Here Are Possible Reasons For Your Roof Insurance Claim Denial And What To Do Next

Unexpected roof damage like roof leaks, water damage, and hail damage is a hassle to deal with. In fact, nearly 46% of all property damage claims are related to wind and hail damage.

For years, you’ve paid your homeowner’s insurance policy premium faithfully. This means you expect your insurer to come to your aid with a settlement to start the roof repair process and help you get back on track after storm damage.

So it’s incredibly frustrating to have your property insurance claim denied. You may be confused and searching for what to do next.

Fortunately, we can help. Let’s look at some of the most missed signs of roof damage in Florida, five reasons why your claim may have been denied or underpaid, and what you can do to appeal your denied claim.

Most Missed Signs Of Roof Damage In Florida

Sometimes, it’s undeniable that your home’s roof is damaged. You may see a large hole, vast amounts of water leaking, or find roof shingles in your yard.

Photo by Hermaion

However, there are other instances where you may miss the early signs of roof damage after a hurricane or hail storm. Here are some things to look out for that may tell you that your roof needs some attention.

Missing or damaged shingles: You may notice some of your shingles curling up or missing altogether. Just one damaged shingle can cause issues to the surrounding ones and wreak havoc on your roof.
Damage to accents or roof supports: These elements can help clue homeowners in on roof damage. If you notice water pooling in certain spots of your roof or areas sagging inward, you may have a damaged roof.
Damaged gutters or spouts: Sagging gutters, spilling water, and sprouting greenery are all signs that a recent storm damaged your roof.
Strange debris in your yard: If you notice fallen branches, foreign objects, or heavy shrubbery in your yard, you will want to get your roof inspected. These items may have hit your roof during a storm, causing damage.
Visible Leaks or water spots: If you notice moisture or rings on your ceiling, you may be dealing with a damaged roof.

You must inspect your property after every storm. If you find signs of damage, take pictures immediately and mitigate the damage. Even minor signs of water damage can lead to big headaches for homeowners.

Check out your roof from the inside out to prevent missing signs of damage that can compound over time. Additionally, prepare for hurricane season by taking inventory of your personal property.

Six Reasons Why Your Roof Damage Claim Was Denied Or Underpaid By Your Insurance Company

When you file a homeowners insurance claim, you may envision roof repair or even a new room. Between wind and hail damage, you feel you have a solid claim.

But the truth is that not all insurance policies provide the same amount of coverage or exclusions. They also vary as to which situations warrant a new roof and which won’t get any coverage.

The insurance claim process is stressful, especially if your efforts end in denial. Your claim could have been rejected for a variety of reasons. Here are some common reasons why your homeowner’s insurance claim was denied or underpaid by your insurer.

1. Missed Insurance Claim Deadlines

Your homeowner’s insurance policy contains specific language about timelines and deadlines for filing a claim.

You must file a roof damage claim in a timely manner and replace or repair the property within 365 days of the date of damage. Your policy may also have deadlines written into the language you must follow for a successful claim.

This means you should request an inspection from an insurance adjuster and meet with a contractor of choice within one year.

So if you don’t request an extension in writing within this timeframe, you may find your claim denied.

2. Normal Wear And Tear

Modern roofing materials may be built to last, but everything wears out eventually. Your shingles may reach the end of their lifespan and no longer protect your home from the elements.

So even if you’ve recently bought a new house, the previous owner may not have done proper maintenance. This will cause your roof to degrade and become more susceptible to damage.

If your insurance adjuster sees that your roof damage stems from wear and tear, more so than the storm, your insurance provider will deny your claim.

3. A Manufacturer’s Defect

While manufacturers mainly offer high-quality products, sometimes defective items can make their way into the construction of your roof.

If the insurance adjuster determines that the manufacturer’s defects caused the roof issues, that means they aren’t responsible for covering the repair costs, which means your claim will be denied.

The good news is that many roofing products have a standard limited warranty, so you can check with them to see if the manufacturer can cover the damage.

4. Previous Or Partial Damage

As a Florida homeowner, you know that hurricanes, tropical storms, and other weather events are common occurrences. So if you missed damage from a previous storm, you might be out of luck.

