A recent court decision in Sublett v. Westfield Insurance Company ¹ shows how even well-intentioned policyholders can lose a flood insurance claim before their lawsuit ever begins. This case is not just about a technical legal loss. It is about a family trying to recover from flood damage to their home and finding themselves out of options, not because they didn’t experience real harm, but because of a series of procedural and strategic missteps that are unfortunately all too common in flood insurance disputes. For insurance claim professionals, public adjusters, and attorneys, the Sublett case shows the critical importance of understanding the unique legal landscape of the National Flood Insurance Program (NFIP) and following its rules with precision.

At the heart of the case was a Standard Flood Insurance Policy (SFIP) issued through the NFIP and administered by a private insurer acting as a federal agent. When the Subletts’ home in Kentucky was flooded on July 28, 2022, they promptly reported their loss. An independent adjuster inspected the property and determined there was no damage to the main living area, only to the basement. The flood adjuster prepared a Proof of Loss (POL) for $6,189.05 and instructed that if the homeowner disagreed with the estimate, she could submit her own POL for a higher amount, supported by documentation. The policyholder hesitated to sign this initial POL, believing there might be structural damage the adjuster had not identified. Eventually, on September 21, within the 60-day deadline to submit a federal proof of loss, she signed the adjuster’s POL, still unsure whether it covered all the damage.

This decision proved to be pivotal. Under the SFIP, a policyholder must submit a signed, sworn, and itemized POL within 60 days of the loss if they intend to claim more than what the insurer offers. Unless FEMA allows for an extension, the law does not allow for flexibility or leniency on this point. When, nearly a year later, the policyholder submitted a supplemental damage estimate for more than $53,000 as part of her lawsuit, the court ruled that the claim was barred because the new estimate was never submitted as a compliant POL. The court emphasized that the NFIP’s proof of loss requirements are to be strictly enforced. There is no allowance for substantial compliance, no room for waiver by the insurer or its adjuster, and no possibility of estoppel based on misleading guidance from an insurance representative. The only party that can waive the 60-day POL requirement is the Federal Insurance Administrator, and there was no evidence that such a waiver was requested or granted in this case.

I have discussed why the National Flood Insurance Program needs reform regarding these overly restrictive proof of loss requirements in NFIP Escapes Payment with Form Over Substance Rules: The Need for Reform of the National Flood Insurance Program.

What makes the Sublett decision even more instructive is that even if a proper POL had been submitted on time, the policyholder still faced serious obstacles because of the content of her own engineering report. The homeowner hired Yeiser Structural to evaluate potential structural damage. While the report noted cracking finishes and sloping floors, it failed to causally link those issues directly to the flood. Instead, the engineer attributed the problems to long-term deterioration, moisture, and aging. He did not relate the damage to the specific flood event. In the eyes of the court, that made all the difference. NFIP policies cover only direct physical loss caused by flooding. Damage attributed to general wear, poor maintenance, or unrelated moisture problems is not covered. Because the report never definitively tied the structural issues to the July 28 flood, it failed to provide the necessary evidence of causation to support the claim, even if a proper POL had been filed.

Another key element of the case and lesson for policyholders suffering flood damage was the role of legal counsel. The plaintiff’s attorney argued the case as if it were governed by Kentucky law, citing state statutes on unfair claims practices, emotional distress, and general principles of good faith and fair dealing. However, NFIP policies are creatures of federal law. The National Flood Insurance Act governs the program, and courts across the country have clarified that state law has no place in resolving disputes under these federally backed policies. The court in Sublett pointed out that the plaintiff’s filings were largely devoid of legal citations to the correct body of law and expressed concern that the attorney appeared unaware of the exclusive application of federal law in NFIP disputes.

This is not to criticize the attorney personally, but rather to highlight a very real problem in the legal community. NFIP cases are not like other insurance disputes. They require a different set of skills, knowledge, and attention to detail. The rules are rigid, the timeframes unforgiving, and the doctrines of waiver, estoppel, and substantial compliance—common lifelines in state law insurance litigation—are nonexistent. Attorneys who venture into this arena must either already possess or quickly understand how the NFIP works. Failing to do so does a disservice to the clients they represent, who may unknowingly lose their ability to recover what they believe is rightfully theirs.

For policyholders, the takeaways from this case are clear. First, when a flood damages your property and you carry an SFIP, you must act quickly and follow FEMA’s rules exactly. That includes submitting a signed and sworn Proof of Loss within 60 days of the event for the full amount of your claim, not just the amount the insurer offers. If you’re unsure of the extent of your damage, you must still submit your own estimate and documentation. Relying on what a FEMA adjuster tells you or assuming the process is flexible will only set you up for disappointment.

Second, hire technical and legal professionals who understand flood claims. Your engineer must be capable of clearly attributing damage to the flood event, not just describing symptoms or possible causes. Your attorney must understand the unique body of federal law that governs flood insurance claims, or at least be willing to research it in detail before filing suit.

The Sublett case is another valuable case providing valuable insights for everyone involved with flood claims. It shows that even when damage is real, and the need for recovery is pressing, failing to follow the strict rules laid out by the NFIP will prevent recovery. It reminds all of us, policyholders, public adjusters, attorneys, estimators, and engineers, that when dealing with federally funded insurance programs, there is no substitute for precision and experienced professionalism. Ultimately, the best way professionals can help those policyholders we serve is to ensure they never have to learn these lessons the hard way. Policyholders should always consider hiring experienced professionals for their flood claims.

For readers wanting a greater understanding of this topic, I suggest reading Federal Flood Insurance: Strict Compliance with Proof of Loss Requirements is Essential, and National Flood Claims Have a One-Year Statute of Limitations.

Thought For The Day

“Turn your wounds into wisdom.”
— Oprah Winfrey

¹ Sublett v. Westfield Ins. Co., No. 7:23-cv-65, 2025 WL 1461817 (E.D. Ky. May 21, 2025).

A recent court decision in Sublett v. Westfield Insurance Company ¹ shows how even well-intentioned policyholders can lose a flood insurance claim before their lawsuit ever begins. This case is not just about a technical legal loss. It is about a family trying to recover from flood damage to their home and finding themselves out of options, not because they didn’t experience real harm, but because of a series of procedural and strategic missteps that are unfortunately all too common in flood insurance disputes. For insurance claim professionals, public adjusters, and attorneys, the Sublett case shows the critical importance of understanding the unique legal landscape of the National Flood Insurance Program (NFIP) and following its rules with precision.

At the heart of the case was a Standard Flood Insurance Policy (SFIP) issued through the NFIP and administered by a private insurer acting as a federal agent. When the Subletts’ home in Kentucky was flooded on July 28, 2022, they promptly reported their loss. An independent adjuster inspected the property and determined there was no damage to the main living area, only to the basement. The flood adjuster prepared a Proof of Loss (POL) for $6,189.05 and instructed that if the homeowner disagreed with the estimate, she could submit her own POL for a higher amount, supported by documentation. The policyholder hesitated to sign this initial POL, believing there might be structural damage the adjuster had not identified. Eventually, on September 21, within the 60-day deadline to submit a federal proof of loss, she signed the adjuster’s POL, still unsure whether it covered all the damage.

This decision proved to be pivotal. Under the SFIP, a policyholder must submit a signed, sworn, and itemized POL within 60 days of the loss if they intend to claim more than what the insurer offers. Unless FEMA allows for an extension, the law does not allow for flexibility or leniency on this point. When, nearly a year later, the policyholder submitted a supplemental damage estimate for more than $53,000 as part of her lawsuit, the court ruled that the claim was barred because the new estimate was never submitted as a compliant POL. The court emphasized that the NFIP’s proof of loss requirements are to be strictly enforced. There is no allowance for substantial compliance, no room for waiver by the insurer or its adjuster, and no possibility of estoppel based on misleading guidance from an insurance representative. The only party that can waive the 60-day POL requirement is the Federal Insurance Administrator, and there was no evidence that such a waiver was requested or granted in this case.

