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How Roofing Insurance Claims Work: A Comprehensive Guide

Many people only read their insurance fine print once it's time to file for a claim. And even then, they need help knowing how to undertake the claim process. Today we will discuss how claims work for one of the most affected parts of a home, the roof.

From understanding the policy coverage to gathering the necessary documentation and negotiating with the insurance company, this blog post covers all the critical aspects of the roofing insurance claims process. We will help you to learn how to protect your home and finances and ensure a successful outcome for your insurance claim.

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Understanding Roofing Insurance Claims: How Does Insurance Work For A Roof?

Roof Insurance: Meaning

Roof insurance is a type of property insurance that covers the roof of a building against damage from various causes, such as natural disasters, fire, theft, and other covered events. Its purpose is to protect the homeowner from the costs of repairing or replacing a damaged roof. In some cases, your roof insurance scheme may cover damage to other parts of the home that occurs as a result of a covered event involving the roof.

The specificity of the term’ roof insurance’ may make it seem like a separate, special insurance policy, but it’s not. Roof insurance is in your homeowner’s policy, but remember that the coverage is not the same in all policies.

Replacement Cost Vs. Actual Cash Value

Roofing insurance coverage typically falls into these two categories: Replacement Cost vs. Actual Cash Value (ACV). 

In Actual Cash Value insurance, the amount your insurance company pays you depends on your roof’s age. To calculate ACV, the insurer will consider the type of roof you have, its age, and the average lifespan of that type of roof. For example, if your roof has a lifespan of 18 years and your roof was nine years old at the time of damage, then the Actual Cash Value is 50% of the original value of the roof since it only had 50% of its lifetime left at the time of loss. 

For replacement Cost roof coverage, your insurer will pay out the full amount required to restore your roof to a pre-damage state, regardless of how old it was at the time of damage. 

The kind of roof insurance policy you have will determine your roofing insurance cost – Premiums for replacement cost policies are generally higher than premiums for actual cash value policies.

Roofing Insurance Claim Process

From the point of view of a person filing a roof insurance claim for the first time, the claim process can seem daunting and confusing. This lack of clarity and fear of increased premiums keeps some homeowners from filing claims after roof damage. 

We’re here to tell you that you shouldn’t fear filing a claim; after all, you paid for the coverage, and in the end, only about 1% of all potential claims actually get filed. Near the end of this article, we’ll give you some tips to help you know when you should file a claim. 

A damaged roof not repaired promptly can lead to more damage in other parts of the home. For this reason, insurance companies will be happy to replace your roof in order to prevent future claims. 

We’ve outlined the following steps to help you navigate the roof replacement insurance process:

1. Document damage ASAP

Immediately after you notice damage to your roof, be quick to document it in the form of time-stamped images. These images will work as supporting documents when filing your claim.

2. Find A Good Roofing Contractor

When you notice roof damage after a bad weather event or from another cause, your first course of action should be to get in touch with a local contractor with a good track record and reputation in your area. Avoid the storm-chasing contractors that come knocking on your door right after harsh weather, promising low-cost fixes. They’ll likely leave you out of money and with a poorly done roof. 

3. Get Your Roof Inspected And Damage Documented

Once you get a good contractor, invite them to inspect your roof damage. An established and experienced contractor will do a thorough inspection, documenting all the damage they can find. They will also be able to give rough estimates on the cost of repairs. 

However, remember that almost every state prohibits your roofing contractor from negotiating or handling your insurance claim. If you need assistance in the claim process, you’ll need to solicit the services of a licensed public adjuster or an attorney, as these are the only professionals allowed to adjust claims in most states.

4. Get Temporary Fixes Done

You probably don’t want to live with a hole in your roof as your insurance claim is being processed. If needed, your contractor can perform minor repairs to prevent additional imminent damage as you wait for the roof replacement approval. 

5. Review Your Insurance Policy, Then File A Claim

At this point, you should review the terms of your homeowner’s policy to determine how your roof coverage is structured. Do you have ACV coverage or replacement cost coverage? What protection does your policy offer on Wind/Hail damage? You should call your insurance provider to clear up any gray areas. 

Once everything is clear, you can proceed to file your claim. 

What do you say when filing a roof claim?

When filing a roof claim, you need to include vital information such as the date of damage, type of roof, etc. Your insurance provider will provide you or your contractor with a roofing insurance questionnaire where you will fill in details about the repair work to be done. These details include the type and cost of materials to be used, the amount of labor required, health and safety precautions, and much more. 

