National Flood Insurance Program (NFIP); Appeal of Decisions Relating to Flood Insurance Claims, 30294-30298 [E6-8180]
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30294
Federal Register / Vol. 71, No. 102 / Friday, May 26, 2006 / Rules and Regulations
Authority: 61 Stat. 681, as amended, 69
Stat. 367; Sec. 5, 50 Stat. 875; 30 U.S.C. 601
et seq.; 43 U.S.C. 1181e.
implications that require consultation
with Indian Tribes.
Executive Order 13211, Actions
Concerning Regulations That
Significantly Affect Energy Supply,
Distribution, or Use
Subpart 5422—Volume Measurements
2. Amend § 5422.2 by revising
paragraph (b) to read as follows:
I
In accordance with Executive Order
13211, BLM has determined that the
final rule will not have substantial
direct effects on the energy supply,
distribution, or use, including a shortfall
in supply or price increase. The rule
does not relate to energy supply,
distribution, or use in any respect.
Executive Order 13352, Facilitation of
Cooperative Conservation
In accordance with Executive Order
13352, BLM has determined that this
final rule is purely administrative and
does not affect cooperative
conservation. This final rule takes
appropriate account of and considers
the interests of persons with ownership
or other legally recognized interests in
land or other natural resources because
it does not interfere with such interests.
The final rule solely affects a Federal
responsibility not involving state or
local participation, and has no impact
on public health and safety.
§ 5422.2
Scale sales.
*
*
*
*
*
(b) (1) BLM may order third party
scaling after determining that all of the
following factors exist:
(i) A timber disaster has occurred;
(ii) A critical resource loss is
imminent; and
(iii) Measurement practices listed in
§ 5422.1 and paragraph (a) of this
section are inadequate to permit orderly
disposal of the damaged timber.
(2) BLM may also order third party
scaling, only by scalers or scaling
bureaus under contract to BLM, for the
scaling of density management timber
sales when the quadratic mean diameter
of the trees to be cut and removed is
equal to or less than 20 inches.
(3) Third party scaling volumes must
be capable of being equated to BLM
standards in use for timber depletion
computations, to insure conformance
with sustained yield principles.
Paperwork Reduction Act
[FR Doc. E6–8109 Filed 5–25–06; 8:45 am]
This final rule does not contain
information collection requirements that
the Office of Management and Budget
must approve under the Paperwork
Reduction Act of 1995, 44 U.S.C. 3501
et seq.
DEPARTMENT OF HOMELAND
SECURITY
BILLING CODE 4310–84–P
Author
The principal authors of this final rule
are Scott Lieurance, Forester—Senior
Specialist, Washington Office, and
Lyndon Werner, Forester, Oregon State
Office, assisted by Ted Hudson, Senior
Regulatory Specialist, Washington
Office, Bureau of Land Management.
List of Subjects in 43 CFR Part 5420
Accordingly, for the reasons stated in
the preamble and under the authorities
stated below, BLM amends 43 CFR part
5420 as set forth below:
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I
PART 5420—PREPARATION FOR
SALE
1. The authority citation for part 5420
continues to read as follows:
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[FEMA–2005–0057]
Public Participation
RIN 1660–AA41
Interested persons are invited to
participate in this notice by submitting
written data, views, or arguments on all
aspects of the interim final rule. FEMA
also invites comments that relate to the
economic, environmental, or federalism
affects that might result from this
interim final rule. Comments that will
provide the most assistance to FEMA in
developing this interim final rule will
reference a specific portion of the
interim final rule, explain the reason for
any recommended change, and include
data, information, or authority that
support such recommended change. See
ADDRESSES above for information on
how to submit comments.
National Flood Insurance Program
(NFIP); Appeal of Decisions Relating to
Flood Insurance Claims
Federal Emergency
Management Agency (FEMA),
Department of Homeland Security.
ACTION: Interim final rule.
Dated: April 20, 2006.
Johnnie Burton,
Acting Assistant Secretary of the Interior.
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44 CFR Part 62
AGENCY:
Forests and forest products,
Government contracts, Public lands,
Reporting and recordkeeping
requirements.
I
Federal Emergency Management
Agency
2005–0057, by one of the following
methods:
Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
E-mail: FEMA–RULES@dhs.gov.
Include Docket Number FEMA–2005–
0057 in the subject line of the message.
Fax: 202–646–4536.
Mail/Hand Delivery/Courier: Rules
Docket Clerk, Office of General Counsel,
Federal Emergency Management
Agency, Room 406, 500 C Street, SW.,
Washington, DC 20472.
Instructions: All Submissions
received must include the agency name
and docket number (if available) for this
interim final rule. All comments
received will be posted without change
to https://www.regulations.gov, including
any personal information provided. For
detailed instructions on submitting
comments, see the ‘‘Public
Participation’’ heading of the
SUPPLEMENTARY INFORMATION section of
this document.
Docket: For access to the docket to
read background documents or
comments received, go to the Federal
eRulemaking Portal at https://
www.regulations.gov. Submitted
comments may also be inspected at
FEMA, Office of General Counsel, 500 C
Street, SW., Room 406, Washington, DC
20472.
FOR FURTHER INFORMATION CONTACT:
James Shortley, Director of Claims,
Federal Emergency Management
Agency, 500 C Street SW., Washington,
DC 20472, (202) 646–3418 (Phone),
(202) 646–4327 (facsimile), or
James.Shortley@dhs.gov. (e-mail).
SUPPLEMENTARY INFORMATION:
SUMMARY: This interim final rule will
amend the National Flood Insurance
Program (NFIP) regulations to include
an appeals process for NFIP
policyholders as required by Congress
in Section 205 of the Bunning-BereuterBlumenauer Flood Insurance Reform
Act (FIRA) of 2004.
DATES: Effective: This rule is effective
June 26, 2006. Comments: Comments
due on or before July 25, 2006.
ADDRESSES: You may submit comments,
identified by Docket Number FEMA–
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Background
In the face of mounting flood losses
and escalating costs of disaster relief to
the taxpayers, the NFIP was established
by Congress as part of the National
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Federal Register / Vol. 71, No. 102 / Friday, May 26, 2006 / Rules and Regulations
Flood Insurance Act of 1968 (the Act).
Public Law 90–448, Title XII (Aug. 1,
1968), as amended, 42 U.S.C. 4001, et
seq. The intent of the NFIP is to reduce
future flood damage through community
floodplain management ordinances, and
to make risk-based flood insurance
generally available for property owners.
FEMA was designated by Congress to be
the administrator of the NFIP.
In 1983, FEMA partnered with the
private insurance industry to expand
the NFIP policy base. This partnership
between FEMA and the private sector
property insurance companies is termed
the Write Your Own (WYO) Program.
The WYO Program is a cooperative
undertaking between the insurance
industry and FEMA. The WYO Program
allows participating property and
casualty insurance companies to issue
and service the NFIP Standard Flood
Insurance policies (SFIPs) in their own
names. FEMA also uses the services of
contractors to process NFIP policy
information from the WYO Companies
and the agents and to service SFIPs sold
directly by FEMA. Contractors are
sometimes employed by the WYO
Companies to handle and adjust claims.
