Duty To Cooperate

Lots of people in Weatherford, Mineral Wells, Aledo, Azle, Willow Park, Hudson Oaks, Springtown, Millsap, Brock, and other places in the Parker County area and for that matter, other places in Texas may not realize that they have responsibility under their insurance policies to cooperate with their insurance company with any claim that is being made against the insurance policy.
This “duty to cooperate” can be confusing at times. There can sometimes be a fine line between what the insurance company has a responsibility for investigating and what the insured must do to help in that investigation.
The Texas Insurance Code, Section 541.060 provides a guideline for some of the things that can be done or asked for by an insurance company in its investigation. Section 541.060(a)(9), is one place where limits are placed on that investigation.
Of relevance is the Prompt Payment of Claims Act. This section of the Texas Insurance Code sets the timelines for payment of claims but part of those time lines takes into consideration the insured’s cooperation with the insurance company in conducting its investigation.
The Beaumont Court of Appeals issued an unpublished opinion in 1998, that is interesting. The style of the case is William Norris v. Fire Insurance Exchange. Here are some of the facts of that case.
William Norris’ home was insured under a policy issued by Fire Insurance Exchange (FIE). Norris’ home was burglarized on December 10, 1994, and he immediately reported the burglary to the police. Norris notified FIE of the loss two days after the burglary. Norris submitted a sworn proof of loss, he gave a recorded statement, and he submitted to an examination under oath. FIE refused to pay the claim because Norris’ alleged wife did not submit to an examination under oath, and because Norris failed to provide the address and phone number of his father. Norris filed suit against FIE, and the trial court granted summary judgment in favor of FIE.
The Beaumont Court of Appeals reversed the summary judgment. In its ruling, the court said that although a spouse of the named insured is required to submit to an examination under oath, a fact issue existed as to whether the woman in question was the legal spouse of Norris.
With regard to the failure to cooperate, it is recognized that the insured has a general duty to cooperate with the insurance company in the investigation of the claim. However, what constitutes a breach of the duty to cooperate is usually a question of fact and thus not appropriate for a summary judgment ruling. Whether Norris’ refusal to provide his father’s address and phone number constituted a breach of the duty to cooperate was also a fact issue for the jury and not appropriate for summary judgment.
An experienced Insurance Law Attorney needs to be involved when an insurance company starts asking for recorded statements and especially when the insurance company asks for an examination under oath. Many things an insurance company will ask for, simply are not relevant to the claim and “none of their business.” Most people would not understand the difference between what is relevant and what is not relevant and thus the need for an attorneys’ help.