Your contractor will be valuable to you as you present your insurance claim to your adjuster.  Without his skill and expertise, you will have a tough time communicating all that has been damaged and the work necessary to restore your home to its original condition.  

You might have read the Missouri law that states that a roofing contractor cannot represent you with your insurance claim when communicating with your insurance company about the condition of your roof. Your insurance company’s adjuster certainly has.

Specifically, it reads in part, “A contractor shall not represent or negotiate, or offer or advertise to represent or negotiate, on behalf of an owner or possessor of real estate on any insurance claim in connection with the repair or replacement of roof systems, or the performance of any other exterior repair, replacement, construction, or reconstruction work.” [Missouri Revised Statute Title XXVI, Trade and Commerce, 407.25]

You can represent your hail damage claim by yourself, or you may decide to hire an attorney or Missouri-licensed public adjuster to represent you with your insurance claim. However, if you choose to have your roofing contractor do the talking for you, he represents only himself and his company’s financial interests in restoring your storm-damaged roof. Not you.

Accordingly, your insurance company’s adjuster will often disregard much of your contractor’s input as being self-serving … unless it serves the insurance company’s best interest to do otherwise. For instance, if your roofing contractor is willing to compromise and agree to the adjuster’s lower computer-generated estimate, the adjuster may strike a deal with you based upon his agreement to work for the lesser amount. However, a roofing contractor’s opinions or arguments calling for more money or materials that differ from what the adjuster has already decided to pay will likely be dismissed. As the governing regulations state, the contractor cannot negotiate your claim.

A policyholder called me for assistance recently and told me that he had three different roofing contractors speak to his insurance company’s adjuster on his behalf, and all three told the adjuster that his roof required replacement. According to him – and to his dismay – the adjuster disregarded the arguments from all three of them and refused to pay him to replace his roof.

Of course, the policyholder was convinced that the adjuster acted improperly and unfairly. He believed that his insurance company had a duty to accept these arguments, particularly since they came from three different contractors, as definitive proof of his loss, but he was wrong. What the policyholder’s three contractors presented to his adjuster were three other sales presentations for replacing his roof – none of which proved to the adjuster that the roof had been damaged by hail on the reported date of loss to the extent that it needed to be replaced.

Simply put, the insurance company’s adjuster was not convinced by the three different contractors, each of whom is in business to sell new roofing systems, that the home required a new roofing system as a direct result of the claimed hail event.

Sometimes, the roof’s overall condition may require the roof to be replaced. The roofing contractor is doing his job by correctly informing the homeowner of that need and can undoubtedly observe and communicate that to the insurance adjuster. The adjuster might even agree with him regarding the roof’s overall condition. However, one item usually required to recover money from the insurance carrier to pay for the roof replacement is physical proof that the reported damage is the only cause of that condition.  Another is to prove that the damage occurred under conditions covered by the insurance policy in effect on the date of the loss.  I have observed that this is where many roof claims presented by roofing contractors, prohibited by law from negotiating the claim on behalf of a homeowner, fall short of those limitations.

Consultation with a reputable roofing contractor or expert is crucial as you prepare to present your claim to your insurance company. Suppose you know what to request from your roofing contractor so that you can acquire and present proof of your loss to your insurance company; you can present that proof to your adjuster, who, under the state rules that govern insurance claims, must respond to you on the record to the evidence that you present. This is what your licensed public adjuster would do on your behalf, as well.

There are a select few high-end roofing companies in Missouri that are staffed with experienced professionals who have proven to be able to acquire and provide convincing evidence that I have used to turn claims that the insurance company initially denied into recoveries of $80,000.00 to $925,000.00 – but the collected evidence was presented to the insurance company by me.

In the absence of such proof of loss or if the adjuster is simply not accepting the sales presentation from the roofing contractor as being definitive, the policyholder will likely be unsuccessful in his attempt to obtain more than what the adjuster initially values the loss to be – whether the adjuster is correct or not.

Since the roofing contractor does not officially represent the policyholder with his claim, the adjuster can disregard anything that the contractor directly presents to him. Where the insurance company’s adjuster must respond to your written requests in writing, he can reject arguments presented by your roofing contractor without justification or explanation. In certain instances, the insurance adjuster will go as far as to ignore or refuse to communicate with the roofing contractor on site since he is not required to do so.

Keep this in mind when you decide to ask your roofing contractor to present your roofing claim to your insurance company. A “no” to your roofing contractor from your insurance adjuster is not always the final word.

 

 

 

This Blog/Web Site is made available by James H. Bushart, Public Adjuster LLC for educational purposes only as well as to give you general information and a general understanding of the work of a public adjuster, not to provide specific legal advice. The authors and/or site manager make no representations as to accuracy, completeness, currentness, suitability, or validity of any information on this site and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. By using this blog site you understand that there is no public adjuster/client relationship between you and James H. Bushart, Public Adjuster LLC.  The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state, nor should it be used as a substitute for competent maintenance or repair advice from a qualified contractor licensed to perform work in your state.