20240918 - Claims Reporting Requirement - Public
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As a Citizens-appointed agent, it is important that you follow the requirements for claims reporting on behalf of a policyholder or a third-party claimant.
Your Citizens agency appointment agreement outlines the requirements for reporting policyholder claims. Effective immediately, you should report all claims when they are received, including third-party claims. The agency appointment agreement will be updated soon to include this new requirement.
Agent Appointment Agreement, Section IV, subsection C, states:
Claims. If an insured reports a claim to the Agent, the Agent must immediately report the claim to Citizens electronically or by calling 866.411.2742. If a catastrophic or other weather-related event prevents reporting immediately, the Agent agrees to instruct the claimant to file the claim directly with Citizens by calling (866) 411-2742; and the Agent further agrees to report the claim to Citizens as soon as possible. The agent agrees to cooperate fully with Citizens in the investigation and adjustment of such claim.
What is a Third-Party Liability Claim?
A third-party claimant is a person or entity that is seeking compensation from a Citizens policyholder after suffering property damage, bodily injury, or both, as a result of the incident, action or failure to act on the part of the Citizens policyholder.
Some examples are:
- A neighbor asserts compensation due to the policyholder’s tree falling and causing damage to their property.
- A tenant in the policyholder’s rental property slipped and fell on water leaking from a faulty water heater in the home and is claiming bodily injury.
- A tenant in the policyholder’s rental property is stating the home has mold and is claiming they suffered damage to their personal property as well as injuries related to the mold.
You must immediately report all claims to Citizens using one of the options outlined below. Uploading documents in PolicyCenter® instead of using one of these options can result in a delay in claim processing.
Claim Reporting Options
Agents may report claims 24/7 to Citizens by:
- Reporting the claim via PolicyCenter’s First Notice of Loss (FNOL). Use the job aid for filing FNOLs to complete the process. Once the claim is filed, a claim number and adjuster will be assigned and a claims representative will provide the policyholder with the adjuster’s contact information.
- Calling the Claims Hotline at 866.411.2742
Failure to report a claim immediately and/or not using the proper claim reporting method, if detrimental to Citizens or the insured, may result in action against you or your agency to recover damages.
Resources
Log in to the Agents website:
- Agent Appointment Agreement is available by selecting myAgency > Agency Forms > Agent Appointment Agreement.
- Review the 4 Easy Steps to Help Your Customer File Claim by selecting Programs > Contact Citizens First. The brochure is in the Spotlight section under Agent Resources.
Legal Disclaimer
Citizens provides agent communications online for historical purposes only, and the communications have not been updated to include any changes that may have been made after publication. Agents can find the latest information by reviewing the applicable underwriting manuals, and by logging in and accessing our FAQs, which are available from the top of any page on our website.