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Louisiana Flooding: How is FEMA involved with My Flood Insurance?

Posted by on August 26, 2016 in Blog | Comments Off on Louisiana Flooding: How is FEMA involved with My Flood Insurance?

Louisiana Flooding: How is FEMA involved with My Flood Insurance?

If this is the first time you have had to contact your flood insurance company about a loss, it can be confusing to understand why or how FEMA has anything to do with your flood insurance.  The reason that FEMA is involved with flood insurance is that FEMA is charged with administering the National Flood Insurance Program.  In the late 1960s and into the 1970s, many insurance companies stopped writing flood insurance policies because they were losing money on the policies.  The flood damages were just too widespread and catastrophic for insurance companies to insure.  Because people needed flood insurance to protect their property, the federal government stepped in and passed legislation that created the National Flood Insurance Program (“NFIP”). The National Flood Insurance Program (“NFIP”) has two programs: the NFIP direct program and the “Write Your Own” (“WYO”) program.  Both programs issue Standard Flood Insurance Policies (“SFIPs”), collect premiums, handle and adjust claims, and issue payments to insured.  The same identical SFIPs are issued under both programs.  Under the direct program, the issuance, handlings and payment of claims is handled directly by the federal government. The WYO program was started in 1983.  It allows private insurance companies to issue and service federally backed SFIPs under their own names, collect premiums, and pay claims.   They are reimbursed by FEMA for these services. The flood policy is backed by the federal government rather than the private insurance company and claims and expenses are paid from U.S. Treasury funds.  The WYO program now accounts for approximately ninety-percent (90%) of all flood insurance policies.  Most of the well-known property and casualty companies participate in the WYO program. Private flood insurance policies and excess flood insurance policies still exist, but are not subject to FEMA administration or rules, and are only subject to the terms set forth in the policy between the insurance company and the...

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Louisiana Flooding: Requirements After a Loss and the Proof of Loss

Posted by on August 24, 2016 in Blog | Comments Off on Louisiana Flooding: Requirements After a Loss and the Proof of Loss

Louisiana Flooding: Requirements After a Loss and the Proof of Loss

Under a National Flood Insurance Program policy, in the event of a flood loss to an insured’s property the insured is required under their policy to comply with certain conditions and requirements,  including: giving prompt notice to the flood carrier, separating damaged and undamaged property for examination; and, preparing an inventory of damaged property which includes the quantity, description, actual cash value, and amount of the loss. Once notification of a flood loss is given to the insurance carrier, the insurance carrier will assign an adjuster to investigate the claim as courtesy to the insured.   In the event of a non-catastrophic flood situation, within sixty (60) days after the loss, the insured is required to submit a Proof of Loss.  The Proof of Loss is the insured’s official claim for damages.  (Currently, the time period to file a proof of loss for a loss from the 2016 Louisiana flood remains at 60 days from the date of the loss.  I anticipate an extension will be given by FEMA, however right now it remains 60 days.) The Proof of Loss must be signed and sworn to, which includes the following information: the date and time of loss; a brief explanation of how the loss happened; the interests of all parties in the damaged property; details of any other insurance covering the property; changes in title or occupancy during the term of the policy; specifications of damaged buildings and detailed repair estimates, names or mortgagees or anyone else having a claim against the property; details about the occupancy of the structure at the time of the loss; and, an inventory of damaged personal property.  The Proof of Loss is a single page document published by the National Flood Insurance Program and FEMA. The insurance adjuster that the carrier hires to investigate the flood loss may furnish the insured with a Proof of Loss form, and may help the insured complete it.  The insurance adjuster will also draft an estimate to support the Proof of Loss that he completes.  However, this is a matter of courtesy only, and the insured must still send the insurance carrier the Proof of Loss within sixty (60) days after the loss even if the adjuster does not furnish the form or help the insured to complete it. The policy holder must also submit a Proof of Loss within the required time period if he/she disagrees with the insurance adjusters estimate and Proof of Loss (i.e. the policyholder believes that he/she is being underpaid).  This is extremely important because the filing of a Proof of Loss is a pre-requisite to a lawsuit and failure to file a Proof of Loss for the damages being denied by the insurance carrier, may preclude any additional recovery. A Proof of Loss should be submitted with enough supporting documentation for the insurance company to evaluate the merits of the claim.  Albeit a contractor’s estimate, a public adjuster’s estimate, engineering report, photos, or the policyholder’s own judgment of the value of the loss, the determination will turn on the fact of whether the supporting documentation that was submitted as part of the Proof of Loss gave the carrier sufficient information to evaluate the merits of the claim.  The more documentation; the...

