National Flood Insurance Claims Appeal Process

National Flood Insurance Program

Flood Insurance
Claims Handbook
FEMA F-687 / February 2009

Thank you for protecting
yourself through the National
Flood Insurance Program

Purchasing flood insurance is a wise decision for
the home or business owner. Like homeowners’
insurance, it’s protection you hope you never
have to use. But if flooding occurs, you will be
protected as outlined in the details of your policy.
This claims guide was created by the Federal
Emergency Management Agency (FEMA), which
oversees the National Flood Insurance Program,
to help you through the process of filing a claim
and appealing the decision on your claim,
if necessary.
While every effort has been made to make sure the
information in this handbook is correct, you should
refer to your policy and its Declarations Page
for specific information on coverage, limitations,
restrictions and deductibles.

Table of Contents
What To Do Before A Flood ____________________________________________________ 2

Check Your Policy ________________________________ 2
Prepare Lists and Documentation ____________________ 2
Secure Important Papers ____________________________ 3
Talk to Your Insurance Agent ________________________ 3
Plan an Emergency Contact __________________________ 3
What To Do After A Flood ______________________________________________________ 4

Steps to Take Immediately __________________________ 4
Handling Your Claim ______________________________ 5
Filing Your Claim__________________________________ 6
Addressing Questions About Your Insurance Claim

________________

8

Four Steps to Appealing Your Claim____________________ 8

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TIP

• When you gather
your insurance
papers for safekeeping, also gather
any other important
papers such as
deeds or stock
certificates that you
may be keeping in
the house.
• Since flood
insurance renews
annually, make it
a point to update
your documentation
and papers at
renewal time. Also,
call your agent
annually to make
sure loss reporting
procedures have
not changed.
• Move any valuable
items out of your
basement. Flood
insurance only
covers items
normally found in a
basement, such as a
furnace or washer
and dryer. Personal
items are not
covered.
• Create an
emergency kit, with
a large flashlight, a
battery powered
radio, spare
batteries, candles,
waterproof matches,
etc. Even if you
never experience
a flood, you’ll be
glad to have this kit
in a power outage.
2

What To Do Before A Flood
Don’t wait until waters are rising in your area and
flood threatens. Take steps now that will make your
life much easier when a flood occurs.

CHECK YOUR POLICY
Make sure all the information is correct, including
information about your mortgage company. If you have
refinanced with a company other than the one shown
on your policy, call your insurance agent or company
representative immediately.

Prepare Lists and Documentation
If you’ve purchased contents coverage,
make it a priority to make a detailed list of
your home or business’s contents and/or your
personal property. Include:

Date and place of purchase
Model number
Serial number (for large appliances)
Descriptions
Original purchase costs
(with receipts, if possible)
Photos or video of your home’s interior
and your personal property

TIP

SECURE IMPORTANT PAPERS
Originals of important insurance papers should
be kept in a safe place, preferably in a bank safe deposit
box. Be sure your papers include contact information
for your agent or company, important receipts, your
flood insurance policy and documentation on your
personal property and contents of your home. Keep
copies in your home or business in the safest, most
accessible place possible that is not subject to flooding.

Having this detailed documentation will make filing
your claim much easier. If floodwaters actually carry
away your property, this list and the photos/receipts
will be important to documenting your loss.
TALK TO YOUR INSURANCE AGENT
Call your insurance agent or company representative
and discuss the particular requirements for reporting
a flood claim. These can vary from company to
company, so knowing how to proceed can save a lot
of effort later.

Remember, after a flood it may be difficult to get
in touch with your agent or insurance company. Power
and phone service may be interrupted, or phone lines
may be overwhelmed with other callers. It will benefit
you to know just what to do in advance of flooding.
PLAN AN EMERGENCY CONTACT
After a flood, you may be unable to stay in your
home or to be contacted at your home address
and phone number. Share an emergency contact—
address and phone number—with your insurance
agent and family so you can be reached.

• If flooding is
imminent, the
number one rule
in a flood is to keep
yourself safe.
• If waters rise in your
house before you
can leave safely,
move to the highest
level necessary—
even the roof. Take
extra clothing, your
radio, a flashlight
and, if possible,
food.
• If you have time, turn
off electricity at your
breaker or fuse box
and close the main
gas valve; get
valuables (furs,
jewelry, important
papers) to a higher
level; fill bathtubs,
sinks and plastic
soda bottles with
water. (Sanitize tubs
and sinks with
bleach, rinse and
then fill); and bring
outdoor possessions
(lawn furniture, grills,
etc.) inside or tie
them down securely.
• Keep away from
downed power lines
and any other
electrical wires—
electrocution is
always a major
cause of death in
floods.