Section 205 of the Bunning-BereuterBlumenauer Flood Insurance Reform
Act (FIRA) of 2004 (Pub. L. 108–264
(June 30, 2004)), requires FEMA to
establish by regulation an additional
process for the appeal of decisions of
flood insurance claims issued through
the NFIP. This process will enable
policyholders to formally appeal the
decisions of any insurance agent or
adjuster, or insurance company, or any
FEMA employee or contractor with
respect to their SFIP claims, proofs of
loss, and loss estimates.
FEMA traditionally has used an
informal process to handle appeals
regarding decisions related to coverage
or claims under the NFIP. The initial
correspondence and associated claims
documentation are reviewed and
additional investigation is conducted as
necessary. The Federal Insurance
Administrator is responsible for
decisions on informal claims, and the
appropriate entities are notified to
facilitate full resolution of the appeal.
FEMA is now codifying into regulation,
pursuant to the FIRA of 2004, its
informal appeals process.
Under this new appeals process,
FEMA will acknowledge receipt of a
policyholder’s appeal in writing and
will advise the policyholder if
additional information is required in
order to consider fully the appeal.
FEMA will review the documentation
submitted by the policyholder and will
conduct any necessary additional
investigation. FEMA will advise the
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policyholder and the appropriate flood
insurance carrier of FEMA’s decision
regarding the appeal.
Discussion
The Act and the SFIP authorize an
insured (or policyholder) who is
dissatisfied with an insurer’s decision to
deny a claim, in whole or part, to file
a lawsuit in Federal district court for the
disallowed portion of the claim, or to
invoke the appraisal provision of the
SFIP, a procedure to resolve disputes
regarding the actual value of covered
losses. This rule provides a formal
appeals process for resolving flood
insurance disputes prior to litigation.
The appeals process outlined in this
interim final rule does not abolish or
replace the right to file a lawsuit against
the insurer pursuant to the Act (42
U.S.C. 4072), nor does it expand or
change the one-year statute of limitation
to file suit against the insurer for the
disallowed portion of the insured’s
claim. To avoid potentially conflicting
results and duplicative efforts, an
insured who files suit against an insurer
is prohibited from filing an appeal
under this appeals process.
Similarly, this appeals process is not
meant to provide an insured with
multiple administrative, pre-litigation
remedies. Accordingly, an insured who
seeks to resolve issues regarding the
actual cash value or, if applicable,
replacement cost of damaged property,
must elect to resolve this dispute
through only one of the following: the
appraisal provision in the SFIP or
through this appeals process.
Finally, this rule does not amend or
change the conditions necessary to
recover under the SFIP. In the case of a
flood loss to insured property, the
insured must comply with the
requirements set out in the SFIP,
including, but not limited to, providing
the insurer with prompt notice of the
loss, submitting a valid proof of loss
within 60 days after the loss,
cooperating with the adjuster,
separating damaged and undamaged
property so that the insurer may
examine it, and preparing an inventory
of damaged personal property. See SFIP
44 CFR Part 61, App.A(1), Part 61, App.
A(2), Part 61, App. A(3).
This appeals process is available after
the issuance of the insurer’s final claim
determination, which is the insurer’s
written denial, in whole or in part, of
the insured’s claim. Once the final claim
determination is issued, an insured may
appeal any action taken by the insurer,
FEMA employee, FEMA contractor,
insurance adjuster, or insurance agent.
An insured must file an appeal within
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60 days after receiving the insurer’s
final claim determination.
Administrative Procedure Act
Statement
In general, FEMA publishes a rule for
public comment before issuing a final
rule, under the Administrative
Procedure Act (APA), 5 U.S.C. 553 and
44 CFR 1.12. However, the APA
exempts from public notice and
comment requirements those rules
pertaining to ‘‘agency organization,
procedure or practice.’’ 5 U.S.C.
553(b)(A). As the instant rule merely
prescribes an available procedure being
established by FEMA, it is exempt from
the notice and comment requirements of
the APA.
Moreover, the APA provides an
exception from the requirements where
the agency for good cause finds the
procedures for comment and response
contrary to public interest. For the
reasons set forth below, FEMA has
determined that such good cause is
present in the instant case.
Hurricane Katrina caused
monumental flooding which Hurricane
Rita exacerbated. The magnitude and
severity of the flood losses related to
these hurricanes are unprecedented in
the history of the NFIP. FEMA estimates
that Hurricanes Katrina, Rita, and
Wilma will result in approximately
240,000 flood insurance claims. This
significantly exceeds the highest
number of claims filed from any single
event in the NFIP’s history, and will
more than triple the total number of
claims filed in 2004. The public benefit
of this rule is to establish a formal
appeals process as soon as possible.
Therefore, FEMA believes it is contrary
to the public interest to delay the
benefits of this rule. In accordance with
the Administrative Procedure Act, 5
U.S.C. 553(d)(3), FEMA finds that there
is good cause for the interim final rule
to be published without a prior public
comment period in order to allow
processes for the appeals to be put into
place prior to implementation.
National Environmental Policy Act
This interim final rule falls within the
exclusion category 44 CFR 10.8(d)(2)(ii),
which addresses the preparation,
revision, and adoption of regulations,
directives, and other guidance
documents related to actions that
qualify for categorical exclusions. Since
this is an administrative action that
qualifies for the exclusion category
described in 44 CFR 10.8(d)(2)(ii) and
because no other extraordinary
circumstances have been identified, this
interim final rule will not require the
preparation of either an environmental
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assessment or an environmental impact
statement as defined by the National
Environmental Policy Act.
Executive Order 12866, Regulatory
Planning and Review
FEMA has prepared and reviewed this
rule under the provisions of Executive
Order 12866, Regulatory Planning and
Review. Under Executive Order 12866,
58 FR 51735, October 4, 1993, a
significant regulatory action is subject to
OMB review and the requirements of
the Executive Order. The Executive
Order defines ‘‘significant regulatory
action’’ as one that is likely to result in
a rule that may:
(1) Have an annual effect on the
economy of $100 million or more or
adversely affect in a material way the
economy, a sector of the economy,
productivity, competition, jobs, the
environment, public health or safety, or
State, local, or tribal governments or
communities;
(2) create a serious inconsistency or
otherwise interfere with an action taken
or planned by another agency;
(3) materially alter the budgetary
impact of entitlements, grants, user fees,
or loan programs or the rights and
obligations of recipients thereof; or
(4) raise novel legal or policy issues
arising out of legal mandates, the
President’s priorities or the principles
set forth in the Executive Order.
In determining how to move forward
with this rule, binding arbitration was
not an option because the NFIP
statutory authority prohibits it. In the
case of non-binding arbitration or
mediation, FEMA recognizes that
mediation is an important tool for the
resolution of claim disputes and
encourages WYO Companies and
policyholders to participate, or continue
to participate, in mediation where it
may lead to an expeditious and mutual
resolution of a disputed claim.
Mediation is most effective when it
occurs early in the process. Therefore
FEMA encourages the WYO Companies
to offer this option to its flood insurance
policyholders since some WYO carriers
already offer this option as a part of
their standard claims resolution service
for their other lines of insurance.