6. Schedule a Visit By A Roofing Insurance Adjuster

After contacting your insurance provider and furnishing them with details of your claim, they will send an adjuster to your premises. The adjuster’s work is to investigate an insurance claim to determine if and how much the insurer should pay for the damage.

Having your contractor present during the adjuster’s visit to your home is good practice. The contractor can provide detailed documentation and help to answer any questions the adjuster may ask. 

Pro tip: Courtesy goes a long way when interacting with an insurance adjuster. Even in disagreement, being kind can only help to make them see your side of the matter. 

What do insurance adjusters look for on roofs?

The adjuster will start by asking you some questions to gather essential info about the damage – When did it occur? Has inspection been done?…

Next, they will check the exterior of the buildings on the property. Afterward, the adjuster will take a look at collateral items. These include fences, patios, decks, walkways, patio unique, and window scenes. If you have more than one building on the property, they will look at each roof. They will be taking many photos to document damaged and undamaged areas to be used as support for any future decisions, whether it’s a denial or exclusion of coverage of specific areas.

After the adjuster finishes the inspection, they will explain their findings. If it is a staff adjuster rather than an adjuster subcontracted by the insurance company, they may even tell you the decision right then and there. They may even write you a check, which will be the first of two cheques. A subcontracted adjuster will likely have to submit the findings to the insurance company, where a claims manager will handle the decision-making.  

Remember to take notes and ask questions!

7. Review of the claim: Finetune the details and negotiate 

If your claim is approved, you will receive a claim document/loss sheet via mail, email, or in your online insurance account.

Your insurance claim estimate will likely be lower than your roofing contractor’s estimate. Remember that this claim document is just an estimate, the adjuster’s best guess at what it will cost to restore your roof to its pre-damage condition. 

When you receive a claim estimate lower than your contractor’s estimate, you should sit down with the contractor to discuss what needs to be added to the claim. Your contractor should then gather all supporting documentation and send it to the insurance company as evidence of why the estimate should be increased. The request for additional line items or increased payout is known as roofing insurance supplements, which we will discuss below. 

Overhead and profit is another line item that the contractor might need to request if needed and if it wasn’t originally included. 

8. The claim is finalized, and the estimate is issued

Once you are satisfied with the claim estimate you receive from your insurance company, the insurance company will write you a check so you can commence your repairs. 

The insurance company will usually issue your roof insurance payout in two phases. The first cheque will be of an amount close to the Actual ash Value of your roof. Once repairs are complete, you will receive the second check for the remaining amount. 

If your house is under a mortgage, the cheques will be made out to you and the lender to protect the lender’s interest in your house.

9. Have the Roof Damage Fixed

Now that the insurance company is out of the picture, you need to sit down with your contractor to decide on the scope of work and the completion time frame. Once these are agreed upon, materials can be ordered, and work can commence. 

Roofing Insurance Supplements

As discussed above, if the difference between the roofing contractor’s estimate and the insurance claim estimate is deemed significant, it may be necessary to ask for supplements from the insurance company.

What is an insurance supplement in roofing?

A roofing insurance supplement or insurance supplement for contractors is a request from a homeowner or contractor to the insurance company to revise the roof insurance damage claim to include more line items, a bigger scope of work, or higher pay on specific line items. It is also known as a contractor supplement. When supplementing insurance claims, you may be provided with a roofing insurance supplement form to fill.

What is a supplement estimate?

A supplement estimate is an estimate that the contractor comes up with after including the suggested line items in the original insurance claim estimate that the insurance company provided. 

Overhead and Profit

Overhead and profit is a line item in roofing damage insurance claims that helps to ensure the contractor can cover their operating/overhead costs and takes home profit at the end of the job. 

A roofing contractor’s pay for a job usually breaks down like this:

In general, from the money a contractor earns on a job, overhead, and profit account for 10% each. This is why roofing insurance claims set the value of ‘Overhead and Profit’ at 20%. 

However, despite this line item being included in most roofing insurance claim forms, it is not always paid. Some reasons why insurance companies give for not paying overhead and profit: 

  1. It’s only one trade. Some insurance companies argue that roofing repairs only call for one trade, which is roofing; hence, there is no need to pay for overhead costs. Many insurers require at least three trades to pay overhead and profit. 
  2. Not complex enough. Sometimes the insurance company may say that the job is not complex enough to require a general contractor, and therefore there is no need to pay for overhead and profit. 
  3. Roofing doesn’t count. Sometimes roofing jobs are just excluded from receiving overhead and profit. 

