The Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Office of the Administrator, Office of External Affairs has a requirement for professional and technical services supporting the Hermit’s Peak/Calf Canyon Claims Office.

The United States Congress introduced H.R. 7721, Hermit’s Peak Fire Assistance Act, to compensate impacted entities of the prescribed burn that resulted in the merged Hermit’s Peak and Calf Canyon Fires in New Mexico for injuries resulting from the fire and to provide for the expeditious consideration and settlement of claims for those injuries. The Act also establishes the Hermit’s Peak/Calf Canyon Fire Claims Office within the Federal Emergency Management Agency. The Claims Office will receive, process, and pay claims to claimants affected by the Hermit’s Peak/Calf Canyon Fire and subsequent floods. Since Injured Persons can submit multiple claims, at this time FEMA estimates a total of 28,000 claims that will be submitted before the current deadline, December 20, 2024 or as otherwise specified by Congressional legislation.

The Hermit’s Peak/Calf Canyon fires resulted in 325,340 acres burned and 900 homes/structures destroyed. From November 14, 2022 until October 2024, FEMA has received over 20,000 Proofs of Loss, with approximately 14% submitted by 3rd party representatives. FEMA anticipates an
additional 5,000 Proofs of Loss may be developed under the Period of Performance of this contract.

The Contractor shall assist the Government with meeting the following objectives, in conformance with applicable documents and regulations:

• Objective 1: Assist the Government with executing a time-efficient, cost-effective, compliant, and accurate claimant-centric process that emphasizes quality customer service, reduction of rework, quality control support, and providing commensurate compensation recommendations in accordance with established program guidance.
• Objective 2: Assist the Government with task-specific support in the following areas: Administrative, Subject Matter Expertise, Site inspections, Appeals and other staff as mission needs dictate in accordance with established program guidance.

• The Contractor shall be required to provide professional and technical services supporting the Hermit’s Peak/Calf Canyon Claims Office. The Contractor shall provide support in operational areas to include, but not limited to claimant intake, query and collection of requisite supporting documentation, development and submissions of comprehensive proofs of loss, claimant inquiries, review requested amounts, establish qualified amounts, assess duplication of benefits and provide comprehensive recommendations for maximum compensation determinations. The Contractor must perform those services in accordance with the terms of Hermit’s Peak/Calf Canyon Fire Assistance Act (Division G of Pub.L. 117-180), Regulation 44 CFR Part 296, and the contract between the Contractor and FEMA.
• The Contractor shall work with the Government to execute a claimant-centric process that puts customer service first, continually increases efficiency and effectiveness, and compiles with respective policy and guidance. FEMA’s overall objective is to provide full compensation available under the law as expeditiously as possible with the smallest burden placed on the claimants. Consequently, a key goal of the program is to support the claimant at every step of the process and to issue Letters of Determination within 90 days after acknowledging a Notice of Loss, but no later than 180 days from such acknowledgment. Contractor shall deliver operations in a cost-effective, accurate, and timely manner, and maximize use of local firms and personnel in support of the program’s objectives.
• The contractor shall furnish staff who provide comprehensive support for both claims review functions and ancillary tasks as required. Contractor shall provide staff support which is scalable and cost-effective to include: Administrative functions, Subject Matter Experts (SMEs) specialists, Site
  Inspectors, Appeals Analysts, Claims Reviewers, Quality Control, and other staff as mission needs require within the scope of the PWS. Activities listed in the tasks below may change based on program and policy revisions.
• Contractor shall provide program support services for the execution of the life cycle of the claims review process of the Hermit’s Peak/Calf Canyon Claims Office, which may include:
  • Assisting the Government with executing a scalable, customer-centric claims review process that provides full compensation available under the law as expeditiously as possible with the smallest burden placed on the claimants.
  • Assisting claimant and/or FEMA Navigator to identify losses eligible for payment and obtaining requisite backup documentation requirements.
  • Utilizing valuation methodologies to conduct claims processing, including standard rate calculation methodologies to expedite claims review process.
  • Apply established procedures for handling all claims-related correspondence, including registrations by mail and upload, and provide mail operations as requested.
  • Contractor shall provide qualified personnel and claims reviewers to process claims and recommend payment to the Authorizing Official within the timelines specified in the Table 2 – Performance Requirements Summary. Claims reviewers shall provide other services as identified in the Final Regulations and associated policies, guidance, and procedures, to include but not limited to using guidance provided by the Government, identify when a Site Inspection or SME Report may be required and refer request to the designated Site Inspection and SME teams.
  • Upon receipt and review of a completed and properly signed Notice of Loss the Contractor shall be responsible to assign a designated claim reviewer for each claim.
  • Claims Reviewers shall work with the claimant, designated claimant representative or the Navigator to assist claimant with formulating a strategy for obtaining any necessary supporting documentation to complete a Proof of Loss, and other requirements as specified by the COR/TM.
  • The contractor shall provide Quality Control staff to review submissions of comprehensive proofs of loss, claimant inquiries, review requested amounts, establish qualified amounts, assess duplication of benefits and provide comprehensive recommendations for maximum compensation determinations.
  • Coordinate with subject matter experts and site inspectors, including other government contractors for the purpose of receiving reports or analysis for the processing and validation of claims
  • Contractor shall provide site inspection support as required. If physical site inspections are required, the Contractor shall provide qualified site inspectors personnel to conduct physical site inspections of damaged properties in the affected counties.
  • ontractor shall produce Subject Matter Expert Reports in the areas including, but not limited to: Forensic Accounting, Reforestation, Risk Reduction, Forestry, Fraud, GIS, Xactimate, and Adobe structures. These reports shall be created and added to claims as documentation to determine allowable payable costs claimed based on the legislation, regulations, and policies of the Claims Office
  • Contractor shall provide coaching support for Claims review and QC teams. Coaching support includes, but is not limited to: claims review, system of record, and Claims Office regulations and policy.
  • Contractor shall coordinate with subject matter experts, including other government contractors for the purpose of processing and validation of claims, to include receiving reports or analysis.
  • Evaluating claims to identify and flag any suspected or potential fraud. Any claims identified by the contractor as having suspected or potential fraud shall be referred to the Government.
  • Review claims through an established quality control process. Any claims that have deficiencies, inconsistencies, or errors are returned to the claims review process.
  • Ensuring all claims reviewers complete and maintain proficiency in Government- provided initial, refresher, and ongoing training. Unless explicitly directed, in writing, by the Government, Contractor is expressly prohibited from developing and delivering trainings which deviate from official program guidance.
  • Monitoring the compliance and proficiency of contracted staff. Contractor shall address any quality or training gaps that exist.
  • Providing exceptional customer service to each claimant and positively and professionally represent FEMA to the public throughout all aspects of services provided on FEMA’s behalf.
  • Contractor may be required to travel to claimant’s residence or locations designated by FEMA to assist with the claim process. The Contractor may be tasked with contacting claimant, scheduling date and time of visit, assist with obtaining documentation, completing necessary forms, and collecting and uploading copies of supporting documentation.
  • Assisting in document retrieval, as requested, to support the Appeals, Audits, and Arbitration of the Claims Office, and other backup documentation requests, at the direction of the Government.