Your home insurance claim will cover damage only from the most recent storm. So if the claims adjuster finds a combination of old and new damage, it may be why you received a denial letter.

If you were seeking a complete roof replacement and were denied, it’s possible that there wasn’t enough damage to warrant a new roof under the 25 percent rule.

While frustrating, denial for partial damage is actually one of the easier reasons to overturn.

5. Inaccurate Insurance Adjuster Interpretation

When you file a roof damage claim, an insurance adjuster will visit your property to inspect your roof. While these insurance professionals are working with your claim, it’s essential to know they are not professional roofers.

Their expertise is typically limited to the training provided by the insurance company, so while their intentions are good, it’s highly possible they misinterpreted the damage on your roof.

It’s always a good idea to have professional roofers or contractors inspect the damage and provide an estimate shortly after discovering the issue.

You should have your roofing contractor of choice on-site with the insurance adjuster at the same time to point out the damage and explain why the insurance company denied it. This will help paint a clear picture of why your roof damage was not approved and whether or not you have a case for an appeal.

Photo by Pixabay

6. The Damage Estimate Is Below Your Deductible

If your roof insurance claim comes back with no additional funds to cover repairs, it could be that they didn’t actually deny it.

Your home insurance policy sets a specific deductible, which is an amount of money you must pay out of pocket before your insurance benefits kick in.

So there is a possibility that the repair estimate came in below your deductible amount, meaning the insurance carrier expects the policyholder to foot the bill.

How To Appeal An Insurance Claim Denial

If you find your roof insurance claim denied, it doesn’t mean you’re out of luck.

Homeowners can file an appeal to reopen the claim and reevaluate whether or not their insurance policy covers their property damage.

Here are some tips you can use during the appeals process to ensure your denied claim is overturned.

Review your policy to ensure your insurance coverage applies to your property damage.
Request an appeal in writing and ask for a resolution date to reduce the length of the appeals process.
Hire an independent roofing company to come and give a second opinion on the damage and costs of repairing your roof.
Ask your insurance company to send an insurance adjuster to reevaluate the site. Have a roofing contractor or public adjuster on site as an unbiased third party.
Gather all documentation, including correspondence, photos, estimates, and any other information regarding your claim.
Mitigate the damage during the appeals process by ensuring no further damage occurs on your property.

Whether you choose to have a roofing professional or public adjuster on your property, you must have abundant evidence proving your claim warrants approval.

If another insurance adjuster denies your roof damage claim, your appeal will need to be brought to a claims manager. After that, the next step is to hire an attorney or file a complaint through your state.

Trust A Public Adjuster To Evaluate Your Roof Damage Claim

Your best weapon is knowledge if you’re facing a denied roof damage claim. The more you know about your insurance policy and the claims process, the more likely you will catch any discrepancies that lead to your denial.

Having an advocate on your side can make a world of difference. NeJame Claims Adjusters is a public adjusting firm that will advocate for you and assist with all the paperwork, management, and correspondence associated with overturning a denied roof claim.

Our public adjusters are former insurance adjusters, meaning they know the ins and outs of the claims process and will work diligently to get your insurance claims resolved.

Resources:

Facts + Statistics: Homeowners and renters insurance. (2022). In Insurance Information Institute . Retrieved from https://www.iii.org/fact-statistic/facts-statistics-homeowners-and-renters-insurance

How to prepare for hurricane season. (2022, June 3). In Insurance Information Institute . Retrieved from https://www.iii.org/article/preparing-hurricane

FAQs

Is hidden water damage covered in a homeowners insurance policy?

Depending on the nature of the damage, hidden water damage may or may not be covered by your insurance policy.

What is the typical cost of roof repair?

$1,000 is the average cost of roof repair, which ranges from $350-$2000, depending on the scope of the damage.

Should I hire a public adjuster?

Yes, hiring a public adjuster can help you navigate a homeowners insurance claim and often get you a larger settlement based on your policy.

6 Common Reasons Roof Claims Are Denied