My Home insurance won't pay

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Hello, I'm hoping that you guys can give me some insight that will help me with my situation. Last year we had a pretty bad hail and couple of storms. My house is 19 yrs old so I have a pretty old roof. With the hail I had some hail damage but mostly wind damage. I got a couple of missing shingles. I had an adjuster come out to the house and the guy was a pretty old guy with a nasty attitude. He got on top of my roof and I did have the roofer present, he told the roofer right away he was denying the claim. He said "I hate when people try to take advantage and file claims to get a new roof" Ok so my thinking here is, doesn't matter if my roof is 100 years old, if I have wind damage and my insurance covers that then so be it. I am paying for a service and that's what I should get. Never the less the roofer ended up sliding off my roof which did not help my case. He is ok thank God, but the insurance company refuses to send another adjuster to my house. Their response was we will cover the missing shingles and that's not enough to cover the deductible so I got nothing. I checked with another roofer and he told me pretty much same thing last roofer said. The roof is too old to just fix missing shingles, the whole thing will tear if you try to repair the broken ones. So this guy tells me that we can take them to APPRAISALS which requires hiring an Engineer which I would have to pay, to force the insurance to pay for the damages. So far everyone I have asked knows nothing about this supposedly appraisal process, and I'm concern that this roofer is just trying to take advantage of me. What should I do? Is anyone familiar with this appraisal thing (Mind you, this appraisal is not to be confused with a house appraisal, this has something to do with insurance appraisal) Please help! I am a young woman who has never filed and insurance claim for nothing so I am clueless what is fair and what is not.

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You are illustrating why the inspector/appraiser denied your claim. The roof is in bad shape to begin with. A storm co... (more)

KYBOSH (Feb. 13, 2013 @ 8:16p) |

SIS said "What company is this , so we can avoid them?"

It's not uncommon for carriers to use their adjusters as underwri... (more)

iseetrails (Feb. 13, 2013 @ 11:26p) |

Translation: "Hey, everyone else is doing it!"

Answer the man's question or go into politics, where avoidance of straight... (more)

Logan71 (Feb. 14, 2013 @ 9:20p) |


Google your state and "bad faith insurance" and call some law firms

Bella48 said:   ...He said "I hate when people try to take advantage ...

No worries... you are among friends.

See if any insurance adjuster in your area is willing to take a look at your roof damage. They typically work at 10-15% commission basis so if the insurance company ends up approving the claim for $10k, the adjuster will charge you $1,000 to $1,500 as their fee/commission. Typically if you let the adjuster fix the roof with their contractors then they waive or reduce their fee/commission. This would be same process in major fire damage claims. The insurance company's adjuster will try his/her best to reduce or deny the claim (it's their job to save $$ for their company) but your own adjuster may/will challenge them as they have vested interest in getting as much as possible out of the insurance co.

Bella48 said:   Please help! I am a young woman who has never filed and insurance claim for nothing so I am clueless what is fair and what is not. (preemptive) pics?

Bella48 said:   
.....
Please help! I am a young woman ....


Pics?

I'm no expert, but I think you are going to have a hard time getting much from insurance on a 19 year old roof.

It sounds like what he told you is exactly right. You're insuring the roof. A few shingles tore off, and that'd typically cost $100 or something cheap to fix. So your insurance would cover that...and your deductible is probably $1000.

Why should you get a brand new roof because the wind blew a couple shingles off? What state?

And post pics of the roof so we can see the "damage". And post other pics ;P

Have you checked to see if your policy covers actual value or replacement value? If it's only actual value, given that your roof is 19 years old, it would prorate to 5-10% at most, which would be less than your deductible. If it's replacement value, then it should be covered regardless, in which case you should take SIS's advice.

You say the house is 19 years old, but do you know if the roof is that old?
(It could have been replaced for some reason since the house was built.)

There are different qualities of shingles, and better ones have longer warranties,

If your shingles have a 25 year warranty or a 40 year warranty would make a huge
difference to your claim. If your roofer fell off the roof, and didn't tell
you how good your shingles are, he may have been wasting your time.

Some states have better regulation than others. Your state insurance commission may
be of use to you.

Good explanation of appraisal process here:
Appraisal process

I would also suggest you find and read the applicable portion of your policy. It will only be a paragraph or so.

Bella48 said:   My house is 19 yrs old so I have a pretty old roof. With the hail I had some hail damage but mostly wind damage. I got a couple of missing shingles.

Insurance doesn't give you a free roof just because of a couple of missing shingles.


Bella48 said:   I checked with another roofer and he told me pretty much same thing last roofer said. The roof is too old to just fix missing shingles, the whole thing will tear if you try to repair the broken ones.

