Connecticut Appellate Court Finds Summary Judgment In Favor Of Insurer Proper Where Insured Failed To File Proofs Of Loss

In Palkimas v. State Farm Fire and Casualty Co., 2014 Conn. App. LEXIS 244 (June 3, 2014), the Connecticut appellate court analyzed the policy requirement for a claimant to submit a proof of loss. The plaintiff, Palkimas, filed a breach of contract claim against State Farm for failure to provide coverage for damage to the plaintiff’s home caused by a ruptured sanitary pipe. At the time of the incident, Palkimas had a homeowners policy issued by State Farm. In September 2006, the plaintiff suffered damage to his property when workers negligently used a toilet that had been blocked off resulting in a buildup of sewage, and the sanitary pipe ruptured, spreading sewage and fecal matter throughout the plaintiff’s home. Later, in 2007, while attempting to repair the damaged pipe, the plaintiff discovered that freezing temperatures caused substantial damage to his home.

The plaintiff notified State Farm of the two claimed losses, but never filed a proof of loss for either of his claims. The plaintiff hired a public adjuster to negotiate with State Farm on his behalf, but State Farm eventually denied coverage for both claims, citing the plaintiff’s failure to submit a proof of loss. The plaintiff did not dispute that no proof of loss was ever filed.

The plaintiff argued that an insurer has the burden of proving prejudice when it refuses to compensate for a covered loss on the ground that the insured failed to submit sworn proof of loss statement. He argues that the question of whether State Farm was prejudiced was a question of material fact, and that summary judgment was inappropriate.

The court distinguished between a delayed proof of loss and a failure to file a proof of loss. The cases cited by the plaintiff in support of the burden of proving prejudice being on the insurer all dealt with delayed proofs of loss, not the failure to file a proof of loss. The court found that the failure to file a proof of loss was fatal to the plaintiff’s breach of contract claim, and the court found that State Farm was entitled to summary judgment, and affirmed the trial court, which had found the same.


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