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I recently received a telephone call from a roofing contractor who asked me for advice concerning a customer that he has been trying to assist who had digitally recorded a hailstorm at the insured dwelling during the hail event and who had photographed and measured the hailstones immediately afterward.
The insurance carrier was insisting that there was no damage to the roof from hail and, on the policyholder’s behalf, the roofing contractor was insisting to the insurance company’s adjuster that the video alone was proof of hail damage and that the insurance company should pay to replace the entire roof, but to no avail. He wanted me to arrange to represent the policyholder in an “appraisal” process … a procedure under the insurance policy where differences of opinion regarding the amount of damage can be settled without litigation.
The first thing I explained to the contractor was that the insurance company’s total denial of the claim due to the lack of apparent hail damage is a coverage issue, and the “appraisal” process cannot be used to determine coverage issues. It is only available to use when both sides agree to the existence of covered damage but do not agree on the amount of that damage and its associated costs.
The second point, one that he did not agree with me on, was that simply the evidence of a hailstorm (in the form of a digital recording and photographs of hailstones) is not evidence of hail damage to the insured property. He tried to assure me that, based upon his many years in the roofing business he is certain that proof of a hail storm with hailstones measuring one inch or more should be sufficient to convince an insurance company to replace an entire roof; however, I pointed out to him that if this were true he would not be calling me for assistance.
This leads to my third point which is, in the State of Missouri, exterior contractors are specifically forbidden from representing policyholders with their insurance claims. In this case, it could have very well been his obvious conflict of interest that nullified his arguments regarding the existence of damage, since he would be enriched from the repair that he was recommending to the insurance adjuster from damage that was not readily visible to them.
Should your home be struck by hail, it is advisable for you to take the step to have your roof carefully inspected by a professional, such as a reputable roofing contractor, to determine if it has been damaged by that hail. Some insurance policies will exclude dents to soft metals (flashing, gutters, downspouts, etc) that are not perforated and leaking, so it is best to compare the damage that is reported to you by the professional inspecting your roof to your insurance policy. Also, it is advisable to ask the professional inspecting your roof to photograph for you the damage that he has found and to describe all of it to you so that you can accurately report it to your insurance company.
After determining the actual presence and amount of damage, and reading what you can understand about your insurance coverage in your policy, consider whether or not it would be in your financial interest to file a claim. If you file your claim, you (not your contractor) should be prepared to explain and prove your loss to your insurance company. While it is acceptable to have your roofing contractor share his observations with your insurance company adjuster and to point out the damage to the roof at the time it is inspected, your contractor is not licensed or qualified to debate with or represent you in discussions with your insurance company regarding your claim. You must do that yourself or through someone licensed to represent you.
If the insurance company agrees that there is hail damage to your roof but does not agree on the amount of the damage, ask your contractor to provide you with a bid (not an “estimate”) to do the necessary roof repair or replacement. The insurance company can agree to pay that bid or, if they do not, should be asked to provide a bid of their own from a contractor of their choosing … rather than to “estimate” the damage on their computer software program. Your payment should be based on the cost to restore your home to its pre-storm condition … not an “estimated” cost to restore your home.
If this process appears complicated, confusing, or something you would not prefer to do on your own, you should seek the advice of a licensed public adjuster or attorney. If you are in Missouri you can call me during normal business hours and I will discuss this with you. There is no charge for the call.
