The following Q&A should help everyone understand how Type 1 and Type 2 claims filed on or after January 13, 2020 will be considered Pending Claims.
Our Underwriting and Claims Management Guidelines have changed in one very important way: claimants coming into our system for the first time on or after January 13, 2020 will be classified as “Pending” claimants until CFSIC has more certainty as to the future of its funding. This is an important distinction and an important change in the way CFSIC is doing business.
The following Q&A should help everyone understand what will happen on January 13.
Question: So if I’m ready to go with an application, are you saying I can’t apply until January 13 or after?
Answer: That’s correct. The electronic application process will not be enabled until January 13; and if you attempt to apply before then by sending us in the mail or as a scan an application that you printed as a pdf, your application will be returned to you.
Question: I’ve been waiting for you to reopen your doors. I have a verified severity class coded 3 foundation, and I want to apply as a Type 1 claimant. I’m going to apply right away on January 13. What will happen to my claim?
Answer: You will become a “Pending Claimant” in our system. That means that we are creating a third category of claimant effective January 13, 2020. Right now, CFSIC only permits a claimant to be “active” or “inactive.” On January 13, you will only be able to file as a claimant under the new third status of claimant...a Pending Claimant. This means that we will register your claim and all the data you send us. We will provide you with a claim number, and we will acknowledge your claim...BUT even if you have a verifiable severity code 3 claim, you will not be able to move out of Pending status to either inactive or active status unless and until CFSIC’s sunset date is moved forward beyond June 30, 2022 AND we determine, starting in June of 2020, what the most likely scenario is for the amount of money we will receive from our share of the Healthy Homes surcharge.
Question: Are you saying that, even if I have a completed application and a verified severity class code 3 foundation, you will be unable to make my claim “active” or even “inactive” on or after January 13?
Answer: That’s correct. You will not be able to be an active or inactive claimant until the two things above are determined. You will be a Pending Claimant. You may remain a Pending Claimant for a very long time.
Question: That doesn’t seem fair. Why is it happening that way?
Answer: Because, until the June 30, 2022 sunset date gets moved to a later date AND we actually see exactly how much money we are getting in June 2020 from the Healthy Homes surcharge, we are flying blind...we can’t set any more claim reserves on any new claims beyond what we’ve already done. If we do that, we run the risk of making promises to claimants on or after January 13 that we can’t fulfill.
Question: So if the sunset gets moved to, say, June 30, 2030 (the end of the Healthy Homes surcharge funding schedule)...are you saying that you will permit claimants who applied on or after January 13 to become active?
Answer: We’re almost saying that...the sunset date is only part of our problem. You have to remember that no one inside or outside of state government can tell us specifically how much revenue we’ll be getting from the Healthy Homes surcharge (just like no one inside or outside of state government can tell us when our next $20 million will be available to us from the CT Bond Commission). We must have time to evaluate both critical sources of revenue in order to make the best decision for homeowners.
Question: But don’t you know for certain that you’re getting approximately $8.5 million in June of 2020 and every year thereafter through June 30, 2030?
Answer: That’s the estimate...but it’s only an estimate. That could be the number. The number could be higher. The number could be considerably lower. No one can tell us.
Question: So if the sunset date gets moved, you get enough money in June of 2020, and you make my Pending Claim an active claim, and I am a severity class 3, that means I jump ahead of all the existing severity class 2s that have been in line since last year...right?
Answer: No. As of January 13, 2020, we are not going to permit any severity class 3 claim originally filed as a Pending Claim to jump ahead of an active severity class code 2 already registered with us as an active claim prior to January 13, 2020. We have many active severity class coded 2 claimants who have been in line since January of 2019, and we have determined that it is fair to issue Participation Agreements first for all existing active 3s and 2s in our system before any Pending Claimant can get in line for a Participation Agreement. This is only fair, given how long people have waited and the fact that we are only going to get $40M more in funding over the next two years from the CT Bond Commission source...and on top of that, we have virtually no idea how much we will get in Healthy Homes surcharge funds.
Question: But I thought severity class coded 3 claimants would always be ahead of everyone else. What has changed?
Answer: CFSIC’s Underwriting and Claims Management Guidelines will change effective January 13, 2020 to require that CFSIC issue Participation Agreements to valid, active severity coded 3 and 2 claimants who have been in line since the inception of our program before we move any other Pending claimants into active or even inactive status...regardless of funding amounts to come. If you file on or after January 13, we will have a record of your claim, and we will also have significantly more data about the extent of the crisis...but we’re not going to be able to do anything with your claim until the sunset date gets moved and we have evidence of a flow of predictable funds from the surcharge.
Question: How long are you going to keep the application process open from January 13?
Answer: A minimum of 30 days, but we don’t know exactly how long yet beyond that.
Question: Why don’t you know?
Answer: CFSIC’s fiscal year budget in the year July 1, 2019 through June 30, 2020 is finite. When claims enter our system, we are charged by our outsourced claims management service company on a per-claim basis, as each claim is entered into the system, is analyzed, and is assessed. We have enough budget for the remainder of the fiscal year for a reasonable number of claims to enter our system between now and June 30, 2020...but not for a significant number to enter our system.
Question: But can’t you make an educated guess as to the number of people who are going to apply on or after January 13?
Answer: No, we can’t. Just before we opened our doors on January 10, 2019, we were told by email and through social media sources that we would get as many as 7,000 applications and that our application system would crash. We got 227 on the first day. We have found, through experience, that the wild projections as to application activity were then and may continue to be exaggerated. The reality of people actually taking action is unknown. We hope to have many new Pending Claimants, which will send a strong message about our need for funding. But to be clear, we will all see together what we will see...when we all see it.
Question: I want to apply as a Type 2 claimant. Will all the same rules apply to me?
Answer: Yes. (With one exception: Type 2 claimants do not require a severity class coding.)
Question: This all seems like a lot of work just to get in line and have my claim be in pending status for what might be a really long time. Is all this worth it?
Answer: That’s totally up to you. We’re giving people an opportunity to give us the data we need to raise more funds by identifying more potential claimants, who we hope to be able to assist at some point in the future when those funds arrive. We’ve gotten emails asking us to re-open for this purpose. We’re doing it. The question now will be how many victims of this crisis will actually take us up on our offer: file a claim, get in line, and with their claims registered...send a strong message about our need for more funding.