Should I Make A Claim On My Roof?

Reasons why you may want to file a claim

  • To protect your claim record
  • It’s expensive to file a claim – you have to pay your deductible out of pocket.

Hee ae some ips to help you decide if you should file an insurance claim on your roof:

NB: Consider some, most, or all of them together in order to make a decision. Don’t hinge on just one. 

Is there visible damage to other parts of your home?

If other exterior parts apart from the roof, such as siding and windows, are damaged, it’s likely that your roof is damaged and you should probably file a claim. Additionally, this damage will be seen by the adjuster.

What is your coverage?

Do you have Actual Cash Value (ACV) or Replacement Cost coverage? If you have ACV coverage, are you prepared to pay out of pocket? If the policy literature is too confusing, call your agent for clarification. 

Know your deductible

This is also about knowing the details of your policy. If you have a high deductible, are you able to afford it at that moment? If the policy literature is too confusing, call your agent for clarification. 

Do you have other claims on your record?

Your insurer keeps a record of your claim history. This record is called the CLUE report and goes back around five years. If you have had multiple claims in the past, you can consider not filing a claim if it is not necessary. However, sometimes filing a claim is unavoidable. Just be careful not to get too many ‘strikes’ on your claim record as it can have negative effects such as:

  • Causing your insurance rates to be raised
  • Make it hard to open an account with a different new insurer

If you have too many claims, the insurance company can also cut ties with you if they consider you too big of a liability. Even after decades of not claiming, a few claims in a short time span can motivate them to cancel your policy. 

Is this your ‘forever’ home?

If the house you’re living in is a temporary home, say you’re looking to sell it soon, then it’s probably necessary to file a roof damage claim in order to maintain the value of the home. On the other hand, if your house is your long-term home, then you can afford to ride out minor damage to your roof without filing a claim. That way, you avoid paying the deductible and protect your claim history. However, whether your ride out the damage or not lies on the answer to the following question: How bad is the damage?

If it is just minor or superficial damage that won’t affect the functionality of your roof, then you’re good for some time. Maybe you can wait until old claims fall off your claim history before filing a claim. But how can you, the homeowner, determine the extent of the damage? Well, you should…

Have the roof inspected

Get in contact with a local roofer who is of good standing in your area. Preferably one recommended to you by their former clients. Have them inspect your roof and tell you their opinion on the roof’s condition and whether they think you should file a claim or not. However, don’t just take their word and run with it – remember to consider some, most, or all of the other tips above and also, if necessary, get a 2nd and even 3rd opinion from other roofing contractors. 

Should You File A Claim For Roof Repairs?

Many times the answer will be no. This is because roof repairs are typically low-cost work. This means if you file a claim, you will end up paying for a significant portion of the repair through your deductible. Apart from that, you will also have one more claim on your claim history

Roofing Insurance Claim Tips

Don’t Sign Anything Until The Claim Is approved and finalized.

Do not get into any concrete or written agreements with any contractor until after the insurance company issues you your claim estimate and approves the work. Otherwise, you might find yourself working with the wrong bunch of people. 

Perform proper documentation

Take as many pictures as you can of the exterior of your home. Not just the roof but other areas as well, including windows, trim, screens, etc. Your contractor should also take good photos and videos to support the claim process. 

NB: It is good practice to regularly take pictures of your roofing so that in case of damage in the future, you have a reference point of what it looks like.

Get a good contractor

A good contractor will help you every step of the way – from initial inspection to supplemental applications and finally to replacing your roof. 

Be patient and persevere

If your claim is denied and you are confident you should receive a payout, work with your contractor to gather more evidence and try again. 

Educate yourself

Insurance companies and contractors can take advantage of your need for more knowledge. Only partially depend on third parties to guide you through the roof insurance claim process. Take time to study your insurance policy and read about other people’s experiences with roof claims. You will be in a better position to succeed in filing roof damage claims.

Conclusion

You’ve now had an inside look into how roofing insurance claims work. Use the information you have picked to determine whether it is worth filing a roof insurance claim. 

GRS Remodelling is your ideal roofing contractor in the DFW Metroplex. We offer installation, repair, and replacement of all commercial and residential roofing systems, gutter systems, and skylights, among other roof implements.

Reach out to us today, and let’s consult on your next custom roofing project.