| Figure 1-6. The illustration above shows a flowchart of the ICC claims
process. The following steps must be taken: (1) Policyholder suffers flood
loss and reports loss to the Insurer (NFIP Direct or to the Write Your Own
(WYO)). (2) During first visit, claims rep. completes Damage Assessment
Form (DAF) if damage appears to be 50% of replacement cost and is in an
SFHA. (3) Claims Rep. sends DAF to Mitigation Division Director at FEMA
Regional Office. (4) Claims rep. advises policyholder of ICC if the structure
appears to be substantially damaged. (5) Policyholder applies to the community
for a permit to begin repairs. (6) Local official determines if this flood
involves "substantial damage" or a "repetitive loss"
that would trigger local cumulative substantial damage ordinance. (7) Policyholder
confers with local officials on local ordinance requirements and mitigation
options. *(8) Policyholder notifies the Insurer of substantial or repetitive
damage repair requirements. (9) Policyholder obtains a permit from the community
to begin repairs. (10) Policyholder gets cost estimate from a contractor
to begin the required work. (11) Insurer sets up ICC claim file and checks
if the policy is rated post-FIRM with negative elevation difference. (12)
For post-FIRM construction with negative elevation difference, claims rep.
must determine: (a) whether the structure was built in compliance at the
time of construction; (b) whether a variance was issued at the time of construction;
(c) whether there has been an increase in BFE. Once variables are determined,
use decision table in Appendix 1-7, and then go on to step 13. (13) If a
community issued a variance at time of construction or before the current
loss, claims rep. must obtain a copy for claim file. (14) Claims rep. determines
on what basis the community determined the loss involving substantial damage.
Claims rep. makes certain substantial damage caused by flood, and also makes
sure no variance has been issued for current loss. (15) If claim involves
repetitive loss structure, insurer must verify that repetitive loss damages
involve flood claims paid by the NFIP direct or a WYO. Note: claims rep.
must obtain documentation from community of building value at the time prior
to flood claim. (16) Claims rep. must verify, within a reasonable range,
that flood damage for the loss(es) supports the community's valuation. (17)
Once the claims rep. confirms that the damage meets the requirements for
ICC eligibility, the claims rep. will forward an ICC Proof of Loss to the
policyholder and indicate under what conditions an advance payment may be
made. (18) Policyholder may receive partial ICC payment provided that claims
rep. received assigned contract for the work, a permit from the community
to do the work and a return of the signed ICC Proof of Loss. (19) Claims
rep. advises policyholder that if the work is not completed, any partial
payment must be returned to the Insurer. (20) When mitigation work is complete,
local official inspects property and issues a certificate of occupancy or
a confirmation letter. (21) Policyholder furnishes claims rep. a copy of
letters of confirmation or a certificate of occupancy from the community.
(22) Insurer pays the final ICC claim installment with appropriate documentation.
*Please note: Steps 8-11 do not necessarily occur in this exact order
or may occur simultaneously. Claims rep. must get documentation for
elevation requirements different from final FEMA BFEs (e.g., unnumbered
A zones or FEMA advisor BFEs freeboard requirements.)
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