The Role Of Fema Insurance Adjusters: Navigating Disaster Claims And Recovery

The National Flood Insurance Program (NFIP) is the insurance arm of the Federal Emergency Management Agency (FEMA). The NFIP was created in conjunction with the National Flood Insurance Act of 1968 following the devastation of Hurricane Betsy. Flood losses tend to be the most costly and widespread, and at the time, private insurance companies were crippled by the damage. As insurers weren’t able to offer cost-effective flood coverage, the NFIP was created to maintain a large enough pool of funds to pay for such events. Even today, most standard homeowners' policies do not offer flood insurance because it is simply too big a risk for insurance carriers. An insurance adjuster for FEMA, therefore, works with the NFIP to handle flood insurance claims.

Adjuster's Preliminary Report

An insurance adjuster for FEMA's National Flood Insurance Program (NFIP) must be certified to handle flood claims, which are often high-value and require specific expertise. The role of an adjuster is to assess and document the damage caused by flooding to a property and its contents, and to help the claimant prepare their repair estimate.

The Adjuster's Preliminary Report is a crucial document in this process. It is the first step in the claims process and is used to report information to the NFIP Servicing Agent for setting services and initial claims. The adjuster will need to fill out this form and submit it, along with supporting documentation and photos, to initiate the claims process.

The report will include detailed information about the property, the extent of the damage, and any relevant circumstances. This may include structural damage, floodwater levels, and damage to appliances, furniture, and other items. It is important for the claimant to provide as much evidence as possible to support their claim, and the adjuster will guide them through this process. The adjuster will also need to provide their own official identification and contact information.

The preliminary report is a critical step in the claims process as it sets the foundation for the entire procedure. It is important for the adjuster to be thorough and accurate in their assessment and reporting, as it will impact the claimant's ability to receive fair compensation for their losses. The adjuster will also need to be mindful of any health and safety risks posed by flooded items and guide the claimant on how to safely document and dispose of these items.

Adjuster's Narrative Report

An Adjuster's Narrative Report is a form used by insurance adjusters to provide additional information that was not included in the Preliminary or Final Report when documenting a claim. This form is used to give a detailed account of the adjuster's findings and assessments during the claim process.

When completing an Adjuster's Narrative Report, it is important to include a comprehensive description of the incident and the resulting damage. This involves detailing the type and extent of damage incurred, as well as any relevant information that could impact the claim outcome. For instance, in the case of flood damage, adjusters would need to document the scope of the damage, including measurements and photos, to support the claim assessment.

The report should also outline any interactions the adjuster had with the policyholder and other relevant parties. This includes documenting the policyholder's account of the incident, any discussions regarding the policy coverage and claim process, and the provision of necessary information and instructions to the policyholder.

Furthermore, the Adjuster's Narrative Report should include a clear explanation of the claim process, including the steps taken to assess the damage, estimate repair costs, and determine the appropriate compensation. This may involve referencing specific clauses in the insurance policy and outlining how they apply to the particular incident and resulting losses.

Additionally, the report can be used to highlight any unique circumstances or complexities associated with the claim. This could include identifying potential third-party contributions to the damage, as well as any health or safety risks that required immediate attention, such as the presence of mould or the need for emergency repairs to prevent further damage.

Overall, the Adjuster's Narrative Report serves as a comprehensive record of the claim process, ensuring that all relevant information is documented and considered when determining the outcome of the insurance claim.

Adjuster's Subrogation Referral

An insurance adjuster for FEMA carries out the following tasks:

• Contacting the insurance agent or company to report flood loss.
• Inspecting the damaged property and providing evidence of the damage, such as photographs and videos.
• Explaining the NFIP Flood Claims Process to the claimant.
• Inspecting the claimant's property, taking measurements, and capturing photos.
• Explaining what an advance payment is and how the claimant can obtain one.
• Discussing the claimant's policy coverage and how they should present their loss to their insurance company.

Adjusters Subrogation Referral is a form used by adjusters to identify potentially responsible third parties and their actions that may have caused or worsened flood damage. It is part of the process of documenting a claim and is used in conjunction with supporting documentation and relevant photos. This form helps adjusters protect the interests of the insured by pursuing legal action or reimbursement from the responsible third party.

The Adjuster's Subrogation Referral form is an important tool for FEMA adjusters in their work of assessing and managing flood damage claims. It enables them to identify and hold accountable any third parties whose actions may have contributed to the flood damage, ensuring that the insured party receives the necessary compensation and support.

Adjuster's Preliminary Damage Assessment (APDA)

An insurance adjuster for FEMA is responsible for conducting preliminary damage assessments (PDAs) to determine the magnitude of damage and impact of disasters. This helps FEMA and its state, local, tribal, and territorial partners decide if federal assistance is necessary.

Now, let's focus on the Adjusters Preliminary Damage Assessment (APDA):

The APDA, or Adjuster Preliminary Damage Assessment, is a form used by adjusters to assess and report on potential substantial structural damage caused by flooding. "Substantial damage" is defined as flood damage where the cost of repairs meets or exceeds 50% of the market value of the structure at the time of the flood. This threshold may be lower in some communities. The APDA form is FEMA Form 086-0-20 and can be downloaded from the official website.

The APDA is used specifically when an adjuster has inspected a structure and believes it may have sustained substantial damage due to flooding. This includes both covered and non-covered flood damage. The adjuster's role is to determine the extent and cause of the damage, and whether repairs are a reasonable option.

How to Complete the APDA:

After inspecting the property, the adjuster should complete the APDA form, listing the potentially substantially damaged structures. This form should then be submitted to the NFIP BSA via email or fax. The subject line of the email should be "APDA Enclosed."

The submission of the APDA form is just one part of the claims process. Once the APDA is submitted, the relevant authorities will review the information to decide if federal assistance is warranted. This may lead to a request for a Disaster Declaration, which can provide additional support beyond what is covered by standard insurance policies.

It is important to note that the APDA is not the only form involved in the claims process. Other forms, such as the Adjuster's Preliminary Report (FF-206-FY-21-146) and the Adjuster's Narrative Report (FF-206-FY-21-147), may also be required to document the claim fully.

Adjuster's Registration Application

The Adjuster's Registration Application is a form used by the National Flood Insurance Program (NFIP) to register independent adjusters who wish to participate in the program. The NFIP is the insurance arm of the Federal Emergency Management Agency (FEMA) and was created in conjunction with the National Flood Insurance Act of 1968 following the devastation of Hurricane Betsy.

The Adjuster's Registration Application form can be found on the FEMA website and must be completed by anyone seeking to become a certified flood adjuster. The application includes five types of registration: Residential (Dwelling), Manufactured (Mobile) Home/Travel Trailer, Small Commercial (General Property), Large Commercial (General Property), and Condominium (RCBAP). An adjuster can be registered for one or all five categories, or any combination, if their qualifications meet the requirements.

To be approved for Residential, Commercial, or Manufactured (Mobile) Homes losses, or any combination of these, an adjuster must have at least four consecutive years of full-time property loss adjusting experience. They must also be capable of preparing an accurate scope of damage and dollar estimate, as well as demonstrating knowledge of the SFIP and NFIP adjustment criteria.

For Large Commercial and RCBAP registration, adjusters must have at least five consecutive years of full-time large-loss property adjusting experience and be able to prepare accurate damage and dollar estimates of $500,000 or more. They must also submit written recommendations from insurance company supervisory personnel and provide information on their current Errors and Omissions coverage.

Once certified, adjusters must be recertified every year to maintain their status.

Frequently asked questions