Hurricane Florence: North Carolina Claim Guidelines
With the Imminent Arrival of Hurricane Florence in North Carolina, Insurers Should Keep in Mind the Following Requirements Contained in the North Carolina Insurance Code:
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Acknowledge the claim in writing within 30 days. N.C. Gen. Stat. §58-3-100(c)
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Acknowledge and respond to claims communications “reasonably promptly.” N.C. Gen. Stat. §58-63-15(11)(b)
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If the Policy requires the submission of a proof of loss, a blank form must be provided within 15 days of the receipt of the claim. N.C. Gen. Stat. §58-3-40
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Affirm or deny coverage within a reasonable time after receipt of proof of loss. N.C. Gen. Stat.§ 58-63-15(11)(e)
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“Promptly” settle claims where liability has become reasonably clear. N.C. Gen. Stat. §58-63-15(11)(f)
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Payment of settled claims must be made within 10 days. 11 N.C. Admin Code 4.0421(1)
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Provide a reasonable explanation of the basis for a claim denial. N.C. Gen. Stat. §58-63-15(11)(n)
Some Additional Issues to Consider:
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A reservation of rights should be issued as appropriate.
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Civil Authority – Mandatory evacuations have been issued in advance of Florence.
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Service Interruption – Power and telephone/cell service may be disrupted.
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Sue and Labor – Businesses may shut down operations in advance.
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Adjuster licensing- North Carolina requires that all adjusters and public adjusters to be licensed in North Carolina. N.C. Gen. Stat. §58-33-5; N.C. Gen. Stat. §58-33A-10. Adjusting losses without a license can be a Class 1 misdemeanor. N.C. Gen. Stat. §58-3-130. There is a provision in place that permits the Insurance Commissioner to allow out of state adjusters to adjust losses without the need for a North Carolina in the event of a catastrophe. N.C. Gen. Stat. §58-33-70
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Flood hazard zone areas—Areas identified on the Flood Insurance Rate Map can change, so be aware of applicable policy limits by hazard zone.
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Flood and Wind sublimits and/or deductibles.
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Definition of “occurrence” (in case of stalled storm)
