Duty to Cooperate
The policyholder's obligation to assist the carrier in investigating and adjusting a claim, including providing information, allowing inspections, submitting requested documentation, and participating in examinations under oath if requested.
The duty to cooperate is the policyholder's contractual obligation to assist the carrier in investigating and adjusting a claim. It is one of the standard conditions of coverage under every property insurance policy.
What Cooperation Looks Like
Typical cooperation includes giving prompt notice of the loss, submitting a sworn proof of loss within the policy timeframe, allowing the carrier to inspect the damaged property, providing requested documentation (photos, receipts, repair estimates, financial records where relevant), and attending an examination under oath if requested. Each step is triggered at a specific point in the claim process.
Why the Clause Exists
Insurance is a contract of utmost good faith. The carrier needs to verify the loss, determine coverage, and quantify the amount owed. Without cooperation from the policyholder, none of that is possible. The cooperation clause aligns the policyholder's incentives with the investigation process so that legitimate claims can be paid promptly and fraudulent ones can be identified.
When Cooperation Becomes an Issue
Claims where cooperation is disputed typically involve suspected fraud, unusual loss circumstances, or unusually large claim amounts. Repeated refusal to provide requested information, allow inspections, or attend an EUO gives the carrier grounds to deny coverage under the cooperation clause. Legitimate policyholders with nothing to hide usually have no trouble satisfying the duty; the clause is a backstop against those who would game the system.
Frequently asked questions
Cooperation typically includes providing a prompt notice of loss, a sworn proof of loss, access to the damaged property for inspection, documentation of the loss (photos, receipts, inventory), and submitting to an examination under oath if the carrier requests one. The cooperation clause in the policy defines the specific obligations.
Breach of the cooperation clause can void coverage for the claim. Carriers do not usually deny claims for minor cooperation issues, but refusal to provide requested documentation, allow inspection, or attend an EUO after repeated requests can give the carrier grounds to deny or limit coverage.
Yes, especially during examinations under oath. Having counsel present during significant claim discussions is standard practice for larger or contested claims. Attorneys ensure questions stay within scope and that responses are properly recorded.
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