TITLE 10

NOTICE OF LOSS
Reported by: Margaux C. Mercado
General Rule:

Insured noncompliance
Bars the right to
with the terms and
recovery
conditions of the policy
Conditions after Loss
Section 90
In case of loss upon an insurance against fire, an insurer is exonerated, if
written notice thereof be not given to him by an insured, or some person
entitled to the benefit of the insurance, without unnecessary delay. For
other non-life insurance, the Commissioner may specify the period for the
submission of the notice of loss. (a)

Section 91
When a preliminary proof of loss is required by a policy, the insured is not
bound to give such proof as would be necessary in a court of justice; but it
is sufficient for him to give the best evidence which he has in his power at
the time.
Conditions after Loss

1. Notice of Loss
2. Preliminary proof of Loss
I - Notice of Loss

Purpose: Apprise the insurance company with

the occurrence of the loss.
gather information
make proper investigation
protect its interest
I - Notice of Loss

Necessity of Notice of Loss

If the notice of loss is not given to the insurer by the
person insured without unnecessary delay or in a
timely manner, the insurer is exonerated.

Section 90: In case of loss upon an insurance against fire, an insurer is exonerated ()
I - Notice of Loss
Time for giving Notice of Loss
Notice of loss must be given without unnecessary
delay which means within reasonable time.

Fire: Immediately
Non-life insurance other than fire: Commissioner may
specify the period
Stipulated in the policy: Valid
I - Notice of Loss

Excuse for non-compliance

Compliance with the requirement is impossible
or unreasonable and the insured has not failed
to use due diligence.
 II - Proof of Loss

Definition
The evidence given to the insurer of the occurrence
of the loss; the particulars and the data necessary to
enable the insurer to determine its liability, and the
amount thereof.
II - Proof of Loss
Form
Fire: Written (Section 90)
Other non-life insurance : Written/Oral
II - Proof of Loss

Purpose
a. Give the insurer information by which he may
determine the extent of his liability
b. Means of detecting fraud
c. Operate as a check upon extravagant claims
Burden of Proof :Insured/Beneficiary
Life Insurance: Death of the insured must be
proven
Property insurance: That there is a loss which the
policy protects
Insured Insurer
There is
Approved
a loss

Notice Denied

Proof of
loss
Waiver of Defects
Section 92 - All defects in a notice of loss, or in preliminary proof
thereof, which the insured might remedy, and which the insurer omits to
specify to him, without unnecessary delay, as grounds of objection, are
waived.

1. When the insurer fails to specify to the insured any defect in the
notice or proof of loss which the insured might remedy without
unnecessary delay.

2. When the insurer already made partial payment of the loss of the
property insured.
Waiver of Defects
3. When the insurer denied liability on a ground other than the defect
in the notice or proof of loss

Example:
o Policy required that the proof of loss to be executed before a notary
public, instead of complying the insured just wrote a letter informing
the insurance company of the loss. The insurance company declare the
policy null and void.
Question: May the insurer still raise the defect in the proof of loss as a
defense?
Answer: No, the denial of liability on other grounds was a waiver of
the defect in the proof of loss
Waiver of Delay
Section 93 : Delay in the presentation to an insurer of notice or
proof of loss is waived if caused by any act of him, or if he omits
to take objection promptly and specifically upon that ground.

1. Where the delay was caused by an act of the insurer

2. Where the insurer failed to object to the delay promptly
and specifically upon such ground.
Certification of Third Person
Section 94 : If the policy requires, by way of preliminary
proof of loss, the certificate or testimony of a person other
than the insured, it is sufficient for the insured to use
reasonable diligence to procure it, and in case of the refusal of
such person to give it, then to furnish reasonable evidence to
the insurer that such refusal was not induced by any just
grounds of disbelief in the facts necessary to be certified or
testified.
Certification of Third Person
Whenever the policy requires by way of preliminary proof
of loss, a certification of a third person, failure to present
the same will not necessarily be fatal to the insureds claim.

In case third person from whom the certification is required

refuses to certify, the insured will have to present
reasonable evidence.