Common use of Customer Service Clause in Contracts

Customer Service. Initial Contact - Initial voice-to-voice contact with the Insured or their Representative is to be made within one (1) calendar day of the receipt of the assignment or reassignment by the Adjuster. For commercial losses, the requirement for contact upon reassignment is two (2) calendar days. In the event of a catastrophic claim, initial voice-to-voice contact is to be made within three (3) calendar days of receipt of the assignment. • If the adjuster fails in their initial attempt to contact the Insured or their Representative, they should continue to make every reasonable effort to make contact in a timely manner including, but not limited to the following: o If unable to make initial contact with the Insured or their Representative within the designated time, send a ClaimCenter e-mail or Contact letter within three (3) calendar days o Document continued and multiple phone call attempts o Leave telephone messages (Voice-to-voice is required for first contact. Text or voice mail messages are not a substitute, and backdating of the first contact is not permitted) o Contact the Insured's agent of record for other potential contact information o If a foreclosure claim was reported by the mortgagee or mortgagee’s representative, initial contact can be made by email and documented in the file • During the initial contact, the Adjuster should: o Determine if any loss information has changed since the original report by verifying the detailed facts, including date and time of loss o Confirm the identity of lienholders, additional Insureds, witnesses, 3rd parties, Attorney or Public Adjuster representation o Review the loss severity as compared to the FNOL o Explain the claims handling process and anticipated timelines o Provide Insured or their Representative with their assigned claim number and the Adjuster’s contact information o Review with the Insured or their Representative all possible coverages, limits, exclusions and deductibles that may apply to the loss o Discuss the Insured’s post-loss duties, obligations and efforts to protect the risk from further damage, for example, tarp and board-up, debris removal and emergency services (mitigation / remediation) o Advise the Insured or Representative to protect any evidence chain of custody o Discuss and consider Additional Living Expenses (ALE) and / or advance claim payments as appropriate, reasonable and necessary o Attempt to schedule an on-site damage inspection of the risk with the insured(s) present Inspection Scheduling - The Adjuster should determine if an on-site inspection is warranted and attempt to schedule the on-site inspection during the initial contact. It is Citizens’ goal to schedule the inspection to occur within forty-eight (48) hours of the initial contact with the Insured or their Representative. If the inspection cannot be scheduled to occur within this time frame, a brief explanation (as to non-compliance) should be entered into the file notes. The inspection does not need to occur within forty-eight (48) hours, but is the preferred course of action. The following should be noted by the Adjuster in preparing for the inspection: o Forty-eight (48) hour notice to the Insured or their Representative, prior to inspection, is required by Florida Statute March 2017 Back To Top 3 ▪ Forty-eight (48) hour notice may be waived by the Insured or their Representative. The claim file notes should reflect this waiver o Prior to the inspection, the Adjuster should complete a full review of the file, facts of loss and detailed policy information o Obtain a signed Financial Release Form, such as a General Release and / or a Medical Release (if applicable) in the investigation of Liability or Medical Payments claims Follow-Up Contact - It is vital that the Adjuster has ongoing contact with the Insured or their Representative during the life of the claim, including the following: • One (1) calendar day response to Insured’s or their Representative’s, emails, phone calls • Five (5) calendar day response to written notifications • Periodic status updates and anticipated future activities should be documented in the file notes • Notify and update Insured or their Representative of any upcoming or scheduled events, inspections, requirements, due dates, etc. • Communicate Citizens' ongoing expectations and duties of the Insured or their Representative • Clearly explain why additional information, documentation, items or actions are requested of the Insured and / or their Representative • Contact the Insured or their Representative to discuss settlement, prior to the issuance of any indemnity payments • Document in file notes the details of voice-to-voice and / or written communications with regard, but not limited to: o Full or partial payments o Vendor and contractor payments o Settlements explanations and / or coverage denials, etc. • When closing claims, with or without payment: o Citizens’ contact information is relayed and the process for reporting new or undiscovered damages is explained. o As appropriate, informal and formal dispute resolution options are explained to the Insured or their Representative and documented in the file notes Written Communication - The following requirements should be followed in the preparation and submission of written communications: • Citizens’ approved letter and ClaimCenter email formats and templates should be used at all times for consistency • Specific claim related information, as required on a claim-by-claim basis, should be added to the letter template in sections where revisions are allowed • Letters are to be addressed to the Named Insured(s), any Additional Insured(s) as listed on the policy, and Insured’s Representatives: o Letters should be mailed separately to each Additional Insured(s), including a spouse, unless the spouse and / or the Additional Insured reside in the same household ▪ This includes system generated letters, i.e. Bill of Rights / Initial Duties letters o When an Insured is represented by an Attorney and / or a Public Adjuster, with proper Letter of Representation downloaded in the ClaimCenter® file documents, all written communications are to be addressed and mailed to the representative. The Insured and any additional named Insureds, as detailed on the declaration page of the policy, are to be copied, with letters mailed to the appropriate address for each named Insured March 2017 Back To Top 4 o If a letter is addressed to an Assignment of Benefits (AOB) vendor, the Insured, any additional named Insureds, as detailed on the declaration page of the policy and any Insured representative are to be copied, with letters mailed to the appropriate addressee o Other individuals and parties of interest (e.g., loss consultants, and mortgage company and premium finance company representatives, etc.) are not to receive copies of written communications, unless you are directed