Addressing Questions About Your Insurance Claims

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If left with questions or need clarification after your insurance claim has been completed, there are steps that can be taken. First, you need to make sure your insurance agent sends a written denial of the claim.

Steps To Appeal The Claim:

1. Take time to talk to your adjuster first for any clarification regarding your claim.
2. Talk to the adjuster’s supervisor or superior if you are unsatisfied with their answers and/or decisions.
3. Contact your insurance agent or company representative.
4. Still not satisfied? Contact FEMA, the Federal Emergency Management Agency.

Below you will find the address for the Federal Insurance an Mitigation Administration:

1800 South Bell Street
Arlington, VA 20598-3010

What needs to be included IN the letter to FEMA:

  • Policyholder’s Name from the Declarations Page
  • Policy Number from the Declarations Page
  • Property address from the Declarations Page
  • Contact Information
  • Thorough details of the complaint
  • Contact information for the others you may have already spoken with (adjuster, insurance company, etc.)

What needs to be included WITH your letter to FEMA:

  • Copy of the written denial from the insurer
  • Claim information and the relevant policy as well as a statement regarding the reason for the appeal
  • Relevant documentation that supports the appeal

Required FEMA Documentation Examples:

  • Proof of Loss copy
  • Final and Preliminary Report from the Adjuster
  • Adjuster’s Itemized Estimates (unit costs and quantities)
  • Proof of Loss Replacement costs
  • Damaged Property Inventory including the age of the property
  • Mobile Home Worksheet that is completed
  • Title and Salvage Title of Mobile Home
  • Advanced Payment Information
  • Exterior and Interior Photographs of Damage
  • If there was prior flood damage, proof that it had been repaired
  • Declarations Page or other evidence of insurance and policy
  • Zone Determinations
  • Elevation Certificate
  • Substantial damage determination from community
  • Financial Statements
  • Inventory, pre-loss and post-loss
  • Substantial Improvement Information
  • Document such as, tax records, sales contracts, settlement papers, deed, lease agreements, etc.
  • Salvage Information
  • Other Insurance Proof (homeowners, wind policies, etc.)
  • Letter of Map Revision or Letter of Map Amendment or Waiver
  • Receipts and Invoices of expenses related to the claim
  • Underwriting Decisions
  • Death Certificates
  • Last Will and Testament
  • Architect plans or drawings
  • Divorce Papers
  • Current lienholder and loss payee information
  • Receipts documenting damaged stock
  • Engineering reports and surveys relating to the damage
  • Market values
  • Flood Insurance Rate Map Documentation
  • Dates of construction and improvements
  • Loan Documents
  • Insurability as a Residential Condominium Association Documents
  • Letters of Representation
  • Assignment of Interest in ICC Claim

Appeals Limitations:

1. If a dispute has been subject to appraisal as provided in the SFIP, then it cannot be appealed.
2. Once an appeal is filed on any issue, there is no longer subject to resolution by any pre-litigation or appraisal remedies.
3. You cannot file a suit and an appeal against an insurer relating to the flood insurance claim.

Resolution of Appeals:

Once you have submitted the appeal, FEMA will review all of the appeal documents. Within 90 days a decision will be made and the policyholder and insurer will receive a written appeal decision. The document will contain all of the information regarding the resolution of the appeal.