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Louisiana Flooding: Debris Removal

Posted by on August 22, 2016 in Blog | Comments Off on Louisiana Flooding: Debris Removal

Louisiana Flooding: Debris Removal

In what FEMA has been calling the 2016 Mid-Summer Severe Storms (i.e. the catastrophic flooding in Louisiana), FEMA (the federal agency charged with administering the National Flood Insurance Program) has issued guidance on the issue of debris removal.   According to FEMA, damaged items should be removed from the insured building for health and/or safety reasons and to mitigate damage. In those instances where the items have been removed from the insured building and deemed debris, the policyholder (i.e. homeowner) is required to substantiate their loss.  See link to FEMA’s bulletin: http://www.nfipiservice.com/Stakeholder/pdf/bulletin/w-16061.pdf The Standard Flood Insurance Policy (SFIP) requires that the policyholder separate damaged from undamaged property putting it in the best possible order so the adjuster may examine it. It is the policyholder’s duty to perform the separation described above and prepare an inventory of damaged property including quantity, description, and the total amount of loss claimed. Any bills, receipts, photographs of damages, and related documents should be attached to the inventory. If building and/or contents flood damaged property is removed before the adjuster is able to examine it, according to FEMA, the policyholder must photograph the items and prepare the aforementioned inventory.  See “Documenting Your Flood Damage Claim with Photographs”: http://www.floodinsuranceattorneys.com/documenting-your-flood-damage-claim-with-photographs/ To minimize potential documentation issues, if possible, the policyholder should retain for the adjuster, samples or swatches of carpeting, wallpaper, furniture upholstery, window treatments, and other items where the type and quality of material will impact the amount payable on the claim. Photographs should also include groups of items such as clothing, kitchen items, furniture, etc. These items, along with the policyholder’s written inventory of damaged items, should be given proper consideration by the insurance company.  And if they are not, it will go a long way in any potential...

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Documenting Your Flood Damage Claim with Photographs

Posted by on August 19, 2016 in Blog | Comments Off on Documenting Your Flood Damage Claim with Photographs

Documenting Your Flood Damage Claim with Photographs

Having litigated hundreds of flood insurance cases, there is nothing more important to proving your damages than good photographs.  Its so important that it is worthy of a full blog post.  First, most people take pictures with their cell phone.  That is fine.  But please, immediately after taking the picture, back them up to the cloud, download them to a computer, and have them printed in hard copy.  That is how important they are.  While litigating Sandy flood cases, many clients told me that they had lost pictures that would have proven their case because they subsequently lost or damaged their phones.  In the end, it cost them money.  In some cases, the clients would not have needed my services if they had good pictures. Second, take lots of pictures. Take photographs of the exterior of the building – all sides, even if you do not see any damage.  Take the photographs from far away, and then move in closer.  Same goes for the inside of the house or building.  Take a picture that includes the entire room, then move in closer for specific damage.  Take pictures of the ceiling and the floor, and all four walls.  Again, even if you do not see damage, it may be helpful later on. Third, take pictures of all personal property (i.e. contents).  If you have contents coverage, flood insurance will pay for personal property.  Most insurance companies will require that you submit a list of personal property, the room it was located, the age, and value –  and you should start working on that immediately as well.  But photos will show evidence of the items on the list and allow you to go back and identify items that you may miss.  You should open every closet and take pictures of the contents of it before the items are removed.  It also includes items under the sink, as well as in all kitchen draws and cabinets.  It is amazing how much money in personal products can be stored under a sink in the bathroom – shampoos, conditioner, cologne, perfume, brushes, hair dryers, moisturizer, razor blades, cleaning products, etc.  There are probably hundreds of dollars of products that are all covered.  Same goes for the kitchen cabinets.  Also, take pictures of the contents of any free standing cabinets or desks.  If you have damaged books, CDs, DVDs, etc. take a picture of all of them.  I had a client once with a DVD collection.  She photographed 5 towers of DVDs.  Despite seeing hundreds of DVDs in other photographs, the insurance company initially denied paying for any they could not actually see.  We eventually were able to obtain coverage, but it could have been avoided with good photographs. Third, take the pictures before you start cleaning the house or building.  Many objects will be tipped over from floating.  The photographs will be dramatic, and if you have to litigate your case, they will have an impact on the judge and the attorney for the insurance company.  It’s a shocking sight to see photographs of a refrigerator flipped over in a living room or a soaking wet couch in a kitchen.  Once you empty the house of damaged personal property, and the rooms are empty, take more photographs of the interior.  Insurance companies want to...

