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The Insured’s Duty To Cooperate

Most policies contain a cooperation provision which might read as follows:

 

DUTIES AFTER AN ACCIDENT OR LOSS

"A person seeking any coverage must:
Cooperate with us in the investigation...of any claim or suit."

The Georgia courts have interpreted the cooperation clause to require that the insured cooperate with his insurer in the investigation of accidents, the securing of evidence, giving notice of the accident, and making full, fair, complete and truthful disclosures of the facts known to them relative to the claim when called upon to do so. St. Paul Fire & Marine Insurance Company v. Gordon, 116 Ga. App. 658 (1967); H.Y. Akers & Sons, Inc. v. St. Louis Fire & Marine Insurance Company, 120 Ga. App. 800 (1969). A breach of the cooperation provisions by the insured relieves the insurer of its obligations to pay any claim asserted. Hurston v. Georgia Farm Bureau Mutual Insurance Company, 148 Ga. App. 324 (1978).

The insurer has the burden of showing, prima facie, a violation of the agreement by the insured and that it has been diligent and acted in good faith in seeking to obtain the insured's cooperation. The breach, once prima facie is shown, shifts the burden to him who seeks to enforce a claim under the policy to show justification or excuse therefore. The insurer is not required to anticipate or negate all excuses or reasons that might justify denial. The breach of the clause is prima facie when it appears that the insurer made reasonable efforts to obtain the insured's cooperation without success. Wolverine Insurance Company v. Sorrough, 122 Ga. App. 556 (1970); H.Y. Akers & Sons, Inc. v. St. Louis Fire & Marine Insurance Company, Supra.

In Hurston, Supra, the insured was shown to have acted in collusion with a claimant in an automobile accident, and assisted the claimant in pursuing a bogus claim against Farm Bureau. The Court of Appeals held that such collusive activities violated the Cooperation Clause of the automobile policy which governed the conduct of the parties. As a result of false statements to the insurer by the insured and collusive activity by the insured, the Court of Appeals held that no coverage was afforded to the insured under the policy.


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