What can occur in case your proof of loss is late or delayed? Can your declare be denied due to a technicality similar to this? Different states have totally different stances on this and in Wisconsin two statues govern this. Wisconsin Statute §§ 631.81 and 632.26 govern discover provisions in Wisconsin insurance coverage insurance policies and set out the rights and duties of the insured and the insurer.
Wisconsin Statute § 631.81 is entitled “Notice and proof of loss.” Subsection (1) reads:
TIMELINESS OF NOTICE. Provided discover or proof of loss is furnished as quickly as fairly attainable and inside one 12 months after the time it was required by the coverage, failure to furnish such discover or proof throughout the time required by the coverage doesn’t invalidate or cut back a declare except the insurer is prejudiced thereby and it was fairly attainable to satisfy the time restrict.
If the discover comes as quickly as fairly attainable and inside a 12 months of the coverage deadline, the declare just isn’t invalidated except the insurer was prejudiced by the delay and it was fairly attainable to satisfy the time restrict.1 Wisconsin Statute 632.26 locations the burden on the insured to point out it was not fairly attainable to offer discover throughout the prescribed time, and locations “the risk of nonpersuasion . . . upon the person claiming there was no prejudice.”2 This statute applies to all insurance coverage insurance policies, together with claims-made insurance policies {and professional} legal responsibility insurance policies.3
In Ehlers v. Colonial Penn Insurance Company, there was a query whether or not the delay was fairly needed.4 The court docket held that the insurer had waived their prejudice protection. The court docket primarily based its holding on waiver, partly:
[T]hat underneath the information and circumstances of this case, significantly the truth that the discover of accident despatched by the plaintiff to the insured on March 7 was returned by the insurer on March 12 with a request for added info and the truth that the defendant denied legal responsibility not more than seven days after receiving the extra info, the defendant denied protection as a matter of regulation inside that point the plaintiff might have submitted her proofs.5
While it’s good to know remember in regards to the impact of delays on offering proofs of loss relating to an insurance coverage declare, the most secure plan of action for Wisconsin policyholders is to be well timed and never present a late proof of loss.6
1 Larson v. Heritage Mut., 132 Wis. second 479, 392 N.W.second 848 (Wis. Ct. App. 1986).
2 Id.
3 Id.
4 Ehlers v. Colonial Penn Ins. Co., 81 Wis. second 64, 75, 259 N.W.second 718, 724 (Wis. 1977).
5 Ehlers, at 81 Wis. second 64, 75, 259 N.W.second 718, 724.
6 Id.