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TIP

• After a flood, even
if your house seems
safe to enter,
be cautious.
• If you hear hissing
or smell gas, leave
immediately and call
the gas company.
Using your home
phone or cell phone
inside the house
could spark an
explosion.
• Keep power off
until an electrician
has inspected
your system.
• If sewer and water
lines are damaged,
don’t use toilets or
sinks. Call a
plumber. Until told
the water supply is
safe, boil water for 5
minutes before
drinking it
or preparing food.
• Throw away
water-damaged
foods, including
canned goods.

What To Do After A Flood
A flood is an overwhelming experience. But taking
quick action will put you back in control of your
home and your life.

STEPS TO TAKE IMMEDIATELY
STEP 1

ContactYour Agent or Company Representative to ReportYour
Loss: Have ready—the name of your insurance
company, policy number and a phone number and/or
e-mail address where you can be reached. All flood
insurance policies require you to give prompt written
notice of loss. If you get in touch with your agent or
company representative directly, they will advise you
how to file your notice of claim. Otherwise, you must
send a written notice to your insurance company with
your policy number.
STEP 2

SeparateYour Property: Your policy also requires
you to separate damaged property from undamaged
property. But don’t throw anything away before an
adjuster has seen it, unless local law requires you
to. In that case, take photos of the property before
disposing of it and keep samples for the adjuster
to see. (For example, cut out a piece of wall-to-wall
carpet.) Do all you can to protect undamaged property.
However, prior to signing an agreement/contract with a
cleaning, remediation, or maintenance contractor, you
should consult with your flood adjuster or flood insurer
concerning coverage.
STEP 3

Make a List of Damaged Contents: If you’ve purchased
contents coverage, make a list of damaged property.
If you prepared comprehensive lists before the flood,
this should be relatively easy. List the quantity of each
item, a description, brand name, where purchased,
its cost, model and serial number (if appropriate)
and your estimate of the loss amount. Attach your
bills, receipts, photos and any other documents.
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NOTE

STEP 4

List Areas of Structural Damage: As you look over your
property, make a list of any areas of structural damage
you want to point out to the insurance adjuster.
HANDLING YOUR CLAIM
WORKING WITH YOUR ADJUSTER

Generally, your adjuster will contact you within 24-48
hours after receiving your notice of loss. However,
depending on local conditions and the severity of
flooding, it may take more time.
Once the adjuster reaches you, a time will be set for
the adjuster to view your property.You may ask the
adjuster for an advance or partial payment. If you have
a mortgage, your mortgage company will need to sign
the Building Property advance check.
“SCOPING” YOUR LOSS

During the initial visit to your property, the adjuster
will take measurements and photographs and note
direct flood damage. This is called “scoping” a loss.
Be assured that your adjuster will be an experienced
claims professional and will notice many points of
damage you could overlook. However, you are
encouraged to point out all damage you have noticed.
After the “scope” is finished, the adjuster will give
you a local contact telephone number and will tell
you whether any additional visits are needed.
(This may be the case if damage is extensive.)

• Any advance
payment will be part
of your total claim
for Building Property
and/or Personal
Property damage.
Your policy does not
provide coverage for
temporary living
expenses or housing.
Only direct physical
damage from
flooding is covered.
• Your policy requires
that you cooperate
with your adjuster
before, during and
after the “scoping.”
You should also
be aware that an
adjuster cannot
approve (or
disapprove) your
claim, or tell you
when or if the
insurance company
will approve it.
Recovering from
a flood is very
stressful for home
or business owners,
but by cooperating
with your adjuster,
your claim can be
processed more
smoothly and
efficiently.

P R E P A R I N G A D E TA I L E D E S T I M AT E

The adjuster then uses the knowledge gained from the
visit(s)—and the documentation you have provided—
to complete a detailed estimate of damages.You will get
a copy. Use it as a guide when you ask for bids for
repair work from licensed professional contractors.
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FILING YOUR CLAIM
TIP
FILING YOUR CLAIM REQUIRES A PROOF OF LOSS

• Get a small
notebook and use it
to track all your
contacts. That way,
you will easily have
all records in one
place.
• In the event you
have a further flood,
you will need copies
of your receipts and
documentation for
all repairs and
replacements for
this prior loss.

