Flood insurance claim: how an NFIP claim works, step by step

A National Flood Insurance Program claim runs in a set order. You report the loss to your flood insurer, an adjuster inspects, and you send a signed, sworn proof of loss within 60 days after the loss. If the insurer denies any part of the claim in writing, you have 60 days from the date on that letter to appeal to FEMA.

The National Flood Insurance Program (NFIP) is the federal flood program managed by FEMA, and its policy is called the Standard Flood Insurance Policy. This guide follows FEMA’s NFIP Claims Handbook and the policy’s Dwelling Form. A private flood policy may have different terms.

How do you report a flood claim?

Tell your insurance agent or flood insurer promptly, and include your policy number. The handbook says to file a notice of loss even if you are unsure the loss is covered or is more than your deductible. The policy itself requires “prompt written notice”.

The handbook and FEMA’s claim page list these steps:

1. Photograph and video the damaged building and belongings, including the serial numbers of appliances.
2. Separate damaged from undamaged property. The policy requires it.
3. Remove wet material that cannot be saved, to avoid mold.
4. Do not discard anything before the adjuster sees it, unless it is a health hazard or local law requires it. Photograph it first and keep samples, such as a piece of carpet.

You can also ask for an advance. FEMA says that during major flood events an insurer may offer up to $5,000 without an adjuster’s visit, and up to $20,000 with documentation and FEMA’s authorization. Any advance is deducted from the final claim.

What does the flood adjuster do?

The adjuster inspects and estimates. The adjuster does not decide.

• Contact. The handbook says the adjuster generally contacts you within one to two days of your notice of loss, though it can take longer after severe flooding.
• Identification. FEMA’s claims checklist says to make sure the adjuster shows a Flood Control Number card and government-issued photo ID.
• Authority. The policy states: “We have not authorized the adjuster to approve or disapprove claims or to tell you whether we will approve your claim.”

FEMA says it can take 4 to 8 weeks before a claim is finalized and paid, and in rare instances longer.

What is a proof of loss, and when is it due?

A proof of loss is your own signed, sworn statement of how much you are claiming. The deadline wording in the policy’s Dwelling Form is:

“Within 60 days after the loss, send us a proof of loss, which is your statement of the amount you are claiming under the policy signed and sworn to by you”

The 60 days run from the loss, not from the adjuster’s visit. Three things in the policy and the handbook are easy to miss:

• The duty is yours. The policy says the adjuster may give you the form and help you complete it, but that this is “a matter of courtesy only”, and “you must still send us a proof of loss within 60 days after the loss even if the adjuster does not furnish the form or help you complete it.”
• The number is yours. The policy says you must use your own judgment about the amount of loss and justify it.
• Extensions are not automatic. The handbook refers to “the 60-day limit or within any extensions of time granted”. It says an insurer may ask FEMA for more time for a late request, “but it is not guaranteed”.

If you find more damage, or repairs cost more than the estimate, the handbook says you can request an additional payment with a proof of loss and your contractor’s detailed estimate. The same 60-day limit applies unless an extension was granted.

FEMA posts the proof of loss form on its claim forms page.

What does the Standard Flood Insurance Policy not cover?

Start with the limits. FEMA says building coverage goes up to $250,000 and contents coverage up to $100,000 for a home, typically bought separately with separate deductibles. If you bought only building coverage, your belongings are not insured.

The Dwelling Form then leaves out:

• Living expenses while the building is being repaired or cannot be occupied. The handbook says FEMA’s Individual Assistance may help if there is a presidential disaster declaration. See additional living expenses.
• Most of a basement. A basement is any area with its floor below ground level on all sides. Coverage there is limited to a list of items such as furnaces, water heaters, and clothes washers and dryers.
• Property outside the building, such as land, trees, fences, decks, patios, swimming pools and septic systems.
• Money, valuable papers and most vehicles, including cars.
• Mold you could have prevented. Mold damage from a condition within your control, including failure to inspect and maintain the property after the flood recedes. The handbook says mold testing is not covered either.
• Water that is not a flood. Sewer backup, sump pump overflow and seepage, unless a flood in the area is the cause. Wind is excluded, and the handbook says rain blown indoors by wind is not covered. See water damage insurance claims for what a home policy does with that water.
• Earth movement such as landslides and sinkholes, even when a flood causes it.
• Building code upgrades, except up to $30,000 under Increased Cost of Compliance coverage if your community finds the building substantially damaged.

How do you appeal a flood claim decision?

FEMA encourages talking to the adjuster or insurer first. If that does not settle it, the handbook describes three routes:

The handbook’s wording on the appeal deadline is: “You must submit your letter of appeal to FEMA within 60 days of the date on the denial letter from your flood insurer.”

What to send. Your policy number, the policyholder names, the property address, your contact details, a copy of the denial letter, and the details of your concern with supporting documents. Send copies, not originals.

Where to send it. Mail to FEMA, 400 C Street S.W., 6th Floor S.W., Washington, DC 20472-3010, or email [email protected]. The postmark or digital timestamp decides whether it was on time.

What it costs. Nothing. FEMA’s appeal page says there is no fee and you do not need a third party to represent you.

What FEMA can do. It sends a written decision, which is its final review. The handbook says FEMA cannot expand coverage or waive limits and exclusions.

The routes limit each other. You may use appeal or appraisal, not both. You may sue after an appeal, but once a lawsuit is filed you can no longer appeal. An appeal does not extend the one-year period to sue, even if FEMA has not decided yet. The handbook points policyholders to their own attorney for questions about a lawsuit. The appraisal clause explains how appraisal works on other policies.

Do you need a public adjuster for a flood claim?

Not to file or to appeal. As noted above, FEMA says you do not need a third party for an appeal.

A public adjuster is a licensed professional you pay to prepare and negotiate a claim. The NAIC, the association of state insurance regulators, notes that paying the fee is your responsibility. Nobody can raise a flood payment above the policy’s limits or past its exclusions, so if the building claim is already at the limit there is nothing left to add.

The two-minute quiz and the fee calculator help with that choice. The directory includes a license check, and the state pages list fee and contract rules where you live.