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    Subject Term: "Insurance claims"

    13 publications with a total of 21 open recommendations
    Director: Alicia Puente Cackley
    Phone: (202) 512-8678

    1 open recommendations
    Recommendation: As Congress considers reauthorizing NFIP, it should consider comprehensive reform to improve the program's solvency and enhance the nation's resilience to flood risk, which could include actions in six areas: (1) addressing the current debt, (2) removing existing legislative barriers to FEMA's revising premium rates to reflect the full risk of loss, (3) addressing affordability, (4) increasing consumer participation, (5) removing barriers to private-sector involvement, and (6) protecting NFIP flood resilience efforts. In implementing these reforms, Congress should consider the sequence of the actions and their interaction with each other.

    Agency: Congress
    Status: Open

    Comments: When we determine what steps the Congress has taken, we will provide updated information.
    Director: Alicia Puente Cackley
    Phone: (202) 512-8678

    1 open recommendations
    Recommendation: To help ensure that the government is not exposed to more liability risk than intended, the Secretary of Transportation should ensure that the FAA Administrator prioritizes the development of a plan to address the identified weakness in the cost-of-casualty amount, including setting time frames for action, and update the amount based on current information.

    Agency: Department of Transportation
    Status: Open

    Comments: The Department of Transportation agreed with the recommendation. As of May 2017, the Federal Aviation Administration (FAA) plans to seek feedback from the commercial space and insurance industries to obtain views on an appropriate cost-of-casualty amount and implications of any changes. After receiving this input, FAA will determine whether to modify the cost-of-casualty amount and initiate action. We will continue to monitor FAA's actions in response to this recommendation.
    Director: Alicia Puente Cackley
    Phone: (202) 512-8678

    1 open recommendations
    Recommendation: To improve the transparency and accountability over the compensation paid to WYO companies and set appropriate compensation rates, the FEMA administrator should take into account WYO company characteristics that may impact companies' expenses and profits when developing the new compensation methodology and rates.

    Agency: Department of Homeland Security: Directorate of Emergency Preparedness and Response: Federal Emergency Management Agency
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    1 open recommendations
    Recommendation: To help support DOD management of its FECA responsibilities, the Secretary of Defense should direct the Office of the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military departments and other defense agency leaders, to monitor timelines associated with significant FECA claims-management actions in order to identify the extent to which delays or inefficiencies may be occurring and at what points in the process; to identify any known reasons for the delays; and to communicate this information to DOL as appropriate for consideration and action.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Anne-Marie Fennell
    Phone: (202) 512-3841

    1 open recommendations
    Recommendation: To reduce the cost of the crop insurance program and achieve budgetary savings for deficit reduction or other purposes, Congress should consider reducing premium subsidies for the highest income participants.

    Agency: Congress
    Status: Open

    Comments: As of July 2017, we await Congressional action.
    Director: Randall Williamson
    Phone: (202) 512-7114

    1 open recommendations
    Recommendation: To improve VA's ability to address its strategic plan objective of educating and empowering veterans, the Secretary of Veterans Affairs should direct the Under Secretary for Health to take steps to better understand gaps in veterans' knowledge regarding eligibility for Millennium Act emergency care, such as by conducting veteran surveys of health care benefits knowledge, and using information from those surveys to more effectively tailor the agency's education efforts regarding the Millennium Act benefit. In conducting these surveys, consideration should be given to including a sample of veterans who have had denied Millennium Act claims in order to provide their views and specific details of their experiences.

    Agency: Department of Veterans Affairs
    Status: Open

    Comments: As of September 2016, VA has taken some actions to address this recommendation, but additional actions are needed to fully implement it. We will update the status of this recommendation when we receive additional information from VA.
    Director: Scire, Mathew J
    Phone: (202) 512-8678

    2 open recommendations
    Recommendation: To strengthen FHA accountability for complying with the Fund's statutory capital requirement, Congress should consider requiring that FHA submit a capital restoration plan and regular updates on plan implementation whenever the capital ratio falls below 2 percent as calculated in the annual actuarial review of the Fund, or the Fund's financial condition does not meet other congressionally-defined requirements.

    Agency: Congress
    Status: Open

    Comments: Congress has not yet acted on this matter for consideration.
    Recommendation: To provide additional perspective on the Fund's financial status, FHA should disclose estimates of the individual cash flows associated with the liability for loan guarantees (premiums, claims, and recoveries), including their value for each year of the 30-year estimation period.

    Agency: Department of Housing and Urban Development: Federal Housing Administration
    Status: Open

    Comments: As of July 2017, HUD has not yet acted on this recommendation.
    Director: Cackley, Alicia P
    Phone: (202) 512-8678

    1 open recommendations
    Recommendation: To establish full-risk rates for properties with previously subsidized rates that reflect their risk for flooding, the Secretary of the Department of Homeland Security (DHS) should direct the FEMA Administrator to develop and implement a plan, including a timeline, to obtain needed elevation information as soon as practicable.

