What to Do if Insurance Denied Roof Claim | 4 Things To Do

What should I do if my insurance denied the roof claim? Many people ask this question today. Thus, we have made this post to aid them. After paying your home insurance premiums for years, one of the most frustrating things that can happen to a homeowner is experiencing damage to your roof, only to have your roof claim denied! Knowledge is your best weapon when combatting a roof claim denial. The highlights below will aid you in what to do if insurance gets denied roof claims. Come along!

Regarding your roof, home insurance policies include a limited number of causes that are grounds for replacement. However, not all policies provide the same level of coverage, and some insurance companies are more flexible than others when it comes to approving claims. Thus, it’s best to do your research and understand your policy before signing on the dotted line.

What to Do if Insurance Denied Roof Claim

What to Do if Insurance Denied Roof Claim

If insurance denied the roof claim, you could take the following steps:

1. Understand why your claim gets denied

Your insurance company will mail you a formal letter explaining their reason for denying your claim. Your claim gets dismissed if your insurance company does not send you a formal letter. This letter explains the specific language in your policy that justifies the claim denial.

Please read the letter carefully and compare their explanation to your understanding of your policy. If there is a legitimate reason for denying your claim, i.e., the premium didn’t get paid, or the type of loss gets explicitly excluded from your coverage, there is nothing more you can do.

However, if, after comparing their explanation to your understanding, you still believe your property damage should be covered, discuss your differing views immediately with your insurance company’s claims adjuster. You can also contact your agent if you have one.

Persuading a company adjuster to reverse a claim denial is not easy. Don’t give up if you can show where coverage gets promised in your homeowners’ insurance policy.

2. File an appeal

If you aren’t getting any satisfaction from explaining your position to your insurance company’s claims adjuster, you will need to file a formal appeal. You only have a limited amount of time to do this.

And the clock starts ticking when your claim gets denied. Your homeowners’ insurance policy outlines the appeals process you must follow.

Filing a formal appeal triggers a review of your denied claim. Include with your appeal as much evidence and documentation as you can to support the position that your damages should get covered. The more organized you present this information, the better your chances of getting more than a cursory review of your denied claim.

3. Consult property insurance claims professional

Seeking advice from a licensed public insurance adjuster is the most brilliant move a homeowner can make after suffering an insured property loss. This is valid, even if the claim has already gets denied.

A public adjuster can verify your coverage and document and value your losses. He can also negotiate the maximum settlement allowed under the terms of your homeowners’ insurance policy. The sooner you contact a public adjuster, the more they can do to help you recover.

Suppose you’ve already reached the point that you must use your insurance carrier and find a qualified attorney with expertise in property insurance claims. Be sure to get references that show a successful track record settling property insurance claims, not just an understanding of property law.

4. File a formal complaint

The insurance industry is exceedingly regulated, yet courts in every state get overrun with property claims disputes and bad faith lawsuits.

As a policyholder in good standing — that is, your premiums get paid — your insurance carrier is obligated to process your property claim fairly. This also gets based on its merit. If the treatment of your claim falls short of this minimum benchmark, you have the option to file a formal complaint with your state’s insurance commissioner.

Reasons Why Roof Claims get Denied by Insurance

What to Do if Insurance Denied Roof Claim

If your claim gets denied, it will very likely be for one of the following reasons:

1. Wear and Tear

While modern roofing materials last longer and can withstand harsher conditions, all materials will degrade over time. If you buy a house with 30-year-old composite shingles that begin leaking after a few years, those shingles may have reached the end of their lifespan.

This is especially true if the previous homeowner failed to do regular maintenance. Wear and tear happen. So, if you are buying a property with an older roof, be aware that natural degradation does not get covered under your home insurance policy.

And this should be factored into your budget or negotiated with the homeowner before purchase.    

2. Previous Damage

In many areas of the country, it’s unlikely to go 30 years without a storm that causes enough damage to warrant a roof replacement under a standard home insurance policy. However, remember that your home insurance policy will not cover damage that occurred under a previous policy.

