You faithfully pay your insurance premiums month after month, year after year, knowing that when you need the coverage, it will be there for you. Then, a big storm blows through and damages your roof, and you call your insurance company for help, only to have your claim denied. It’s a frustrating situation, which is all the more challenging because you are attempting to navigate the process while your roof is leaking and your nerves are frazzled.
Let’s examine insurance denials for roof repairs to help you understand why they happen and what you can do about them.
Here are some of the common reasons insurance companies reject claims:
1. The Roof was Improperly Installed
If your roof was not installed properly, there may be damage that wouldn’t have occurred if your roofer had done everything correctly. Potential insurance problems are one of many reasons it’s critical that you work with an experienced, trustworthy roofing contractor. A cheap roofing company might cut corners, leaving you without insurance coverage if your roof is damaged.
2. There is No Damage
If the insurance adjuster doesn’t find any damage, there’s nothing for them to cover. You may have a leak inside your home, but if the adjuster can’t trace it back to a roof problem, they may deny your claim.
3. Your Attic is Inadequately Vented
Proper ventilation is part of a well-functioning roof system. Without adequate ventilation, your home can’t breathe properly. When your home can’t exhale moist, hot air, you can end up with mold, ice dams, and other issues with your roof. Your insurer may deny your claim if they find that insufficient ventilation led to your roof damage.
4. Your Roof is Outdated
Some insurers will exclude old roofs from their coverage. If your roof has already reached or exceeded its expected lifespan, your insurer won’t be anxious to cover it. Insurers know that damage or failure is far more likely on an old roof. Check your policy or speak with an insurance agent to see if your policy excludes or has a clause about the age of your roof.
5. Your Roof Materials Have a Manufacturing Flaw
Manufacturing errors occur, especially with cheaper roofing materials. A flaw in the materials may cause damage or failure. In that case, your insurer may decide the issue is between you and the manufacturer. You may need to work with your roofing contractor to access the manufacturer’s warranty.
6. The Damage Seems to Predate the Recent Storm
The adjuster who inspects your roof will not only look for damage but also try to determine when the damage occurred. If the issue is older, the company may claim that the damage is from before the start of your policy or may be from normal wear and tear rather than the recent storm.
7. Policy Exclusions Mean the Damage Isn’t Covered
Each insurance carrier has different coverage. Even within the same carrier, individual policy terms vary. That means that what may be covered by one policy may not be covered by another. Read through your policy to see what’s covered and what conditions or causes are exempt.
If Your Claim Is Denied
Unfortunately, for most denials caused by these reasons, there may not be much you can do. If damage isn’t covered, there is no way to get your insurance company to pay. However, there are a few things you can try after an initial denial.
Request a New Adjuster
Requesting a new adjuster is the equivalent of finding a new doctor to give you a second opinion. If you disagree with the initial adjuster’s findings, you have a right to request a new adjuster. A second set of eyes may help. Their findings could be different.
If the first adjuster claims to have found no damage or says that the damage was pre-existing, the second adjuster may have a different opinion. They may see something the first person missed or interpret the details differently, which could result in your claim being approved after the initial denial.
There’s no guarantee that a second adjuster’s finding will be more favorable than the first, but it may be worth trying to see if they deliver better news.
Accept that the Damage isn’t Covered
Whatever happened to your roof may not be covered under your policy. If this is the case, you won’t receive help from your insurer, no matter how long or well you argue. You’ll need to cover the repair or replacement expenses on your own.
If you don’t have the funds to pay for the necessary work and your insurer refuses to cover it, look for roofing companies that offer financing. Their payment plans can help you get your roof repaired or replaced immediately so you don’t have even more damage to your roof and home.
Hire a Structural Engineer
You can hire a structural engineer if you want to continue the fight to get your damage covered. They can perform a thorough inspection of your entire home. In some cases, they may discover something your insurer missed or misunderstood. However, you will have to pay for the engineer’s services, and there’s no guarantee that anything in their report will sway your insurer.
Seek Legal Advice
You can pursue legal avenues to fight your insurance company. If you are confident that your policy covers the damage and your insurer won’t budge, you might consider working with a lawyer specializing in insurance claims.
What About Your Roofing Contractor?
If you are fighting with your insurance company, your roofing contractor may be able to offer some help. Ultimately, whether the damage is covered is the insurance company’s call. Your roofer can provide information about the storm’s path or show similar damage to surrounding homes. This information can help prove that a damaging storm hit your property.
If you’ve had a recent roof inspection, your contractor can provide documentation showing your roof’s condition before the storm. The inspection report may help substantiate your claim that recent events caused the damage.
A roof expert can also pinpoint damage that an adjuster might have missed. You can share their findings with the second adjuster so they know where to look.
Your insurance company controls the final decision on your policy’s coverage. However, if you are fighting with them to get something covered, it’s worth contacting a roofing contractor for help. If you explain the reason for the initial denial, a roofing company may be able to help you provide additional information or language that gets your insurer to reconsider.
Roof insurance denials are incredibly frustrating. Don’t hesitate to push back if you feel insurance should cover your damage. Review your policy and exclusions, have the adjuster explain in detail why they denied your claim, and then determine your next steps.