Appeals Procedure:

The appeals procedure is simple and informal. No special forms are required, although one is available for your use on this website. View a sample form (You will need Adobe Acrobat Reader to view this form. Click here to download it.)

There is no need to hire an attorney. The Office of the Ombudsman has the responsibility of assisting homeowners in filing appeals. A simple letter asking for a review of the claim will suffice. You should include a brief explanation of why you believe the denial of benefits was not proper. Include any documentation such as repair bills, photographs, copies of insurance claim documents, water bills, etc. that will support your position. Most appeals can be resolved by the Office of the Ombudsman. If not, the Ombudsman will present your appeal to the Appeals Committee as described below. It should be understood that while the Ombudsman may assist individuals, he is not an advocate for the individual homeowner, but represents and protects the interests of the members of the Class as a whole.

The Appeals procedure described below is found in the Settlement Agreement at Exhibit A, Section VII

Claimants whose claims are denied or who are dissatisfied with the relief offered by the CPRC shall have the right to appeal through the following process, which per the Terms of Settlement shall be the exclusive appeals process.

Click to view issues which are considered appealable issues.
Click to view Filing Deadline Issues.
Click to view issues which are considered non-appealable issues.

A claimant wishing to appeal the decision of a representative of the CPRC shall do so, in writing, within sixty (60) days of said decision, stating his or her reason for the dissatisfaction with the adjustment of the claim and including copies of any supporting documentation.

Appeals shall be considered by an Appeal Committee appointed by the Board of Directors from among the employees of the CPRC. While the Appeals Committee may include employees with claim handling duties, any such employee shall not participate in the consideration of an appeal with respect to a claim that was adjusted under his or her personal authority.

Claims that cannot be resolved by the appeals process shall be submitted to binding arbitration, conducted in the manner determined to be appropriate by the Board of Directors, in the state in which the property is located.

The fee of the arbitrators and other costs of arbitration shall be paid 75% by the CPRC and 25% by the claimant.

Each party shall bear his own attorney’s fees and related expenses.

Click to view Frequently Asked Questions on Appeals