Options if an Adjuster Denies Your Roof Damage Claim

Nov 1, 2010 | Insurance Claims

What are the options if an insurance adjuster denies my roof damage claim.

I was recently asked by one of my new clients, “If everyone of the roofs on my block is getting replaced, what is the chance that mine is the only one that did not sustain damage? My adjuster said it did not have enough damage to replace the roof.”

My answer was to allow us to inspect it to determine if the tree coverage or angle of the home was such that it prevented his home from damage. As it turned out, his roof had obvious damage. We suggested that he call the claims office for a re-inspection by an insurance representative in which we would be present to discuss and document the damages along with the adjuster.

It’s Time to Get a Re-inspection of The Roof

He decided to call his insurance carrier back, who readily agreed to send another adjuster out to inspect it. This time we were there to look at it together. The weather conditions were good, and the new adjuster documented the damages and totaled the roof.

A common practice is to count the number of hail marks within a 10 x10 square. Depending on the selection of slope or exact location in which they choose to place their square, the results can be skewed. It has been our experience that most adjusters want to be fair to the insured,  but at times we encounter the one who refuses to be reasonable and finds the only 10×10 area without enough visible damage so they can deny the roof. Usually we get calls from clients after this meeting has taken place without our representation. Either way, if you or your roofer feels that the roof damages that were overlooked, it is better to call the claims office for a re-inspection. Please read the next section to make sure that your roofer is qualified to make the assessment of whether or not you really do have damage to your roof. If you really have damage than a second inspection is in order.

The adjuster marked the roof for wind damage.

Wind Damage Marked with Chalk

Rarely do they refuse a second inspection. When a re-inspection is requested, the insurance company will often send a different adjuster out or even a supervisor. Sometimes, the original adjuster will come back out alone or along with his or her supervisor to reinspect it, especially if the roof was wet during the first inspection or if the adjuster did not get on the roof to inspect closely.

The claim handler may ask for photos of the damages prior to sending out another representative. Your roofer should be able to take these for you and make them available to the designated decision maker.  We have seen roof replacements approved based on the photos, especially  if the insurance company is very busy or based in different geographical area and are unable to easily have a representative stop back by.

Occasionally a team of adjusters will come out together. If your roofing contractor inspects your home and finds storm damage, it is wise to include him in that meeting to present those damages. He needs to be experienced and comfortable meeting with insurance adjusters, even if outnumbered five to one. The goal is never to punish or embarrass a professional insurance adjuster, but simply to provide the opportunity to present the actual damage to the insurance representative who will objectively inspect the damaged area.

If a roofer ever offers to “create” hail or wind damage for a re-inspection, that should be a red flag that they are not trustworthy! Integrity Roofing and Painting will never create hail or wind damage, but will document actual damages and be available to present that documentation in an initial or subsequent re-inspection.

close up of hail damage on roof shingle

Hail Damage

Make Sure that You Really Have Functional Damage

We recommend for homeowners that are working with a roofing company in Denver or Colorado Springs to make sure that the contractor has roof inspectors that are certified by Haag Engineering. This organization is the forensics expert in the insurance storm restoration industry. There is not another organization that has as much experience as Haag. These are the guys that have helped to developed many standards in the roofing and insurance industry. For instance Haag helped in developing testing measurements to determine if a shingle is able to withstand hail impacts. They routinely bring in different shingles from various manufacturers to test these shingles and metal products by propelling ice balls at high speeds and examining the shingles and metal panels for damage. It’s important to work with a roof inspector that can truly identify real hail damage. For some contractors every roof has hail damage. All because you have missing granules or a few shingles are missing it doesn’t justify a total roof replacement. A roof repair might be all that’s needed and the cost of the repair may be less than your deductible. If the repair is less than the deductible we’d recommend to not call for a re-inspection.

Obviously if you don’t have legitimate damage on the roof than it doesn’t make sense to pursue a re-inspection. However if the roof has legitimate damage that has been validated by a single certified inspector than it’s worth pursuing the second inspection. I need to clarify this point. Even if you have many roofers that stop by and make a claim that your roof has sustained damage it doesn’t mean that you actually have damage. The only way to know is to have an inspection performed by an ethical inspector certified by Haag Engineering. Please ask them to provide images of the actual damage on the roof. Ask them to clarify with you what the damage is and if the roof has real functional damage that has even created punctures or tears that may create a leak. Another type of functional damage is when the roof systems like expectancy has diminished significantly because of the hail impacts. If your roof has significant wind damage similar principles will apply. The inspector will follow guide lines that have been established by Haag and will let you know the true condition of your roof.

Roofing Inspection Technician

Appraisal Process May be Invoked if the Adjuster Can’t See the Actual Damage

The appraisal process is typically invoked as a final resolution to a disputed claim. Some Denver and Colorado Springs roofing companies may have appraisers that are willing to hire themselves out in a disputed case between the adjuster and roofer. The appraisal process is continually changing and what was law yesterday may be different tomorrow. The appraisal may or may not address scope, pricing and the cause of damage. The policyholder would have to read the appraisal clause to determine what their rights are. In addition, a policyholder should contact their insurance carrier to discuss their rights. They may need to go past their agent and contact a manager in the claims department to determine their rights under their current policy.

Find a Roofing Company in Denver or Colorado Springs That is Qualified to Work With Your Insurance Company

Integrity Roofing and Painting has years of experience working with insurance companies. We have re-inspected many roofs with adjusters and they have reversed their original decision to deny the roof replacement. If your insurance company has denied the replacement of your roof and you’re confident that you have functional damage, please contact us and we will be happy to help you assess your situation.