However, once the dispute has evolved,
FEMA believes the appeals process as
described in this interim final rule
would be the most cost effective and
efficient mechanism.
Under the new appeals process, when
a NFIP policyholder does not agree with
a decision made by an insurer,
including a determination of any
insurance agent, adjuster, insurance
company, or any FEMA employee or
contractor with respect to a claim, proof
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of loss and loss estimate the
policyholder may submit an appeal of
the insurer’s decision to FEMA. FEMA
will provide written acknowledgement
of the policyholder’s appeal and will
advise the policyholder if additional
information is required in order to
consider the appeal. FEMA will review
the documentation submitted by the
policyholder and will conduct any
additional investigation that is
necessary to formulate a decision
concerning the appeal. FEMA will
advise the policyholder and the
appropriate flood insurance carrier of
FEMA’s decision regarding the appeal.
Currently, when policyholders are not
satisfied with a claim settlement they
may informally appeal to FEMA. The
initial correspondence and associated
claims documentation are reviewed and
additional investigation is conducted as
necessary. The Federal Insurance
Administrator is responsible for
decisions on informal claims, and the
appropriate entities are notified to
facilitate the full resolution of the
appeal.
Under section 1341 of the Act (42
U.S.C. 4072) and the provisions of the
SFIP, a policyholder may file suit in the
United States District Court of the
district in which the insured property
was located at the time of loss within
one year after the written denial of all
or part of the claim. This one year time
period starts from the date of the
original denial and not the date of a
decision regarding an appeal. A
policyholder may choose the appraisal
process under the policy, or participate
in the appeals process created by this
interim final rule instead of filing a
lawsuit. The one year period for filing
a suit is not extended by the submission
of an appeal or participating in the
appraisal provision of the SFIP.
Historically, significantly less than 1
percent of all NFIP claims result in
litigation. A policyholder who chooses
to file suit either sues a WYO Company
if the policy was issued by a WYO
Company or the Director of FEMA if the
policy was issued directly by FEMA.
The policyholder is responsible for their
litigation costs including filing fees,
attorney costs, and expenses. Federal
law does not allow the policyholder to
recover attorney’s fees or other legal
expense if they prevail in the lawsuit.
The NFIP received 686,389 claims
beginning in fiscal year 1996 and ending
with fiscal year 2005. Using these years
as a reference point for the impact on
claims when this interim final rule
establishes a formal appeals process, it
is estimated that in a typical year,
claims will be slightly more than
68,000. In 2004, NFIP received 75,022
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claims; of those claims, FEMA received
360 informal appeals concerning claim
disputes. The total number of claims
received from Hurricanes Katrina, Rita,
and Wilma is approximately 240,000
which is approximately three and a
third times greater than an average year
and more than triple the total number of
claims filed in 2004. Based on the
above, the number of appeals is
estimated to be three and a third times
the number for an average year, or
approximately 1,200. However, given
the magnitude and severity of Hurricane
Katrina, FEMA believes that with the
publication of this interim final rule and
the distribution of the National Flood
Insurance Program Flood Insurance
Claims Handbook, FEMA estimates that
the number of appeals could be as high
as approximately 2,000 in 2006. FEMA
anticipates that, after 2006, it will
receive somewhere between the lower
average of 360 and 1200 appeals. FEMA
also anticipates that a successful appeal
will result in an average range of
approximately $3,000 to $8,000 more
being paid to a policyholder. Therefore,
this interim final rule is not a
economically significant regulatory
action; as, FEMA estimates that
formalizing FEMA’s appeals process
will result in less than $10 million
dollars in additional flood insurance
payments.
Therefore, this rule is a significant
regulatory action, but not an
economically significant regulatory
action within the definition of section
3(f) of Executive Order 12866, and it
adheres to the principles of regulation of
the Executive Order. OMB has reviewed
this rule under the provisions of the
Executive Order.
Paperwork Reduction Act
This interim final rule contains
information collection requirements
subject to the Paperwork Reduction Act
of 1995. Under the Paperwork
Reduction Act, a person may not be
penalized for failing to comply with an
information collection that does not
display a currently valid OMB control
number.
FEMA has submitted an information
collection request for review and
approval of an existing collection in use
without an OMB control number under
the emergency processing procedures in
OMB regulation 5 CFR 1320.13, and
requested expedited approval, allowing
FEMA to use the collection for 180 days.
The proposed information collection
request is published to solicit and
obtain comments from the public and
affected agencies. FEMA will follow this
emergency request with a request for a
3-year approval under normal clearance
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procedures in accordance with the
provisions of OMB regulation 5 CFR
1320.10. Comments should be directed
to OMB, Office of Information and
Regulatory Affairs, Attention: FEMA
Desk Officer, Washington, DC 20530.
FEMA will accept comments on the
proposed collection through July 25,
2006. All comments and suggestions, or
questions regarding additional
information, including obtaining a copy
of the proposed information collection
instrument with instructions, should be
directed to Chief, Records Management
Section, Information Resources
Management Branch, Information
Technology Services Division, FEMA,
500 C Street, SW., Room 306,
Washington, DC 20472. FEMA requests
written comments and suggestions from
the public and affected agencies
addressing one or more of the following
points:
(1) Whether the proposed collection
of information is necessary for the
proper performance of the functions of
the agency, including whether the
information will have practical utility.
(2) The accuracy of the agency’s
estimate of the burden of the proposed
collection of information, including the
validity of the methodology and
assumptions used.
(3) Suggestions to enhance the
quality, utility, and clarity of the
information to be collected.
(4) Suggestions to minimize the
burden of the collection of information
on those who are to respond, including
through the use of appropriate
automated, electronic, mechanical, or
other technological collection
techniques or other forms of information
technology, e.g., permitting electronic
submission of responses.
The following is an overview of this
information collection:
(1) Type of Information Collection:
Existing Collection In Use Without an
OMB Control Number.
(2) Title of the Forms/Collection:
National Flood Insurance Program
Appeals Process.
(3) Agency form number, if any, and
the applicable component of FEMA
sponsoring the collection: Forms are not
used in the appeals process, but rather
the policyholder will submit a letter
requesting an appeal.
(4) Affected public who will be asked
or required to respond, as well as a brief
abstract. Primary: National Flood
Insurance Program policyholders that
dispute the results of their claim, proof
of loss, and loss estimate
determinations. These policyholders
will be asked to provide relevant
information that will facilitate the
resolution of the appeal. Brief abstract:
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This information collection implements
the mandates of section 205 of the FIRA
of 2004 to establish by regulation what
was traditionally an informal appeals
process for NFIP policyholders in cases
of unsatisfactory decisions on claims,
proof of loss, and loss estimates made
by any insurance company, agent,
adjuster, or FEMA employee or
contractor.
(5) An estimate of the total number of
respondents and the amount of time
estimated for an average respondent to
respond to the FIRA of 2004 appeals
process: It is estimated that in a typical
year claims received will be
approximately 68,000 resulting in 360
appeals. However, considering the
recent impact of Hurricanes Katrina,
Rita, and Wilma in the number of claims
received referenced earlier, the program
has estimated that approximately 2,000
respondents per year will file an appeal,
each spending an average of two hours
drafting the letter and compiling the
required information.
