F-687 Claims Handbook - North Carolina

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National Flood Insurance ProgramFlood InsuranceClaims HandbookFEMA F-687 / February 2009

Thank you for protectingyourself through the NationalFlood Insurance ProgramPurchasing flood insurance is a wise decision forthe home or business owner. Like homeowners’insurance, it’s protection you hope you neverhave to use. But if flooding occurs, you will beprotected as outlined in the details of your policy.This claims guide was created by the FederalEmergency Management Agency (FEMA), whichoversees the National Flood Insurance Program,to help you through the process of filing a claimand appealing the decision on your claim,if necessary.While every effort has been made to make sure theinformation in this handbook is correct, you shouldrefer to your policy and its Declarations Pagefor specific information on coverage, limitations,restrictions and deductibles.

Table of ContentsWhat To Do Before A Flood 2Check Your Policy 2Prepare Lists and Documentation 2Secure Important Papers 3Talk to Your Insurance Agent 3Plan an Emergency Contact 3What To Do After A Flood 4Steps to Take Immediately 4Handling Your Claim 5Filing Your Claim 6Addressing Questions About Your Insurance Claim8Four Steps to Appealing Your Claim 81

TIP When you gatheryour insurancepapers for safekeeping, also gatherany other importantpapers such asdeeds or stockcertificates that youmay be keeping inthe house. Since floodinsurance renewsannually, make ita point to updateyour documentationand papers atrenewal time. Also,call your agentannually to makesure loss reportingprocedures havenot changed. Move any valuableitems out of yourbasement. Floodinsurance onlycovers itemsnormally found in abasement, such as afurnace or washerand dryer. Personalitems are notcovered. Create anemergency kit, witha large flashlight, abattery poweredradio, sparebatteries, candles,waterproof matches,etc. Even if younever experiencea flood, you’ll beglad to have this kitin a power outage.2What To Do Before A FloodDon’t wait until waters are rising in your area andflood threatens. Take steps now that will make yourlife much easier when a flood occurs.CHECK YOUR POLICYMake sure all the information is correct, includinginformation about your mortgage company. If you haverefinanced with a company other than the one shownon your policy, call your insurance agent or companyrepresentative immediately.Prepare Lists and DocumentationIf you’ve purchased contents coverage,make it a priority to make a detailed list ofyour home or business’s contents and/or yourpersonal property. Include:Date and place of purchaseModel numberSerial number (for large appliances)DescriptionsOriginal purchase costs(with receipts, if possible)Photos or video of your home’s interiorand your personal property

TIPSECURE IMPORTANT PAPERSOriginals of important insurance papers shouldbe kept in a safe place, preferably in a bank safe depositbox. Be sure your papers include contact informationfor your agent or company, important receipts, yourflood insurance policy and documentation on yourpersonal property and contents of your home. Keepcopies in your home or business in the safest, mostaccessible place possible that is not subject to flooding.Having this detailed documentation will make filingyour claim much easier. If floodwaters actually carryaway your property, this list and the photos/receiptswill be important to documenting your loss.TALK TO YOUR INSURANCE AGENTCall your insurance agent or company representativeand discuss the particular requirements for reportinga flood claim. These can vary from company tocompany, so knowing how to proceed can save a lotof effort later.Remember, after a flood it may be difficult to getin touch with your agent or insurance company. Powerand phone service may be interrupted, or phone linesmay be overwhelmed with other callers. It will benefityou to know just what to do in advance of flooding.PLAN AN EMERGENCY CONTACTAfter a flood, you may be unable to stay in yourhome or to be contacted at your home addressand phone number. Share an emergency contact—address and phone number—with your insuranceagent and family so you can be reached. If flooding isimminent, thenumber one rulein a flood is to keepyourself safe. If waters rise in yourhouse before youcan leave safely,move to the highestlevel necessary—even the roof. Takeextra clothing, yourradio, a flashlightand, if possible,food. If you have time, turnoff electricity at yourbreaker or fuse boxand close the maingas valve; getvaluables (furs,jewelry, importantpapers) to a higherlevel; fill bathtubs,sinks and plasticsoda bottles withwater. (Sanitize tubsand sinks withbleach, rinse andthen fill); and bringoutdoor possessions(lawn furniture, grills,etc.) inside or tiethem down securely. Keep away fromdowned power linesand any otherelectrical wires—electrocution isalways a majorcause of death infloods.3

