How Do Insurance Agents Determine Roof Damage Claims?

Fran Majidi
March 15, 2019

Home insurance policies usually cover roof damage caused by fire, vandalism and storms like hurricanes and tornadoes.Roof damage is one of the most common homeowners insurance claims that people file. However, not all claims are paid out. Also, not every insurance company pays out a claim to the same degree. What all insurance companies do have in common, however, is that they are all wary of insurance fraud. Keep this in mind if you legitimately have a need for roof repairs and can’t afford to fix it out of pocket. You’d be shocked by the lengths many people go to to get a new roof -- paid for by their insurance carrier, of course. The fact is that homeowners insurance was not designed to cover small or even big fixes, but to repair damage that is covered under the stipulations of your policy. In fact, you may end up paying more in monthly premiums if you file a claim that gets rejected. For this reason, we advise you to fully review your case and your policy to see if you’re covered before filing a claim. For all you know, it might be financially beneficial for you to pay for the roof yourself instead of a deductible and only partially getting reimbursed.

What Are Your Policy Exclusions?

Your policy will have an entire section listing all the exclusions on your policy, which means that your insurance carrier will not pay for these sorts of issues. You don’t want to file a claim if it’s going to be rejected so know this section well. Every policy is different but the most common exclusions include the following:

Improper Maintenance:

Did you neglect the roof for 20 years and are now expecting the insurance company to pay for an entirely new roof? Unfortunately, that’s not how insurance works. In fact, if the roof is more than 20 years old, most insurance companies won’t cover your home at all unless it passes inspection first. It’s not unheard of for a homeowners insurance policy not to be renewed because the roof failed inspection. If your roof is 10 years old and suffers extensive damage after a hurricane, however, you will be covered.

Generally speaking, you should have a professional roofer inspect your roof once a year, making small repairs along the way and cleaning it of debris. Keeping your gutters clean also prolongs the life of your roof. You should also cut back trees handing over the house and remove dead trees.

Don’t assume that nothing will be covered by homeowners insurance but in most cases, the insured has to pay for a portion of costs of replacing the roof. Not all insurers have age restrictions but check to see if yours does. Also, if you have put a new roof over an old one, its age is determined by the first layer of shingles. Some insurers will only insure a roof with one or maybe two layers so think twice before lobbing on another roof.

The way the insurance company determines whether or not they will pay your claim is by inspecting the damage after you report it. The carrier will also have a list of roofing materials that are excluded. Often, slate, recycled and solar roofs are not covered or are not fully covered due to the extra costs associated with their maintenance. For this reason, you should also be selective about the new roof you plan to install (check your policy or change your homeowners insurance company if your current one is unreasonable).

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Repair vs Replacement of Roof:

Don’t assume that just because a storm came and left damage to your roof that your insurance company will replace the entire roof. While it may look like a mess to you, an adjuster may decide that you’re fine with just having some of the damaged shingles replaced. If you still decide to redo the whole roof, you may be footing most of the bill. You will also still have to pay the full deductible on your policy before the repairs to your roof are partially covered. Do the math in its entirety before assuming that filing a claim is worth it.

Protecting Yourself:

It’s always a good idea to have a roof inspector give you a written report on the state of your roof annually so that in the aftermath of a damaging storm you have something to show the insurance company proving that a new event caused damage and that it wasn’t a pre-existing condition. Having recent photographs, especially before-and-after photos of the roof damage helps greatly too.

Taking care of your roof is the most important thing you can do when you own a home. An old or damaged roof can lead to other expensive home damage. It may also prevent you from getting home insurance coverage.

Signs of Roof Damage:

  • Check the metal part that connects your chimney, vents and skylights to the roof. Also check your porch roof where it connects to the second story of the house. If it’s corroded or cracked it must be replaced.
  • Check rubber gaskets around plumbing vents for deterioration and cracking. They may or may not need to be replaced.
  • If the surface of your shingles are abraded and granules are missing, they need to be replaced. So should cracked tiles.
  • If shingle edges are curled up or the tabs are cupped.
  • Moss growth may look pretty but it will eventually lead to roof problems, namely rotting of your roof sheathing. Have a professional remove the moss and apply a treatment to kill any remaining spores.
  • Some signs of damage are not visible to the eye. After a severe storm, call in a trustworthy roofer to inspect your roof.

Homeowners Insurance

Note that the amount your policy will cover for the damage your roof sustains after a storm may not be as much as the deductible you have to pay to get covered. Always ask your insurance agent what the company will and will not cover first because of the fact that you may only get partially reimbursed for repairs/replacement.. Get all the numbers and then decide which is most cost effective, reaching into your own pocket or paying a deductible to having your homeowners insurance help pay for costs.

The last thing you want to do, however, is sit on the problem. Your roof protects your home. If it’s damaged, you may incur deeper damages to the structure of your home so make sure to do your due diligence but act fast after you have all the facts. 

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