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Sandy FEMA Review Process: Victims Rights Group Encourages Victims to Keep Fighting

Posted by on August 1, 2016 in Blog | Comments Off on Sandy FEMA Review Process: Victims Rights Group Encourages Victims to Keep Fighting

Sandy FEMA Review Process:  Victims Rights Group Encourages Victims to Keep Fighting

The grassroots organization Stop FEMA Now is encouraging its members, who are victims of Hurricane Sandy, that are still in FEMA’s Sandy review process “not to settle” and hire an attorney. (www.StopFEMANow.com)  Stop FEMA Now is a grassroots movement of concerned policyholders and victims of Superstorm Sandy that successfully fought and petitioned government officials to revise the Biggert-Waters Act of 2012 that would have drastically increased flood insurance premiums.  Stop FEMA Now became a driving force in disseminating information to victims of Superstorm Sandy and evolved into a powerful organization for victims of Superstorm Sandy, and the alleged conduct of flood insurance companies and FEMA following the storm. Stop FEMA Now’s website cites examples of homeowners receiving settlements through the FEMA review process of an additional $4,000 to 10,000 for their Sandy damage, which according to its members was woefully inadequate to rebuild their homes.  But according to its website, many have become tired and are settling for far less than they feel their claim was worth.  In fairness to FEMA and its efforts, the website also cites examples of others receiving policy limits, $80,000, and one example of $200,000. After a year of representing clients in the FEMA review process that was originally suppose to be resolved in 90 days, I understand the frustration of many policyholders.  But as the claims move through the review process toward a resolution or a decision by a Neutral Review, there is finally an end in sight.  About the Author: Christopher W. Gerold is an attorney in Chiesa, Shahinian & Giantomasi’s (“CSG”) Disaster Recovery Claims Group. For the past three years, Chris has been representing homeowners, condominium associations and businesses with their Sandy related insurance claims with a special focus on flood insurance. For more information on flood insurance and ways CSG can help you with your flood insurance claim, please contact Chris at (973)...

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FEMA Review of Sandy Claims: By the Numbers (Update)

Posted by on July 5, 2016 in Blog | Comments Off on FEMA Review of Sandy Claims: By the Numbers (Update)

FEMA Review of Sandy Claims: By the Numbers (Update)

According to FEMA’s website, as of June 30, 2016, within the Sandy Claims Review, 82 percent of requested claims reviews are through the process (15,907) and/or are ready for review with policyholders; 7,663 claims have been closed with claims paid totaling $77,179,695 to 5,646 policyholders, which averages out to an additional $13,669 per successful claim. To date, according to FEMA, 74 percent of closed claims received additional payment. The review process continues for 3,390 policyholders. http://www.fema.gov/media-library-data/1467396469998-6fa2f7405ccda9381b6837ec9ab64ab3/FSNFIPTransformation07012016.pdf About the Author: Christopher W. Gerold is an attorney in Chiesa, Shahinian & Giantomasi’s (“CSG”) Disaster Recovery Claims Group. For the past three years, Chris has been representing homeowners, condominium associations and businesses with their Sandy related insurance claims with a special focus on flood insurance. For more information on flood insurance and ways CSG can help you with your flood insurance claim, please contact Chris at (973)...

