Hail Damage Claim Denied


#1

It is my opinion that our customer has a legitimate hail damage claim; however, the insurance company has regrettably denied the claim.

To be honest the roof is approaching the expected lifetime (approximately 20yr), however, I firmly believe that hail damage has lessened the remaining life of the three-tab asphalt shingle. Another factor working against the claim is the poor ventilation issue that is also evident.

However, I provided the adjustor with the following NOAA Satellite and Information Services Reports of hail events dating: 1.75" on July 28, 1996, 1.75" on August 26, 1996 and 1.00" on September 22, 2006. All of these events are documented at this very LAT/LON and they still discount this claim.

The report claims: “Minor dents and dings in metal caps of the roof vents may be attributed to past hail events, however, the size of the dents and dings are inconsistent with the reported events and the location of some of the damage is at an angle that would make hail impact improbable.”

How should does one proceed with a standoff like this? Your advice is greatly appreciated. Please advise.


#2

Well if the roofs life is over, poor ventilation is present and no visible damage on the vents like you have described of. I can understand why the claim has been deined. If the life of the roof is gone and it was not installed correctly like you say then yes it will be deined. They look at it like you want a free roof. This happens 99% of the time with your condition. So do not take it personally.


#3

Do you have pictures of what you think are the hail bruises on the roof? If so can you link them here?

It doesn’t matter if the roof is old, installed incorrectly or whatever. The roof was previously insured prior to the storm and using those conditions for denial of a claim are outside of the policy language and are not considered exclusions to coverage in the actual policy language. Therefor the adjuster just can’t decide not to cover a claim based on those reasons.

However, what you need to show is fresh bruises or fractures that expose the bitumen mat, which should still be relatively “BLACK” in color as it’s not had time to oxidize.


#4

I just disagree. If the roof was shot before the storm it becomes pro rated at that point. If it is at the end of the life cycle they dont have to pay squat. Atleast that is what i have seen in the last 14 years. But hey what do i know.


#5

gtp1003, what you’ve seen is an insurance company taking advantage of some one who never took the time to read and understand thier home owners policy. Again it does not matter if the roof is considered old, or shot. The policy says they owe for direct phsyical damage. So even if the shingles are old and brittle and breaking apart, and the hail caused even more breakage it’s phsyical damage. The roof should be paid for becuase there is no realistic repairability factor. And no wise roofer would agree to replace this or that hail damaged shingle on a roof in this condition.

Remember the insurance policy is a contract with specific terminology. No one should let emotions, opinion,or moral crisis dicate the terms of the policy. Otherwise the policy holder is making the decision for the isnurance company and paying premiums for coverage they are really owed for. So in essence the policy holder is screwing themselves. I’ve told many home owners who “FEEL” they are taking advantage of thier insurance company by asking them to replace thier roof, to look at it from a contractual perspective. No one is going to “MAKE” the insurance company pay if it’s not actually damaged, so there’s no reason to feel any moral remorse for filing a claim.

PS: Insurance companies have lines thier pockets with money on the ingnorance of their customers.


#6

I agree with what you have said. Im just stating from what i have seen out here. Kinda like when part of it blows off from wind they will only pay for a repair. Maybe i just dont have alot of luck with insurance companies but my hands are tied for the most part.


#7

The key to getting what you feel is right when dealing with an adjuster is knowing what the policy actually says, and having the last word. = )


#8

Thank you all for your input. Please review the Southerly Plane photo provided. Keep in mind that there is a mixture of heat related damage and hail damage.

There are impact craters that appear to vary from dime to quarter size. I hope you can get some idea from the photo provided. Keep in mind that the damage is isolated to the South plane of the home. The North plane does not show any of the same signs displayed on the South plain photo provided. By the way the home owner does have a full replacement coverage policy.

 http://www.roofing.com/images/topics/5447/100_0880.JPG

#9

To me it looks like heat damage. But i dont get alot of storms like that around here. Blistering is from heat.


#10

There is nothing that looks like hail damage in that photo. Looks like blistering from excessive heat. Sorry


#11

By the pic it looks like pitting which is not hail related. What you need to do is section off a 10 by 10 foot section and find as many puck marks as possible on 2-3 slopes. When I say puck marks I mean areas were the shingles aren’t damaged to the base but areas that look more like bruises. The 1sq standard of hail marks varies by insurance company from 5-17.

Most adjusters from the South would say those marks are hail here in MN and aprove the roof for full replacement.

Been working mostly hail and wind jobs for the past year and have learned that 99% of the time the insurance company will pay 100% of the roof if a cause is found. The insurance companies all pay different and most will pay more if you submit a detailed estimate.

What your customer may need to do is call the agent and ask for another adjuster. Even adjusters say to ask for another adjuster if you’re claim is denied. It costs you nothing and sooner or later you’ll find a nice adjuster who wants to see a new roof on your house.

The best adjusters give you the chaulk and digital camera and call you with addresses!!!


#12

Thank you for your input. I was under the impression that there was a combination of heat related damage and hail damage.

I should have marked the suspect hail impact points prior to taking the photo. However, I believe your evaluation is accurate. Thank you again for all of your expert advice. It is all greatly valued and appreciated.


#13

valley.guy where you loctaed? It simply looks to me like the typical asphalt shingle.
If you are up north it prolly is.
Someone disguised junk as quality on you.
But that is what has been installed for years. No one really knew the dif, except the manufacturers…
I say this because most of my O/C “Classic” jobs from 1990, '91, '92 are still there.
The organic Globes, C-T, Horizons - the “Quality” shingles are a long time gone. Especially if they were installed from the mid 90’s on.
Looked at a 30-yr organic Independence I installed in 1994. 13 yrs. old and going, going…


#14

What GTP said.


#15

Here is some information from the “Insurance Information Institute” that may help. But, IMO, that pitting shown is due to old age and a lack of proper ventilation.

Ed

HOMEOWNERS INSURANCE INFORMATION

How is the settlement amount determined?

The settlement amount depends on which type of policy you have. Having inadequate insurance can affect the amount of compensation you get.

Replacement Cost and Actual Cash Value
Replacement cost provides you with the dollar amount needed to replace a damaged item with one of similar kind and quality without deducting for depreciationâ€â€


#16

Ed, while all of that is good information & stuff the typical homeowner might not be aware of (& consequently might be well served to know), there isn’t anything you posted that will affect or change our opinion on whether or not that’s a hail damaged roof.

Oh, & “What Tar Monkey Said”…


#17

Most homeowners, contractors and adjusters are not aware of this statement that was contained in the script from the “Insurance Information Institute”.

Replacement cost provides you with the dollar amount needed to replace a damaged item with one of similar kind and quality without deducting for depreciationâ€â€


#18

IMO, natural aging & improper ventilation.