(6) An estimate of the total public
burden (in hours) associated with the
collection: 4,000 hours per year.
If additional information is required,
contact: Sylvia Correa, FEMA, 500 C
Street, SW., Room 316, Washington, DC
20472.
Executive Order 13175, Indian Tribal
Governments
This rule does not have tribal
implications under Executive Order
13175, Consultation and Coordination
with Indian Tribal Governments,
because it does not have a substantial
direct effect on one or more Indian
tribes, on the relationship between the
Federal Government and Indian tribes,
or on the distinction of power and
responsibilities between the Federal
Government and Indian tribes. It does
not have a substantial direct effect
because the rule does not make
distinctions of where the property
insured is located, the rule will apply
uniformly to all policyholders
regardless if they live on or off Tribal
lands.
Executive Order 13132, Federalism
Executive Order 13132, Federalism,
dated August 4, 1999, sets forth
principles and criteria that agencies
must adhere to in formulating and
implementing policies that have
federalism implications, that is,
regulations that have substantial direct
effects on the States, or on the
distribution of power and
responsibilities among the various
levels of government. Federal agencies
must closely examine the statutory
authority supporting any action that
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would limit the policymaking discretion
of the States, and to the extent
practicable, must consult with State and
local officials before implementing any
such action.
FEMA has reviewed this rule under
Executive Order 13132 and has
concluded the rule does not have
federalism implications as defined by
the Executive Order. FEMA has
determined the rule does not
significantly affect the rights, roles, and
responsibilities of States, and involves
no preemption of State law nor does it
limit State policymaking discretion.
Executive Orders 12898 and 12948,
Environmental Justice
Under Executive Orders 12898 and
12948, respectively, ‘‘Federal Actions to
Address Environmental Justice in
Minority Populations and Low-Income
Populations,’’ FEMA incorporates
environmental justice into our policies
and programs. Executive Order 12898
requires each Federal agency to conduct
its programs, policies, and activities that
substantially affect human health or the
environment in a manner that ensures
those programs, policies, and activities
do not have the effect of excluding
persons from participation in, denying
persons the benefits of, or subjecting
persons to discrimination because of
their race, color, or national origin.
Executive Order 12898 also requires that
each Federal Agency shall identify and
address as appropriate,
disproportionately high and adverse
human health or environmental effects
of its programs, policies, and activities
on minority populations and lowincome populations.
FEMA does not anticipate that actions
under the rule would have a
disproportionately high and adverse
human health effect on any segment of
the population. FEMA has determined
that the requirements of these Executive
Orders do not apply to this rule.
Regulatory Flexibility Act
The Regulatory Flexibility Act (RFA)
mandates that an agency conduct an
RFA analysis when an agency is
‘‘required by section 553 * * *, or any
other law, to publish general notice of
proposed rulemaking for any proposed
rule, or publishes a notice of proposed
rulemaking for interpretative rule
involving the internal revenue laws of
the United States * * *.’’ 5 U.S.C.
603(a). RFA analysis is not required
when a rule is exempt from notice and
comment rulemaking under 5 U.S.C.
553(b). FEMA has determined that good
cause exists under 5 U.S.C. 553(b)(B) to
exempt this rule from the notice and
comment requirements of 5 U.S.C.
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553(b). Therefore no RFA analysis under
5 U.S.C. 603 is required for this rule.
Executive Order 12988
This interim final rule meets the
applicable standards of Executive Order
12988.
List of Subjects in 44 CFR Part 62
Flood insurance.
I Accordingly, for the reasons set forth
in the preamble, FEMA amends 44 CFR
part 62 as follows:
PART 62–SALE OF INSURANCE AND
ADJUSTMENT OF CLAIMS
1. The authority citation for part 62
continues to read as follows:
I
Authority: 42 U.S.C. 4001 et seq.;
Reorganization Plan No. 3 of 1978, 43 FR
41943, 3 CFR, 1978 Comp., p. 329; E.O.
12127 of Mar. 31, 1979, 44 FR 19367, 3 CFR,
1979 Comp., p. 376.
2. Revise the title of subpart B of part
62, to read as follows:
I
Subpart B—Claims Adjustment, Claims
Appeals, and Judicial Review
I
3. Add § 62.20 to read as follows:
cprice-sewell on PROD1PC66 with RULES
§ 62.20
Claims appeals.
(a) Definitions.
Administrator means the Federal
Insurance Administrator.
Appeal decision means the
disposition of the appeal by the
Administrator.
Decision means the insurer’s final
claim determination, which is the
insurer’s written denial, in whole or in
part, of the insured’s claim.
(b) Appeal. A National Flood
Insurance Program (NFIP) policyholder,
whether insured by a participating
Write-Your-Own (WYO) Company or
directly by the Federal Emergency
Management Agency (FEMA), may
appeal a decision, including a
determination of any insurance agent,
adjuster, insurance company, or any
FEMA employee or contractor with
respect to a claim, proof of loss, and loss
estimate. In order to file an appeal, the
insured must comply with all
requirements set out in the Standard
Flood Insurance Policy (SFIP). This
appeals process is available after the
issuance of the insurer’s final claim
determination, which is the insurer’s
written denial, in whole or in part, of
the insured’s claim. Once the final claim
determination is issued, an insured may
appeal any action taken by the insurer,
FEMA employee, FEMA contractor,
insurance adjuster, or insurance agent.
(c) Limitations on Appeals.
The appeals process is intended to
resolve claim issues and is not intended
VerDate Aug<31>2005
15:18 May 25, 2006
Jkt 208001
to grant coverage or limits that are not
provided by the SFIP. Filing an appeal
does not waive any of the requirements
for perfecting a claim under the SFIP or
extend any of the time limitations set
forth in the SFIP.
(1) Disputes that are or have been
subject to appraisal as provided for in
the SFIP cannot be appealed under this
section.
(2) When a policyholder files an
appeal on any issue, that issue is no
longer subject to resolution by appraisal
or other pre-litigation remedies.
(d) Litigation preclusion. An insured
who files suit against an insurer on the
flood insurance claim issue is
prohibited from filing an appeal under
this section. All appeals submitted for
decision but not yet resolved shall be
terminated upon notice of the
commencement of litigation regarding
the claim.
(e) Procedures. To pursue an appeal
under this section a policyholder must:
(1) Submit a written appeal to FEMA
within 60 days from the date of the
decision. The appeal should be sent to:
Federal Emergency Management
Agency, Federal Insurance
Administrator, Mitigation Division, 500
C Street, SW., Washington, DC 20472;
(2) Identify relevant policy and claim
information and state the basis for the
appeal;
(3) Submit relevant documentation;
and
(4) Submit a copy of the proof of loss
submitted to the insurer as required in
the policy.
(f) Appeal resolution. (1) FEMA will
acknowledge, in writing, receipt of a
policyholder’s appeal.
