Monday, November 15, 2004

Proof of Loss - Part II

Downthread, I caution readers to file a Proof of Loss by Monday, November 15, 2004, if they are in any doubt that their Hurricane Ivan casualty insurance claims have been opened. I wouldn't change my gratuitous advice, but it should be mentioned that the deadline for federally insured flood insurance claims was extended on September 24 by Acting Federal Insurance Administrator David Maurstad.

Claimants under a federal flood insurance policy now have up to one year "from the date of the loss." Presumably, that would be September 15, 2005.

The policy statement issued by Maurstad is not findable on FEMA's public web site. But a copy is available on the web at Bureau Net, the federal flood insurance web site set up for insurers and adjusters. Members of the general public can access select portions of that semi-private web site without a password -- including the September 24 bulletin, which is (sigh) available only in un-friendly pdf (Adobe Acrobat) format.

In part, that bulletin reads:
To expedite claims payments so that policyholders affected by these circumstances are not subject to undue hardship, I am waiving the requirement in VII.J.4 of the SFIP Dwelling and General Property Forms and VIII.J.4 of the SFIP Residential Condominium Building Association Policy Form for the policyholder to file a proof of loss prior to receiving insurance proceeds. Instead, payment of the loss will be based on the evaluation of damage in the adjuster’s report. This means the requirement in VII.M.1 and VIII.M.1 that losses will be payable 60 days after the insurer receives the policyholder’s proof of loss (or within 90 days after the adjuster files a report signed and sworn to by the policyholder in lieu of a proof of loss) will not apply. Instead, the loss will be payable as soon as practicable after the insurer receives the adjuster’s report. This procedure will allow the insurer to promptly adjust, settle, and pay claims based on the adjuster’s report.

The Proof of Loss requirement is not waived entirely, but the deadline is substantially extended:
In the event a policyholder disagrees with the insurer’s adjustment, settlement, or payment of the claim, a policyholder may submit to the insurer a proof of loss within one year from the date of the loss. [emphasis added] The proof of loss must meet the requirements of VII.J.4 of the SFIP Dwelling or General Property Form or VIII.J.4 of the SFIP Residential Condominium Building Association Policy Form. The insurer will then process the policyholder’s proof of loss in its normal fashion. If the insurer rejects the proof of loss in whole or in part, the policyholder may file a lawsuit against the insurer within one year of the date of the written denial of all or part of the claim as provided in VII.R of the SFIP Dwelling or General Property Form or VIII.R of the SFIP Residential Condominium Building Association Policy Form.

To repeat: The Proof of Claim waiver applies only to flood insurance claims. Homeowner insurance policies, windstorm, auto, and other policies are not affected.


1 comment:

Linda L. said...

Thanks for the info, JB. As I understand it, the operative phraseology is "In the event a policyholder disagrees with the insurer’s adjustment, settlement, or payment of the claim..." In other words, if I receive a payment based on the adjuster's report and am completely satisfied with it, there will be no need to file a Proof of Loss for a flood claim at any time. In that instance, then, the Proof of Loss requirement is in fact entirely waived.