to send by your manager / supervisor • All settlements, a portion of the claim where coverage is not afforded or full denials are to be accompanied by written correspondence explaining the resolution and include appropriate and supporting documentation but not limited to: o Damage estimate o Personal Property Inventory Form (PPIF) o Invoices and other documented expenses o Applicable policy form, edition and / or endorsement(s), specific language and relevant dates o Other Citizens’ proprietary documents (i.e., Engineer, Expert, Strikenet reports, etc.), only upon management approval • The Agent of Record should receive a copy of any formal, complete denial letter communicated to the Insured • Formal communication of full denial claims are to be reviewed and approved by a Supervisor and/or Manager prior to issuance • Time sensitive correspondence / letters should be processed and documented in the file as required Insureds are our customers and have a contractual right to receive original or copies, when represented or assigning benefits, of all written communications pertaining to their claim. Utilizing information secured through the initial contact with the Insured or their Representative, the Adjuster should conduct an appropriate, complete and timely investigation in good faith to determine the direct and proximate cause and origin of the loss for a full, fair and prompt resolution of the claim. (i.e., not "pipe break or “supply line break," but rather include what caused the break) • Thoroughly review information contained in the First Notice of Loss (FNOL) • Review Local, State and / or Federal laws and statutes that may be applicable • Formulate and document the file with an initial ‘plan of action’ based on facts of loss received • Determine any necessary escalations or referrals to Citizens’ internal departments o If referrals to other resources or units are deemed necessary, the Adjuster should complete the referral as soon as the need is recognized Review Loss History - Search and review ClaimCenter and ISO Reports for potential matches by Insured name and / or property address for prior, duplicate or existing claims. A file note should be entered to address prior claims, any potential overlap, or lack of prior or related claims matches. March 2017 Back To Top 5 Onsite Inspection - Field inspections are an integral part of the claims investigation process. Adjusters should take great care when determining the cause of loss. Facts determined should be accurately captured and memorialized through: • Potential witnesses and third party contributors • The need for experts or engineers • Subrogation and Salvage potential The Adjuster should also: • Consider the need for a signed Non-Waiver or Reservation of Rights (ROR) letter, if a coverage question arises requiring additional investigation • Fully discuss with the Insured or their Representative and document any coverage concerns • Secure any supporting documentation relevant to the claim • Secure Police, Fire, Weather and other relevant expert reports as needed o Reports are to be reviewed within five (5) calendar days of receipt • Determine ALE / FRV and Personal Property exposures: o Including the need for advanced payments for temporary housing and other emergency needs • Obtain applicable legal documents such as Tax Liens, Mortgages, Sales / Purchase Agreements, Home Inspection Reports and Condo By-laws. o Confirm through the Property Appraisers office if / when ownership is in question • Determine if any collateral damages may exist for liability exposures Follow-up inspection(s) may be required: • If any potentially covered damages are hidden from view at the initial inspection • If there is a need for outside experts (i.e., Engineer / Expert, etc.) o Manager approval is needed for outside expense budget • If additional damages are claimed or discovered • To determine release of the holdback of recoverable depreciation • If a dispute arises over scope of damages, estimate, or cause of loss Recorded Interview – The Adjuster should secure the recorded interview at first contact, time of inspection, or as soon as facts arise that would reasonably require a recorded interview. The following should be considered: • Access the Adjuster Portal for Citizens’ Recorded Statement Guides and Standards: • The Adjuster must always obtain permission and acknowledgement from all parties present to record the interview • The Adjuster should secure the recorded interview(s) from the person(s) most knowledgeable about the facts surrounding the cause of loss, the mitigation of the loss and the related and unrelated damages • The Adjuster should ask focused questions material and relevant to the investigation and follow- up questions based on the answers provided by the person(s) being interviewed • The Adjuster should avoid leading the interviewee or supplying answers to the question(s) being asked • The Adjuster should avoid questions which are solely meant to harass, embarrass or “badger” the examinee The Adjuster is required to take a recorded interview for the following types of claims. If a recorded interview is not taken, the Adjuster should provide a file note stating reasonable rationale: March 2017 Back To Top 6 • Fire • Large loss • Theft or Mysterious Disappearance • Motor vehicle impact • Water damage claims that involve: o Long term and / or repeated discharge / seepage o Slab water leaks o Leaks with no visible damage o Permanent repairs completed prior to CPIC’s inspection o AOB claims • All non-weather related water losses • Vandalism with occupancy issues • Sinkhole and catastrophic ground cover collapse • Liability and Medical Payments claims • Late notice claims • Coverage questions o Including vacancy / occupancy • Mitigation / Remediation issues • Multiple or similar prior and / or current losses • To seek a resolution to conflicting information Internal Resources / Communication - Referrals should be submitted in a timely manner to utilize the expertise of Citizens’ specialized units. The Adjuster engages internal resources, as necessary, based on the facts of the claim. Timely referral or consulting with these units is essential; therefore, the Adjuster should immediately recognize the necessity and act accordingly. The file notes should be documented with the appropriate rationale. Potential internal resources include: • Special Investigations Unit (SIU) • Recovery (Subrogation / Salvage) • Claims Legal / Appraisal / Mediation • Underwriting • Contents Unit • Burglary, Lightning & Theft (BLT) Unit • Loss Assessment Team • Late First Notice of Loss (FNOL) Team • Special Investigative Unit (SIU) – Citizens is required by statute to investigate and report suspected insurance fraud. The Adjuster should review claim facts to identify any industry accepted indicators (Red Flags) that raise awareness of potential insurance fraud. Adjuster responsibilities are as follows:

Customer Service. Initial Contact - Initial voice-to-voice contact with the Insured or their Representative is to be made within one (1) calendar day of the receipt of the assignment or reassignment by the Adjuster. For commercial losses, the requirement for contact upon reassignment is two (2) calendar days. In the event of a catastrophic claim, initial voice-to-voice contact is to be made within three (3) calendar days of receipt of the assignment. •  If the adjuster fails in their initial attempt to contact the Insured or their Representative, they should continue to make every reasonable effort to make contact in a timely manner including, but not limited to the following: o If unable to make initial contact with the Insured or their Representative within the designated time, send a ClaimCenter e-mail or Contact letter within three (3) calendar days o Document continued and multiple phone call attempts o Leave telephone messages (Voice-to-voice is required for first contact. Text or voice mail messages are not a substitute, and backdating of the first contact is not permitted) o Contact the Insured's agent of record for other potential contact information o If a foreclosure claim was reported by the mortgagee or mortgagee’s representative, initial contact can be made by email and documented in the file •  During the initial contact, the Adjuster should: o Determine if any loss information has changed since the original report by verifying the detailed facts, including date and time of loss o Confirm the identity of lienholders, additional Insureds, witnesses, 3rd parties, Attorney or Public Adjuster representation o Review the loss severity as compared to the FNOL o Explain the claims handling process and anticipated timelines o Provide Insured or their Representative with their assigned claim number and the Adjuster’s contact information o Review with the Insured or their Representative all possible coverages, limits, exclusions and deductibles that may apply to the loss o Discuss the Insured’s post-loss duties, obligations and efforts to protect the risk from further damage, for example, tarp and board-up, debris removal and emergency services (mitigation / remediation) o Advise the Insured or Representative to protect any evidence chain of custody o Discuss and consider Additional Living Expenses (ALE) and / or advance claim payments as appropriate, reasonable and necessary o Attempt to schedule an on-site damage inspection of the risk with the insured(s) present Inspection Scheduling - The Adjuster should determine if an on-site inspection is warranted and attempt to schedule the on-site inspection during the initial contact. It is Citizens’ goal to schedule the inspection to occur within forty-eight (48) hours of the initial contact with the Insured or their Representative. If the inspection cannot be scheduled to occur within this time frame, a brief explanation (as to non-compliance) should be entered into the file notes. The inspection does not need to occur within forty-eight (48) hours, but is the preferred course of action. The following should be noted by the Adjuster in preparing for the inspection: o Forty-eight (48) hour notice to the Insured or their Representative, prior to inspection, is required by Florida Statute March 2017 Back To Top 3 ▪  Forty-eight (48) hour notice may be waived by the Insured or their Representative. The claim file notes should reflect this waiver o Prior to the inspection, the Adjuster should complete a full review of the file, facts of loss and detailed policy information o Obtain a signed Financial Release Form, such as a General Release and / or a Medical Release (if applicable) in the investigation of Liability or Medical Payments claims Follow-Up Contact - It is vital that the Adjuster has ongoing contact with the Insured or their Representative during the life of the claim, including the following: •  One (1) calendar day response to Insured’s or their Representative’s, emails, phone calls •  Five (5) calendar day response to written notifications •  Periodic status updates and anticipated future activities should be documented in the file notes •  Notify and update Insured or their Representative of any upcoming or scheduled events, inspections, requirements, due dates, etc. •  Communicate Citizens' ongoing expectations and duties of the Insured or their Representative •  Clearly explain why additional information, documentation, items or actions are requested of the Insured and / or their Representative •  Contact the Insured or their Representative to discuss settlement, prior to the issuance of any indemnity payments •  Document in file notes the details of voice-to-voice and / or written communications with regard, but not limited to: o Full or partial payments o Vendor and contractor payments o Settlements explanations and / or coverage denials, etc. •  When closing claims, with or without payment: o Citizens’ contact information is relayed and the process for reporting new or undiscovered damages is explained. o As appropriate, informal and formal dispute resolution options are explained to the Insured or their Representative and documented in the file notes Written Communication - The following requirements should be followed in the preparation and submission of written communications: •  Citizens’ approved letter and ClaimCenter email formats and templates should be used at all times for consistency •  Specific claim related information, as required on a claim-by-claim basis, should be added to the letter template in sections where revisions are allowed •  Letters are to be addressed to the Named Insured(s), any Additional Insured(s) as listed on the policy, and Insured’s Representatives: o Letters should be mailed separately to each Additional Insured(s), including a spouse, unless the spouse and / or the Additional Insured reside in the same household ▪  This includes system generated letters, i.e. Bill Xxxx of Rights / Initial Duties letters o When an Insured is represented by an Attorney and / or a Public Adjuster, with proper Letter of Representation downloaded in the ClaimCenter® file documents, all written communications are to be addressed and mailed to the representative. The Insured and any additional named Insureds, as detailed on the declaration page of the policy, are to be copied, with letters mailed to the appropriate address for each named Insured March 2017 Back To Top 4 o If a letter is addressed to an Assignment of Benefits (AOB) vendor, the Insured, any additional named Insureds, as detailed on the declaration page of the policy and any Insured representative are to be copied, with letters mailed to the appropriate addressee o Other individuals and parties of interest (e.g., loss consultants, and mortgage company and premium finance company representatives, etc.) are not to receive copies of written communications, unless you are directed to send by your manager / supervisor •  All