(2) The Administrator will review the
appeal documents and may notify the
policyholder in writing of the need for
additional information. A request for the
additional information will include the
date by which the information must be
provided, and shall in no case be less
than 14 calendar days. Failure to
provide the requested information in
full, or to request an extension by the
due date, may result in a dismissal of
the appeal. A re-inspection of the
policyholder’s property may be
conducted at the discretion of the
Administrator to gather more
information. The Administrator will
ensure that all information necessary to
rule on the appeal has been provided
prior to making an appeal decision.
(3) The Administrator will review the
appeal documents, including any
reinspection report, if appropriate. The
Administrator will provide an appeal
decision in writing to the policyholder
and insurer. No further administrative
review will be provided to the insured.
PO 00000
Frm 00036
Fmt 4700
Sfmt 4700
(4) A policyholder who does not agree
with FEMA’s appeal decision should
refer to the SFIP, for options for further
action (see Part 61, App. A(1) VII.R.,
Part 61, App. A(2) VII.R., and Part 61,
App. A(3) VIII.R.). The one-year period
to file suit commences with the written
denial from the insurer and is not
extended by the appeals process.
Dated: May 23, 2006.
R. David Paulison,
Acting Director, Federal Emergency
Management Agency, Department of
Homeland Security.
[FR Doc. E6–8180 Filed 5–25–06; 8:45 am]
BILLING CODE 9110–11–P
FEDERAL COMMUNICATIONS
COMMISSION
47 CFR Part 54
[CC Docket No. 96–45 and WC Docket No.
05–337, FCC 06–69]
Federal-State Joint Board on Universal
Service, High-Cost Universal Service
Support
Federal Communications
Commission.
ACTION: Interim order.
AGENCY:
SUMMARY: In this document, the
Commission extends the high-cost
universal service support rules adopted
in, among others, the Rural Task Force
Order on an interim basis until the
Commission concludes its rural review
proceeding and adopts changes, if any,
to those rules as a result of that
proceeding.
DATES: Effective June 26, 2006, the
framework adopted at 66 FR 30081, June
5, 2001, is extended.
FOR FURTHER INFORMATION CONTACT:
Katie King, Special Counsel, Wireline
Competition Bureau,
Telecommunications Access Policy
Division, (202) 418–7400, TTY (202)
418–0484.
SUPPLEMENTARY INFORMATION: This is a
summary of the Commission’s Order, in
CC Docket No. 96–45 and WC Docket
No. 05–337, released May 16, 2006. The
full text of this document is available for
public inspection during regular
business hours in the FCC Reference
Center, Room CY–A257, 445 12th Street,
SW., Washington, DC 20554.
I. Introduction
1. This Order, extends the high-cost
universal service support rules adopted
in the Rural Task Force Order,
Fourteenth Report and Order and
Twenty-Second Order on
Reconsideration, 66 FR 30080, June 5,
E:\FR\FM\26MYR1.SGM
26MYR1
Agencies
[Federal Register Volume 71, Number 102 (Friday, May 26, 2006)]
[Rules and Regulations]
[Pages 30294-30298]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-8180]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
44 CFR Part 62
[FEMA-2005-0057]
RIN 1660-AA41
National Flood Insurance Program (NFIP); Appeal of Decisions
Relating to Flood Insurance Claims
AGENCY: Federal Emergency Management Agency (FEMA), Department of
Homeland Security.
ACTION: Interim final rule.
-----------------------------------------------------------------------
SUMMARY: This interim final rule will amend the National Flood
Insurance Program (NFIP) regulations to include an appeals process for
NFIP policyholders as required by Congress in Section 205 of the
Bunning-Bereuter-Blumenauer Flood Insurance Reform Act (FIRA) of 2004.
DATES: Effective: This rule is effective June 26, 2006. Comments:
Comments due on or before July 25, 2006.
ADDRESSES: You may submit comments, identified by Docket Number FEMA-
2005-0057, by one of the following methods:
Federal eRulemaking Portal: https://www.regulations.gov. Follow the
instructions for submitting comments.
E-mail: FEMA-RULES@dhs.gov. Include Docket Number FEMA-2005-0057 in
the subject line of the message.
Fax: 202-646-4536.
Mail/Hand Delivery/Courier: Rules Docket Clerk, Office of General
Counsel, Federal Emergency Management Agency, Room 406, 500 C Street,
SW., Washington, DC 20472.
Instructions: All Submissions received must include the agency name
and docket number (if available) for this interim final rule. All
comments received will be posted without change to https://
www.regulations.gov, including any personal information provided. For
detailed instructions on submitting comments, see the ``Public
Participation'' heading of the SUPPLEMENTARY INFORMATION section of
this document.
Docket: For access to the docket to read background documents or
comments received, go to the Federal eRulemaking Portal at https://
www.regulations.gov. Submitted comments may also be inspected at FEMA,
Office of General Counsel, 500 C Street, SW., Room 406, Washington, DC
20472.
FOR FURTHER INFORMATION CONTACT: James Shortley, Director of Claims,
Federal Emergency Management Agency, 500 C Street SW., Washington, DC
20472, (202) 646-3418 (Phone), (202) 646-4327 (facsimile), or
James.Shortley@dhs.gov. (e-mail).
SUPPLEMENTARY INFORMATION:
Public Participation
Interested persons are invited to participate in this notice by
submitting written data, views, or arguments on all aspects of the
interim final rule. FEMA also invites comments that relate to the
economic, environmental, or federalism affects that might result from
this interim final rule. Comments that will provide the most assistance
to FEMA in developing this interim final rule will reference a specific
portion of the interim final rule, explain the reason for any
recommended change, and include data, information, or authority that
support such recommended change. See ADDRESSES above for information on
how to submit comments.
Background
In the face of mounting flood losses and escalating costs of
disaster relief to the taxpayers, the NFIP was established by Congress
as part of the National
[[Page 30295]]
Flood Insurance Act of 1968 (the Act). Public Law 90-448, Title XII
(Aug. 1, 1968), as amended, 42 U.S.C. 4001, et seq. The intent of the
NFIP is to reduce future flood damage through community floodplain
management ordinances, and to make risk-based flood insurance generally
available for property owners. FEMA was designated by Congress to be
the administrator of the NFIP.
In 1983, FEMA partnered with the private insurance industry to
expand the NFIP policy base. This partnership between FEMA and the
private sector property insurance companies is termed the Write Your
Own (WYO) Program.
The WYO Program is a cooperative undertaking between the insurance
industry and FEMA. The WYO Program allows participating property and
casualty insurance companies to issue and service the NFIP Standard
Flood Insurance policies (SFIPs) in their own names. FEMA also uses the
services of contractors to process NFIP policy information from the WYO
Companies and the agents and to service SFIPs sold directly by FEMA.
Contractors are sometimes employed by the WYO Companies to handle and
adjust claims.
Section 205 of the Bunning-Bereuter-Blumenauer Flood Insurance
Reform Act (FIRA) of 2004 (Pub. L. 108-264 (June 30, 2004)), requires
FEMA to establish by regulation an additional process for the appeal of
decisions of flood insurance claims issued through the NFIP. This
process will enable policyholders to formally appeal the decisions of
any insurance agent or adjuster, or insurance company, or any FEMA
employee or contractor with respect to their SFIP claims, proofs of
loss, and loss estimates.