Of course the roofers will tell you that. They rather make $5000 on replacing the roof than $100 replacing a few shingles.

If the wind only blew off a couple shingles why do you think insurance should buy you a new roof? Esp if it is 19years old.

I grew up near a beach and so many tried and scam insurance by getting a new roof when a couple shingles got damaged. Most insurance companies have got wise and deny claims like yours unless their is structial damage or very large patchs of the roof torn off.

Many State's have licensed public insurance adjusters that can be found by a Google search. Stay away from roofing company's that claim to work for you, yet do not have a licensed public insurance adjuster on staff and willing to show their current license. Those roofer's that pretend to be licensed adjusters are breaking the law in most State's and you have no recourse if the roofing company screws up your claim, unless they are licensed to do public insurance adjusting.

The fee that the licensed insurance adjuster would charge is typically 10 to 15%, and if the settlement is less then that they recieve nothing out of your pocket. That was your first mistake, all insurance company's adjusters will not consider a claim that is not by a licensed adjuster, but by a "roofer", who is misleading you.

chibimike said:   I'm no expert, but I think you are going to have a hard time getting much from insurance on a 19 year old roof.

I'm not following your logic here.

If a fire breaks out in the laundry room, regardless of home age, repairs have to be made to the home.

If a furnace is old, but fails under home warranty (ie..insurance of another flavor), it has to be repaired/replaced, regardless of age.

I'm not familiar with clause or case where the 'age' of a roof would come into play, assuming that real damage occurred and possibly leaks were present. I agree that this might be in 'bad faith' considering the prices of home insurance.

Slightly off-topic:

I have a 10yr old, original roof, and about once a year, I lose 3-10 shingles due to high winds that accompany storms.

Last summer, I called around, and a local roofer wanted $400 to replace what he estimated were 12 shingles. Seemed high to me.
I walked across to the neighbor and chatted about who did their roof recently, and they referred me to another local guy. I talked to him, and he came by and looked at the roof and said he doesn't mind helping out on 'little jobs' because times are tough, etc..etc. He said it'd be $350.

Two weeks go by and I talk to a third roofer, who lacked a fancy truck, fancy title on his business card, or the like. He stopped by on a Saturday, walked around the house, spit on the ground and said " 'bout 15 shingles. A hundred bucks". He left to get materials, and I ran my weekend errands. Two hours later I come home to shingles that had been replaced, and matched perfectly. There was a note on my front door that just said "Just drop the check in the mail when you have time"....

Moral of this story? Keep shopping around until you hear what sounds 'right' to you. Good luck.

An article in Bloomberg Businessweek this week discusses how insurance companies are trying to limit claims due to roof damage.

I was looking to replace my 24 year old roof and one of the people doing the estimate said there was wind/hail damage I had someone come out and the insurance company replaced the ENTIRE second story roof. I had to pay for the roof over the garage because there was no damage, but the roof was already on it's last legs.. that is just my story.

I think you are confusing 2 separate events.
1. Your roof has aged. Depending on a lot of factors, the lifespan is probably ~25 years, so your roof has been mostly used up. This is a maintenance cost, something not covered by home insurance.
2. You had a storm that damaged some shingles.

Just because (2) happened, insurance isn't required to replace your entire roof. They say that they will cover the costs of (2), but that is under your deductible. Even were it slightly over your deductible, the roofers are probably correct in that the condition of the roof will not allow a patch job, and it is time to look at a full roof replacement.

I was looking to replace my 24 year old roof and one of the people doing the estimate said there was wind/hail damage I had someone come out and the insurance company replaced the ENTIRE second story roof. I had to pay for the roof over the garage because there was no damage, but the roof was already on it's last legs.. that is just my story.

If you have a car and cause an accident (so it's your fault), some items, such as tires, may need to be replaced. However, because of the nature of tires and the wear they receive, it is possible for your tires to be worn down. If your tire is damaged beyond repair, of course you will get new tires, but the insurance company calls it betterment, meaning you end up better off than before the accident (new tire when your tires were old and worn). In this case, they will only agree to pay for part of the cost of the tire, even though brand new tires are required.

Not sure how this relates to a roof on a house, but I could definitely see where the insurance either wouldn't want to replace an entire roof just because of some missing shingles, or where they might prorate the amount they will pay because of the age and wear on the roof.

Logan71 said:   chibimike said:   I'm no expert, but I think you are going to have a hard time getting much from insurance on a 19 year old roof.

I'm not following your logic here.

If a fire breaks out in the laundry room, regardless of home age, repairs have to be made to the home.

If a furnace is old, but fails under home warranty (ie..insurance of another flavor), it has to be repaired/replaced, regardless of age.
First, #2 has nothing to do with OP's question; a home warranty is not homeowner's insurance, it's more akin to an extended warranty on a new TV. Homeowner's insurance isn't going to pay for a new furnance because it is old and dies.

