Section 5.26 Cooperation

• Library: Insurance Practice 2015

A person claiming coverage under this policy must also:

(1) Cooperate with us and assist us in any matter concerning a claim or suit;

(2) Send us promptly any legal papers received relating to any claim or suit;

(3) Submit to physical examinations at our expense by doctors we select as often as we may reasonably require;

(4) Authorize us to obtain medical and other records;

(5) Provide any written proofs of loss we require.

To successfully deny coverage for a breach of a cooperation clause, an insurer must prove (1) substantial prejudice resulting from the breach and (2) the exercise of reasonable diligence to secure the insured’s cooperation. Riffe v. Peeler, 684 S.W.2d 539 (Mo. App. W.D. 1984). The noncooperation of one insured may even negate coverage of other insureds if the policy provides that coverage is dependent on the cooperation of all insureds. Hayes v. United Fire & Cas. Co., 3 S.W.3d 853 (Mo. App. E.D. 1999). In that case, this was true despite the presence of a severability clause.

Whether the notice provision in a cooperation clause is enforceable depends on whether the insurer has been prejudiced by the delay or lack of notice in that particular claim. Greer v. Zurich Ins. Co., 441...