FEMA Bulletin W-17013a outlines updated flood insurance denial letter requirements.

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New FEMA Flood Insurance Denial Letter Requirements

FEMA has issued updated flood insurance denial letter requirements to help policyholders better understand why the Standard Flood Insurance Policy (SFIP) may not cover all or part of their claims.

On October 16, 2017 FEMA issued Bulletin W-17013a which mandates standard elements for all SFIP denial letters. According to FEMA, these requirements are meant to improve the policyholder experience by providing a plain-language description and standardized information about their denial.

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Updated Denial Letter Requirements:

  • Date of denial letter.

    IMPORTANT: The date of the initial denial starts the one-year period from which the policyholder may file suit. This date also triggers the 60-day period to file an appeal with FEMA.

  • Names of the policyholders, their mailing address and the loss location.
  • Date(s) of loss.

    Necessary when policyholders file claims for the same properties across multiple events.

  • Date policyholder submitted a request for payment or failed to comply with a material term of the SFIP (e.g., failed to submit a timely proof of loss).

    Sequentially, a denial letter should be issued only after the policyholder submits a signed and sworn proof of loss, signs the final adjuster’s report or fails to comply with a material term of the SFIP.

  • Item denied with corresponding dollar amounts denied.

    Denial letters should avoid general terms and instead list the items not covered by the SFIP.

  • Plain-language explanation for the non-payment or non-coverage.

    Rather than quote the SFIP at length, the denial letter should explain why the SFIP does not provide coverage.

  • Citations to the relevant sections of the SFIP and a web link to the SFIP.

In addition to the requirements outlined above, flood insurance carriers must also include a document that explains the rights of policyholders after a whole or partial denial.

Other FEMA Bulletin Updates

In an effort to prevent policyholders from appealing denials before they are issued, FEMA also asked flood insurance carriers to remind adjusters of their role in the flood claim process:

  • Adjusters are not authorized to approve or disapprove claims or to tell the policyholder whether their insurer will approve the claim.
  • Adjusters may answer general flood insurance coverage questions in the effort to provide good customer service to policyholders, but should also let policyholders know that their insurer provides the final claim decision.
  • Adjusters should inform policyholders that they cannot file an appeal until they receive a denial letter from their insurer.

View FEMA Bulletin W-17013a

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Call: 877-803-2897
Text: 817-203-0260

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