settlements, a portion of the claim where coverage is not afforded or full denials are to be accompanied by written correspondence explaining the resolution and include appropriate and supporting documentation but not limited to: o Damage estimate o Personal Property Inventory Form (PPIF) o Invoices and other documented expenses o Applicable policy form, edition and / or endorsement(s), specific language and relevant dates o Other Citizens’ proprietary documents (i.e., Engineer, Expert, Strikenet reports, etc.), only upon management approval •  The Agent of Record should receive a copy of any formal, complete denial letter communicated to the Insured •  Formal communication of full denial claims are to be reviewed and approved by a Supervisor and/or Manager prior to issuance •  Time sensitive correspondence / letters should be processed and documented in the file as required Insureds are our customers and have a contractual right to receive original or copies, when represented or assigning benefits, of all written communications pertaining to their claim. Utilizing information secured through the initial contact with the Insured or their Representative, the Adjuster should conduct an appropriate, complete and timely investigation in good faith to determine the direct and proximate cause and origin of the loss for a full, fair and prompt resolution of the claim. (i.e., not "pipe break or “supply line break," but rather include what caused the break) •  Thoroughly review information contained in the First Notice of Loss (FNOL) •  Review Local, State and / or Federal laws and statutes that may be applicable •  Formulate and document the file with an initial ‘plan of action’ based on facts of loss received •  Determine any necessary escalations or referrals to Citizens’ internal departments o If referrals to other resources or units are deemed necessary, the Adjuster should complete the referral as soon as the need is recognized Review Loss History - Search and review ClaimCenter and ISO Reports for potential matches by Insured name and / or property address for prior, duplicate or existing claims. A file note should be entered to address prior claims, any potential overlap, or lack of prior or related claims matches. March 2017 Back To Top 5 Onsite Inspection - Field inspections are an integral part of the claims investigation process. Adjusters should take great care when determining the cause of loss. Facts determined should be accurately captured and memorialized through: •  Potential witnesses and third party contributors •  The need for experts or engineers •  Subrogation and Salvage potential The Adjuster should also: •  Consider the need for a signed Non-Waiver or Reservation of Rights (ROR) letter, if a coverage question arises requiring additional investigation •  Fully discuss with the Insured or their Representative and document any coverage concerns •  Secure any supporting documentation relevant to the claim •  Secure Police, Fire, Weather and other relevant expert reports as needed o Reports are to be reviewed within five (5) calendar days of receipt •  Determine ALE / FRV and Personal Property exposures: o Including the need for advanced payments for temporary housing and other emergency needs •  Obtain applicable legal documents such as Tax Liens, Mortgages, Sales / Purchase Agreements, Home Inspection Reports and Condo By-laws. o Confirm through the Property Appraisers office if / when ownership is in question •  Determine if any collateral damages may exist for liability exposures Follow-up inspection(s) may be required: •  If any potentially covered damages are hidden from view at the initial inspection •  If there is a need for outside experts (i.e., Engineer / Expert, etc.) o Manager approval is needed for outside expense budget •  If additional damages are claimed or discovered •  To determine release of the holdback of recoverable depreciation •  If a dispute arises over scope of damages, estimate, or cause of loss Recorded Interview – The Adjuster should secure the recorded interview at first contact, time of inspection, or as soon as facts arise that would reasonably require a recorded interview. The following should be considered: •  Access the Adjuster Portal for Citizens’ Recorded Statement Guides and Standards: •  The Adjuster must always obtain permission and acknowledgement from all parties present to record the interview •  The Adjuster should secure the recorded interview(s) from the person(s) most knowledgeable about the facts surrounding the cause of loss, the mitigation of the loss and the related and unrelated damages •  The Adjuster should ask focused questions material and relevant to the investigation and follow- up questions based on the answers provided by the person(s) being interviewed •  The Adjuster should avoid leading the interviewee or supplying answers to the question(s) being asked •  The Adjuster should avoid questions which are solely meant to harass, embarrass or “badger” the examinee The Adjuster is required to take a recorded interview for the following types of claims. If a recorded interview is not taken, the Adjuster should provide a file note stating reasonable rationale: March 2017 Back To Top 6 •  Fire •  Large loss •  Theft or Mysterious Disappearance •  Motor vehicle impact •  Water damage claims that involve: o Long term and / or repeated discharge / seepage o Slab water leaks o Leaks with no visible damage o Permanent repairs completed prior to CPIC’s inspection o AOB claims •  All non-weather related water losses •  Vandalism with occupancy issues •  Sinkhole and catastrophic ground cover collapse •  Liability and Medical Payments claims •  Late notice claims •  Coverage questions o Including vacancy / occupancy •  Mitigation / Remediation issues •  Multiple or similar prior and / or current losses •  To seek a resolution to conflicting information Internal Resources / Communication - Referrals should be submitted in a timely manner to utilize the expertise of Citizens’ specialized units. The Adjuster engages internal resources, as necessary, based on the facts of the claim. Timely referral or consulting with these units is essential; therefore, the Adjuster should immediately recognize the necessity and act accordingly. The file notes should be documented with the appropriate rationale. Potential internal resources include: •  Special Investigations Unit (SIU) •  Recovery (Subrogation / Salvage) •  Claims Legal / Appraisal / Mediation •  Underwriting •  Contents Unit •  Burglary, Lightning & Theft (BLT) Unit •  Loss Assessment Team •  Late First Notice of Loss (FNOL) Team •  Special Investigative Unit (SIU) – Citizens is required by statute to investigate and report suspected insurance fraud. The Adjuster should review claim facts to identify any industry accepted indicators (Red Flags) that raise awareness of potential insurance fraud. Adjuster responsibilities are as follows:

