Instructions For Filing A Claim Form - Federal Emergency Management Agency (Page 2 of 4) in pdf

• Financial statements;

2. � The policyholder’s name, as shown as the Named

• Tax records, lease agreements, sales contracts,

Insured on the declarations page.

settlement papers, deed, etc.;

3. � The property address, as shown on the declarations

• Emergency (911) address change information;

page. (Not your mailing address, if it is different

• Salvage information (proceeds and sales);

from the property address.)

• Condominium association by-laws;

• Proof of other insurance, including homeowners or

4. � How you can be contacted, if you are out of

wind policies, and any claim information submitted

your home.

to the other companies;

• Waiver, Letter of Map Revision (LOMR), or Letter of

5. � The details of your concern. (Please be as complete

Map Amendment (LOMA) information;

as possible.)

• Paid receipts and invoices, including canceled

6. � The dates of contact and contact details for the

checks that support an insured’s out-of-pocket

persons with whom you have spoken in steps 1

expenses pertaining to the claim;

through 3 on the previous page.

• Underwriting decisions;

• Architectural plans and drawings;

• Death certificates;

What to include With your letter

• Last will and testament;

Enclose documentation of everything that supports

• Divorce decree;

your appeal.

• Power of attorney;

• Current lienholder information;

• Provide a copy of the insurer’s written denial, in

• Current loss payee information;

whole or in part, of the claim;

• Paid

receipts

and

invoices

documenting

• Identify relevant policy and claim information and

damaged stock;

state the basis for the appeal; and

• Detailed engineering reports specifically addressing

• Submit relevant documentation to support the

flood-related damage and pre-existing damage;

appeal, but only documentation that directly pertains

• Engineering surveys;

to your claim.

• Market values;

• Documentation of Flood Insurance Rate Map

The following are examples of the kinds of

(FIRM) dates;

documentation that FEMA will require:

• Documentation reflecting date(s) of construction

• A copy of the Proof of Loss submitted to the insurer,

and substantial improvement;

as required in the policy;

• Loan documents including closings;

• Room-by-room itemized estimates from the adjuster

• Evidence of insurability as a Residential Condominium

(include contractors’ estimates), detailing unit

Association;

costs and quantities for the items needing repair or

• Franchise agreements;

replacement;

• Letters of representation, i.e., attorneys and

• Replacement cost Proofs of Loss;

public adjusters;

• Adjuster’s Preliminary Report;

• Any assignment of interest in a claim; and

• Adjuster’s Final Report;

• Any other pertinent information that FEMA may

• Detailed damaged personal property inventories

request in processing a claim.

that include the approximate ages of the items;

A re-inspection of your property may be conducted at

• Completed Mobile Home Worksheet;

the discretion of FEMA to gather more information.

• Mobile home title, including salvage title;

• Real estate appraisals that exclude land values;

A request by FEMA for additional information will include

• Advance payment information;

the date by which the information must be provided,

• Clear photographs (exterior and interior) confirming

which shall in no case be less than 14 calendar

damage that resulted from direct physical loss by or

days. Failure to provide the requested information in

from flood;

full within 14 calendar days may result in dismissal

• Proof that prior flood damage has been repaired;

of your appeal. FEMA will ensure that all information

• Evidence of insurance and policy information, i.e.,

necessary to rule on the appeal has been provided

declarations page;

prior to making an appeal decision.

• Elevation Certificate, if the building is elevated;

• The

community’s

determination

concerning

liMitations on appeals

substantial damage;

• Information regarding substantial improvement;

The appeals process is intended to resolve claim

• Zone determinations;

issues and is not intended to grant coverage or limits

• Pre-loss and post-loss inventories;

that are not provided by the Standard Flood Insurance

CL 2

May 1, 2011

Instructions For Filing A Claim Form - Federal Emergency Management Agency Page 2

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