    Agency: Department of Homeland Security
    Status: Open

    Comments: As we reported in February 2016 in GAO-16-190, FEMA has taken limited action to implement this recommendation. For example, FEMA noted that the agency would evaluate the appropriate approach for obtaining or requiring the submittal of information needed to determine full-risk rates for subsidized properties. FEMA also said it would explore technological advancements and engage with industry to determine the availability of technology, building information data, readily available elevation data, and current flood hazard data that could be used to implement the recommendation. However, FEMA officials also said that the agency faced a cost challenge with respect to elevation certificates and that obtaining these certificates could take considerable time and cost. They noted that requiring policyholders to incur the cost of obtaining elevation certificates would not be consistent with NFIP's policy objective to promote affordability. The officials added that the agency encourages subsidized policyholders who seek to ensure the appropriateness of their NFIP rates to voluntarily submit elevation documentation.
    Director: Shames, Lisa R
    Phone: (202) 512-3841

    1 open recommendations
    Recommendation: To reduce the cost of the crop insurance program, Congress may wish to consider limiting the subsidy for premiums that an individual farmer can receive each year or reducing the subsidy for all farmers participating in the program, or both limiting and reducing these subsidies.

    Agency: Congress
    Status: Open

    Comments: As of December 2016, Congress has not taken action to implement this matter.
    Director: Brown, Orice Williams
    Phone: (202)512-5837

    3 open recommendations
    Recommendation: To improve strategic planning, performance management, and program oversight within and related to NFIP, the Secretary of DHS should direct the FEMA Administrator to develop a comprehensive workforce plan according to PKEMRA that identifies agency staffing and skills requirements, addresses turnover and staff vacancies, and analyzes FEMA's use of contractors.

    Agency: Department of Homeland Security
    Status: Open

    Comments: According to FEMA officials, as of July 2016, FEMA is in the process of developing a Workforce Strategic Plan they say will contribute to organizational performance and mission by enabling FEMA to align the overall workforce with strategic priorities. FEMA expected to complete the plan by the first quarter of FY2017. As of December 2016, FEMA officials said they were still working to implement this recommendation and agreed to provide us with an update of their progress.
    Recommendation: To improve FEMA's policies, procedures, and systems for achieving NFIP's program goals, the Secretary of DHS should direct the FEMA Administrator to consider the costs and benefits of implementing an interim system for FEMA and updating its document management policies and procedures while waiting for DHS to implement an agencywide electronic document management system.

    Agency: Department of Homeland Security
    Status: Open

    Comments: FEMA officials stated that, as of July 2016, FEMA is working to pilot an Electronic Records Management System (ERMS). They said that they expected to have all email records in an electronic state by December 31, 2016, and all records in an electronic state by December 31, 2019. They said that they expect the end state in 2019 to meet the Presidential Directive and NARA guidelines. As of December 2016, FEMA officials said they were still working to implement this recommendation and agreed to provide us with an update of their progress.
    Recommendation: To improve FEMA's policies, procedures, and systems for achieving NFIP's program goals, the Secretary of DHS should direct the FEMA Administrator to establish timelines for and complete the development and implementation of FEMA's revised acquisition process, in line with the DHS Acquisition Directive 102-01, including a rollout process with staff training and a mechanism to better ensure that all acquisitions undergo the necessary reviews.

    Agency: Department of Homeland Security
    Status: Open

    Comments: FEMA officials stated that, as of July 2016, a Disaster Acquisitions Response Team (DART) was in place along with metrics in place to monitor the team's success. They said they had also awarded a contract to serve as a contract file repository and that previously scanned contract files would be uploaded by December 31, 2016. As of December 2016, FEMA officials said they were still working to implement this recommendation and agreed to provide us with an update of their progress.
    Director: Scire, Mathew J
    Phone: (202)512-6794

    1 open recommendations
    Recommendation: To strengthen accountability and transparency in FHA's management of the Fund, Congress may wish to consider clarifying (1) the definition of the Fund's capital ratio--specifically, whether the denominator of the ratio was intended to be the amortized insurance-in-force; (2) the definition of the phrase "established target subsidy rate" used in HERA; and (3) the nature and extent of information that FHA should be reporting on subsidy rates pursuant to HERA, recognizing that subsidy rates are generally only reestimated once a year under current budget processes.

    Agency: Congress
    Status: Open

    Comments: As of July 2017, Congress has not acted on this matter for consideration.
    Director: Brown, Orice Williams
    Phone: (202) 512-3000

    5 open recommendations
    Recommendation: To provide transparency and accountability over the payments FEMA makes to WYOs for expenses and profits, the Secretary of Homeland Security should direct the Under Secretary of Homeland Security, FEMA, to determine in advance the amounts built into the payment rates for estimated expenses and profit.

