What To Do if Insurance Denied Roof Claim?

It’s difficult enough trying to get your storm-damaged roof repaired through the insurance process. But when your claim is rejected, the stress level increases.

Unfortunately, I frequently witness this. Homeowners are left with more questions than answers when it does occur.

Just be aware that a first denial does not necessarily signal the end of the case. What options do you have if the insurance provider rejects your roof claim?

The staff at Bill Ragan Roofing has been open and honest with homeowners about the difficult and drawn-out insurance procedure for more than 30 years. As a result, I want to assist you comprehend your alternatives if your insurance company rejects a claim for roof damage.

The following are covered in his article:

  • The reason for your insurance claim being rejected.
  • If insurance rejects your roof claim, what can you do?
  • Can a roofing contractor do anything to help your claim be approved?
  • The reason for your insurance claim being rejected.

Let’s examine the reasons why your roof damage claim was initially rejected before moving on to what you can do. Unfortunately, there are a number of reasons why the insurance company can reject your claim.

The Insurance Claim Procedure for Roof Damage

Roof damage insurance claims are not always straightforward. There are various persons involved in the approval process when you submit a claim.

Most insurance claims involve a homeowner as well as an insurance adjuster, who is effectively an agent for the insurance provider. This person participates in decision-making and ultimately writes the cheque. Expert roof repair companies are the third party in the procedure. These are the individuals that will examine the harm and repair your roof.

You should thoroughly examine your homeowner’s insurance policy before contacting your insurance provider. If you think the damage should be covered, contact nearby roof repair professionals to assess the situation. An accurate quote can be obtained from a reliable roof repair contractor. The best course of action may be to file a roof damage insurance claim if the estimate exceeds the amount of your deductible.

Your insurance provider will set up an appointment for an insurance adjuster to visit your house and evaluate the damage as soon as you contact them about the damage. Even if you have a contractor, the insurance company will want to evaluate the damage themselves.

a seriously damaged roof that will require the assistance of roof repair specialists in order to be fixed while the homeowners wait for the approval of their roof damage insurance claim.

Within a few days of the insurance adjuster determining the extent of the damage, you ought to get a homeowner summary of damages.

You should also get your first payment if the roof damage insurance claim is granted. This first payment will only cover half of what is required to replace or repair the roof as needed. The deductible that the homeowner agreed to pay when the insurance policy was first bought will also need to be paid by the homeowner. You will be given a specific length of time to complete the required roof repairs after the roof claim has been approved.

The insurance provider will demand proof that the funds were used for the roof repairs or replacement after the work is finished.

The homeowner will get a second cheque to cover any outstanding expenses that the first check did not cover after analysing this information. The second check should be used to complete the job’s payment. At this stage of the roof damage insurance claim procedure, the homeowner ought to have a new or repaired roof, and the qualified roof repair contractors ought to receive full payment for their work.

Why Are Claims Denied?

Making an insurance claim is not always easy. When you submit a claim for roof damage, a few persons are involved in deciding whether to approve or deny it.

Most claims involve you, the homeowner, as well as an adjuster, who is essentially an agent for the insurance company. This individual will essentially assist in making the final decision and, if they so choose, write you a check to cover the cost of the repairs. The expert roofing contractor who will examine the damage and repair your roof is the third party.

But approval is far from guaranteed. Numerous insurance contracts contain stringent clauses and unexpected exclusions. This is why it’s crucial to study your policy in its entirety before attempting to submit a claim.

In fact, not all types of roof damage fall within the tight insurance policy coverage requirements. Here are a some of the most frequent justifications for claim denials:

  • Roof repairs are less expensive than the deductible.
  • When it comes to hail or wind claims, the company has a different deductible.
  • Damage brought on by earthquakes, wildfires, or other specific sources is not covered.
  • Inadequate maintenance was found to be the cause of the damage.
  • The roof’s lifespan has already been attained or surpassed.
  • There has already been prior harm done to the roof.
  • A manufacturer’s flaw was found to be the cause of the damage.
  • It is too late to file your claim.
  • The adjuster decides that because the damage to the roof is only partial, a full replacement is not necessary.
  • In the end, how an insurance claim is approved depends on how the insurance adjuster interprets the damages. It’s crucial to realise that insurance adjusters are not trained roofers, though. Their knowledge is hence typically restricted to the instruction they receive from the insurance company. Even a sincere and well-meaning adjuster may fail to see roof damage, which could result in the denial of your claim.

For this reason, it’s advisable to always have a dependable roofing contractor meet your adjuster on-site for the duration of the inspection.

By doing this, they can identify harm and argue for its coverage before it is rejected. State regulations compel insurance companies to set up a fair appeals procedure that allows homeowners a chance to present their case, even if your claim is rejected.

Insurers frequently reject roof damage claims for the reasons listed below:

  • Nothing was damaged.
  • incorrectly installing a roof
  • inadequate ventilation in the attic
  • manufacturing flaw
  • You submitted your Policy exclusions too late.
  • When your policy first began, the roof was outdated.
  • An earlier storm caused damage to your roof.

Unfortunately, for the majority of these causes, there is little you can do. However, your insurance provider must provide a justification for the claim denial.

If the insurance provider rejects your roof claim, what can you do?

Let’s discuss your alternatives if your initial claim is rejected after discovering the reason why. You have no control over the majority of the reasons, so keep that in mind.

However, if you’re adamant that your roof has storm damage and your claim is rejected because the adjuster claims they didn’t locate any or enough damage, you can double and even quadruple check your roof.

Requesting another adjuster

The simplest approach to obtain a second opinion from a fresh set of eyes is to request that your insurance provider send out a different adjuster. Sadly, I observe that some insurance firms refuse to send homeowners a second adjuster.

Just be aware that you have the right to a second adjuster. Following their examination, they will either accept your claim or concur with the initial adjuster that it lacks merit.

Contacting a structural engineer

After the second adjuster denies your claim, if you’re still convinced there is roof damage and want to pursue it, you can speak with a structural engineer. They will conduct an examination and provide the insurance provider with documentation proving that the roof must be replaced due to structural issues.

It is only advised to do this if the insurance adjusters are irrational and only seldom done. Even this may still go wrong, though.

You’ll either have to take the risk or explore legal options that we aren’t qualified to discuss.

Can a roofing contractor do anything to help your claim be approved?

When there are issues with their claim being granted, the majority of homeowners turn to their roofing contractor. I’ve therefore had numerous inquiries over the years questioning “Why is my claim being refused if you indicated I had roof damage?”

The truth is that whether or not the claim is granted is entirely out of your roofing contractor’s control. The insurance adjuster will have the last say on whether to accept or reject your claim, but they can search for and record any indicators of storm damage.

The insurance adjuster is the only person who may advance the approval procedure, even if the roofing contractor is satisfied that you require a new roof due to storm damage. However, this does not imply that your roofing contractor is ineffective at this time.

A roofing contractor with insurance experience will battle to guarantee that your policy is followed if you employ them. To prove that your residence was in the storm’s path, they provide documentation or retrieve hail/wind maps.

However, after your claim is accepted, the battle for you typically doesn’t end. Additionally, they will add to your insurance claim to make sure your roof receives all the support it need.

A roofing contractor is ultimately your advisor and partner during the insurance claim procedure. Finding a professional you can trust and who has experience is vital.


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