FEMA traditionally has used an informal process to handle appeals
regarding decisions related to coverage or claims under the NFIP. The
initial correspondence and associated claims documentation are reviewed
and additional investigation is conducted as necessary. The Federal
Insurance Administrator is responsible for decisions on informal
claims, and the appropriate entities are notified to facilitate full
resolution of the appeal. FEMA is now codifying into regulation,
pursuant to the FIRA of 2004, its informal appeals process.
Under this new appeals process, FEMA will acknowledge receipt of a
policyholder's appeal in writing and will advise the policyholder if
additional information is required in order to consider fully the
appeal. FEMA will review the documentation submitted by the
policyholder and will conduct any necessary additional investigation.
FEMA will advise the policyholder and the appropriate flood insurance
carrier of FEMA's decision regarding the appeal.
Discussion
The Act and the SFIP authorize an insured (or policyholder) who is
dissatisfied with an insurer's decision to deny a claim, in whole or
part, to file a lawsuit in Federal district court for the disallowed
portion of the claim, or to invoke the appraisal provision of the SFIP,
a procedure to resolve disputes regarding the actual value of covered
losses. This rule provides a formal appeals process for resolving flood
insurance disputes prior to litigation.
The appeals process outlined in this interim final rule does not
abolish or replace the right to file a lawsuit against the insurer
pursuant to the Act (42 U.S.C. 4072), nor does it expand or change the
one-year statute of limitation to file suit against the insurer for the
disallowed portion of the insured's claim. To avoid potentially
conflicting results and duplicative efforts, an insured who files suit
against an insurer is prohibited from filing an appeal under this
appeals process.
Similarly, this appeals process is not meant to provide an insured
with multiple administrative, pre-litigation remedies. Accordingly, an
insured who seeks to resolve issues regarding the actual cash value or,
if applicable, replacement cost of damaged property, must elect to
resolve this dispute through only one of the following: the appraisal
provision in the SFIP or through this appeals process.
Finally, this rule does not amend or change the conditions
necessary to recover under the SFIP. In the case of a flood loss to
insured property, the insured must comply with the requirements set out
in the SFIP, including, but not limited to, providing the insurer with
prompt notice of the loss, submitting a valid proof of loss within 60
days after the loss, cooperating with the adjuster, separating damaged
and undamaged property so that the insurer may examine it, and
preparing an inventory of damaged personal property. See SFIP 44 CFR
Part 61, App.A(1), Part 61, App. A(2), Part 61, App. A(3).
This appeals process is available after the issuance of the
insurer's final claim determination, which is the insurer's written
denial, in whole or in part, of the insured's claim. Once the final
claim determination is issued, an insured may appeal any action taken
by the insurer, FEMA employee, FEMA contractor, insurance adjuster, or
insurance agent. An insured must file an appeal within 60 days after
receiving the insurer's final claim determination.
Administrative Procedure Act Statement
In general, FEMA publishes a rule for public comment before issuing
a final rule, under the Administrative Procedure Act (APA), 5 U.S.C.
553 and 44 CFR 1.12. However, the APA exempts from public notice and
comment requirements those rules pertaining to ``agency organization,
procedure or practice.'' 5 U.S.C. 553(b)(A). As the instant rule merely
prescribes an available procedure being established by FEMA, it is
exempt from the notice and comment requirements of the APA.
Moreover, the APA provides an exception from the requirements where
the agency for good cause finds the procedures for comment and response
contrary to public interest. For the reasons set forth below, FEMA has
determined that such good cause is present in the instant case.
Hurricane Katrina caused monumental flooding which Hurricane Rita
exacerbated. The magnitude and severity of the flood losses related to
these hurricanes are unprecedented in the history of the NFIP. FEMA
estimates that Hurricanes Katrina, Rita, and Wilma will result in
approximately 240,000 flood insurance claims. This significantly
exceeds the highest number of claims filed from any single event in the
NFIP's history, and will more than triple the total number of claims
filed in 2004. The public benefit of this rule is to establish a formal
appeals process as soon as possible. Therefore, FEMA believes it is
contrary to the public interest to delay the benefits of this rule. In
accordance with the Administrative Procedure Act, 5 U.S.C. 553(d)(3),
FEMA finds that there is good cause for the interim final rule to be
published without a prior public comment period in order to allow
processes for the appeals to be put into place prior to implementation.
National Environmental Policy Act
This interim final rule falls within the exclusion category 44 CFR
10.8(d)(2)(ii), which addresses the preparation, revision, and adoption
of regulations, directives, and other guidance documents related to
actions that qualify for categorical exclusions. Since this is an
administrative action that qualifies for the exclusion category
described in 44 CFR 10.8(d)(2)(ii) and because no other extraordinary
circumstances have been identified, this interim final rule will not
require the preparation of either an environmental
[[Page 30296]]
assessment or an environmental impact statement as defined by the
National Environmental Policy Act.
Executive Order 12866, Regulatory Planning and Review
FEMA has prepared and reviewed this rule under the provisions of
Executive Order 12866, Regulatory Planning and Review. Under Executive
Order 12866, 58 FR 51735, October 4, 1993, a significant regulatory
action is subject to OMB review and the requirements of the Executive
Order. The Executive Order defines ``significant regulatory action'' as
one that is likely to result in a rule that may:
(1) Have an annual effect on the economy of $100 million or more or
adversely affect in a material way the economy, a sector of the
economy, productivity, competition, jobs, the environment, public
health or safety, or State, local, or tribal governments or
communities;
(2) create a serious inconsistency or otherwise interfere with an
action taken or planned by another agency;
(3) materially alter the budgetary impact of entitlements, grants,
user fees, or loan programs or the rights and obligations of recipients
thereof; or
(4) raise novel legal or policy issues arising out of legal
mandates, the President's priorities or the principles set forth in the
Executive Order.
In determining how to move forward with this rule, binding
arbitration was not an option because the NFIP statutory authority
prohibits it. In the case of non-binding arbitration or mediation, FEMA
recognizes that mediation is an important tool for the resolution of
claim disputes and encourages WYO Companies and policyholders to
participate, or continue to participate, in mediation where it may lead
to an expeditious and mutual resolution of a disputed claim. Mediation
is most effective when it occurs early in the process. Therefore FEMA
encourages the WYO Companies to offer this option to its flood
insurance policyholders since some WYO carriers already offer this
option as a part of their standard claims resolution service for their
other lines of insurance. However, once the dispute has evolved, FEMA
believes the appeals process as described in this interim final rule
would be the most cost effective and efficient mechanism.
Under the new appeals process, when a NFIP policyholder does not
agree with a decision made by an insurer, including a determination of
any insurance agent, adjuster, insurance company, or any FEMA employee
or contractor with respect to a claim, proof of loss and loss estimate
the policyholder may submit an appeal of the insurer's decision to
FEMA. FEMA will provide written acknowledgement of the policyholder's
appeal and will advise the policyholder if additional information is
required in order to consider the appeal. FEMA will review the
documentation submitted by the policyholder and will conduct any
additional investigation that is necessary to formulate a decision
concerning the appeal. FEMA will advise the policyholder and the
appropriate flood insurance carrier of FEMA's decision regarding the
appeal.
