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Old 07-14-2024, 11:29 AM
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On the insurance issue, I'e been on both sides of the table (representing insurers and representing insureds).

The alpha and omega is what the policy says. If there is a specific condition required, it better be in there in black and white or the ambiguity goes against the insurer. For example, I represented the insured on a first-party burglary claim where there insurer denied the claim because the policy required a working burglar alarm at the property. Well, it had one but it wasn't turned on at the time. The insurer (mis)interpreted the policy to require that the alarm be armed at the time of the burglary. If the policy in this case does not require a specific security measure at the time of the theft, it is not a part of the insurance contract, period.

Now, on the flip side, if the loss is big and the circumstances are 'dumbass' or worse in terms of the insured's conduct, the insurer may call in its own attorneys to conduct an "examination under oath" (EUO) of the insured and any other related parties, like employees. The EUO functions like a deposition and the insured may be required to cough up documentation related to the costs of the stolen items as well as the insured's own financial condition. Failure to cooperate may be cause to reject the claim. The insurer will look especially hard at the finances of the insured to see whether there is a financial motive for a fraud case. Actually voiding a policy for fraud is rare but knocking down a claim for lack of proof is not.

Assuming that there is no evidence of fraud and no solid basis to refuse the claim for non-compliance with policy terms, the real action revolves around valuation of the loss. Most of what was stolen is readily valued since it is slabbed mainstream stuff, but there may be some battles on the periphery over whether a card is deserving of a premium for some reason (eye appeal etc.).

Hope this answers some questions.
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