After faithfully paying your home insurance premiums for years, one of the most infuriating things that can happen is discovering roof damage only to have your claim denied! Knowledge is your best weapon against a roof claim denial. Today, we’ll cover some common reasons home insurance claims are denied and explain how a savvy roofing company can help you not only get your claim approved but potentially increase your settlement by thousands of dollars in legitimate upgrades.

Reasons Why Roof Claims Are Denied By Insurance

Wear and Tear

While modern roofing materials last longer and endure harsher conditions, everything degrades over time. If your 30-year-old composite shingles start leaking, it’s likely they’ve reached the end of their lifespan, especially if the previous owner skipped regular maintenance. Wear and tear happen, and natural degradation isn’t covered by your home insurance. Factor this into your budget or negotiate with the seller if you’re buying an older home.

Previous Damage

It’s unlikely to go decades without a storm causing enough damage to warrant a roof replacement under a standard policy. However, your home insurance only covers damage from the most recent event, not old damage. If your roof’s failure is due to a mix of old and new damage, they might deny your claim, blaming previous damage.

Partial Damage

For insurance to approve a full roof replacement, the adjuster must determine enough damage has occurred that a partial repair won’t restore the roof. Unfortunately, this varies by insurance company and can depend on the adjuster. It’s frustrating when neighbors get approved for replacements, but your claim is denied. Since partial damage is subjective, it’s one of the most likely denials to be overturned.

Manufacturer’s Defect

Despite their best efforts, manufacturers occasionally produce defective products that degrade prematurely. If a manufacturer’s defect causes your roof to fail, your insurer isn’t responsible for replacement costs. However, major manufacturers typically offer limited warranties. Discuss additional coverage with your roofing contractor before installation.

Claims Filed Too Late

Most policies state a claim must be filed within a reasonable time, typically within 365 days of the damage. Fail to notify your insurer on time, and they’ll likely deny your claim. Avoid this by promptly requesting an inspection, often free of charge, and meeting with your chosen contractor.

Insurance Adjuster Interpretation

Insurance adjusters aren’t roofing experts. They might miss damage signs that could get your claim approved. Have your contractor present during the inspection to point out damage and explain why it should be covered before a denial occurs.

Appealing A Claim Denial

If your claim is denied, you can appeal. To avoid denial, have your contractor on-site for the inspection. The appeals process can be lengthy, so it’s in your best interest to prevent a denial in the first place. If denied, learn the appeal time limit from your insurer and appeal in writing. Often, another adjuster will be sent for a second opinion. Have an experienced contractor or public adjuster (at your expense) present to provide unbiased representation and compile evidence. If denied again, elevate to a claims manager, file a state complaint, or hire an attorney.

Understanding Roofing & Building Code

Hiring an experienced roofing contractor is crucial not only for getting your claim approved but also for maximizing its value. Insurance policies covering code upgrades can add thousands of dollars in protective and energy-efficient improvements. A knowledgeable contractor will ensure these upgrades aren’t overlooked. Also, roof damage often affects your home’s interior, which can be covered if the exterior claim is approved. An experienced contractor will inspect and coordinate repairs for both interior and exterior damage.

Get Your Claim Approved With A Knowledgeable Roofing Contractor

Knowledge is your best defense against a claim denial. An experienced roofing contractor will guide you through the entire process, from filing a claim to the final inspection, helping you get the most value from your home insurance policy. Choose a professional contractor who will stand by your side and navigate the complexities of insurance claims for you.

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