Roof damage claim denial, HELP !!

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I recently had a wind damage claim on my roof. The insurance company (Olympus) sent out the 1st insurance adjuster for inspection. I waited for a couple of weeks to get the results but did not get. Then we called and they told me they need send another roof consultant for re-inspection. Right after they completed the 2nd inspection, I received a non-renewable notice of my policy for next year because of potetial risk identifed. One week later, I received my claim denial letter. I called them to request the inspection reports. But they only sent me the 2nd one and tried to keep me from getting the 1st report. Their decision was purely based on the 2nd inspection report, which identified no wind damage at all. I asked why they would not release the 1st report, they told me the 1st one was not done properply.

I guess they have to pay me for a new roof if based on the 1st inspection report. But they just don't want to pay, and hired another roof consultant instead of insurance adjuster, which they might have good relationship, to get my claim denied.

ps. Many my neighborhood homes got roof replaced recently from their insurance.

Any suggestions for the appeal? Many thanks!!

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wynlily said:   I recently had a wind damage claim on my roof. The insurance company (Olympus) sent out the 1st insurance adjuster for inspection. I waited for a couple of weeks to get the results but did not get. Then we called and they told me they need send another roof consultant for re-inspection. Right after they completed the 2nd inspection, I received a non-renewable notice of my policy for next year because of potetial risk identifed. One week later, I received my claim denial letter. I called them to request the inspection reports. But they only sent me the 2nd one and tried to keep me from getting the 1st report. Their decision was purely based on the 2nd inspection report, which identified no wind damage at all. I asked why they would not release the 1st report, they told me the 1st one was not done properply.

I guess they have to pay me for a new roof if based on the 1st inspection report. But they just don't want to pay, and hired another roof consultant instead of insurance adjuster, which they might have good relationship, to get my claim denied.

ps. Many my neighborhood homes got roof replaced recently from their insurance.

Any suggestions for the appeal? Many thanks!!


Get an independent inspection done for damage and get prepared to contact your state insurance commissioner. Scumbag insurance don't want to cover what they should so you may be going to court, hopefully the commissioner can put some pressure.

Go online or phone book and look for a roof inspection report company in your area. Get your roof inspected and if their opinions differs; submit it to the carrier for review. Not that hard.

Thanks for the replies. Guess I have to pay for another inspection to fight on this.

wynlily said:   Thanks for the replies. Guess I have to pay for another inspection to fight on this.

You should be able to get a free quote from a reputable company.

Your insurer hired a scam inspection company to justify the denial and claim they relied on their contractor

Ask one of the licensed contractors who did your neighbors homes to do your inspection for free and argue with your insurer for approval. Most will in hopes to get the job at no cost to you

If your insurer refuses to accept the claim , take the report you got from your contractor to a bad faith insurance lawyer ,you'll get paid eventually

The insurance world is also very familiar with bogus roofing claims. Companies will go from house to house, telling homeowners they see wind damage on their home and that insurance will cover replacement.... OP do you have a specific weather event that caused your roofing issues? Change your insurance to that of your neighbors - with new roofs, and maybe you'll have a better chance, lol.

I had a hail damage claim for my roof last year and the roofing contractor circled the area of the hail damage with chalk all over the roof and window flashing, which made the insurance adjuster's job easier and he approved the entire new roof replacement on the spot.

Facebook.

JaxFL said:   The insurance world is also very familiar with bogus roofing claims. Companies will go from house to house, telling homeowners they see wind damage on their home and that insurance will cover replacement.... OP do you have a specific weather event that caused your roofing issues? Change your insurance to that of your neighbors - with new roofs, and maybe you'll have a better chance, lol.

Yeah it's getting bad too, it's almost like people expect their insurance company to replace their roofs once every 20 years. I have been getting quotes for some redesign work and several of the reps mentioned half their time is spent giving quotes to people who are just trying to get their roofs replaced by the ins company. I wouldn't be suprised if you see roof deductibles go to 5k or so in some states. Fraud is getting bad, and locally a man was charged with ins fraud related to his roof. (Beat it with a golf ball in a sock).



Anyway, be prepared to come with your own inspection or two and involve your state commission. Check you may or may not have a right o that first report.

wynlily said:   I recently had a wind damage claim on my roof. The insurance company (Olympus) sent out the 1st insurance adjuster for inspection. I waited for a couple of weeks to get the results but did not get. Then we called and they told me they need send another roof consultant for re-inspection. Right after they completed the 2nd inspection, I received a non-renewable notice of my policy for next year because of potetial risk identifed. One week later, I received my claim denial letter. I called them to request the inspection reports. But they only sent me the 2nd one and tried to keep me from getting the 1st report. Their decision was purely based on the 2nd inspection report, which identified no wind damage at all. I asked why they would not release the 1st report, they told me the 1st one was not done properply.

I guess they have to pay me for a new roof if based on the 1st inspection report. But they just don't want to pay, and hired another roof consultant instead of insurance adjuster, which they might have good relationship, to get my claim denied.

ps. Many my neighborhood homes got roof replaced recently from their insurance.

Any suggestions for the appeal? Many thanks!!


What was the "potential risk identified" that was cited in the non-renewal?

FWIW, the insurance company product (i.e. adjusters reports) are their property and they do not have to give those to you. I would assume what happened here is that an adjuster was out, took a look at the roof and thought there were issues contributing to the loss and advised the carrier they needed a second, more seasoned opinion. The insurance company then sent out an engineer or roofing expert to confirm or deny the prior adjusters thoughts.

What was the specific verbiage of the denial? What did the 2nd report, which they provided to you, advise that caused them to deny the claim?

JaxFL said:   Fraud is getting bad, and locally a man was charged with ins fraud related to his roof. (Beat it with a golf ball in a sock).



I don't have anything productive to add but that's hilarious!

ach1199 said:   I had a hail damage claim for my roof last year and the roofing contractor circled the area of the hail damage with chalk all over the roof and window flashing, which made the insurance adjuster's job easier and he approved the entire new roof replacement on the spot.Exactly. And a roofing company will be happy to be there when the insurance adjuster shows up to insure that everyone is on the same page.

Marc



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