In fact, depending on your insurance, even if stuff in the house is damage from a storm or fire, you may not get "replacement" cost; the insurance may only pay a pro-rated value depending on the item's age.

As far as your first point, yes if you suffer fire damage, insurance will pay to fix/repair, but not buy you a new house because of a small fire in the laundry room or even re-tile the entire floor in said laundry room, because a couple of tiles were damaged by the fire.

If a tree falls in a storms and only damages a few sections of siding on your house, the insurance company is not going to pay to replace all the siding on the house or pay to repaint the whole house.

Who was your insurance company? I have similar situation last year with Allstate. They paid around $10K + broken skylight + painting the bathroom which was damaged due to skylight. My house was built in 1992 with original that needed replacing anyways. Still I got a new roof.

chan101qua said:   Bella48 said:   
.....
Please help! I am a young woman ....


Pics?


Go watch twilight, new moon etc to see Bella

king0fSpades said:   Who was your insurance company? I have similar situation last year with Allstate. They paid around $10K + broken skylight + painting the bathroom which was damaged due to skylight. My house was built in 1992 with original that needed replacing anyways. Still I got a new roof.

Same for me with Allstate. Big storm came through, ripped off enough shingles to be of concern, had a trusted roofer (good referral from a friend) be there when the adjuster came out, they talked and I got a new roof. House isn't huge but replacement cost about $6800.

rvette454 said:   The fee that the licensed insurance adjuster would charge is typically 10 to 15%, and if the settlement is less then that they recieve nothing out of your pocket. That was your first mistake, all insurance company's adjusters will not consider a claim that is not by a licensed adjuster, but by a "roofer", who is misleading you.

Um, no. By a "licensed adjuster", I presume you mean "Public Adjuster". Public Adjusters probably get hired on about 1% of all losses. Insurance companies, by your logic, would be denying 99% of all claims (those where the insured has not hired a PA). A competent claims adjuster should be able to assess whether a roof is damaged by wind or hail without the need of a roofer/engineer/PA, in most cases.

And how can 10% to 15% of a settlement be more than the settlement itself??

I had shingles blown off by hurricane Sandy and my roof is 17 years old. My insurance paid a pro-rated amount for the damage but will pay 100% once I get it replaced and submit the invoice.

I have Kemper Insurance.

I am an adjuster in California and this comes up quite often. I know my guidelines are to only replace a face or elevation if it is over 50% wind damaged. If less than 50%; we only pay to patch. If the roof also appears worn out; they will send a partial claim denial on the non wind damaged areas of the roof and inform underwriting that your roof is defective. At that point, underwriting informs the insured that they need to pay and replace their roof or the policy will not be renewed.

iseetrails said:   I am an adjuster in California and this comes up quite often. I know my guidelines are to only replace a face or elevation if it is over 50% wind damaged. If less than 50%; we only pay to patch. If the roof also appears worn out; they will send a partial claim denial on the non wind damaged areas of the roof and inform underwriting that your roof is defective. At that point, underwriting informs the insured that they need to pay and replace their roof or the policy will not be renewed.
What company is this , so we can avoid them?

Thank you all for your insights, some of this comments are very helpful. To answer a few questions I wouldn't have an issue if replacing the missing shingles was just that, problem is the remaing shigles are worn and rip when you try to lift them, so trying to replace missing shingles will break the non missing ones. This is the problem that I'm running in to. Thank you so much Dnickerson on the appraisal process, this was great info. I wanted to make sure this roofer isn't just trying to make a sale. I would rather avoid all this mess, its time consuming and it just sucks having to fight with these people. Again thank you so much for your help.

You are illustrating why the inspector/appraiser denied your claim. The roof is in bad shape to begin with. A storm comes in and blows a few shingles off a roof that probably needs replacement anyway. Its not reasonable to expect your insurance co. to spring for an whole new roof.

Now if the storm blew off half of your shingles then you probably could get a new roof.

SIS said "What company is this , so we can avoid them?"

It's not uncommon for carriers to use their adjusters as underwriters and have them report back on the condition of the house both on physical and liability hazards and non-renew policies as appropriate. Pools without proper fencing, worn roofs, falling over fences, or anything else that could cause a claim.

Insurance is for unplanned disasters. If people let there house deteriorate; the risk of loss becomes certain.

iseetrails said:   SIS said "What company is this , so we can avoid them?"

It's not uncommon for carriers <snipped>


Translation: "Hey, everyone else is doing it!"

Answer the man's question or go into politics, where avoidance of straight answers is valued, unlike FWF.



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