Customer Service. Initial Contact - Initial voice-to-voice contact with the Insured or their Representative is to be made within one (1) calendar day of the receipt of the assignment or reassignment by the Adjuster. For commercial losses, the requirement for contact upon reassignment is two (2) calendar days. In the event of a catastrophic claim, initial voice-to-voice contact is to be made within three (3) calendar days of receipt of the assignment. •  If the adjuster fails in their initial attempt to contact the Insured or their Representative, they should continue to make every reasonable effort to make contact in a timely manner including, but not limited to the following: o If unable to make initial contact with the Insured or their Representative within the designated time, send a ClaimCenter e-mail or Contact letter within three (3) calendar days o Document continued and multiple phone call attempts o Leave telephone messages (Voice-to-voice is required for first contact. Text or voice mail messages are not a substitute, and backdating of the first contact is not permitted) o Contact the Insured's agent of record for other potential contact information o If a foreclosure claim was reported by the mortgagee or mortgagee’s representative, initial contact can be made by email and documented in the file •  During the initial contact, the Adjuster should: o Determine if any loss information has changed since the original report by verifying the detailed facts, including date and time of loss o Confirm the identity of lienholders, additional Insureds, witnesses, 3rd parties, Attorney or Public Adjuster representation o Review the loss severity as compared to the FNOL o Explain the claims handling process and anticipated timelines o Provide Insured or their Representative with their assigned claim number and the Adjuster’s contact information o Review with the Insured or their Representative all possible coverages, limits, exclusions and deductibles that may apply to the loss o Discuss the Insured’s post-loss duties, obligations and efforts to protect the risk from further damage, for example, tarp and board-up, debris removal and emergency services (mitigation / remediation) o Advise the Insured or Representative to protect any evidence chain of custody o Discuss and consider Additional Living Expenses (ALE) and / or advance claim payments as appropriate, reasonable and necessary o Attempt to schedule an on-site damage inspection of the risk with the insured(s) present Inspection Scheduling - The Adjuster should determine if an on-site inspection is warranted and attempt to schedule the on-site inspection during the initial contact. It is Citizens’ goal to schedule the inspection to occur within forty-eight (48) hours of the initial contact with the Insured or their Representative. If the inspection cannot be scheduled to occur within this time frame, a brief explanation (as to non-compliance) should be entered into the file notes. The inspection does not need to occur within forty-eight (48) hours, but is the preferred course of action. The following should be noted by the Adjuster in preparing for the inspection: o Forty-eight (48) hour notice to the Insured or their Representative, prior to inspection, is required by Florida Statute March 2017 Back To Top 3 ▪  Forty-eight (48) hour notice may be waived by the Insured or their Representative. The claim file notes should reflect this waiver o Prior to the inspection, the Adjuster should complete a full review of the file, facts of loss and detailed policy information o Obtain a signed Financial Release Form, such as a General Release and / or a Medical Release (if applicable) in the investigation of Liability or Medical Payments claims Follow-Up Contact - It is vital that the Adjuster has ongoing contact with the Insured or their Representative during the life of the claim, including the following: •  One (1) calendar day response to Insured’s or their Representative’s, emails, phone calls •  Five (5) calendar day response to written notifications •  Periodic status updates and anticipated future activities should be documented in the file notes •  Notify and update Insured or their Representative of any upcoming or scheduled events, inspections, requirements, due dates, etc. •  Communicate Citizens' ongoing expectations and duties of the Insured or their Representative •  Clearly explain why additional information, documentation, items or actions are requested of the Insured and / or their Representative •  Contact the Insured or their Representative to discuss settlement, prior to the issuance of any indemnity payments •  Document in file notes the details of voice-to-voice and / or written communications with regard, but not limited to: o Full or partial payments o Vendor and contractor payments o Settlements explanations and / or coverage denials, etc. •  When closing claims, with or without payment: o Citizens’ contact information is relayed and the process for reporting new or undiscovered damages is explained. o As appropriate, informal and formal dispute resolution options are explained to the Insured or their Representative and documented in the file notes Written Communication - The following requirements should be followed in the preparation and submission of written communications: •  Citizens’ approved letter and ClaimCenter email formats and templates should be used at all times for consistency •  Specific claim related information, as required on a claim-by-claim basis, should be added to the letter template in sections where revisions are allowed •  Letters are to be addressed to the Named Insured(s), any Additional Insured(s) as listed on the policy, and Insured’s Representatives: o Letters should be mailed separately to each Additional Insured(s), including a spouse, unless the spouse and / or the Additional Insured reside in the same household ▪  This includes system generated letters, i.e. Bill Xxxx of Rights / Initial Duties letters o When an Insured is represented by an Attorney and / or a Public Adjuster, with proper Letter of Representation downloaded in the ClaimCenter® file documents, all written communications are to be addressed and mailed to the representative. The Insured and any additional named Insureds, as detailed on the declaration page of the policy, are to be copied, with letters mailed to the appropriate address for each named Insured March 2017 Back To Top 4 o If a letter is addressed to an Assignment of Benefits (AOB) vendor, the Insured, any additional named Insureds, as detailed on the declaration page of the policy and any Insured representative are to be copied, with letters mailed to the appropriate addressee o Other individuals and parties of interest (e.g., loss consultants, and mortgage company and premium finance company representatives, etc.) are not to receive copies of written communications, unless you are directed to send by your manager / supervisor •  All settlements, a portion of the claim where coverage is not afforded or full denials are to be accompanied by written correspondence explaining the resolution and include appropriate and supporting documentation but not limited to: o Damage estimate o Personal Property Inventory Form (PPIF) o Invoices and other documented expenses o Applicable policy form, edition and / or endorsement(s), specific language and relevant dates o Other Citizens’ proprietary documents (i.e., Engineer, Expert, Strikenet reports, etc.), only upon management approval •  The Agent of Record should receive a copy of any formal, complete denial letter communicated to the Insured •  Formal communication of full denial claims are to be reviewed and approved by a Supervisor and/or Manager prior to issuance •  Time sensitive correspondence / letters should be processed and documented in the file as required Insureds are our customers and have a contractual right to receive original or copies, when represented or assigning benefits, of all written communications pertaining to their claim. Utilizing information secured through the initial contact with the Insured or their Representative, the Adjuster should conduct an appropriate, complete and timely investigation in good faith to determine the direct and proximate cause and origin of the loss for a full, fair and prompt resolution of the claim. (i.e., not "pipe break or “supply line break," but rather include what caused the break) •  Thoroughly review information contained in the First Notice of Loss (FNOL) •  Review Local, State and / or Federal laws and statutes that may be applicable •  Formulate and document the file with an initial ‘plan of action’ based on facts of loss received •  Determine any necessary escalations or referrals to Citizens’ internal departments o If referrals to other resources or units are deemed necessary, the Adjuster should complete the referral as soon as the need is recognized Review Loss History - Search and review ClaimCenter and ISO Reports for potential matches by Insured name and / or property address for prior, duplicate or existing claims. A file note should be entered to address prior claims, any potential overlap, or lack of prior or related claims matches. March 2017 Back To Top 5 Onsite Inspection - Field inspections are an integral part of the claims investigation process. Adjusters should take great care when determining the cause of loss. Facts determined should be accurately captured and memorialized through: •  Potential witnesses and third party contributors •  The need for experts or engineers •  Subrogation and Salvage potential The Adjuster should also: •  Consider the need for a signed Non-Waiver or Reservation of Rights (ROR) letter, if a coverage question arises requiring additional investigation •  Fully discuss with the Insured or their Representative and document any coverage concerns •  Secure any supporting documentation relevant to the claim •  Secure Police, Fire, Weather and other relevant expert reports as needed o Reports are to be reviewed within five (5) calendar days of receipt •  Determine ALE / FRV and Personal Property exposures: o Including the need for advanced payments for temporary housing and other emergency needs •  Obtain applicable legal documents such as Tax Liens, Mortgages, Sales / Purchase Agreements, Home Inspection Reports and Condo By-laws. o Confirm through the Property Appraisers office if / when ownership is in question •  Determine if any collateral damages may exist for liability exposures Follow-up inspection(s) may be required: •  If any potentially covered damages are hidden from view at the initial inspection •  If there is a need for outside experts (i.e., Engineer / Expert, etc.) o Manager approval is needed for outside expense budget •  If additional damages are claimed or discovered •  To determine release of the holdback of recoverable depreciation •  If a dispute arises over scope of damages, estimate, or cause of loss Recorded Interview – The Adjuster should secure the recorded interview at first contact, time of inspection, or as soon as facts arise that would reasonably require a recorded interview. The following should be considered: •  Access the Adjuster Portal for Citizens’ Recorded Statement Guides and Standards: •  The Adjuster must always obtain permission and acknowledgement from all parties present to record the interview •  The Adjuster should secure the recorded interview(s) from the person(s) most knowledgeable about the facts surrounding the cause of loss, the mitigation of the loss and the related and unrelated damages •  The Adjuster should ask focused questions material and relevant to the investigation and follow- up questions based on the answers provided by the person(s) being interviewed •  The Adjuster should avoid leading the interviewee or supplying answers to the question(s) being asked •  The Adjuster should avoid questions which are solely meant to harass, embarrass or “badger” the examinee The Adjuster is required to take a recorded interview for the following types of claims. If a recorded interview is not taken, the Adjuster should provide a file note stating reasonable rationale: March 2017 Back To Top 6 •  Fire •  Large loss •  Theft or Mysterious Disappearance •  Motor vehicle impact •  Water damage claims that involve: o Long term and / or repeated discharge / seepage o Slab water leaks o Leaks with no visible damage o Permanent repairs completed prior to CPIC’s inspection o AOB claims •  All non-weather related water losses •  Vandalism with occupancy issues •  Sinkhole and catastrophic ground cover collapse •  Liability and Medical Payments claims •  Late notice claims •  Coverage questions o Including vacancy / occupancy •  Mitigation / Remediation issues •  Multiple or similar prior and / or current losses •  To seek a resolution to conflicting information Internal Resources / Communication - Referrals should be submitted in a timely manner to utilize the expertise of Citizens’ specialized units. The Adjuster engages internal resources, as necessary, based on the facts of the claim. Timely referral or consulting with these units is essential; therefore, the Adjuster should immediately recognize the necessity and act accordingly. The file notes should be documented with the appropriate rationale. Potential internal resources include: •  Special Investigations Unit (SIU) •  Recovery (Subrogation / Salvage) •  Claims Legal / Appraisal / Mediation •  Underwriting •  Contents Unit •  Burglary, Lightning & Theft (BLT) Unit •  Loss Assessment Team •  Late First Notice of Loss (FNOL) Team •  Special Investigative Unit (SIU) – Citizens is required by statute to investigate and report suspected insurance fraud. The Adjuster should review claim facts to identify any industry accepted indicators (Red Flags) that raise awareness of potential insurance fraud. Adjuster responsibilities are as follows:

