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; or
b. 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.
2.
3.
When delay is attributable to the insurer;
When there was no prompt objection; and
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.
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This provision must be liberally construed in favour of the insured.
