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Does a Policy Holder Have to Comply With the Conditions of Their Policy?

The state of insurance claims and ensuing litigation has become very contested. In many cases the insurance company explores every possible opportunity to dismiss the policyholder’s case and deny insurance coverage.

One opportunity for an insurance carrier to deny coverage is to identify a condition precedent that the policy holder failed to meet. If the policy holder fails to meet certain conditions it is likely that the insurance policy's language establishes that benefits or coverage may be denied.

Many policyholders do not know that the insurance companies own actions may have negated this defense.

For instance, Florida case law establishes that a material breach by one party may be considered a discharge of the other’s party’s obligations thereunder. See Nacooche Corp. v. Pickett, 948 So.2d 26, Fla 1st DCA 2006). Florida case law dictates that the insurance company is not entitled to specific performance where they did not perform the obligations under the clear terms of the contract.

Thus if an insurance company has materially breached the policy in question than the policy holder should not have any obligations to meet. Many policyholders are unaware of the case law governing this issue and may inadvertently accept the denial by the insurance company. Therefore it is highly recommend that any type of insurance claim be reviewed by an attorney practicing in insurance law.

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