Roof Insurance Claim Denied | The Insurance Company
Jul
23

Roof Insurance Claim Denied

We’ll cover the following topics in this blog post on Roof Insurance Claim Denied

  1. Why Do Insurers Deny Claims?
  2. How to Minimize the Chance of Denial
  3. Is the Claims Process Different for Commercial Buildings?
  4. How to Work With Adjusters to Achieve the Best Results
  5. What Do I Do If I’m Denied?
  6. Choose TEC for Your Roof Repair

 

A roof replacement is a considerable expense, which is why it’s critical to have homeowner’s insurance. However, it’s not uncommon for insured homeowners to have their roof claims rejected by insurance companies, and they have a number of valid reasons for doing so.

 

Read our guide to learn the most common reasons why roof claims are denied, how to deal with a claim denial and how to avoid rejection in the first place.

 

Why Do Insurers Deny Claims?


If your roof insurance claim is rejected, it is most likely because of one of the following reasons:

 

  • Lack of maintenance: Failing to perform routine maintenance on the roof is one of the most common mistakes homeowners make. It shows the claims adjuster that you could have prevented the damage but did not make the effort to do so. Examples include removing moss and debris, which will minimize the chances of mold and mildew growth, and cleaning the gutters, which prevents water from seeping into the roof and causing damage.
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  • A non-covered issue: Make an effort to understand what your plan does and does not cover. You don’t want to learn that your policy doesn’t cover earthquakes after an earthquake hits.
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  • Insufficient coverage: If you filed a claim for damages that exceed the limits of your coverage, the claim will most likely be rejected. For instance, if your policy’s home coverage has a $200,000 limit but your house will require $250,0000 to repair, your $250,000 damage claim will not be successful.
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  • Delay in filing: Another common reason for claim rejection is making a claim after too much time has passed. The majority of insurers have a statute of limitations regarding long how after the event you can file a claim.

 

How to Minimize the Chance of Denial

Avoid your claim getting denied by taking the following steps:

 

  • Carefully read the fine print: Take the time to understand which risks your home insurance policy covers and which it does not. Also, make sure to understand how much coverage your home insurance policy provides. Look over your policy twice a year or whenever you renovate your home. Confirm that any addition you build will be covered. If it isn’t covered, speak with your insurer and change your policy.
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  • Let your insurer know about any life event changes: Disclose major life events or changes to your insurer. For example, if you got married and your spouse moved in with you, let your insurer know.
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  • Make a home inventory list: Take inventory of all the possessions in your home and take photos of your home’s structure. By doing this, if you end up in a claims dispute, you can provide your insurer with before and after photos.
  • Research insurers before you choose one: When looking for homeowner’s insurance, do thorough research. Consider each company’s customer satisfaction reviews to get an idea of their reputation for claim approvals. A.M. Best, J.D. Power, Moody’s and the Better Business Bureau are great sites to find insurance company reviews.
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  • Increase your coverage: Sometimes insurers will deny your claim if your coverage is insufficient. Prevent this from happening by upping your coverage. Every time you renovate or build an addition onto your home, your home’s value will increase, so you will want a larger safety net. If you’re switching insurance companies, make sure to have your new policy in place before canceling your existing one so you won’t have a lapse in coverage.

 

What Is the Typical Claims Process and How Do I File?

To give you an idea of how to file a claim, we will use the example of filing a claim for a roof that was damaged by hail.

When a damaging storm passes through a neighborhood, many homeowners make the mistake of immediately contacting their insurer. However, doing this may not be advantageous if you haven’t gathered all the needed information to file a solid claim. If the insurer is dealing with a deluge of claims due to the storm, it is possible the company may try to downplay its claims and reject the claims of anyone unable to make a compelling case.

 

To make sure your hail damage claim is absolutely rock-solid, you must follow the steps below:

 

  1. Look closely at your roof: Once the storm has passed, go outside and inspect your roof’s condition. If it looks like there are impact marks from the hail, you must report the issue.
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  3. Contact a roofing expert: Before you file a claim, call your trusted roof specialist and describe the condition of your roof. Roof experts tend to have many years of experience inspecting hail damage and should know whether your situation calls for a claim. Try to have one visit as soon as possible, as you do not want to have too much time pass before you file your claim.
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  5. Explain the damage in great detail: Describe the full extent of the roof’s damage. Is the hail damage all over the roof or is it limited to a few places?
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  7. Arrange an inspection: If you’ve described your roof in vivid detail, the specialist will probably have a good idea of the extent of the damage and will know whether your roof will need to be replaced. If the specialist thinks the roof should be replaced, have a roof repair company send over a contractor to inspect your roof. Pick a time when you can be there.
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  9. Take photos and notes: Homeowners should always be involved when their roof is being inspected. By doing this, you can better understand the problem and will be in a better position to negotiate with the claims adjuster. During the inspection, ask the contractor all the questions you can think of and make note of all the important details that you observed and learn about. Also, take photos of all the damage.
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  11. Protect undamaged property: You are responsible for protecting undamaged property. This will be important when the claims adjuster arrives. They will take into account whether you’ve done all you can do to mitigate additional damage or whether you have allowed even more liability to be incurred. However, be sure to use common sense and refrain from any activity that could put your life or health in danger. Hold on to any receipts for supplies that you used to protect your property. These are a covered expense and you can add it to your claim.

 

Is the Claims Process Different for Commercial Buildings?

