Failure to Provide Proof of Loss Results in Loss of Additional Benefits

Andrew Yanez’s Texas property sustained flood damage during a storm in 2016. He filed a claim with his insurance company, American Strategic Insurance Corporation, through which he had a Standard Flood Insurance Policy. He’d also filed a prior flood loss claim on the property in 2014. After an adjuster evaluated the property, ASIC paid Yanez $1,315.20, which was less than what Yanez believed was due. Yanez lost an administrative appeal because he failed to provide evidence that he made repairs required after the 2014 flood and before the 2016 flood. Yanez filed suit against his insurer and the adjusting firm for breach of contract and breach of the duty of good faith and fair dealing. The district court dismissed the claim for breach of the duty of good faith and fair dealing, and rendered summary judgment against Yanez on the breach of contract claim finding that Yanez had failed to submit a proof of loss following the 2016 flood. Find out whether the Fifth Circuit Court of Appeals agreed with Yanez that he was not required to submit a form and that the defendants waived any such requirement by their conduct here: