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 Insurance Insights

Why Are Roof Claims Denied?

4/19/2023

 
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​Typically, your homeowners insurance policy covers certain perils that cause roof damage.  However, there are factors that are NOT covered, including the following:
​Wear and Tear: Homeowners are expected to properly maintain their roofs over time.  Even when that is done, natural roof ageing and degradation is not covered, and you should put funds aside over time to anticipate the cost of roof replacement.
 
Previous Damage:  Your policy covers damage by a recent occurrence, not a previous one that happened under a previous owner and policy.
 
Partial Damage:  Depending on the extent of the damage, it may be determined that a full roof replacement isn't warranted.  Criteria to determine this can vary from one insurer to another, and can also come down to the adjuster's interpretation of the damage.
 
Manufacturers Defect:  Sometimes a manufacturer's defect in its materials causes a roof to degrade unusually fast.  In this case, responsibility lies with the manufacturer, not the insurance company to resolve this issue.  If you're having your roof repaired or replaced, check with your roofer prior to installation to understand the extent of the roofing product warranty.
 
Unskilled Roofing Contractor:  Roofing is a highly specialized skill, and it's critical that you choose a contractor who will not only do the work correctly but will be around to honor their warranty if something should happen.  For these reasons, exercise caution in hiring an out-of-town contractor.
 
Claims Filed Too Late:  Most homeowners insurance policies include a clause about the timeline in which a claim must be filed. If you don't file a claim within that time frame, the company is likely to deny the claim.
 
Insurance Adjuster Interpretation: Insurance adjusters are likely trained by the insurance company, so they can miss signs of damage because they do not have professional roofing skills. If you feel the adjuster's recommendation is incorrect, request that the adjuster inspect your roof with an experienced and reputable roofing contractor so he can point out any damage the adjuster may have missed.
 
Exclusions:  Because coverage varies from policy to policy, work with your insurance agent to understand what is covered and what is excluded.  If they exclude wind and hail and you want those incidents covered, you'll need to add a rider to include those options.

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    Dennis Lam

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