119 Trigger the We Pay: How a Sworn Proof of Loss Changes Everything: Shaun Hodge, Melanie Spoon, Cal Spoon

Trigger the We Pay: How a Sworn Proof of Loss Changes Everything https://www.publicadjusterbootcamp.com/ Recorded live at the SRC Summit, this conversation brings together Attorney Shaun Hodge and Public Insurance Adjusters Cal and Melanie Spoon for a blunt, practitioner level breakdown of what actually moves an insurance claim from "stuck" to "resolved." Their core message is simple: most delays, denials, and "frivolous" lawsuits trace back to one root problem, incomplete performance of the policy's Duties After a Loss. When the claim file is built correctly and the Sworn Proof of Loss (SPOL) is submitted as a true package, it triggers the carrier's obligations under the We Pay section, starts real statutory timelines, and forces a decision. From there, the path is clean: pay and close, or breach and face consequences. Expect practical guidance on documentation, process discipline, when to go legal, how to preserve leverage, and why so many professionals unknowingly give the carrier extra time, extra control, and extra "float." Speakers Shaun Hodge: Policyholder Attorney focused on insurance claim litigation and pre suit strategy. Cal Spoon: Public Insurance Adjuster and educator focused on building defensible claim files and contract compliance. Melanie Spoon: Public Insurance Adjuster and operator known for process, documentation standards, and clean file systems that hold up under scrutiny. What You Will Learn Why education is the real separator in claims handling, not influence, hype, or "industry talk." How the SPOL is the carrier's kryptonite because it triggers the first step toward the We Pay obligation. Why the "proof of loss" is not a single page, it is a complete package built from the Duties After a Loss. Why bad faith verdicts are rare, and how most cases never qualify because the policy conditions were not fully met. What the 60 day pre suit notice really does, and how it can become both a delay tool and a leverage point depending on file quality. How to treat the claim like a relay race, where PAs run their lap, then hand off cleanly to counsel at the right moment. Why documentation must be business record quality, not memory, not verbal, not "I remember he said." How supplements and amended SPOL submissions affect timelines, and what does and does not restart the clock. How DRP and managed repair programs should be evaluated against one standard: does it match the SPOL scope and restore pre loss condition. Why appraisal often becomes a "baseball bat" when the dispute is really scope or coverage, not price. The debate around PA fees, historical context, and why they argue it should be treated like other required experts. Key Topics Covered 1) Stop making the contract "gray" The speakers argue the policy is far less confusing than people assume, but it becomes gray when professionals do not follow the Duties After a Loss with precision. 2) The We Pay section is not a suggestion Until the insured's side fulfills the conditions, the carrier can treat payment like a "gimme." Once conditions are met, it becomes obligation. 3) SPOL as leverage, not paperwork They frame the SPOL as the trigger that changes the carrier's risk assessment, shifting you from "low threat" to "this file is dangerous." 4) Why attorneys end up doing adjusting work When a file reaches counsel without proper performance, the attorney spends the pre suit period doing the Duties After a Loss for the first time, which weakens bad faith potential and delays progress. 5) Documentation that survives depositions Contemporaneous field notes, follow up emails, consistent templates, and repeatable process create business records that are admissible and defensible. 6) Timing: do not hand off too early or too late They push a practical expectation that many residential claims should be positioned for resolution or litigation within roughly 60 to 90 days, depending on complexity. 7) Float, delays, and why time is money They explain how carriers benefit when claims linger, and why fast, compliant performance forces either closure or escalation. 8) Engineering reports, rebuttals, and control If a carrier produces a report, you rebut it with specificity and speed. If you do not call out the issues in writing, the carrier later argues they were never given the chance to correct it. 9) Complaints with teeth A complaint should be tied to a clear violation of statute or required timelines, supported by evidence, and copied appropriately including the insured. Memorable Lines and Ideas "You will never force the We Pay section until you perform the Duties After a Loss." "The proof of loss is a package." "Build every file like it's going to war, then hope for peace." "Do not make the attorney become an adjuster. Let the attorney do attorney things." Practical Takeaways You Can Apply Immediately Treat the SPOL as a complete package, not a summary sheet. Run a repeatable process on every claim, no shortcuts, no "this one is different." ...