Wisconsin Guide To Property Insurance Claims: Deadlines & FAQs

In order to initiate a claim under a property insurance policy in Wisconsin, the policyholder must inform their insurance carrier of the loss (either directly or through their agent), and that they are making a claim. This means that the only requirements to initiate the process is that the insurance carrier is informed that there has been a loss, some details about the loss, and that the policyholder wants to make a claim.  

In many cases, an insurance company will call this communication a first notice of loss, or FNOL. In Wisconsin, insurance laws call this communication a “notification of claim.” 
 
Most insurance companies provide multiple ways to contact them after a loss to begin the claims process, these usually include: 

a. Phone call (a number is usually provided on the insurance company’s website);
b. Online portal – many insurance companies have an online form to notify the claims department of a loss, this may even be through a mobile app;
c. Your agent – many insurance companies even have a different section of their website or phone number for an agent to inform them of a policy-holder’s loss;
d. Online software as a virtual assistant. 

While it is easy and quick to start a claim, claimants need to continue to follow-up and provide more information. In many cases, the insurer will require more information and supporting documentation, including specific forms, to actually process and adjust the claim. These specific necessary forms should be provided to the claimant by the insurance company. 

1. Promptly inform your insurance carrier of the loss (see above);

2. As soon as possible begin to mitigate the damage – protect the property and secure it against further damage as soon as it is safe and possible to do so.

3. Cooperate with your insurance company and communicate with them (and keep copies of all correspondence).

4. Make your property available for inspection as soon as it is safe and possible to do so.

5. Prepare supporting documents for your claim including:
– Inventory list;
– Description of damages;
– Photographs and/or videos of the damage;
– Receipts; etc.

Reporting Deadline: Wisconsin insurance law does not set forth any specific deadline for making a property insurance claim. This means that the deadline for informing the insurer of a claim is set by the policy itself. It is important to be familiar with the insurance policy so that deadlines are not missed. The “standard” policy in Wisconsin requires the policyholder to provide “immediate written notice” of the loss to the insurance company, and to “protect the property from further damage, forthwith separate the damaged and undamaged personal property, put it in the best possible order, and furnish a complete inventory of the destroyed, damaged, and undamaged property, showing in detail quantities, costs, actual cash value, and amount of loss claimed.”

It is always best practice to inform an insurance company of the losses sustained and that a claim is being made as soon as it is reasonably possible to do so after the damage is incurred and a determination that a claim will be filed is made. While it is never a good idea to delay in providing the insurance company with information once it has been determined that a claim will be filed, the actual meaning of “immediate” or “prompt” or “reasonable” with respect to making a claim depends on the circumstances – if a home is completely destroyed by a storm and the phones, internet, and power are off, it may take a little longer to make the claim. 
 
Be sure to check the language of the insurance policy to determine the notification or reporting deadlines. But, in any event, remember that best practice is to provide notice of the loss and claim to the insurer as soon as possible.   

Documentation Deadline: Wisconsin does not really set a specific deadline to provide support for a claim by statute, but instead allows this timeline to be set by the policy itself. The standard Wisconsin property insurance policy requires that a proof of loss document be provided within 60 days of when the loss occurred, so many policies use this language. 

However, Wisconsin does have a statute providing a generally permissive ability to “miss” the policy “proof of loss” deadline. Specifically, “Provided notice or proof of loss is furnished as soon as reasonably possible and within one year after the time it was required by the policy, failure to furnish such notice or proof within the time required by the policy does not invalidate or reduce a claim unless the insurer is prejudiced thereby and it was reasonably possible to meet the time limit.” This means that if the policyholder can prove that it was not reasonably possible to provide the proof of loss on time according to the policy, it can be given any time before 1 year past that deadline as long as the insurer is not prejudiced by the delay.
   
In any event, however, the deadline for submitting a proof of loss may be extended by agreement between the parties. The standard policy proof of loss requirements need substantial information to be provided, so getting started quickly is crucial. Additionally, Wisconsin requires insurers to provide proof of loss forms promptly, within 10 consecutive days, after receipt of notice of claim.
 
Note, however, that no matter the actual deadline for providing supporting documentation, it is always best practice to provide a proof of loss document and support of the claim as soon as possible (while noting that the document only presents the knowledge at the time and may be amended or updated). Getting a properly completed proof of loss to the insurance company quickly is a good way to get the claim process moving along, and to facilitate payment.

Wisconsin has adopted laws governing unfair claims settlement practices to protect policyholders and to provide a streamlined timeline for claims to be handled, and these laws provide deadlines for the acknowledgment and processing of claims.

Deadlines for Acknowledgment: Wisconsin requires insurance companies to acknowledge property insurance claims promptly after receiving notification of the claim unless payment is made within that time period. Promptly is defined by Wisconsin statute as “10 consecutive days.”

Further, Wisconsin requires insurers to provide all “necessary claim forms, instructions and reasonable assistance so that [policyholders] can comply with the policy conditions and reasonable requirements [of the insurer]” within the same prompt, 10-consecutive-day period.    

Deadlines for Investigation: Wisconsin doesn’t really provide a specific breakdown of the time to begin an investigation of the claim. However, Wisconsin does specify that insurers are “to initiate and conclude a claims investigation with all reasonable dispatch.” Unlike “promptly” that we discussed above, “all reasonable dispatch” is not defined by statute. 

Wisconsin requires insurers to “promptly acknowledge pertinent communications with respect to claims arising under insurance policies.” Specifically, as noted above, this means within 10 consecutive days of receipt of the communication.

Deadline for Acceptance/Denial: Wisconsin insurance regulations do not set a specific deadline for the acceptance or denial of a property insurance claim. It is required, however, for an insurance company to “affirm or deny coverage of claims within a reasonable time after proof of loss has been completed.” While “reasonable” is not specifically defined, there are general deadlines for payment – and the failure to comply with the reasonable time standard can subject the company to getting their license to transact insurance revoked.

Deadline for Payment: Wisconsin requires that insurance companies “attempt in good faith to effectuate fair and equitable settlement of claims submitted in which liability has become reasonably clear.” Further, Wisconsin requires insurance companies to “promptly pay every insurance claim.” This “prompt” period is not the 10-day period discussed above, but rather, within “30 days after the insurer receives the proof of loss required under the policy or equivalent evidence of such loss.”

If the insurance company doesn’t pay within the deadlines set forth above, and doesn’t have a valid reason for the delay, the insurer is required to pay interest on the amount due.

Further, if an insurance company is determined to be in violation of the unfair claims settlement practices requirements, the insurer is subject to penalties. While the unfair trade practices requirements do not create a private right of action (the ability for a policyholder to sue the insurance company directly for breach) the policyholder can complain to the state insurance department and the insurer can be penalized. 

Additionally, insurers have a requirement to act in good faith in investigating and settling the claim. A policyholder may file suit against the insurer if they believe the insurer has failed to act in good faith in the processing and settlement of the claim. In order to establish an insurer’s bad faith the claimant must show:

(1) An absence of a reasonable basis for denial of policy benefits;
(2) The insurer’s knowledge or reckless disregard of a reasonable basis for a denial.

If an insurance company is found to have acted in bad faith, the insurance company can be liable for the policyholder’s attorneys’ fees, and can be subject to punitive damages, as well. 

Deadlines to File Suit: Wisconsin sets the deadline to file suit pursuant to a property insurance policy at 12 months “after the inception of the loss.” Note that in Wisconsin, the inception of the loss is not when the loss is discovered by the policyholder, or when the insurance company denies the claim – Wisconsin courts have ruled it means the date on which the loss occurs.