I have discussed why the National Flood Insurance Program needs reform regarding these overly restrictive proof of loss requirements in NFIP Escapes Payment with Form Over Substance Rules: The Need for Reform of the National Flood Insurance Program.

What makes the Sublett decision even more instructive is that even if a proper POL had been submitted on time, the policyholder still faced serious obstacles because of the content of her own engineering report. The homeowner hired Yeiser Structural to evaluate potential structural damage. While the report noted cracking finishes and sloping floors, it failed to causally link those issues directly to the flood. Instead, the engineer attributed the problems to long-term deterioration, moisture, and aging. He did not relate the damage to the specific flood event. In the eyes of the court, that made all the difference. NFIP policies cover only direct physical loss caused by flooding. Damage attributed to general wear, poor maintenance, or unrelated moisture problems is not covered. Because the report never definitively tied the structural issues to the July 28 flood, it failed to provide the necessary evidence of causation to support the claim, even if a proper POL had been filed.

Another key element of the case and lesson for policyholders suffering flood damage was the role of legal counsel. The plaintiff’s attorney argued the case as if it were governed by Kentucky law, citing state statutes on unfair claims practices, emotional distress, and general principles of good faith and fair dealing. However, NFIP policies are creatures of federal law. The National Flood Insurance Act governs the program, and courts across the country have clarified that state law has no place in resolving disputes under these federally backed policies. The court in Sublett pointed out that the plaintiff’s filings were largely devoid of legal citations to the correct body of law and expressed concern that the attorney appeared unaware of the exclusive application of federal law in NFIP disputes.

This is not to criticize the attorney personally, but rather to highlight a very real problem in the legal community. NFIP cases are not like other insurance disputes. They require a different set of skills, knowledge, and attention to detail. The rules are rigid, the timeframes unforgiving, and the doctrines of waiver, estoppel, and substantial compliance—common lifelines in state law insurance litigation—are nonexistent. Attorneys who venture into this arena must either already possess or quickly understand how the NFIP works. Failing to do so does a disservice to the clients they represent, who may unknowingly lose their ability to recover what they believe is rightfully theirs.

For policyholders, the takeaways from this case are clear. First, when a flood damages your property and you carry an SFIP, you must act quickly and follow FEMA’s rules exactly. That includes submitting a signed and sworn Proof of Loss within 60 days of the event for the full amount of your claim, not just the amount the insurer offers. If you’re unsure of the extent of your damage, you must still submit your own estimate and documentation. Relying on what a FEMA adjuster tells you or assuming the process is flexible will only set you up for disappointment.

Second, hire technical and legal professionals who understand flood claims. Your engineer must be capable of clearly attributing damage to the flood event, not just describing symptoms or possible causes. Your attorney must understand the unique body of federal law that governs flood insurance claims, or at least be willing to research it in detail before filing suit.

The Sublett case is another valuable case providing valuable insights for everyone involved with flood claims. It shows that even when damage is real, and the need for recovery is pressing, failing to follow the strict rules laid out by the NFIP will prevent recovery. It reminds all of us, policyholders, public adjusters, attorneys, estimators, and engineers, that when dealing with federally funded insurance programs, there is no substitute for precision and experienced professionalism. Ultimately, the best way professionals can help those policyholders we serve is to ensure they never have to learn these lessons the hard way. Policyholders should always consider hiring experienced professionals for their flood claims.

For readers wanting a greater understanding of this topic, I suggest reading Federal Flood Insurance: Strict Compliance with Proof of Loss Requirements is Essential, and National Flood Claims Have a One-Year Statute of Limitations.

Thought For The Day

“Turn your wounds into wisdom.”
— Oprah Winfrey

¹ Sublett v. Westfield Ins. Co., No. 7:23-cv-65, 2025 WL 1461817 (E.D. Ky. May 21, 2025).