What to Do if Insurance Denied My Roof Claim

If insurance denied your roof claim, you can dispute the decision. However, you must gather evidence and build a case proving the insurance company wrongfully denied your property insurance settlement. If necessary, you can take action to recover compensation for your damages in civil court. 

 

Learn more about securing fair and full payment for your roof claim below. 

 

Why Did Insurance Deny Your Roof Claim? 

 

Insurance companies increase their profits by keeping claims payouts as low as possible. Therefore, insurers will look for reasons to deny your roof claim. Common reasons for denial include the following:

 

  • Wear and tear. Roofing materials naturally degrade over time, which can lead to leaking and other issues. If your roof is old, your insurance company may blame your problem on wear and tear, which homeowners or renters insurance usually doesn’t cover. 
  • Pre-existing damage. Insurance will not pay for damages that occurred before you took out your policy. Additionally, if you had previous storm damage and did not repair it or report it to your insurer, they may blame your current roof problem on a combination of old and new damage. This could be grounds for denying your coverage. 
  • Lack of maintenance. If your insurance company thinks your roof damage resulted from a lack of maintenance, it can deny your claim. 
  • Manufacturing/installation defects. Your insurer may deny your claim if your roof issue resulted from a materials defect or improper roof installation. However, in this instance, you have a claim against a negligent manufacturer or roofing company. 
  • The insurance adjuster’s assessment. Your insurance company bases its opinion in large part on its adjuster’s assessment. If an adjuster does not think your roof sustained damage, assesses the damage as partial, or improperly estimates the cost of repairs, it can lead to a denied or underpaid roof claim. 
  • Late filing. Your policy dictates how long you have to file a roof claim. Failing to meet this deadline can lead to a denial. 
  • Policy exclusions. Your policy outlines exactly what your insurer will and will not cover. If your roof damage resulted from an uncovered issue, insurance will deny your claim. 

 

If you disagree with your roof claim denial, we can help. A residential property insurance lawyer with our firm can help you understand the insurance company’s determination and fight back against wrongfully denied payments. 

 

How Can You Dispute a Denied Roof Damage Settlement?

 

If your insurer denied your roof claim, the first thing to do is carefully review your policy. If you believe the denial was incorrect, you should:

 

  • Contact your insurance agent and ask them to review the claim.
  • Collect evidence to challenge the decision. For example, bills and receipts demonstrating previous repairs could be evidence against a denial based on lack of maintenance. If your denial concerns the insurance adjuster’s assessment, you may want to bring in your adjuster. 
  • Appeal the claim in writing and submit it to your insurance company. Provide a detailed explanation of why you disagree with its initial decision and any evidence you have to back up your argument. 
  • File a complaint with the state. You have the right to complain about your insurance company or an unfair decision to the Texas Department of Insurance (TDI)
  • Consider mediation. You can enter mediation with your insurance company. We can represent you during this process. However, mediation may not change the outcome of your claim. Even if it does, the decision is non-binding, meaning your insurer could ignore an outcome it disagrees with. 
  • Take legal action. You have the right to sue your insurance company over wrongfully denied roof claims in civil court. According to Texas Civil Practice & Remedies Code Section 16.003, you must file your lawsuit within two years of when your roof damage occurred. 

 

What Does a Roof Damage Claim Pay For? 

 

Most homeowners insurance policies provide payment for the following:

 

  • Dwelling/structural damage, including damage to roofs, walls, windows, flooring, and other buildings on your property (such as sheds, garages, or gazebos)
  • Personal property, including furniture, electronics, appliances, and personal items
  • Loss of use/additional living expenses (ALEs) if you must vacate your property and must pay for alternative lodgings, food, clothing, and other necessities you would not need to buy if you were still in your home
  • Liability/medical payments for injuries and financial damages caused to others while on your property

 

What Is Covered?

 

Most homeowners insurance policies will provide compensation for the above if your damages result from the following:

 

  • Fire
  • Lightening
  • Vehicles or aircraft
  • A sudden, accidental release of water or smoke
  • Explosions
  • Vandalism
  • Windstorms, hail, and hurricanes (for those not on Texas’s Gulf Coast)

 

What Is Not Covered? 

 

In addition to wear and tear, most property insurance policies will not pay for roof damages caused by:

 

  • Flooding
  • Earthquakes
  • A continuous water leak (including mold removal)
  • Termites, mice, or other pests

 

Depending on where you live in Texas, your homeowners insurance may or may not pay for hurricane, hail, or windstorm damage. According to TDI, residents on the Gulf Coast or in Harris County on Galveston Bay must purchase separate coverage against these types of weather events through the Texas Windstorm Insurance Association (TWIA).

 

Do You Need a Property Damage Lawyer to Fight Your Roof Claim Denial?

 

You can appeal denied roof claims or sue your property insurance provider with or without an attorney. However, working with a lawyer from our firm can provide you with a legal advocate who can take the stress off your shoulders. We will:

 

  • Review your insurance policy and reasons for denial
  • Collect evidence to support your appeal
  • Draft and file all your case-related paperwork
  • Track and adhere to case deadlines
  • Communicate with insurance agents and other parties
  • Negotiate a fair and full settlement for you
  • Prepare your case for court and represent you at trial if necessary

 

Contact Carrigan & Anderson, PLLC, for Help With Denied Roof Claims

Contact us for help fighting back if insurance denies your roof claim. Our firm has 50-plus years of experience with personal injury and insurance law we can put behind seeking justice for you. Connect with our Texas lawyer near you today.

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Location: 101 N Shoreline Blvd #420
Corpus Christi, TX 78401