TIP After a flood, evenif your house seemssafe to enter,be cautious. If you hear hissingor smell gas, leaveimmediately and callthe gas company.Using your homephone or cell phoneinside the housecould spark anexplosion. Keep power offuntil an electricianhas inspectedyour system. If sewer and waterlines are damaged,don’t use toilets orsinks. Call aplumber. Until toldthe water supply issafe, boil water for 5minutes beforedrinking itor preparing food. Throw awaywater-damagedfoods, includingcanned goods.What To Do After A FloodA flood is an overwhelming experience. But takingquick action will put you back in control of yourhome and your life.STEPS TO TAKE IMMEDIATELYSTEP 1ContactYour Agent or Company Representative to ReportYourLoss: Have ready—the name of your insurancecompany, policy number and a phone number and/ore-mail address where you can be reached. All floodinsurance policies require you to give prompt writtennotice of loss. If you get in touch with your agent orcompany representative directly, they will advise youhow to file your notice of claim. Otherwise, you mustsend a written notice to your insurance company withyour policy number.STEP 2SeparateYour Property: Your policy also requiresyou to separate damaged property from undamagedproperty. But don’t throw anything away before anadjuster has seen it, unless local law requires youto. In that case, take photos of the property beforedisposing of it and keep samples for the adjusterto see. (For example, cut out a piece of wall-to-wallcarpet.) Do all you can to protect undamaged property.However, prior to signing an agreement/contract with acleaning, remediation, or maintenance contractor, youshould consult with your flood adjuster or flood insurerconcerning coverage.STEP 3Make a List of Damaged Contents: If you’ve purchasedcontents coverage, make a list of damaged property.If you prepared comprehensive lists before the flood,this should be relatively easy. List the quantity of eachitem, a description, brand name, where purchased,its cost, model and serial number (if appropriate)and your estimate of the loss amount. Attach yourbills, receipts, photos and any other documents.4

NOTESTEP 4List Areas of Structural Damage: As you look over yourproperty, make a list of any areas of structural damageyou want to point out to the insurance adjuster.HANDLING YOUR CLAIMWORKING WITH YOUR ADJUSTERGenerally, your adjuster will contact you within 24-48hours after receiving your notice of loss. However,depending on local conditions and the severity offlooding, it may take more time.Once the adjuster reaches you, a time will be set forthe adjuster to view your property.You may ask theadjuster for an advance or partial payment. If you havea mortgage, your mortgage company will need to signthe Building Property advance check.“SCOPING” YOUR LOSSDuring the initial visit to your property, the adjusterwill take measurements and photographs and notedirect flood damage. This is called “scoping” a loss.Be assured that your adjuster will be an experiencedclaims professional and will notice many points ofdamage you could overlook. However, you areencouraged to point out all damage you have noticed.After the “scope” is finished, the adjuster will giveyou a local contact telephone number and will tellyou whether any additional visits are needed.(This may be the case if damage is extensive.) Any advancepayment will be partof your total claimfor Building Propertyand/or PersonalProperty damage.Your policy does notprovide coverage fortemporary livingexpenses or housing.Only direct physicaldamage fromflooding is covered. Your policy requiresthat you cooperatewith your adjusterbefore, during andafter the “scoping.”You should alsobe aware that anadjuster cannotapprove (ordisapprove) yourclaim, or tell youwhen or if theinsurance companywill approve it.Recovering froma flood is verystressful for homeor business owners,but by cooperatingwith your adjuster,your claim can beprocessed moresmoothly andefficiently.P R E P A R I N G A D E TA I L E D E S T I M AT EThe adjuster then uses the knowledge gained from thevisit(s)—and the documentation you have provided—to complete a detailed estimate of damages.You will geta copy. Use it as a guide when you ask for bids forrepair work from licensed professional contractors.5

