What is a proof of loss and when is it required for apartment claims?

A proof of loss is a formal, sworn statement that the insured submits to the insurance company documenting the facts and circumstances of a covered loss and the amount claimed. The ISO Commercial Property Conditions form (CP 00 90, Section E.3) requires the insured to submit a signed, sworn proof of loss within 60 days after the insurer requests one. The document must include the time and cause of loss, the interest of the insured and all others in the property, all other insurance policies that may cover the loss, detailed repair or replacement cost estimates, and inventory of damaged property.

The proof of loss is a critical document because it becomes the legal basis for the claim. The amount stated in the proof of loss caps the insured's recovery unless the proof is amended. Submitting an inaccurate or incomplete proof of loss can delay claim payment or provide grounds for the insurer to deny the claim. Conversely, failing to submit a proof of loss within the required timeframe can void coverage for the claim under the policy's conditions.

Some states have modified the proof of loss requirements by statute or regulation. For example, Texas Insurance Code Section 542.055 imposes separate prompt-payment obligations that run from the date the claim is reported, not from the date a proof of loss is submitted. New York Insurance Law Section 3407 requires insurers to provide proof of loss forms within 30 days of receiving notice of loss.

For major apartment losses, the proof of loss should be prepared with the assistance of a public adjuster or insurance coverage attorney who can ensure the document accurately reflects the full scope of covered damages, including property damage, loss of rents, ordinance or law costs, and extra expenses. Signing a proof of loss that understates the claim amount can leave significant money on the table.