Currently, when policyholders are not satisfied with a claim
settlement they may informally appeal to FEMA. The initial
correspondence and associated claims documentation are reviewed and
additional investigation is conducted as necessary. The Federal
Insurance Administrator is responsible for decisions on informal
claims, and the appropriate entities are notified to facilitate the
full resolution of the appeal.
Under section 1341 of the Act (42 U.S.C. 4072) and the provisions
of the SFIP, a policyholder may file suit in the United States District
Court of the district in which the insured property was located at the
time of loss within one year after the written denial of all or part of
the claim. This one year time period starts from the date of the
original denial and not the date of a decision regarding an appeal. A
policyholder may choose the appraisal process under the policy, or
participate in the appeals process created by this interim final rule
instead of filing a lawsuit. The one year period for filing a suit is
not extended by the submission of an appeal or participating in the
appraisal provision of the SFIP.
Historically, significantly less than 1 percent of all NFIP claims
result in litigation. A policyholder who chooses to file suit either
sues a WYO Company if the policy was issued by a WYO Company or the
Director of FEMA if the policy was issued directly by FEMA. The
policyholder is responsible for their litigation costs including filing
fees, attorney costs, and expenses. Federal law does not allow the
policyholder to recover attorney's fees or other legal expense if they
prevail in the lawsuit.
The NFIP received 686,389 claims beginning in fiscal year 1996 and
ending with fiscal year 2005. Using these years as a reference point
for the impact on claims when this interim final rule establishes a
formal appeals process, it is estimated that in a typical year, claims
will be slightly more than 68,000. In 2004, NFIP received 75,022
claims; of those claims, FEMA received 360 informal appeals concerning
claim disputes. The total number of claims received from Hurricanes
Katrina, Rita, and Wilma is approximately 240,000 which is
approximately three and a third times greater than an average year and
more than triple the total number of claims filed in 2004. Based on the
above, the number of appeals is estimated to be three and a third times
the number for an average year, or approximately 1,200. However, given
the magnitude and severity of Hurricane Katrina, FEMA believes that
with the publication of this interim final rule and the distribution of
the National Flood Insurance Program Flood Insurance Claims Handbook,
FEMA estimates that the number of appeals could be as high as
approximately 2,000 in 2006. FEMA anticipates that, after 2006, it will
receive somewhere between the lower average of 360 and 1200 appeals.
FEMA also anticipates that a successful appeal will result in an
average range of approximately $3,000 to $8,000 more being paid to a
policyholder. Therefore, this interim final rule is not a economically
significant regulatory action; as, FEMA estimates that formalizing
FEMA's appeals process will result in less than $10 million dollars in
additional flood insurance payments.
Therefore, this rule is a significant regulatory action, but not an
economically significant regulatory action within the definition of
section 3(f) of Executive Order 12866, and it adheres to the principles
of regulation of the Executive Order. OMB has reviewed this rule under
the provisions of the Executive Order.
Paperwork Reduction Act
This interim final rule contains information collection
requirements subject to the Paperwork Reduction Act of 1995. Under the
Paperwork Reduction Act, a person may not be penalized for failing to
comply with an information collection that does not display a currently
valid OMB control number.
FEMA has submitted an information collection request for review and
approval of an existing collection in use without an OMB control number
under the emergency processing procedures in OMB regulation 5 CFR
1320.13, and requested expedited approval, allowing FEMA to use the
collection for 180 days. The proposed information collection request is
published to solicit and obtain comments from the public and affected
agencies. FEMA will follow this emergency request with a request for a
3-year approval under normal clearance
[[Page 30297]]
procedures in accordance with the provisions of OMB regulation 5 CFR
1320.10. Comments should be directed to OMB, Office of Information and
Regulatory Affairs, Attention: FEMA Desk Officer, Washington, DC 20530.
FEMA will accept comments on the proposed collection through July
25, 2006. All comments and suggestions, or questions regarding
additional information, including obtaining a copy of the proposed
information collection instrument with instructions, should be directed
to Chief, Records Management Section, Information Resources Management
Branch, Information Technology Services Division, FEMA, 500 C Street,
SW., Room 306, Washington, DC 20472. FEMA requests written comments and
suggestions from the public and affected agencies addressing one or
more of the following points:
(1) Whether the proposed collection of information is necessary for
the proper performance of the functions of the agency, including
whether the information will have practical utility.
(2) The accuracy of the agency's estimate of the burden of the
proposed collection of information, including the validity of the
methodology and assumptions used.
(3) Suggestions to enhance the quality, utility, and clarity of the
information to be collected.
(4) Suggestions to minimize the burden of the collection of
information on those who are to respond, including through the use of
appropriate automated, electronic, mechanical, or other technological
collection techniques or other forms of information technology, e.g.,
permitting electronic submission of responses.
The following is an overview of this information collection:
(1) Type of Information Collection: Existing Collection In Use
Without an OMB Control Number.
(2) Title of the Forms/Collection: National Flood Insurance Program
Appeals Process.
(3) Agency form number, if any, and the applicable component of
FEMA sponsoring the collection: Forms are not used in the appeals
process, but rather the policyholder will submit a letter requesting an
appeal.
(4) Affected public who will be asked or required to respond, as
well as a brief abstract. Primary: National Flood Insurance Program
policyholders that dispute the results of their claim, proof of loss,
and loss estimate determinations. These policyholders will be asked to
provide relevant information that will facilitate the resolution of the
appeal. Brief abstract: This information collection implements the
mandates of section 205 of the FIRA of 2004 to establish by regulation
what was traditionally an informal appeals process for NFIP
policyholders in cases of unsatisfactory decisions on claims, proof of
loss, and loss estimates made by any insurance company, agent,
adjuster, or FEMA employee or contractor.
(5) An estimate of the total number of respondents and the amount
of time estimated for an average respondent to respond to the FIRA of
2004 appeals process: It is estimated that in a typical year claims
received will be approximately 68,000 resulting in 360 appeals.
However, considering the recent impact of Hurricanes Katrina, Rita, and
Wilma in the number of claims received referenced earlier, the program
has estimated that approximately 2,000 respondents per year will file
an appeal, each spending an average of two hours drafting the letter
and compiling the required information.
(6) An estimate of the total public burden (in hours) associated
with the collection: 4,000 hours per year.
If additional information is required, contact: Sylvia Correa,
FEMA, 500 C Street, SW., Room 316, Washington, DC 20472.
Executive Order 13175, Indian Tribal Governments
This rule does not have tribal implications under Executive Order
13175, Consultation and Coordination with Indian Tribal Governments,
because it does not have a substantial direct effect on one or more
Indian tribes, on the relationship between the Federal Government and
Indian tribes, or on the distinction of power and responsibilities
between the Federal Government and Indian tribes. It does not have a
substantial direct effect because the rule does not make distinctions
of where the property insured is located, the rule will apply uniformly
to all policyholders regardless if they live on or off Tribal lands.
