Duplication of Benefits – Insurance

Duplication of Benefits

HEADNOTES

Stafford Act § 312 prohibits an applicant from receiving public assistance where it has received financial assistance under its insurance or any other source. The Applicant’s Deductible Buy Back protection was an insurance policy held by the Applicant’s wholly owned subsidiary, its captive insurance company. As such, it would constitute a duplication of benefits. Pursuant to FEMA policy, if the Applicant receives insurance proceeds for both eligible and insured ineligible damages, such as property and business income losses, without specifying limits for each type of loss, FEMA will apportion eligible costs between the two based on the ratio of insured eligible to insured ineligible damages, similarly, deductibles are apportioned in the same manner. The Applicant received proceeds for both eligible property damage and ineligible business interruption loss and FEMA appropriately apportioned the proceeds. Pursuant to 44 C.F.R. § 206.250(c), FEMA is required to deduct actual and anticipated insurance recoveries from otherwise eligible costs.

CONCLUSION

: FEMA correctly deducted insurance proceeds Christus Health (Applicant) received under its Deductible Buy Back Policy to prevent the Applicant from receiving a duplication of benefits. Accordingly, the appeal is denied.

AUTHORITIES

Stafford Act § 312. 44 C.F.R. § 206.250. PA Guide, at 41, 119. Roman Catholic Diocese of Brooklyn, FEMA-4020-DR-NY.

44 C.F.R. § 206.250
Duplication of Benefits – Insurance