Flood Claims Manager – Senior Flood Claims Examiner/media/Files/S/Selective/documents/Flood/... · Confidential and Proprietary Flood Claims Staff 3 • Cassie Masone – Assistant

Confidential and Proprietary 1

Confidential and Proprietary

Flood Claims Process

Selective Flood Department

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Flood Claims Staff

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• Cassie Masone – Assistant Vice President • Stephen Weber – Flood Claims Manager • Lori Paliana – Senior Flood Claims Examiner • James Page – Flood Claims Examiner • Kimberly Kaiser – Flood Claims Examiner • Amy Englert – Flood Claims Technical Assistant

• Selective’s Flood Claims Department can be reached at (877) 348-0552 or

via e-mail at [email protected]

mailto:[email protected]


Flood - Definition

Flood: A general and temporary condition of partial or complete inundation of two or more acres of a normally dry land area or two or more properties (at least one of which is the policyholder’s property)

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• Agents: www.Selectiveflood.com o Locate a policy using Policy Search. o From the policy’s Account History, click the Notice of Loss

link. o Fill out the Submit Notice of Loss Page. Must include:

o Date of loss o Contact phone number o Temporary mailing address o Pertinent loss information

• Agents and customers: email [email protected] or fax 877-647-1798

• Customers registered on the self service website: www.MySelectiveFlood.com

• Call 877-348-0552 - 24 hours a day, 7 days a week and follow prompts

Reporting a claim

http://www.selectiveflood.com/

mailto:[email protected]

http://www.myselectiveflood.com/


• An adjusting company is assigned the claim based on its expertise and availability

• Adjuster will make contact with the insured within 24-48 hours of assignment

• During a CAT event, adjuster contact may take longer than 24-48 hours

Claim Process – First Steps


Claim Process - Expectations

• Selective will make initial contact with customer via phone, email, or mail to:

o Confirm receipt of claim o Provide name of adjusting company handling the claim o Provide the claims manual which gives guidance on the process and

the steps to take


Claims Process – Customers’ Responsibilities

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• Report loss on a timely basis o Take photos and make a list of ALL damages – including

structural o Separate damaged and undamaged property o Work with the adjuster o Customer must submit a signed

proof of loss to Selective within 60 days of the date of loss, regardless of whether adjuster has provided one


Remediation Companies

• Selective does not recommend companies or provide opinions on who to use

• Not all services are covered by the flood policy o Equipment setup and takedown

charges, monitoring fees or supervisor fees, emergency service charges, air scrubbers, HEPA filters, odor control, or protective gear for workers

o No coverage of replacement = no coverage of removal

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Claim Process – Adjuster Inspection

• During the inspection, the adjuster is to: o Discuss coverage/policy o Inspect the property o Provide the claims handbook o Discuss Increased Cost of

Compliance (ICC) coverage, if applicable

o Address any concerns o If applicable, discuss in advance

payment options and process


Claims Process – Adjuster’s Responsibilities

• Provides carrier with the preliminary report within 15 days of claim assignment

• May provide insured with proof of loss form • Completes a final report


Claims Process – Selective’s Responsibilities

• If applicable, release advance payment(s) to customer • Answer any questions or concerns of all interested parties • Examine the final report • Address underwriting concerns • Close claim by issuing final payment and/or denial letter


Flood Policy Forms

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Dwelling Condominium (RCBAP)

General Property


• Replacement Cost is the cost to replace property with the same kind of material and construction without deduction for depreciation.

• Actual Cash Value is the cost to replace an insured item of property at the time of loss, less the value of its physical depreciation.