Executive Order 13132, Federalism
Executive Order 13132, Federalism, dated August 4, 1999, sets forth
principles and criteria that agencies must adhere to in formulating and
implementing policies that have federalism implications, that is,
regulations that have substantial direct effects on the States, or on
the distribution of power and responsibilities among the various levels
of government. Federal agencies must closely examine the statutory
authority supporting any action that would limit the policymaking
discretion of the States, and to the extent practicable, must consult
with State and local officials before implementing any such action.
FEMA has reviewed this rule under Executive Order 13132 and has
concluded the rule does not have federalism implications as defined by
the Executive Order. FEMA has determined the rule does not
significantly affect the rights, roles, and responsibilities of States,
and involves no preemption of State law nor does it limit State
policymaking discretion.
Executive Orders 12898 and 12948, Environmental Justice
Under Executive Orders 12898 and 12948, respectively, ``Federal
Actions to Address Environmental Justice in Minority Populations and
Low-Income Populations,'' FEMA incorporates environmental justice into
our policies and programs. Executive Order 12898 requires each Federal
agency to conduct its programs, policies, and activities that
substantially affect human health or the environment in a manner that
ensures those programs, policies, and activities do not have the effect
of excluding persons from participation in, denying persons the
benefits of, or subjecting persons to discrimination because of their
race, color, or national origin. Executive Order 12898 also requires
that each Federal Agency shall identify and address as appropriate,
disproportionately high and adverse human health or environmental
effects of its programs, policies, and activities on minority
populations and low-income populations.
FEMA does not anticipate that actions under the rule would have a
disproportionately high and adverse human health effect on any segment
of the population. FEMA has determined that the requirements of these
Executive Orders do not apply to this rule.
Regulatory Flexibility Act
The Regulatory Flexibility Act (RFA) mandates that an agency
conduct an RFA analysis when an agency is ``required by section 553 * *
*, or any other law, to publish general notice of proposed rulemaking
for any proposed rule, or publishes a notice of proposed rulemaking for
interpretative rule involving the internal revenue laws of the United
States * * *.'' 5 U.S.C. 603(a). RFA analysis is not required when a
rule is exempt from notice and comment rulemaking under 5 U.S.C.
553(b). FEMA has determined that good cause exists under 5 U.S.C.
553(b)(B) to exempt this rule from the notice and comment requirements
of 5 U.S.C.
[[Page 30298]]
553(b). Therefore no RFA analysis under 5 U.S.C. 603 is required for
this rule.
Executive Order 12988
This interim final rule meets the applicable standards of Executive
Order 12988.
List of Subjects in 44 CFR Part 62
Flood insurance.
0
Accordingly, for the reasons set forth in the preamble, FEMA amends 44
CFR part 62 as follows:
PART 62-SALE OF INSURANCE AND ADJUSTMENT OF CLAIMS
0
1. The authority citation for part 62 continues to read as follows:
Authority: 42 U.S.C. 4001 et seq.; Reorganization Plan No. 3 of
1978, 43 FR 41943, 3 CFR, 1978 Comp., p. 329; E.O. 12127 of Mar. 31,
1979, 44 FR 19367, 3 CFR, 1979 Comp., p. 376.
0
2. Revise the title of subpart B of part 62, to read as follows:
Subpart B--Claims Adjustment, Claims Appeals, and Judicial Review
0
3. Add Sec. 62.20 to read as follows:
Sec. 62.20 Claims appeals.
(a) Definitions.
Administrator means the Federal Insurance Administrator.
Appeal decision means the disposition of the appeal by the
Administrator.
Decision means the insurer's final claim determination, which is
the insurer's written denial, in whole or in part, of the insured's
claim.
(b) Appeal. A National Flood Insurance Program (NFIP) policyholder,
whether insured by a participating Write-Your-Own (WYO) Company or
directly by the Federal Emergency Management Agency (FEMA), may appeal
a decision, including a determination of any insurance agent, adjuster,
insurance company, or any FEMA employee or contractor with respect to a
claim, proof of loss, and loss estimate. In order to file an appeal,
the insured must comply with all requirements set out in the Standard
Flood Insurance Policy (SFIP). This appeals process is available after
the issuance of the insurer's final claim determination, which is the
insurer's written denial, in whole or in part, of the insured's claim.
Once the final claim determination is issued, an insured may appeal any
action taken by the insurer, FEMA employee, FEMA contractor, insurance
adjuster, or insurance agent.
(c) Limitations on Appeals.
The appeals process is intended to resolve claim issues and is not
intended to grant coverage or limits that are not provided by the SFIP.
Filing an appeal does not waive any of the requirements for perfecting
a claim under the SFIP or extend any of the time limitations set forth
in the SFIP.
(1) Disputes that are or have been subject to appraisal as provided
for in the SFIP cannot be appealed under this section.
(2) When a policyholder files an appeal on any issue, that issue is
no longer subject to resolution by appraisal or other pre-litigation
remedies.
(d) Litigation preclusion. An insured who files suit against an
insurer on the flood insurance claim issue is prohibited from filing an
appeal under this section. All appeals submitted for decision but not
yet resolved shall be terminated upon notice of the commencement of
litigation regarding the claim.
(e) Procedures. To pursue an appeal under this section a
policyholder must:
(1) Submit a written appeal to FEMA within 60 days from the date of
the decision. The appeal should be sent to: Federal Emergency
Management Agency, Federal Insurance Administrator, Mitigation
Division, 500 C Street, SW., Washington, DC 20472;
(2) Identify relevant policy and claim information and state the
basis for the appeal;
(3) Submit relevant documentation; and
(4) Submit a copy of the proof of loss submitted to the insurer as
required in the policy.
(f) Appeal resolution. (1) FEMA will acknowledge, in writing,
receipt of a policyholder's appeal.
(2) The Administrator will review the appeal documents and may
notify the policyholder in writing of the need for additional
information. A request for the additional information will include the
date by which the information must be provided, and shall in no case be
less than 14 calendar days. Failure to provide the requested
information in full, or to request an extension by the due date, may
result in a dismissal of the appeal. A re-inspection of the
policyholder's property may be conducted at the discretion of the
Administrator to gather more information. The Administrator will ensure
that all information necessary to rule on the appeal has been provided
prior to making an appeal decision.
(3) The Administrator will review the appeal documents, including
any reinspection report, if appropriate. The Administrator will provide
an appeal decision in writing to the policyholder and insurer. No
further administrative review will be provided to the insured.
(4) A policyholder who does not agree with FEMA's appeal decision
should refer to the SFIP, for options for further action (see Part 61,
App. A(1) VII.R., Part 61, App. A(2) VII.R., and Part 61, App. A(3)
VIII.R.). The one-year period to file suit commences with the written
denial from the insurer and is not extended by the appeals process.
Dated: May 23, 2006.
R. David Paulison,
Acting Director, Federal Emergency Management Agency, Department of
Homeland Security.
[FR Doc. E6-8180 Filed 5-25-06; 8:45 am]
BILLING CODE 9110-11-P