With Hurricane Dorian causing flooding on the east coast as we speak the question, I often get asked is: when can I sue my flood insurer for a violation of state law? Recently the Corpus Christi Division of the Southern District of Texas addressed the question.
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The Tampa Bay Times ran an excellent story, Hurricane Michael Destroyed Their Homes Then The Insurance Heartache Began, which tells a sad but familiar theme about insurance company denials and delayed payments following hurricane losses. I was quoted in the piece:

Chip Merlin, a Tampa insurance lawyer, said the same conflict happened in the last 15 years after Hurricane Katrina and Hurricane Ike. He said companies try to avoid making payment even when a slab is all that’s left of a property, as is the case in much of Mexico Beach.

‘Typically you have the strongest wind speeds come first, and then the storm surge follows it,’ Merlin said. Both cause damage. But residents and their attorneys, he said, may need to pay meteorologists and engineers to prove that flood and wind are to blame, and how much.
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Photo by Win McNamee

Flood insurance claims governed by the National Flood Insurance Program are different. The requirements to get paid are strict and must be complied with. Many inexperienced attorneys and public adjusters prepare these claims improperly and the result is that policyholders do not get paid or paid as much as they otherwise deserve. Federal proofs of loss have to be completed fully, properly, and on time.
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After every major flood event, I am contacted by at least one business owner and/or condominium owner who suffered flood damage, filed their claim with their NFIP1 Flood Insurance Company (Allstate, Hartford, Wright Flood, Farmers, FEMA, etc.), and was then told by either the flood insurance company or adjuster that the flood insurance policy did not cover all of the buildings or structures on the property. The business owners are enraged because they were under the impression that all buildings on the property were covered.
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When a National Flood Insurance Program (“NFIP”) insured is not satisfied with the payment for flood-related losses, the NFIP insured is directed to three options:1

  1. The NFIP insured may file an appeal with the Federal Emergency Management Agency (“FEMA”) within 60 days of the NFIP insurer’s written denial or partial denial of the requested claim amount.2
  2. The NFIP insured can invoke the Appraisal Provision of her policy. NOTE: The NFIP insured may not file option one above, the appeal with FEMA, if the Appraisal Provision is invoked.
  3. The NFIP insured may file a lawsuit within one year of the date of the written denial of all or part of the NFIP insured’s claim. NOTE: The filing of a lawsuit precludes option one, the appeal, and option two, the appraisal process, as those are considered pre-litigation administrative remedies.
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In a recent case,1 a federal court dismissed a flood claim following a nor’easter storm because the insureds’ proof of loss under the National Flood Insurance Act failed to satisfy the Standard Flood Insurance Policy’s (“SFIP”) “signed and sworn” requirement.2 In that case, the insureds submitted two claims to recover damages from the storm to their insurance company. The first claim of approximately $2,000 was completed on a form provided by the Federal Emergency Management Agency (“FEMA”). Both insureds signed and dated the document, which stated, “I declare under penalty of perjury that the information contained in the foregoing is true and correct to the best of my knowledge and belief.” Shortly thereafter, the insurance company issued a check to the insureds for the covered building damages.
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