Instructions For Filing A Claim Form - Federal Emergency Management Agency (Page 3 of 4) in pdf

Policy (SFIP). Filing an appeal does not waive any of the

When it appears that a situation is serious enough that

requirements for perfecting a claim under the SFIP or

a FICO may be necessary, the NFIP will notify agents/

extend any of the time limitations set forth in the SFIP.

producers and agent/producer trade associations in

the affected area (using the broadcast media and

1. � Disputes that are or have been subject to appraisal

press releases) as soon as possible to hold their

as provided for in the SFIP cannot be appealed.

loss notices unassigned until further instructions

are received.

2. � If you file an appeal on any issue, that issue is no

longer subject to resolution by appraisal or other

In the case of a WYO Company claim, the WYO

pre-litigation remedies.

Company’s agent/producer will follow the established

procedures when assigning an adjuster.

3. � If you file suit against an insurer on the flood

insurance claim issue, you are prohibited from

III. SINGLE ADJUSTER PROGRAM

filing an appeal. All appeals submitted for

IMPLEMENTATION

decision but not resolved shall be terminated

upon notice of the commencement of litigation

regarding the claim.

A. Schedule and Notification

FEMA and various Coastal Plans will determine whether

appeals resolution

a catastrophe event will necessitate a Single Adjuster

FEMA will review the appeal documents, including any

Program (SAP) response. The National Weather Service

re-inspection report, if appropriate. FEMA will provide

declaration of a tropical storm or hurricane event will

specific information on what grounds the claim was

begin the watch for possible single adjuster response.

initially denied.

When the storm is 48 hours from landfall, this will

initiate FEMA’s approval of the SAP response.

FEMA will provide an appeal decision in writing to

the policyholder and insurer within 90 days from the

During that time, the NFIP Bureau and Statistical

date that all information has been submitted by the

Agent’s General Adjusters will be deployed to strategic

policyholder and will include specific information for

areas close to where the storm is predicted to strike.

the resolution of the appeal. No further administrative

At landfall, they will be able to immediately assess the

review will be provided to the insured.

damage impact from the storm. No later than 24 hours

after landfall, the WYO Companies will be advised by

If you do not agree with the final decision, please refer

telephone, fax, or email through their designated Single

to your flood insurance policy. See the “GENERAL

Adjuster Liaison, as to the areas and state(s) that will

CONDITIONS” Section, Paragraph R. “Suit Against

be activated. At that point, the WYO Companies will be

Us.” The 1-year period to file suit commences with the

asked to immediately notify their agents/producers of

written denial from the insurer and is not extended by

the SAP procedures in reporting the claims.

the appeals process.

The NFIP Bureau will notify the WYO Companies by

telephone, fax, or email to have their agency staff

II. AGENT’S/PRODUCER’S RESPONSIBILITIES

submit all flood losses that are reasonably believed

to involve wind and flood damage to the State Coastal

Agents/producers may request that any NFIP Direct

Plans (i.e., Windpool, Fairplan, Beachplan).

claim be assigned to an NFIP-approved independent

adjuster. The NFIP Direct makes all NFIP Direct claim

The NFIP will notify all SAP Liaisons of the CCO’s

assignments, except:

location,

telephone

number,

fax

number,

and

address, if the CCO does not co-locate with the State

• When, in major flooding disasters, the Flood Insurance

Coastal Plans.

Claims Office (FICO) makes all assignments;

When the CCO is operational, the WYO Companies

• When an Adjuster Control Office is established;

will be notified of all assigned claims. Notice of

• W hen a Claims Coordinating Office (CCO) is

losses reflecting the assigned adjusting firms will be

established.

faxed each day. Once the assignment is made and

communicated to each company, the WYO Company

Failure to indicate the assigned adjuster on the

will manage its own loss adjustment. However, the

loss notice, or assignment of an adjuster who is not

Catastrophe CCO will ensure that the adjuster receives

authorized by the NFIP, will delay the adjustment process

a copy of the loss assignments, the name of the WYO

and may result in duplicate adjuster assignments.

Company, and the SAP Liaison telephone number.

CL 3

May 1, 2011

Instructions For Filing A Claim Form - Federal Emergency Management Agency Page 3

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