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FEMA Implements Enhancements to NFIP Claims Process

By Shane Smith on June 9, 2018
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In a June 7, 2018, FEMA bulletin, W-18013, FEMA discusses several claims process enhancements and claims handling reminders that apply to all claims with a date of loss of June 7, 2018 through December 31, 2018. The enhancements to the NFIP’s claim process are in response to the widespread flooding that occurred in 2017.

You can read the full bulletin here, but here are a few of the highlights and excerpts:

  • NFIP insurers (WYO Companies and NFIP Direct) may offer policyholders advance payments in anticipation of future claim payments in 2 situations: (1) an pre-inspection advance payment of up to $5,000 if certain criteria is met, and (2) an advance payment for significant damages (up to 50% of a contractor’s estimate) if the policyholder provides the insurer with certain information.
  • Handling Claims with Prior Losses
    • NFIP insurers must verify that damages from any prior loss have been repaired before the subject loss occurred and must exclude from the adjustment any unrepaired prior damages. This normally requires the NFIP insurer to obtain and review prior flood claim files prior to adjusting the loss.
    • To expedite the handling of claims, an NFIP insurer may adjust a claim without obtaining a prior flood claim file if there is substantial evidence of completed repairs following a prior flood loss.
  • Wind vs. Flood Loss
    • When adjusting wind/water losses, the adjuster should use established and proven investigative methods to document flood and wind damage to buildings and/or contents occurring during hurricane or storm events. “Wind/Water Investigative Tips” attached to bulletin W-17042 can be helpful.
    • The adjuster is asked to record the process they use when approaching a wind/water claim. In addition to looking for signs of flood damage and/or a general condition of flood and documenting the exterior water line, the adjusters should note any exterior wind damage, such as missing shingles, turbine or fascia damage. The adjuster should also photograph this damage and mention what was observed in the narrative report.
  • Substantial Damage: Adjusters must submit timely Adjuster Preliminary Damage Assessments (APDA) on probable substantially damaged structures following the initial inspection.

The bulletin states it will be “. . .superseded on December 31, 2018. All appropriate claims handling procedures will be documented in the release of the next NFIP Claims Manual which will be located on FEMA.gov at https://www.fema.gov/claims-manual.”

This bulletin will likely be a topic of discussion at next week’s National Flood Conference in Washington, D.C.

  • Posted in:
    Insurance
  • Blog:
    Property Insurance Coverage Law Blog
  • Organization:
    Merlin Law Group, P.A.
  • Article: View Original Source

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