Home insurance will only cover damage caused by the most recent event. So, if a combination of old and new damage is causing your roof system to fail, they may deny your claim. This will get based on the fact that previous damage is the primary source of the issue.  

3. Partial Damage

For insurance to approve a claim for a complete roof replacement, the Insurance Adjuster needs to determine that enough damage has occurred to the roofing system. It will also get established that a partial repair cannot restore the roof to its previous condition.

Unfortunately, the criterion for determining partial damage varies from insurance company to insurance company. And it ultimately can come down to the Insurance Adjuster who gets sent to inspect your roof. This can be one of the most frustrating scenarios for homeowners after a storm.

This is also valid when homes throughout your neighborhood get approved for roof replacements, but your insurance company has denied your claim. Because the determination for partial damage is arbitrary, partial damage is one of the most likely denials to be overturned.

4. Manufacturers Defects

While manufacturers will try their best to maintain quality control on their products, defective products sometimes come onto your roof. And this will degrade long before the intended life expectancy. If gets determined that a manufacturer defect is the cause of your roofing system failing, your home insurance provider is not responsible for replacement costs.

However, almost all major manufacturers of roofing products have a standard limited warranty provided with the purchase of their products. What that warranty covers depends on the specific manufacturer and your selected warranty.

So, speak to your roofing contractor about contracts with additional coverage before installation.    

5. Claims Filed Too Late

Most home insurance policies include language stating that a claim must be filed within a reasonable time. And damaged property must get replaced within 365 days from the time damage was incurred. If you fail to do so or notify your insurance company in writing before the 365 days expires, they will likely deny your claim.

Insurance inspections after suspected damage often come at no charge to the homeowner. So, avoiding a denial based on timeliness is often as simple as requesting a review and meeting with your Contractor of Choice.  

Frequently Asked Questions

Can I succeed if insurance denies my roof claim?

Yes. The above tips on what to do if insurance denies a roof claim would help you succeed.

How can I Avoid Having my Roof Insurance Claim Denied?

 Here are a few steps you can take to help avoid having your roof insurance claim denied:

1. Review your insurance coverage.

Understand how your insurance policy handles pre-existing damage and maintenance issues. Also, see what tactics they can use to deny your roof insurance claim.

Even after reading through your current policy, call your insurer directly to clarify your coverage if you aren’t sure.

2. Inspect your property regularly.

If you don’t know a potential problem or previously sustained loss, you can’t expect your insurance company to know—or to pay. Always check your properties with regularity.

3. Pay special attention to your roof.

It’s easy to miss small leaks or tears that can lead to significant damage.

Roof damage is the main reason for hurricane insurance claims, aside from damages caused by a storm surge. Hurricane winds can lift shingles, puncture roofing material, and even remove or shift the entire roof.

4. Take “before” photos.

Most people take “after” photos of hurricane damage when it happens. But “before” condition photos show that damages did not exist before the storm.

Take pictures or shoot a video of your home and property before storm season starts. Also, date the footage, and retain this documentation just in case it’s needed for an insurance claim. If you can add a date stamp on a newspaper to show the date the video gets created, it will only help further. Evidence will help you avoid having your roof insurance claim denied.

​6. Bring in a professional.

Roofing or repair professionals can help you inspect your home for hard-to-spot problems. They can also repair gaps and holes, secure loose roof shingles or siding, and even install precautions such as hurricane straps.

If you’ve already sustained damage from a hurricane, a professional can also help provide thorough assessments and estimates for insurance purposes.

It is significantly a wise choice to get the help of an insurance litigation lawyer to help you avoid having your roof insurance claim denied. Precautions provide peace of mind, but hurricanes and tropical storms can still wreak havoc on your home and cause damage.

What is the meaning of home insurance?

Homeowners insurance is a form of property insurance that covers losses and damages to an individual’s residence, along with furnishings and other assets in the home. Homeowners’ insurance also provides liability coverage against accidents in the house or on the property.

Conclusion

In conclusion, home insurance offers various merits. And if your roof has gotten damaged, the above tips will show you what to do to prevent an insurance denial.

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