Understanding Coverage Decisions

This is a collection of FEMA decisions in response to NFIP policyholders who have appealed their flood insurer's denial. These documents are provided to claim professionals, as well as current and future policyholders for use to better understand flood policy coverage, claim requirements, and why claims get denied or overturned.

Flood Claim Decision Memos

Please use the features below to search the collection. You may sort by appeal issue, which is based on a common subject ‘tagwords’, decision type, or based on type decision rule, which are categorized on the hierarchy of insurance policy rules on (1) eligibility, (2) coverage, (3) scope of damage, and (4) price or scope to repair. FEMA will periodically add new decisions to its collection over time.

Displaying 1 - 10 of 89

Actual Cash Value Proof of Loss Decision Upheld

The policyholder appeals the denial for an additional payment for personal property items. (Price)

Price

drying mitigation

Basement Coverage Limitations Decision Overturned

The policyholder appeals the denial due to basement limitations. (Coverage.)

Coverage

basement

Basement Coverage Limitations Decision Upheld

The policyholder appeals the denial of personal property due to basement limitations. (Coverage)

Coverage

basement coverage

Complying with Law or Ordinance Decision Upheld

The policyholder appeals the denial for asbestos testing. (Coverage)

Coverage

flood loss

Condo Loss Assessments Decision Upheld

The policyholder appeals the insurer’s denial and seeks payment for condominium loss assessments (coverage).

Coverage

flood loss

Detached Garages Overturn

The policyholder appeals the denial related to a non-qualified building. (Eligibility)

Eligibility

detached garage

Direct Physical Loss Flood Borne Debris Overturn

The policyholder appeals the denial for the removal of non-owned flood-borne debris on the insured property. (Coverage. Scope.)

Coverage
Scope

lake flooding

Direct Physical Loss Prior Damages Sheathing Upheld

The policyholder appeals the denial of building property not repaired or replaced after a prior loss. (Coverage)

Coverage

Drying Mitigation

Direct Physical Loss Sheathing Overturn

The policyholder appeals the denial for the exterior wall sheathing due to no direct physical loss by or from flood. (Scope. Price)

Price
Scope

A1 Sheathing Overturn

Earth Movement Decision Overturned

The policyholder appeals the denial for foundation damages, gravel, and well damages. (Coverage.)

Coverage

earth movement

Understanding Coverage Decisions (New)