Your official claim for damages is called a Proof of
Loss. This must be fully completed and signed and
in the hands of your insurance company within 60
days after the loss occurs.
The Proof of Loss includes a detailed estimate to
replace or repair the damaged property. In most cases,
the adjuster, as a courtesy, will provide you with a
suggested Proof of Loss. However, you are responsible
for making sure that it is complete, accurate and filed
in a timely manner.
Be sure to keep a copy of the Proof of Loss—and
copies 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 S

In some severe floods, FEMA may authorize Proof
of Loss extensions for everyone in your area.
Your insurance company will be notified, as will local
news outlets.
P AY M E N T O F C L A I M S

Your claim is payable after:
• You and the insurer agree on the amount of damages.
• The insurer receives your complete, accurate and
signed Proof of Loss.
More information on claims payment is in your policy.
PAYMENT FOR BUILDINGS AND PERSONAL PROPERTY

Any check for building property must include
your mortgage company name, or the name of the
individual holding your mortgage. A check for
Personal Property will usually be in your name only.

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NOTE
F I L I N G Y O U R S U P P L E M E N TA L C L A I M

If you notice additional damage to your Building
Property or Personal Property after filing your
claim, you may file a Supplemental Claim. This means,
essentially, that you must repeat the documentation and
filing process for your original claim, including a Proof
of Loss—but only for the newly discovered damage.
Supplemental Claims should start with immediately
notifying your adjuster, agent and/or company
representative. Once you have completed
documentation, present it to your adjuster who may
need to make another property visit to verify your loss.
FILING YOUR INCREASED COST OF
COMPLIANCE (ICC) CLAIM

• A Supplemental
Claim, like your
original claim,
must be filed within
60 days after the
loss. If you discover
additional damage
after the 60-day limit
has passed, contact
your adjuster
immediately. Claims
filed after 60 days
are decided on a
case-by-case basis.

Once you receive the community’s letter stating that
the cost to repair flood damage to your building is 50
percent or more of its market value, you may file an
ICC claim. You should contact your flood adjuster or
your flood insurer’s claims representative to file the
ICC claim. You have 4 years from the date of the
community’s letter declaring the building to be
substantially damaged to complete your chosen
mitigation activity under the terms of the Standard
Flood Insurance Policy. Your flood insurer will provide
you with additional information to assist you in
completing your ICC claim.
The Completed Claim
Once you receive final payment for your building
and/or personal property, the claims process is
complete.
Please remember:

Any claim settlement you make in the event
of a flood will be determined by the amount of
coverage you have and the deductibles you have
chosen. If you are concerned that your coverage is
not high enough, or that your deductibles are too
high, your agent or company representative can
counsel you about increasing coverage and/or
decreasing deductibles.
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NOTE

• At each step, you
should keep clear
records of your
attempts to resolve
issues. Write down
the names and titles
of people you speak
with; dates of
contact; contact
information; and
details of the
discussion. If you
have to go further
in appealing your
claim, these records
can be vitally
important.
• Every effort has been
made to ensure that
the information
provided here is
accurate. However,
your Standard Flood
Insurance Policy
(SFIP), your
application, any
endorsements, and
the Declarations
Page comprise the
official Policy or
contract of insurance.
Any differences
between that
information and the
wording in this
handbook will be
resolved in favor of
your flood insurance
policy. If you have
questions, please
refer to your policy,
or call your insurance
agent or company
representative.
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Addressing Questions About
Your Insurance Claim
The NFIP provides you with a process to appeal
decisions regarding your flood insurance claim.
This process will help you resolve claim issues,
but it cannot give you added coverage or claim
limits beyond those in your NFIP policy.

In filing and completing your insurance claim, you
may have questions, or need further explanations of
decisions that have been made, especially with regard
to coverage, dollar amount of damages, or your Proof
of Loss. Before you may appeal, your insurer must
make a final determination and send you a written
denial of your claim or any part of it
FOUR STEPS TO APPEALING YOUR CLAIM
STEP 1

Talk with your adjuster, who has more knowledge
about your claim than anyone. If you don’t understand
certain decisions regarding, for example, application
of coverage, timing of the filing of Proof of Loss,
or the damage estimate, contact your adjuster first.
STEP 2

If you are not satisfied with the adjuster’s answers,
or do not agree with decisions, get contact
information for the adjuster’s supervisor.
STEP 3

If the adjuster’s supervisor can’t resolve your issues,
contact the insurance company’s claim representative.
Ask your insurance agent or your insurance company
representative for assistance.
Please refer to your flood policy for more information on appeals.
See Section 7 of General Conditions, Paragraph R.
STEP 4

If you still have questions or concerns after following
steps one through three, contact the Federal
Emergency Management Agency (FEMA).

