Was your roof damaged after a recent storm? Was your claim denied, or are you just wondering what happens if it does?
Getting a roof damage claim denied can seem like a slap in the face after paying premiums for so many years. There are legitimate reasons to deny claims, but sometimes they’re wrong.
Fortunately, you have options if insurance initially denies your claim.
For over 30 years, the team at Bill Ragan Roofing has been transparent with homeowners about the confusing and long insurance process. Because of this, I want to help you understand what you can do when insurance denies a roof damage claim.
By the end of this article, you’ll have the answers to the following questions:
An insurance company can deny your roof damage claim for many reasons. While most denials are for one reason or another, it’s always possible for there to be multiple issues with a single roof.
Let’s look at the common reasons why insurance companies deny roof damage claims.
The most obvious way insurance denies roof damage insurance claims is because there isn’t noticeable damage. If there isn’t damage, then there’s simply no viable claim.
Just keep in mind that insurance adjusters aren’t roofing experts, so there’s room for missed signs or mistakes. So, having your trusted roofing contractor for the adjuster inspection is always a good idea.
Depending on your insurance company, you usually have 1 year (some allow up to 2) after the storm to file a claim for roof damage. So, it’s an easy denial if you wait too long to start the claim process.
You’ll need to look at your insurance policy and paperwork to learn how long you have. You may think there’s no way for insurance companies to track this, but they have access to things that tell them when and where a storm hit (more on this next).
Insurance companies have access to wind and hail maps to determine when a storm hit a given area. Let’s say you didn’t know you had damage after a storm in the past but think it was impacted after the most recent storm.
They’ll come out and determine if your roof has damage, but they’ll also check timelines and storm paths. If your home wasn’t in the impact zone of the most recent storm, they can deny your claim by saying it was existing damage from a previous storm.
Your insurance policy determines what’s covered and the payout from the insurance company if a claim is approved. While not as common, a roof damage claim can be denied due to policy exclusions.
This could be because a certain type of damage is excluded or limited. However, it’s also possible for the roof to lose coverage completely if the insurance company isn’t happy with the shape it’s in.
Two of the biggest reasons a roof damage claim is denied improper roof installation and inadequate attic ventilation. They simply won’t approve a claim on a roof that wasn't done correctly and destined for premature failure.
Even worse, the insurance company could pull coverage until you replace the roof out of pocket.
This is probably the least common reason, but it’s still possible for a roof damage claim to be denied because of defective materials. Fortunately, you still may be able to get the roof taken care of if material warranties are still in effect.
However, this depends on the manufacturer, specific defect, warranty length, and if a certified roofer installed it.
If insurance denies your roof damage claim, you should get an explanation why. Many denials are legitimate, especially for improper installation, defective materials, and waiting too long to file.
However, you still have options if you were denied because the adjuster didn’t find any or enough damage to approve the claim. Just know this doesn’t guarantee approval, but it will give you a second and possibly a third opinion if you’re adamant there’s roof damage.
If your insurance claim is denied, the first thing to do is ask for a different adjuster to get a second opinion with a new pair of eyes. Maybe the first one was having a bad day or didn’t have the right experience.
No matter the reason, getting a second adjuster will give you confirmation of whether or not there’s damage. After the second inspection, they'll approve the claim or agree with the first adjuster that there’s no basis for a claim.
Some insurance companies deny homeowners a second adjuster, but just know it’s your right to request one.
If the second adjuster also denies the claim, you can reach out to a structural engineer if you want to continue pursuing a claim. They’ll do an inspection and offer proof (if there is any) to the insurance company that the roof must be replaced because of structural problems.
This is done on very rare occasions and is only recommended if insurance adjusters are unreasonable. On top of this, there’s no guarantee it’ll be approved.
If it isn't approved, you’ll accept the denial or go to your area’s Commissioner of Insurance. However, I am not qualified to touch on this outside of our local service areas.
While approval is completely out of their hands, a roofing contractor plays a crucial role in the claim process. Their main role is to guide you and provide crucial information you need during the insurance claim process.
This includes inspecting your roof, documenting signs of storm damage, and attending the adjuster meeting to answer any questions. However, their role doesn’t stop after the claim is approved.
They’ll also help supplement your insurance claim and know how to follow the process correctly to avoid common scams/fraud attempts. A roofing contractor is your partner through the insurance claim process, so it’s crucial to find one with experience that you trust.
Now you know why insurance companies deny insurance claims, what you can do about it, and what the roofer’s role looks like. The insurance adjuster has all the power to approve your claim, but hiring a roofer with insurance experience will help you fight if there’s viable damage.
You may think you’re ready to move forward, but you probably have more questions. There may even be things you don’t know to ask but need the answers to.
Unfortunately, moving further into the insurance claim process is full of confusion. That’s why I wrote another article that answers the top insurance-related questions homeowners have about getting a new roof through insurance.
Check out The Top 9 Insurance Roof Replacement Questions Answered to learn the answers to the most frequently asked insurance questions by homeowners.