FEMA Explains Flood Insurance Program Appeals Process Following Hurricanes

December 30, 2005

A four-step process exists for homeowners to appeal decisions regarding a claim through the National Flood Insurance Program (NFIP) administered by the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA).

The process helps resolve claim issues, but can’t give homeowners added coverage or claim limits beyond those in their NFIP policies.

Step 1
Homeowners should talk with their adjuster, who has more knowledge about the claim than anyone. If clients don’t understand certain decisions regarding application of coverage, timing of the filing of proof of loss, or the damage estimate, they should first contact their adjuster.

Step 2
Clients who aren’t satisfied with the adjuster’s answers, or do not agree with the decisions, should get contact information for the adjuster’s supervisor. The adjuster should provide contact information.

Step 3
If the adjuster’s supervisor can’t resolve the issue, clients should contact the insurance company’s claim representative. The insurance agent or another company representative should provide assistance.

Step 4
Clients with questions or concerns after following the first three steps may contact FEMA in writing at:

FEMA-Mitigation Division-Room 433
Risk Insurance Branch
Attn: Director of Claims
500 C Street, S.W.
Washington D.C. 20472

The letter should be written by the named insured as it appears on the NFIP policy or by a legal representative such as a child handling a claim for an elderly parent. This representative should clearly identify their relationship to the named insured. A legal representative may be asked to provide authorization from the named insured or other legal documents verifying the relationship.

Six items should be in the letter:

* The policy number, as shown as the named insured on the NFIP policy’s declarations page.
* The policyholder’s name, as shown as the named insured on the declarations page.
* The property address, as shown on the declarations page. This is NOT the person’s mailing address if it is different from the property address.
* How the claimant can be contacted if they are out of the home.
Specific details of the claimant’s concern.
* The dates of contact and contact details for the persons with whom the claimant has spoken to while completing the first three steps of the appeals process.

Claimants should also enclose documentation of everything that supports their appeal such as a detailed list of damaged property and the value of individual items; supporting photographs; and a contractor’s detailed estimate to repair damages. Comparing contractor and adjuster estimates in detail may help resolve differences. Claimants should not send original documents.

Under the NFIP, federally-backed flood insurance is available to homeowners, renters and business owners in communities that adopt and enforce floodplain management ordinances to reduce future flood losses by regulating new construction in high flood-risk areas.

More than 4.7 million flood insurance policies exist in about 20,000 participating communities nationwide, representing nearly $793 billion worth of coverage. The NFIP is self-supporting: claims and operating expenses are paid from policyholder premiums, not taxpayer dollars.

More than 220,000 claims have been made since Hurricane Katrina struck Aug. 29 and Hurricane Rita landed Sept. 21, with more than $8 billion already paid and about 60 percent of claims closed. That includes about 40,000 claims not paid because damage suffered by homes wasn’t caused by flooding or the amount suffered was below the homeowner’s deductible.

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