FILING YOUR CLAIMTIPFILING YOUR CLAIM REQUIRES A PROOF OF LOSS Get a smallnotebook and use itto track all yourcontacts. That way,you will easily haveall records in oneplace. In the event youhave a further flood,you will need copiesof your receipts anddocumentation forall repairs andreplacements forthis prior loss.Your official claim for damages is called a Proof ofLoss. This must be fully completed and signed andin the hands of your insurance company within 60days after the loss occurs.The Proof of Loss includes a detailed estimate toreplace or repair the damaged property. In most cases,the adjuster, as a courtesy, will provide you with asuggested Proof of Loss. However, you are responsiblefor making sure that it is complete, accurate and filedin a timely manner.Be sure to keep a copy of the Proof of Loss—andcopies of all supporting documents—for your records.E X T E N S I O N S B E Y O N D 6 0 D AY SIn some severe floods, FEMA may authorize Proofof Loss extensions for everyone in your area.Your insurance company will be notified, as will localnews outlets.P AY M E N T O F C L A I M SYour claim is payable after: You and the insurer agree on the amount of damages. The insurer receives your complete, accurate andsigned Proof of Loss.More information on claims payment is in your policy.PAYMENT FOR BUILDINGS AND PERSONAL PROPERTYAny check for building property must includeyour mortgage company name, or the name of theindividual holding your mortgage. A check forPersonal Property will usually be in your name only.6

NOTEF I L I N G Y O U R S U P P L E M E N TA L C L A I MIf you notice additional damage to your BuildingProperty or Personal Property after filing yourclaim, you may file a Supplemental Claim. This means,essentially, that you must repeat the documentation andfiling process for your original claim, including a Proofof Loss—but only for the newly discovered damage.Supplemental Claims should start with immediatelynotifying your adjuster, agent and/or companyrepresentative. Once you have completeddocumentation, present it to your adjuster who mayneed to make another property visit to verify your loss.FILING YOUR INCREASED COST OFCOMPLIANCE (ICC) CLAIM A SupplementalClaim, like youroriginal claim,must be filed within60 days after theloss. If you discoveradditional damageafter the 60-day limithas passed, contactyour adjusterimmediately. Claimsfiled after 60 daysare decided on acase-by-case basis.Once you receive the community’s letter stating thatthe cost to repair flood damage to your building is 50percent or more of its market value, you may file anICC claim. You should contact your flood adjuster oryour flood insurer’s claims representative to file theICC claim. You have 4 years from the date of thecommunity’s letter declaring the building to besubstantially damaged to complete your chosenmitigation activity under the terms of the StandardFlood Insurance Policy. Your flood insurer will provideyou with additional information to assist you incompleting your ICC claim.The Completed ClaimOnce you receive final payment for your buildingand/or personal property, the claims process iscomplete.Please remember:Any claim settlement you make in the eventof a flood will be determined by the amount ofcoverage you have and the deductibles you havechosen. If you are concerned that your coverage isnot high enough, or that your deductibles are toohigh, your agent or company representative cancounsel you about increasing coverage and/ordecreasing deductibles.7

NOTE At each step, youshould keep clearrecords of yourattempts to resolveissues. Write downthe names and titlesof people you speakwith; dates ofcontact; contactinformation; anddetails of thediscussion. If youhave to go furtherin appealing yourclaim, these recordscan be vitallyimportant. Every effort has beenmade to ensure thatthe informationprovided here isaccurate. However,your Standard FloodInsurance Policy(SFIP), yourapplication, anyendorsements, andthe DeclarationsPage comprise theofficial Policy orcontract of insurance.Any differencesbetween thatinformation and thewording in thishandbook will beresolved in favor ofyour flood insurancepolicy. If you havequestions, pleaserefer to your policy,or call your insuranceagent or companyrepresentative.8Addressing Questions AboutYour Insurance ClaimThe NFIP provides you with a process to appealdecisions regarding your flood insurance claim.This process will help you resolve claim issues,but it cannot give you added coverage or claimlimits beyond those in your NFIP policy.In filing and completing your insurance claim, youmay have questions, or need further explanations ofdecisions that have been made, especially with regardto coverage, dollar amount of damages, or your Proofof Loss. Before you may appeal, your insurer mustmake a final determination and send you a writtendenial of your claim or any part of itFOUR STEPS TO APPEALING YOUR CLAIMSTEP 1Talk with your adjuster, who has more knowledgeabout your claim than anyone. If you don’t understandcertain decisions regarding, for example, applicationof coverage, timing of the filing of Proof of Loss,or the damage estimate, contact your adjuster first.STEP 2If you are not satisfied with the adjuster’s answers,or do not agree with decisions, get contactinformation for the adjuster’s supervisor.STEP 3If the adjuster’s supervisor can’t resolve your issues,contact the insurance company’s claim representative.Ask your insurance agent or your insurance companyrepresentative for assistance.Please refer to your flood policy for more information on appeals.See Section 7 of General Conditions, Paragraph R.STEP 4If you still have questions or concerns after followingsteps one through three, contact the FederalEmergency Management Agency (FEMA).