    Agency: Department of Homeland Security
    Status: Open

    Comments: FEMA is continuing (as of 08/29/2014) to analyze Write-Your-Own (WYO) payments and related flood expenses for selected companies and is evaluating the reliability (accuracy, consistency, etc.) of the National Association of Insurance Commissioners (NAIC) data for purposes of performing the analysis we had recommended.
    Recommendation: To provide transparency and accountability over the payments FEMA makes to WYOs for expenses and profits, the Secretary of Homeland Security should direct the Under Secretary of Homeland Security, FEMA, to annually analyze the amounts of actual expenses and profit in relation to the estimated amounts used in setting payment rates.

    Agency: Department of Homeland Security
    Status: Open

    Comments: In its initial response to this report, FEMA did not concur with this recommendation. In November 2016, FEMA restated its position and concurs with this recommendation, and is in the process of implementing it.
    Recommendation: To provide transparency and accountability over the payments FEMA makes to WYOs for expenses and profits, the Secretary of Homeland Security should direct the Under Secretary of Homeland Security, FEMA, to consider the results of the analysis of payments, actual expenses, and profit in evaluating the methods for paying WYOs.

    Agency: Department of Homeland Security
    Status: Open

    Comments: FEMA is continuing (as of 08/29/2014) to analyze WYO payments and related flood expenses for selected companies and is evaluating the reliability (accuracy, consistency, etc.) of the National Association of Insurance Commissioners (NAIC) data for purposes of performing the analysis we had recommended.
    Recommendation: To increase the usefulness of the data reported by WYOs to the National Association of Insurance Commissioners (NAIC) and to institutionalize FEMA's use of such data, the Secretary of Homeland Security should direct the Under Secretary of Homeland Security, FEMA, to take actions to obtain reasonable assurance that NAIC flood insurance expense data can be considered in setting payment rates that are appropriate, including identifying affiliated company profits in reported flood insurance expenses.

    Agency: Department of Homeland Security
    Status: Open

    Comments: FEMA continues (as of 08/29/2014) to work with the National Association of Insurance Commissioners (NAIC) to improve the consistency with which commission, operating, and loss adjustment expenses are reported by insurance companies that participate in the National Flood Insurance Program.
    Recommendation: To increase the usefulness of the data reported by WYOs to the National Association NAIC and to institutionalize FEMA's use of such data, the Secretary of Homeland Security should direct the Under Secretary of Homeland Security, FEMA, to develop comprehensive data analysis strategies to annually test the quality of flood insurance data that WYOs report to NAIC.

    Agency: Department of Homeland Security
    Status: Open

    Comments: FEMA continues (as of 08/29/2014) to work with the National Association of Insurance Commissioners (NAIC) to improve the consistency with which commission, operating, and loss adjustment expenses are reported by insurance companies that participate in the National Flood Insurance Program.
    Director: Williams, Orice M
    Phone: (202)512-5837

    2 open recommendations
    Recommendation: The Secretary of the Department of Homeland Security should direct FEMA to take steps to ensure that its rate-setting methods and the data it uses to set rates result in full-risk premiums rates that accurately reflect the risk of losses from flooding. These steps should include, for example, verifying the accuracy of flood probabilities, damage estimates, and flood maps; ensuring that the effects of long-term planned and ongoing development, as well as climate change, are reflected in the flood probabilities used; and reevaluating the practice of aggregating risks across zones.

    Agency: Department of Homeland Security
    Status: Open

    Comments: As of January 2017, FEMA is taking steps to verify the accuracy of flood probabilities by collecting and analyzing data from flood insurance studies. FEMA is also continuing to monitor the completion of these studies to determine when a statistically valid amount of data is available so that it can better assess flood risk. To verify the accuracy of damage estimates, FEMA is collecting data required to revise its estimates of flood damage and is undertaking studies to determine factors beyond flood water depth that contribute to flood damage. FEMA will incorporate that information into its rate-setting methodology as the necessary data becomes available. To verify the accuracy of flood maps, FEMA continues to reassess flood risk, evaluate coastal flood maps, and update its overall map inventory. To ensure that flood probabilities reflect long-term and ongoing planned development and climate change, FEMA is working with the Technical Mapping Advisory Committee to ensure the best available information on flood probabilities is used for rate-setting. In addition, as FEMA collects information on flood probabilities, it will conduct analyses to evaluate the practice of classifying risk across zones.
    Recommendation: The Secretary of the Department of Homeland Security should direct FEMA to ensure that information is collected on the location, number, and losses associated with existing and newly created grandfathered properties in NFIP and to analyze the financial impact of these properties on the flood insurance program.

    Agency: Department of Homeland Security
    Status: Open

    Comments: To assess the impact of grandfathered properties on the NFIP, as of January 2017, FEMA has begun to develop a process to obtain current zone designations for all existing policyholders. In addition, FEMA is requiring zone determination data to be updated as flood maps change. According to FEMA, this will allow officials to determine which policyholders are grandfathered but will not allow the determination of a property-specific rate in all circumstances.