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Sandy FEMA Review Process: What is the role of the Neutral Reviewer?

Posted by on June 25, 2016 in Blog | Comments Off on Sandy FEMA Review Process: What is the role of the Neutral Reviewer?

Sandy FEMA Review Process:  What is the role of the Neutral Reviewer?

According to FEMA, the role of the Neutral Reviewer in the Sandy FEMA Review Process is to issue a recommendation to FEMA based upon the information in the case file and any clarifications provided by policyholders, their representatives and FEMA personnel.  The adjuster will make a recommendation after a review of the claim file and any new documentation or information provided by the policyholder during the desk review.  If the policyholder does not agree with the recommendation, the policyholder will have the opportunity to request in writing an additional review of the claim file by a Neutral Reviewer, who may be a retired judge or attorney.  After the policyholder’s request, the Neutral Reviewer will assess the claim file and will contact the policyholder to discuss any concerns.  The Neutral Reviewer will consider the information contained in the case file, which should be the same information provided to policyholders and their attorneys (if applicable).  The Neutral Reviewer will then issue a recommendation. However, according to FEMA, the Neutral Reviewer – as a contractor of the government – does not have the ability to direct payments or bind FEMA to any particular result that requires expenditure of government funds.  FEMA may then adopt the recommendation by the third-party neutral reviewer and may authorize the recommendation for payment to the policyholder when the finding is in compliance with NFIP regulations and policy.  Once the final determination on a recommendation is received from a third-party neutral, FEMA must adhere to NFIP regulations and policies that are currently in effect, including those that limit or disallow coverage of certain expenses as outlined in the Standard Flood Insurance Policy.  The Neutral Reviewer will issue a recommendation based upon the information in the case file and any clarifications provided by policyholders, their attorneys and FEMA personnel during oral presentations (if requested). About the Author: Christopher W. Gerold is an attorney in Chiesa, Shahinian & Giantomasi’s (“CSG”) Disaster Recovery Claims Group. For the past three years, Chris has been representing homeowners, condominium associations and businesses with their Sandy related insurance claims with a special focus on flood insurance. For more information on flood insurance and ways CSG can help you with your flood insurance claim, please contact Chris at (973)...

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FEMA Review of Sandy Claims: What Happens If You Accept a Resolution Before the Neutral Review?

Posted by on June 24, 2016 in Blog | Comments Off on FEMA Review of Sandy Claims: What Happens If You Accept a Resolution Before the Neutral Review?

FEMA Review of Sandy Claims: What Happens If You Accept a Resolution Before the Neutral Review?

What happens if you accept an agreed upon resolution with the adjuster handling your FEMA Review claim? You forfeit your right to a Neutral Review. By agreeing to and signing the Proof of Loss provided by the desk review (i.e. adjuster) indicates you agreed with the outcome of the review and have not elected the Neutral Review. This is an administrative review of the claim file.  But what happens if you disagree with the desk review (i.e. adjuster)? You will have the opportunity to request a review by a qualified third-party Neutral Review. If you have reached policy limits or are satisfied with the desk review, by all means you should accept the agreed upon sum.  However, if you are unsatisfied and have not reached policy limits, the Neutral Review is the last hope to prove your case and it may be time consult with an attorney.  It will be the last chance to receive any additional money from your loss. About the Author: Christopher W. Gerold is an attorney in Chiesa, Shahinian & Giantomasi’s (“CSG ”) Disaster Recovery Claims Group. For the past three years, Chris has been representing homeowners, condominium associations and businesses with their Sandy related insurance claims with a special focus on flood insurance. For more information on flood insurance and ways CSG can help you with your flood insurance claim, please contact Chris at (973)...

