One of the last things you want to think about when your family home or your business has been damaged by storm or other event is jumping through all the hoops and paperwork that your insurance company requires. One of those hoops that is commonly seen after a sworn proof of loss is filed is an insurance company’s request for an Examination Under Oath (EUO).
Receiving a letter for an Examination Under Oath (EUO) can be a triggering experience, especially when dealing with a property damage claim in Wisconsin. Usually by that time you or your business has paid significant amounts of money for insurance premiums and the response in your time of loss is to put every aspect of the claim under a microscope. Rest assured, when you receive this request for an Examination Under Oath (EUO), the correct move is to be on high alert and contact a lawyer.
When you contact a Wisconsin insurance coverage lawyer to discuss this request, the lawyer will help answer your questions so that you can understand your rights and responsibilities pursuant to the insurance policy and comply with how the law is interpreted in respect to your claim.
Understanding Examination Under Oath (EUO)
An EUO is a formal procedure wherein the insured, under oath, answers questions posed by the insurance company’s representative, generally, another lawyer. It is akin to a deposition. There is no judge present to “rule” on anything, but this is a process designed by the insurer to gather additional information about the claim, assess its validity, and determine whether it has any coverage defenses. These EUOs are opportunities for the insurance company to investigate ways in which it could pay less, whether it is by undercutting the total value of your claim, or by finding facts it could use to support a coverage defense that would allow it to pay you less than what you are seeking.
Non-Cooperation Defense in Wisconsin
One of the common tactics employed by insurance companies or their lawyers in Wisconsin is to push the insured who sustained the loss far enough to make that insured fail to cooperate with the investigation. Often the insurance company will seek private, personal financial information of you or your business as a precursor to paying the claim. If you fail to adequately “cooperate” with this aspect of the investigation, the insurance company could assert the insured failed to comply.
Consequences of Non-Cooperation:
If a policyholder fails to cooperate with the insurance company, then the company may turn to the following tactics to attack your claim:
- Claim Denial: The insurance company may deny the claim entirely if your non-cooperation hampers the investigation process. One of the questions then is whether the investigation was actually “prejudiced,” but that often becomes an issue that unfortunately courts side with the insurance companies.
- Legal Action: In some cases of non-cooperation, the insurance company may pursue legal action against you for a declaratory judgment citing breach of contract
In Patenaude v. Safeco Insurance Co. of America, 639 N.W.2d 224, 249 Wis. 2d 489 (Wis. Ct. App., 2001), the court of appeals confirmed the basic requirements that policyholders must abide by when submitting a claim. Patenaude had suffered a fire loss and was in the process of making a claim with Safeco. Instead of cooperating with the insurance company’s lawyer and appearing at an Examination Under Oath, and assisting in other aspects of the investigation, his lawyer decided to file suit immediately.
Here, the court noted that “the terms of the insurance policy provide Safeco with the opportunity to examine its insured under oath before making a decision about a claim.” Ultimately, the court of appeals held that this was a substantial breach of the policyholder obligations by Patenaude.
The lesson from the Patenaude decision for policyholders is clear. The best way to manage these requests from the insurance company is consulting with an experienced insurance coverage lawyer to address these issues strategically so that coverage benefits are not lost because of a failure to cooperate adequately.
When your insurance company notifies you that it is seeking an Examination Under Oath, reaching out to an experienced Wisconsin lawyer is necessary. Once you obtain legal representation, that lawyer can help you cooperate strategically and effectively so that you are best prepared for the EUO.
Facing an EUO might be challenging, but with the right preparation and legal support, you can assert your rights and work towards a fair resolution of your property damage claim in Wisconsin. You need to protect your rights and contact experienced legal counsel to assist.