If you are filing a claim for a commercial building, keep in mind that commercial insurance policies are different in several ways:

  • There may be more than one insured party: Whereas the insured names on a residential policy are typically an individual or a married couple, commercial policies can have any number of listed parties. Make sure you know what and who is covered under the insurance policy.
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  • The policy usually includes multiple types of liability insurance: Whereas residential policies usually cover against premises liability, businesses typically require several other types of liability coverage.
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  • There may be different policies for different properties: If your business has multiple buildings, you may have different policies for each, especially if they have different uses.

 

How to Work With Adjusters to Achieve the Best Results

Once the inspection is finished and you’ve done all you safely can to protect your property from additional damage, you can get ready to work with your claims adjuster. Here’s the process:

  1. Review your policy: Although you’re going to want to call the insurance company as soon as you can, before that, you should make sure you know what your policy covers and what it doesn’t. Being familiar with your entitlements will make everything go much more efficiently. Make sure to go over Coverage, Deductible, Depreciation and Incidental Clauses. Once you know what you’re entitled to, you can move on to filing a claim.
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  3. Call your insurance company: Call your insurance company as soon as possible, even if it’s past business hours. Many companies have call centers that operate 24 hours a day. When making the call, provide your company with all the information you’ve gathered. The Exterior Company will work directly with the insurance company and will work 100% for what the insurance company is willing to pay for.
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  5. Connect with your contractor: Once the adjuster concludes that the claim is valid, he or she will begin assessing the extent of your damage. To make this easier, put the claims adjuster in contact with the contractor. Roofing contractors are accustomed to working with insurance claims and know exactly what they need and will be able to readily provide them with photos and documents.
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  7. Negotiate respectfully: The adjuster should be completely transparent about the settlement figure they arrive at and why they denied certain claim expenses. You are allowed to negotiate if you like, but be sure to do so respectfully and fairly. If you cannot reach a settlement, you’re also allowed to appeal the decision.
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  9. Approving work to receive payment: The adjuster will now have to authorize work to begin, so arrange a meeting with the adjuster, contractor and yourself to expedite the process.
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  11. Ask about payments: In the meeting, ask the adjuster how the payments will be disbursed. In insurance payments, two payments are usually issued.

 

What Do I Do If I’m Denied?

If the insurance company rejects the claim, don’t despair! You can still get your claim approved by appealing the decision and following these steps:

 

  1. Review your policy again: Look over every detail of your insurance policy and fully understand what your policy includes and what it excludes. Make sure you didn’t wrongly estimate your policy coverage amounts when originally filing the claim.
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  3. Review the claim denial letter: It may have been the adjuster who made the mistake.
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  5. Review all the documentation you gathered: Look over all of the photos you took and the receipts from the contractors you hired to do the repairs. These are all evidence of the damage. The more evidence you have, the more likely it is your claim will be approved.
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  7. Contact the adjuster about any discovered errors: If you’ve discovered an error made by the adjuster, speak with the adjuster and explain to them where they went wrong. Only speak about the points of your claim that were rejected, and provide all documentation related to the claim.
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  9. If unsuccessful, hire a public claims adjuster: Just as the insurance company has an adjuster who works for them, you too can have an adjuster who works for you. Public adjusters are able to appeal the decision with your insurance company to dispute the claim. An experienced public claims adjuster will be able to help with the denied claim process and handle all of the involved paperwork.

 

Here are some other options to consider if you are denied:

 

1. Hire a Denied Insurance Claim Attorney

Hiring a home insurance lawyer who is knowledgeable about property insurance is also an option.

 

2. Request a Re-Inspection

If you or the contractor feel that some damage on your roof was overlooked, you can request a re-inspection. The insurance company will typically send out a different adjuster and, in some cases, even a supervisor.

 

3. Get Financing for Your Roof Repairs

The Exterior Company also offers financing for your roof repairs. The process goes as follows:

  1. Contact the finance center: This will be done together with your project manager.
  2. Choose your program: There is a wide variety of options to choose from.
  3. Receive approval: Once you’re approved, we will email you loan documents right away.
  4. Return documents: Send us back your completed and signed documents.
  5. Take it easy: Kick back and enjoy your new roof!

 

Choose TEC for Your Roof Repair

Below are just some of the ways we work to make your roofing installation as efficient and hassle-free as possible:

  • Access to your house: Unlike a good number of home improvement projects, roofing installation almost always takes place outside the house, which means you don’t need to be present while we’re working.
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  • Scheduling: Roofing projects generally only require a day or two to complete, and we’ll do our best to find a time that’s convenient for you. We generally arrive around 7 am, which gives a greater chance of finishing by the end of the day.
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  • Greenery: While we do our best to avoid damaging plants and trees near the roof, in some cases there may be a chance of slight, unavoidable damage, in which case we will compensate you.
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  • Satellite dish: If your roof has a TV dish, chances are good we’ll need to remove and later reattach it. If you experience any connectivity or signal issues later on, contact your satellite provider to fix the issue and we’ll pay your bill.
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  • Cleanup: We always strive to leave properties in the same condition in which we found them. After finishing a project, we’ll thoroughly clean up our work area, which includes picking up any debris or excess roofing materials. We’ll also collect loose nails with a magnet.
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  • Final walkthrough: Our very last step is a walkthrough, where we closely inspect our work and make sure you are satisfied with the results.

 

To learn more about our roof installation process, call TEC at 855-766-3264 or fill out our online form.

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