• Replacement cost is applicable to Single Family Dwellings only (building coverage) if: 1. Dwelling is the insured’s principal residence at the time

of loss 2. Amount of insurance on the dwelling is 80% or more of

the full replacement cost or maximum coverage

Replacement Cost vs Actual Cash Value


Building Coverage

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We insure against direct physical loss by or from flood to:

• Dwelling • Additions and extensions • Detached garage

What’s Covered? - Building


• Materials and supplies to be used for construction

• Building under construction • Manufactured home or travel

trailer

What’s Covered? – Building Continued…


• Central air conditioners • Cisterns and the water in them • Built-in dishwashers • Built-in microwave ovens • Carpet permanently installed over

unfinished flooring • Elevator equipment • Fire sprinkler equipment • Walk-in freezers • Ranges, cooking stoves, and ovens • Refrigerators • Furnaces and radiators • Garbage disposal units

• Hot water heaters, including solar water heaters

• Light fixtures

• Outdoor antennas and aerials fastened to the building

• Permanently installed cupboards, bookcases, cabinets, paneling, and wallpaper

• Plumbing fixtures

• Pumps and machinery for operating pumps

• Wall mirrors permanently installed





Personal Property

Contents Coverage

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• We insure against direct physical loss by or from flood to personal property inside a building at the described location

• Personal property is also covered for a period of 45 days at another location

What’s Covered? - Personal Property


• Lenders do NOT require personal property coverage • Flood agents must sell/offer personal property coverage • Policy contains restrictions for personal property located in a

basement and in an elevated building that is post-FIRM in a SFHA

• Personal property is covered anywhere on property as long as inside a building – if building not fully enclosed, it must be secured to prevent flotation out of building

• Personal property is paid on an Actual Cash Value basis

Personal Property - Facts


What’s Covered? - Personal Property


What is Not Insured Under Building or Contents Coverage

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Loss Avoidance Measures

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Sandbags, Supplies and Labor Property removed to safety


Common Exclusions

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• Additional Living Expenses • Loss of Revenue or Profits • Loss in Progress We do not insure a loss directly or indirectly caused by a flood that is already in progress at the time and date:

1. the policy term begins; or 2. coverage is added at your request


Increased Cost of Compliance (ICC)

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• An ICC claim is coverage for expenses that a property owner must incur, above and beyond the cost to repair the physical damage the structure sustained from a flooding event, to comply with mitigation requirements of state or local floodplain management ordinances.

• Up to $30,000 available in addition to amount of coverage appearing on declaration page to bring building to compliance with state or local floodplain ordinances

• Eligibility: 1) Repetitive Loss Structure 2) Flood damage equals or exceeds

50% of the market value of the structure at the time of the flood


Assisting Your Customer

• Advise customer to take photos and clean up • If customer purchased contents coverage, a detailed list of

damaged personal property or business contents should be made • Encourage customer to work closely with adjuster • Stress the importance of submitting a signed proof of loss and

supporting documentation within 60 days. • Reiterate the customers’ responsibilities in the event of a loss. • Limit surprises by identifying and explaining potential coverage

limitations per the NFIP

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Setting Expectations – Claim Payment

• Adjusters don’t have the authority to approve or deny claim payments, nor can they provide timeframes for payment

• Generally, flood claims are paid and closed within 45 – 60 days of date of loss. Note: During a CAT event, payment timeframes may be extended.

• Approximate turnaround for payment of a claim is ten days from date closing report is received.

• If signed Proof of Loss is received after 60 days from the date of loss, regardless of reason, the claim must be referred to Federal Insurance Administrator for approval to pay. It can take up to ten business days to receive approval.

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It’s the insured’s responsibility to submit the signed proof of loss with supporting documentation of damages regardless of whether the adjuster provides one or not.


Questions?

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E-mail the Flood Claims Department at

[email protected]


©2012 Selective Ins. Group, Inc. (“Selective”, Branchville, NJ). Selective’s “Write Your Own” (WYO) insurers are Selective Ins. Co. of America, Selective Ins. Co. of New England, Selective Ins. Co. of N.Y., Selective Ins. Co. of the Southeast and Selective Ins. Co. of S.C.. The National Flood Insurance Program (NFIP) is managed by the Federal

Emergency Management Agency (FEMA). These descriptions are summaries and not offers to sell insurance; the actual policies show complete coverage, exclusions and limitations details. Policy issuance is subject to

underwriting approval. Availability is limited to participating NFIP communities.

Do not duplicate or distribute

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Documents

Flood Claims Manager – Senior Flood Claims Examiner/media/Files/S/Selective/documents/Flood/... · Confidential and Proprietary Flood Claims Staff 3 • Cassie Masone – Assistant