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FEMA Announces a Review Process for Sandy Claims

Posted by on May 29, 2016 in Blog | Comments Off on FEMA Announces a Review Process for Sandy Claims

FEMA Announces a Review Process for Sandy Claims

The Federal Emergency Management Agency’s (FEMA) National Flood Insurance Program (NFIP) recently announced that they would provide policyholders that were impacted by Hurricane Sandy the opportunity to have their flood insurance claim files reviewed.  This review was the result of allegations of fraud and improper conduct by flood insurance companies, insurance adjusters, and engineers working for the insurance companies.  Based on FEMA’s statements, it wants to ensure that it treats NFIP policyholders who suffered a loss from Hurricane Sandy fairly and is committed to reviewing claim files to ensure that policyholders receive every dollar they are entitled to under their policy. FEMA is notifying approximately 142,000 NFIP policyholders who submitted a Hurricane Sandy flood claim that they could request that their claim files be reviewed. Letters will be sent to claimants who incurred a loss from Hurricane Sandy from Oct. 27, 2012, through Nov. 6, 2012.  Policyholders who received the maximum amount under their policy (policy limits) or were in litigation will not qualify for this review. Once a claim is filed an adjuster will contact the policyholder to guide them through the review process.  Policyholders are required to submit any additional information they would like considered as part of their review.  The adjuster will make a recommendation after a review of the claim file and any new information provided. If the policyholder does not agree with the recommendation, the policyholder will have the opportunity to request in writing an additional review of the file by a neutral reviewer. After the policyholder makes the request, the neutral reviewer will examine the file and will contact the policyholder to discuss any concerns. The policyholder may request an oral presentation involving the policyholder, the adjuster and the neutral reviewer. An oral presentation is not necessary; but will be an option.  The neutral reviewer will examine information in the file and documentation, and will ask questions of the adjuster and the policyholder when an oral presentation is requested. This neutral reviewer will make a recommendation to FEMA and FEMA will give substantial weight to the recommendation.  If the results of the review support additional payment, FEMA will direct the insurance carrier to issue payment.  FEMA will notify the policyholder by letter.  Policyholders who receive additional funds will need to provide a signed Proof of Loss. A Proof of Loss is a policyholder’s statement of the amount of money being requested, signed to and sworn to by the policyholder with documentation to support the amount requested. About the Author: Christopher W. Gerold is an attorney in Chiesa, Shahinian & Giantomasi’s (“CSG”) Disaster Recovery Claims Group. For the past three years, Chris has been representing homeowners, condominium associations and businesses with their Sandy related insurance claims with a special focus on flood insurance. For more information on flood insurance and ways CSG can help you with your flood insurance claim, please contact Chris at (973)...

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FEMA Extends Deadline to File Sandy Claim Review

Posted by on September 17, 2015 in Blog | Comments Off on FEMA Extends Deadline to File Sandy Claim Review

FEMA Extends Deadline to File Sandy Claim Review

Within hours of the expiration of the initial deadline of 9 p.m. on September 15, 2015, the Federal Emergency Management Agency (“FEMA”) announced that it was extending the deadline 30 days for victims of Hurricane Sandy to file a FEMA Claim Review.   In May 2015, FEMA implemented a claims review process after allegations that the National Flood Insurance Program, through various insurance companies, had vastly and systemically underpaid flood insurance claims. The review process allowed homeowners and business owners to present their claims directly to FEMA for review, and if necessary, to have an independent 3rd party issue a decision on any disputed facts related to coverage.    The deadline to file the claim was initially September 15, 2015.  With FEMA’s most recent announcement, homeowners and business owners will have another 30 days to file their claim for review or retain counsel to represent them in the filing of the claim.   About the Author: Christopher W. Gerold is an attorney in Chiesa, Shahinian & Giantomasi’s (“CSG Law”) Disaster Recovery Claims Group. For the past three years, Chris has been representing homeowners, condominium associations and businesses with their Sandy related insurance claims with a special focus on flood insurance. For more information on flood insurance and ways CSG Law can help you with your flood insurance claim, please contact Chris at (973)...

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