Write to:

Federal Emergency Management Agency
Mitigation Directorate
Federal Insurance Administrator

NOTE

1800 South Bell Street
Arlington, VA 20598-3010

This letter should be written by the Named Insured (as it
appears on your NFIP policy) or by a legal representative, if
necessary. The representative should clearly identify his/her
relationship to the Named Insured. (For example, a son or
daughter could be handling a claim for an elderly parent.)
A legal representative may be asked to provide authorization
from the Named Insured or other legal documents verifying
the relationship.

• Please do not
send originals of
documents such
as contractor’s
estimates. Send
photocopies and
keep originals in
a safe place.

Your letter of appeal must be submitted to FEMA within 60
days from the date of the denial letter that you receive from
your 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 R

The following six items should be in your letter to FEMA
in order to address your questions. (If for some reason,
your policy is not available, your insurance agent can
provide details for the first three items.)
1. The Policy Number, as shown on your NFIP policy’s
Declarations Page.
2. The policyholder’s name, as shown as the Named
Insured on the Declarations Page.
3. The property address, as shown on the Declarations
Page. (Not your mailing address, if it is different from
the 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 persons
with whom you have spoken in steps one through three
on the previous page.

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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 R

NOTE

• Please do not
send originals of
documents such
as contractor’s
estimates. Send
photocopies and
keep originals in
a safe place.

Enclose documentation of everything that supports your
appeal.
• Provide a copy of the insurer’s written denial, in
whole or in part, of the claim;
• Identify relevant policy and claim information and
state the basis for the appeal; and
• Submit relevant documentation to support the
appeal, but only documentation that directly
pertains to your claim.
The following are examples of the kinds of
documentation 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 costs
and quantities for the items needing repair or
replacement
• Replacement cost Proofs of Loss
• Adjuster’s Preliminary Report
• Adjuster’s Final Report
• Detailed damaged personal property inventories that
include 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) confirming
damage that resulted from direct physical loss by or
from 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 concerning
substantial damage
• Information regarding substantial improvement
• Zone determinations
• Pre-loss and post-loss inventories

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• 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 or
wind policies, and any claim information submitted
to the other companies
• Waiver, Letter of Map Revision (LOMR), or Letter of
Map Amendment (LOMA) information
• Paid receipts and invoices including cancelled checks
that support an insured’s out-of-pocket expenses
pertaining 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 damaged
stock
• Detailed engineering reports specifically addressing
flood-related damage and pre-existing damage
• Engineering surveys
• Market values
• Documentation of Flood Insurance Rate Map (FIRM)
dates
• Documentation reflecting date(s) of construction and
substantial improvement
• Loan documents including closings
• Evidence of insurability as a Residential
Condominium Association
• Franchise agreements
• Letters of representation, i.e., attorneys and public
adjusters
• Any assignment of interest in a claim
• And, any other pertinent information that FEMA may
request in processing a claim.

NOTE

• Please do not
send originals of
documents such
as contractor’s
estimates. Send
photocopies and
keep originals in
a safe place.

11

NOTE

• Please do not
send originals of
documents such
as contractor’s
estimates. Send
photocopies and
keep originals in
a safe place.

A re-inspection of your property may be conducted at
the discretion of FEMA to gather more information.
A request by FEMA for additional information will
include the date by which the information must be
provided, which shall in no case be less than 14 calendar days. Failure to provide the requested information in full within 14 calendar days may result in dismissal of your appeal. FEMA will ensure that all information necessary to rule on the appeal has been provided prior to making an appeal decision.
L I M I TAT I O N S O N A P P E A L S

The appeals process is intended to resolve claim issues
and is not intended to grant coverage or limits that are
not provided by the SFIP. Filing an appeal does not
waive any of the requirements for perfecting a claim
under the SFIP or extend any of the time limitations
set forth in the SFIP.
1. Disputes that are or have been subject to appraisal
as provided for in the SFIP cannot be appealed.
2. If you file an appeal on any issue, that issue is no
longer subject to resolution by appraisal or other
pre-litigation remedies.
3. If you file suit against an insurer on the flood
insurance claim issue, you are prohibited from filing an appeal. All appeals submitted for decision
but not resolved shall be terminated upon notice of
the commencement of litigation regarding the
claim.

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APPEALS RESOLUTION

FEMA will review the appeal documents, including
any reinspection report, if appropriate. FEMA will provide specific information on what grounds the claim
was initially denied.
FEMA will provide an appeal decision in writing to
the policyholder and insurer within 90 days from the
date that all information has been submitted by the
policyholder and will include specific information for
the resolution of the appeal. No further administrative
review will be provided to the insured.
If you do not agree with the final decision, please
refer to your flood insurance policy. See the “GENERAL CONDITIONS” Section, Paragraph R. “Suit Against
Us.” The 1-year period to file suit commences with
the written denial from the insurer and is not extended by the appeals process.

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