Fire Loss, Sworn Proof, and a Reservation of Rights

The adjuster should treat the proof of loss and examinations under oath as policy conditions and calendar every deadline immediately. The proof of loss should be sworn, itemized, and based on documented amounts. Because the POS system was destroyed, the adjuster should reconstruct sales and income from bank deposits, tax returns, vendor records, payroll, credit-card statements, and any cloud backup. If the 60-day deadline cannot be met with accurate figures, the adjuster should request a written extension before the deadline, explaining the missing records and the reconstruction effort. Marcus should never sign a blank proof of loss or allow the adjuster to guess at contents or income. The examination under oath requires the insured and bookkeeper to appear and answer truthfully; the adjuster can prepare them, organize documents, and attend if the policy and insurer allow, but cannot answer for them. The reservation of rights is not a denial, so the adjuster should continue cooperating while preserving coverage objections in writing.

Not yet, and not for the coverage question. Appraisal is generally a mechanism to resolve the amount of loss when coverage is accepted or when the parties disagree only about value, scope, or repair cost. It does not decide whether arson occurred, whether the insured caused the fire, or whether a policy condition was breached. If the insurer has reserved rights on causation and coverage, demanding appraisal may be premature and may not force payment. The adjuster should first demand the insurer's specific coverage position, the evidence supporting arson, and the exact suppression-system condition allegedly breached. The adjuster should preserve and inspect the fire scene, obtain the fire marshal's report, and retain an origin-and-cause expert if needed. Appraisal can still be useful later for the amount of covered damage if coverage is accepted or if the only remaining dispute is valuation. Documenting the coverage dispute separately from the valuation dispute prevents the insurer from using appraisal to avoid deciding coverage.

The adjuster should build a dated claim file containing the policy, all endorsements, the reservation of rights, every insurer request, and every response. Preserve the fire marshal's report, photographs, video, witness statements, and origin-and-cause evidence. Keep the emergency board-up invoice, mitigation contracts, repair estimates, inventory, receipts, purchase records, tax returns, profit-and-loss statements, bank statements, payroll records, and proof of lost income. Document the insurer's refusal to discuss scope, the demand for a "perfect" proof, and any delay in responding. Save emails, letters, fax confirmations, portal screenshots, and phone logs. The adjuster should also track business-income and extra-expense calculations separately, because those are often disputed after the property damage is resolved. If suit becomes necessary, the insured must comply with the policy's suit-limitation period and any statutory bad-faith demand requirements. A well-organized chronology showing the insurer's conduct and the insured's cooperation is more useful than a premature bad-faith threat.