/>iThis alert begins our series discussing legal issues related to the Southern California wildfires. We invite you to contact us if you would like a free consultation related to this topic. We will continue to provide updates as more information becomes available.
Due to the high risk of wildfires in California, many private homeowner insurers have made a business decision to leave the state. These decisions have left thousands of homeowners seeking insurance from an ever-dwindling pool of providers. Those who are unable to obtain insurance have instead turned to the “insurer of last resort,” better known as the California Fair Access to Insurance Requirements Plan (FAIR Plan).
What is the FAIR Plan?
The FAIR Plan is an insurance “pool” comprised of all California-licensed insurers that allows high-risk California homeowners to have access to basic fire insurance protection while limiting any one insurer’s liability. The plan is run by the California FAIR Plan Association, which, notably, is not a state or public agency. This means it is not taxpayer-funded, and profits from participating insurers come primarily from the sales of policies. However, though the FAIR Plan reported that the number of FAIR Plan dwelling and commercial policyholders grew by a reported 225% over the past two fiscal years, FAIR Plan’s exposure has also significantly increased.
If you were affected by the recent Eaton and Palisades fires in Southern California, there is a relatively good chance you are preparing to, or are in the process of, submitting an insurance claim through your FAIR Plan. You are not alone. Recent reports suggest more than 3,600 policyholders in Altadena, Pacific Palisades, and other parts of greater Los Angeles have already submitted claims to the FAIR Plan. Unfortunately, the claims submission and adjudication process for these policyholders is unlikely to be smooth due to the sheer number of claims and the FAIR Plan’s high exposure in the Southern California area. As such, there are a few points to remember when submitting a claim and communicating with FAIR Plan representatives.
How to Submit a Claim
Policyholders should understand the process for submitting claims. The FAIR Plan website provides a claims submission link. This link can be found here, along with a brief “FAQ” page here. We encourage all policyholders to submit their claims as soon as possible due to the expected delays in the claims adjudication process. Moreover, policyholders should take special care to document all communications with the FAIR Plan in case disputes arise later in the process. All emails with FAIR Plan representatives should be preserved, and, if possible, all phone conversations with representatives should be confirmed in writing through email. In addition, all documentation relevant to a policyholder’s claim, including pictures of the premises and receipts for lost or affected property, should be kept in a secure location. We also encourage policyholders to document the condition of their homes to the extent possible. Pictures should be taken of every room and all surrounding property prior to any remediation work.
We encourage policyholders to review the language of their FAIR Plan carefully and to submit all possible claims. When in doubt, make the claim. This applies even if your home is not destroyed, as the FAIR Plan should cover fire damage even if the home is left standing.
Understanding Smoke Damage Coverage
Policyholders should be aware of FAIR Plan administrators’ views on coverage for smoke damage. Properties of many policyholders have experienced profound smoke damage that prevents them from returning to their homes. While FAIR Plan policies are required to cover smoke damage, the FAIR Plan has recently narrowed its policies so that smoke damage may only be covered if there are clearly visible signs of damage or if smoke is detectable through smell. Class-action lawsuits have been filed in Alameda and Los Angeles Counties addressing the FAIR Plan’s narrowing of their policies. A primary argument by the plaintiffs in those cases is that the FAIR Plan is required to provide coverage for all smoke damage in accordance with California Insurance Code Section 2071. This would expand policies issued by the FAIR Plan to cover damages beyond permanent physical damage or damage detectable through smell. However, litigation on these issues is ongoing and may drag on for several years. In the meantime, policyholders should assume that all fire damage to their homes, including all smoke damage, will be covered by the FAIR Plan and submit claims accordingly. This should ensure that your claims are included in the class of claims covered by these class-action lawsuits, and that you benefit from any favorable rulings.