Customer Service. Initial Contact - Initial voice-to-voice contact with the Insured or their Representative is to be made within one (1) calendar day of the receipt of the assignment or reassignment by the Adjuster. For commercial losses, the requirement for contact upon reassignment is two (2) calendar days. In the event of a catastrophic claim, initial voice-to-voice contact is to be made within three (3) calendar days of receipt of the assignment. •  If the adjuster fails in their initial attempt to contact the Insured or their Representative, they should continue to make every reasonable effort to make contact in a timely manner including, but not limited to the following: o If unable to make initial contact with the Insured or their Representative within the designated time, send a ClaimCenter e-mail or Contact letter within three (3) calendar days o Document continued and multiple phone call attempts o Leave telephone messages (Voice-to-voice is required for first contact. Text or voice mail messages are not a substitute, and backdating of the first contact is not permitted) o Contact the Insured's agent of record for other potential contact information o If a foreclosure claim was reported by the mortgagee or mortgagee’s representative, initial contact can be made by email and documented in the file •  During the initial contact, the Adjuster should: o Determine if any loss information has changed since the original report by verifying the detailed facts, including date and time of loss o Confirm the identity of lienholders, additional Insureds, witnesses, 3rd parties, Attorney or Public Adjuster representation o Review the loss severity as compared to the FNOL o Explain the claims handling process and anticipated timelines o Provide Insured or their Representative with their assigned claim number and the Adjuster’s contact information o Review with the Insured or their Representative all possible coverages, limits, exclusions and deductibles that may apply to the loss o Discuss the Insured’s post-loss duties, obligations and efforts to protect the risk from further damage, for example, tarp and board-up, debris removal and emergency services (mitigation / remediation) o Advise the Insured or Representative to protect any evidence chain of custody o Discuss and consider Additional Living Expenses (ALE) and / or advance claim payments as appropriate, reasonable and necessary o Attempt to schedule an on-site damage inspection of the risk with the insured(s) present Inspection Scheduling - The Adjuster should determine if an on-site inspection is warranted and attempt to schedule the on-site inspection during the initial contact. It is Citizens’ goal to schedule the inspection to occur within forty-eight (48) hours of the initial contact with the Insured or their Representative. If the inspection cannot be scheduled to occur within this time frame, a brief explanation (as to non-compliance) should be entered into the file notes. The inspection does not need to occur within forty-eight (48) hours, but is the preferred course of action. The following should be noted by the Adjuster in preparing for the inspection: o Forty-eight (48) hour notice to the Insured or their Representative, prior to inspection, is required by Florida Statute March 2017 Back To Top 3 ▪  Forty-eight (48) hour notice may be waived by the Insured or their Representative. The claim file notes should reflect this waiver o Prior to the inspection, the Adjuster should complete a full review of the file, facts of loss and detailed policy information September Rev.4, Back To Top 3 o Obtain a signed Financial Release Form, such as a General Release and / or a Medical Release (if applicable) in the investigation of Liability or Medical Payments claims Follow-Up Contact - It is vital that the Adjuster has ongoing contact with the Insured or their Representative during the life of the claim, including the following: •  One (1) calendar day response to Insured’s or their Representative’s, emails, phone calls •  Five (5) calendar day response to written notifications •  Periodic status updates and anticipated future activities should be documented in the file notes •  Notify and update Insured or their Representative of any upcoming or scheduled events, inspections, requirements, due dates, etc. •  Communicate Citizens' ongoing expectations and duties of the Insured or their Representative •  Clearly explain why additional information, documentation, items or actions are requested of the Insured and / or their Representative •  Contact the Insured or their Representative to discuss settlement, prior to the issuance of any indemnity payments •  Document in file notes the details of voice-to-voice and / or written communications with regard, but not limited to: o Full or partial payments o Vendor and contractor payments o Settlements explanations and / or coverage denials, etc. •  When closing claims, with or without payment: o Citizens’ contact information is relayed and the process for reporting new or undiscovered damages is explained. o As appropriate, informal and formal dispute resolution options are explained to the Insured or their Representative and documented in the file notes Written Communication - The following requirements should be followed in the preparation and submission of written communications: •  Citizens’ approved letter and ClaimCenter email formats and templates should be used at all times for consistency •  Specific claim related information, as required on a claim-by-claim basis, should be added to the letter template in sections where revisions are allowed •  Letters are to be addressed to the Named Insured(s), any Additional Insured(s) as listed on the policy, policy and Insured’s Representatives: o Letters should be mailed separately to each Additional Insured(s), including a spouse, unless the spouse and / or the Additional Insured reside in the same household ▪ This includes system generated letters, i.e. Bill of Rights / Initial Duties letters o When an Insured is represented by an Attorney and / or a Public Adjuster, with proper Letter of Representation downloaded in the ClaimCenter® file documents, all written communications are to be addressed and mailed to the representative. The Insured and any additional named Insureds, as detailed on the declaration page of the policy, are to be copied, with letters mailed to the appropriate address for each named Insured March 2017 Back To Top 4 o If a letter is addressed to an Assignment of Benefits (AOB) vendor, the Insured, any additional named Insureds, as detailed on the declaration page of the policy and any Insured representative are to be copied, with letters mailed to the appropriate addressee o Other individuals and parties of interest (e.g., loss consultants, and mortgage company and premium finance company representatives, etc.) are not to receive copies of written communications, unless you are