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Denials and What to Do Next

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A difficult moment in any insurance agent's week is facing clients whose claims have been denied. Your clients may become disheartened, upset or frustrated with the situation. As their agent, you can support them as they begin to navigate the flood insurance claim appeals process.

Experiencing a flood is shocking and overwhelming. When your clients have their insurance claims denied, it only adds to their stress. That's why having you in their corner to inform them how to appeal their claims is crucial—and the push your clients will need to carry on. To make your job easier, we've outlined the steps they need to take to appeal their claims with FEMA quickly and smoothly.

Why Claims Are Denied

Understanding the appeals process is vital to understanding why a claim gets denied in the first place. Your clients' claims can be denied for several reasons: including issues regarding documentation, a misunderstanding of their policy coverage or, in some cases, errors in the adjuster's report. When a claim is denied, be sure your clients understand they must submit their appeal to FEMA within 60 days of the initial denial.

How Your Clients Appeal Their Flood Insurance Claim

Flood insurance is crucial in helping your clients recover from flood losses quickly. Ensure your clients follow these steps in a timely manner.

  1. Review the Denial Letter
    1. Read the denial letter. It will outline the reasons for the decision and the specifics of what was covered or denied.
  2. Gather Supporting Documentation
    1. Your clients will need to gather all necessary documents that support their appeal. The necessary documents may include:
      1. Copies of their policy
      2. Photos and videos of the damage
      3. Repair bills or estimates
  3. Write an Appeal Letter
    1. The letter should provide a clear and detailed explanation that articulates why they believe the denial was incorrect. In it, they must include their policy number and attach all supporting documents.
  4. Submit the Appeal
    1. Ensure they send their appeal letter to FEMA at:
      FEMA, 400 C Street SW, 3rd Floor
      Washington, DC 20472-3010
      Or they can email their appeal at FEMA-NFIP-Appeals@fema.dhs.gov.

Once your clients have submitted their appeals, let them know that FEMA will review them. However, that review may take several months.

Appealing a flood insurance claim can feel overwhelming, which is why providing your clients step-by-step information can help them understand the timelines and the processes. Be sure to download the official fact sheet on appealing your flood insurance claim to share with your clients!

For more resources to make your life as an insurance agent easier, visit https://agents.floodsmart.gov.