Write to:Federal Emergency Management AgencyMitigation DirectorateFederal Insurance AdministratorNOTE1800 South Bell StreetArlington, VA 20598-3010This letter should be written by the Named Insured (as itappears on your NFIP policy) or by a legal representative, ifnecessary. The representative should clearly identify his/herrelationship to the Named Insured. (For example, a son ordaughter could be handling a claim for an elderly parent.)A legal representative may be asked to provide authorizationfrom the Named Insured or other legal documents verifyingthe relationship. Please do notsend originals ofdocuments suchas contractor’sestimates. Sendphotocopies andkeep originals ina safe place.Your letter of appeal must be submitted to FEMA within 60days from the date of the denial letter that you receive fromyour flood insurer.W H AT T O I N C L U D E I N Y O U R L E T T E RThe following six items should be in your letter to FEMAin order to address your questions. (If for some reason,your policy is not available, your insurance agent canprovide details for the first three items.)1. The Policy Number, as shown on your NFIP policy’sDeclarations Page.2. The policyholder’s name, as shown as the NamedInsured on the Declarations Page.3. The property address, as shown on the DeclarationsPage. (Not your mailing address, if it is different fromthe property address.)4. How you can be contacted, if you are out of your home.5. The details of your concern.(Please be as complete as possible.)6. The dates of contact and contact details for the personswith whom you have spoken in steps one through threeon the previous page.9

W H AT T O I N C L U D E W I T H Y O U R L E T T E RNOTE Please do notsend originals ofdocuments suchas contractor’sestimates. Sendphotocopies andkeep originals ina safe place.Enclose documentation of everything that supports yourappeal. Provide a copy of the insurer’s written denial, inwhole or in part, of the claim; Identify relevant policy and claim information andstate the basis for the appeal; and Submit relevant documentation to support theappeal, but only documentation that directlypertains to your claim.The following are examples of the kinds ofdocumentation that FEMA will require: A copy of the Proof of Loss submitted to the insurer,as required in the policy Room-by-room itemized estimates from the adjuster(include contractors’ estimates), detailing unit costsand quantities for the items needing repair orreplacement Replacement cost Proofs of Loss Adjuster’s Preliminary Report Adjuster’s Final Report Detailed damaged personal property inventories thatinclude the approximate ages of the items Completed Mobile Home Worksheet Mobile home title, including salvage title Real estate appraisals that exclude land values Advance payment information Clear photographs (exterior and interior) confirmingdamage that resulted from direct physical loss by orfrom flood Proof that prior flood damage has been repaired Evidence of insurance and policy information, i.e.,Declarations Page Elevation Certificate, if the building is elevated The community’s determination concerningsubstantial damage Information regarding substantial improvement Zone determinations Pre-loss and post-loss inventories10

Financial statements Tax records, lease agreements, sales contracts,settlement papers, deed, etc. Emergency (911) address change information Salvage information (proceeds and sales) Condominium association by-laws Proof of other insurance, including homeowners orwind policies, and any claim information submittedto the other companies Waiver, Letter of Map Revision (LOMR), or Letter ofMap Amendment (LOMA) information Paid receipts and invoices including cancelled checksthat support an insured’s out-of-pocket expensespertaining to the claim Underwriting decisions Architectural plans and drawings Death certificates Last Will and Testament Divorce decree Power of attorney Current lienholder information Current loss payee information Paid receipts and invoices documenting damagedstock Detailed engineering reports specifically addressingflood-related damage and pre-existing damage Engineering surveys Market values Documentation of Flood Insurance Rate Map (FIRM)dates Documentation reflecting date(s) of construction andsubstantial improvement Loan documents including closings Evidence of insurability as a ResidentialCondominium Association Franchise agreements Letters of representation, i.e., attorneys and publicadjusters Any assignment of interest in a claim And, any other pertinent information that FEMA mayrequest

Claims Handbook FEMA F-687 / February 2009 National Flood Insurance Program. Thankyouforprotecting yourselfthroughtheNational . plumber.Untiltold thewatersupplyis safe,boilwaterfor5 minutesbefore drinkingit orpreparingfood. Th

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