Navigating a Denied Roof Insurance Claim

Reasons Why Roofing Insurance Claims Get Denied

The most common reason for a denied roofing claim is that the damage is not covered under the policy. This can happen if the damage is determined to be caused by wear and tear or is excluded under the policy. For example, some policies may exclude damage caused by hail or windstorms. In this case, it is important to provide evidence that the damage was caused by a covered event, such as by providing photographs of the damage and reports from contractors that indicate the cause of the damage.

Another reason for a denied claim is that the policyholder did not meet the policy’s requirements for filing a claim. This can happen if the policyholder did not report the damage in a timely manner or did not provide all the required documentation. In this case, it is important to provide evidence that you did meet the policy’s requirements, such as by providing proof of the date you reported the damage and all the documentation you submitted.

Another possible reason for a denied claim is that the insurance company determined that the cost of repairs is not covered under the policy. This can happen if the policy has a cap on the amount that can be claimed or if the policyholder did not have enough coverage to cover the cost of repairs. In this case, it is important to provide evidence that the cost of repairs is reasonable and that you had adequate coverage at the time of the damage.

Overturning The Denial

If your roofing claim has been denied, there are several steps you can take to try to overturn the denial:

1. Review the denial letter: The first step is to carefully review the denial letter to understand the reason for the denial. The letter should state the specific reason for the denial and any policy provisions that were relied upon.
2. Gather supporting documentation: Next, gather any supporting documentation that may help to strengthen your case. This may include receipts for repairs, photographs of the damage, and any reports or estimates from contractors.
3. Submit an appeal: If you believe the denial was made in error, you can submit an appeal to the insurance company. The appeal should explain why you believe the denial was incorrect and include any supporting documentation.
4. Negotiate: If the insurance company is unwilling to overturn the denial, you may be able to negotiate a settlement. This may involve offering additional documentation or agreeing to a compromise.
5. Seek outside help: If you are unable to resolve the matter with the insurance company, you may want to seek outside help. This may include consulting with a lawyer or contacting a state insurance commissioner or consumer advocacy group.

Remember – It is important to be persistent and to keep a record of all communication with the insurance company. It may also be helpful to seek the advice of a professional, such as a lawyer or a public adjuster, if you are having difficulty resolving the matter.

It is also important to note that some states have laws that require insurance companies to provide a certain level of coverage for roofing claims, so it may be helpful to research the laws in your state to see if they can help support your case.