preliminary proof of loss is required by a policy, the insured is not bound to give such proof as would be necessary in a court of justice; but is sufficient for him to give the best evidence which he has in his power at the time.

What is Notice of Loss?

It is the more or less formal notice given the insurer by the insured or claimant under a policy of the occurrence of the loss insured against

Purpose: To apprise the insurance company with the occurrence of the loss so that it may gather information and make proper investigation while the evidence is still fresh, and take such action as may be necessary to protect its interest from fraud or imposition; in the case of property insurance, to prevent further loss to the property.Is there a form required?

In case of loss upon an insurance against fire, the law requires a written notice thereof. The law does not make any requirement as to the form in case of other non-life insurance.

Time for giving Notice of Loss

1. the notice of loss upon an insurance against fire must be given without unnecessary delay.

2. for non-life insurance, other than fire, the Commissioner may specify the period for the submission of the notice of loss

3. the insurance contract may provide that the notice of loss shall be given within a state of time after the loss occurs and that failure to give the notice within such time shall preclude recovery.

What is Proof of Loss?

It is more or less formal evidence given by the insured or claimant under a policy of the occurrence of the loss, the particulars thereof and the data necessary to enable the company to determine its liability and the amount thereof.It is not required to submit a preliminary proof of loss unless there is a stipulation in the policy requiring submission of proof of loss.

Evidence Required: The best evidence which the insured has in his power to submit. However, if the claim is denied and the insured is constrained to file a case in court, the burden of proof is on the insured to prove his cause of action by preponderance of evidence.

General Rule: Timely compliance with the conditions is required as a condition precedent to the right to recover under the policy.

Excuses of non-compliance with conditions

Failure to give notice and proof of loss will be excused when it is due to the death or incapacity of the insured or the fact that the beneficiary had no knowledge of the existence of the policy of the insured who died before the fire.

Defects in Notice and Proof

Sec. 92. All defects in a notice of loss, or in preliminary proof thereof, which the insured might remedy, and which the insurer omits to specify to him, without unnecessary delay, as grounds of objection, are waived.When defects in notice or proof deemed waived.a. Joins in the proceedings for determining the amount of the loss by arbitration, making no objections on account of notice and preliminary proof; orb. Makes objection on any ground other than a formal defect in the preliminary proof.Effect of Delay

Sec. 93. Delay in the presentation to an insurer of notice or proof of loss is waived if caused by any act of him, or if he omits to take objection promptly and specifically upon that ground.When delay in presentation of notice or proof deemed waived.1. When delay is attributable to the insurer;2. When there was no prompt objection; and3. There was an objection but not specifically on the ground that there was delay of notice or proof of loss. Sec. 94. If the policy requires, by way of preliminary proof of loss, the certificate or testimony of a person other than the insured, it is sufficient for the insured to use reasonable diligence to procure it, and in case of the refusal of such person to give it, then to furnish reasonable evidence to the insurer that such refusal was not induced by any just grounds of disbelief in the facts necessary to be certified or testified. This provision must be liberally construed in favour of the insured.