directed to send by your manager / supervisor • All settlements, a portion of the claim where coverage is not afforded or full denials are to be accompanied by written correspondence explaining the resolution and include appropriate and supporting documentation but not limited to: o Damage estimate o Personal Property Inventory Form (PPIF) o Invoices and other documented expenses o Applicable policy form, edition and / or endorsement(s), specific language and relevant dates o Other Citizens’ proprietary documents (i.e., Engineer, Expert, Strikenet reports, etc.), only upon management approval • The Agent of Record should receive a copy of any formal, complete denial letter communicated to the Insured • Formal communication of full denial claims are to be reviewed and approved by a Supervisor and/or Manager prior to issuance • Time sensitive correspondence / letters should be processed and documented in the file as required Insureds are our customers and have a contractual right to receive original or copies, when represented or assigning benefits, of all written communications pertaining to their claim. Utilizing information secured through the initial contact with the Insured or their Representative, the Adjuster should conduct an appropriate, complete and timely investigation in good faith to determine the direct and proximate cause and origin of the loss for a full, fair and prompt resolution of the claim. (i.e., not "pipe break or “supply line break," but rather include what caused the break) • Thoroughly review information contained in the First Notice of Loss (FNOL) • Review Local, State and / or Federal laws and statutes that may be applicable • Formulate and document the file with an initial ‘plan of action’ based on facts of loss received • Determine any necessary escalations or referrals to Citizens’ internal departments o If referrals to other resources or units are deemed necessary, the Adjuster should complete the referral as soon as the need is recognized Review Loss History - Search and review ClaimCenter and ISO Reports for potential matches by Insured name and / or property address for prior, duplicate or existing claims. A file note should be entered to address prior claims, any potential overlap, or lack of prior or related claims matches. March 2017 Back To Top 5 Onsite Inspection - Field inspections are an integral part of the claims investigation process. Adjusters should take great care when determining the cause of loss. Facts determined should be accurately captured and memorialized through: • Potential witnesses and third party contributors • The need for experts or engineers • Subrogation and Salvage potential The Adjuster should also: • Consider the need for a signed Non-Waiver or Reservation of Rights (ROR) letter, if a coverage question arises requiring additional investigation • Fully discuss with the Insured or their Representative and document any coverage concerns • Secure any supporting documentation relevant to the claim • Secure Police, Fire, Weather and other relevant expert reports as needed o Reports are to be reviewed within five (5) calendar days of receipt • Determine ALE / FRV and Personal Property exposures: o Including the need for advanced payments for temporary housing and other emergency needs • Obtain applicable legal documents such as Tax Liens, Mortgages, Sales / Purchase Agreements, Home Inspection Reports and Condo By-laws. o Confirm through the Property Appraisers office if / when ownership is in question • Determine if any collateral damages may exist for liability exposures Follow-up inspection(s) may be required: • If any potentially covered damages are hidden from view at the initial inspection • If there is a need for outside experts (i.e., Engineer / Expert, etc.) o Manager approval is needed for outside expense budget • If additional damages are claimed or discovered • To determine release of the holdback of recoverable depreciation • If a dispute arises over scope of damages, estimate, or cause of loss Recorded Interview – The Adjuster should secure the recorded interview at first contact, time of inspection, or as soon as facts arise that would reasonably require a recorded interview. The following should be considered: • Access the Adjuster Portal for Citizens’ Recorded Statement Guides and Standards: • The Adjuster must always obtain permission and acknowledgement from all parties present to record the interview • The Adjuster should secure the recorded interview(s) from the person(s) most knowledgeable about the facts surrounding the cause of loss, the mitigation of the loss and the related and unrelated damages • The Adjuster should ask focused questions material and relevant to the investigation and follow- up questions based on the answers provided by the person(s) being interviewed • The Adjuster should avoid leading the interviewee or supplying answers to the question(s) being asked • The Adjuster should avoid questions which are solely meant to harass, embarrass or “badger” the examinee The Adjuster is required to take a recorded interview for the following types of claims. If a recorded interview is not taken, the Adjuster should provide a file note stating reasonable rationale: March 2017 Back To Top 6 • Fire • Large loss • Theft or Mysterious Disappearance • Motor vehicle impact • Water damage claims that involve: o Long term and / or repeated discharge / seepage o Slab water leaks o Leaks with no visible damage o Permanent repairs completed prior to CPIC’s inspection o AOB claims • All non-weather related water losses • Vandalism with occupancy issues • Sinkhole and catastrophic ground cover collapse • Liability and Medical Payments claims • Late notice claims • Coverage questions o Including vacancy / occupancy • Mitigation / Remediation issues • Multiple or similar prior and / or current losses • To seek a resolution to conflicting information Internal Resources / Communication - Referrals should be submitted in a timely manner to utilize the expertise of Citizens’ specialized units. The Adjuster engages internal resources, as necessary, based on the facts of the claim. Timely referral or consulting with these units is essential; therefore, the Adjuster should immediately recognize the necessity and act accordingly. The file notes should be documented with the appropriate rationale. Potential internal resources include: • Special Investigations Unit (SIU) • Recovery (Subrogation / Salvage) • Claims Legal / Appraisal / Mediation • Underwriting • Contents Unit • Burglary, Lightning & Theft (BLT) Unit • Loss Assessment Team • Late First Notice of Loss (FNOL) Team • Special Investigative Unit (SIU) – Citizens is required by statute to investigate and report suspected insurance fraud. The Adjuster should review claim facts to identify any industry accepted indicators (Red Flags) that raise awareness of potential insurance fraud. Adjuster responsibilities are as follows:supervisor