most Overlooked items by Insurance Adjusters in A Roof Claim

When handling a roof claim, insurance adjusters and roofers may have different perspectives on what needs to be repaired or replaced, leading to potential discrepancies in the claim. Though insurance companies are often ethical companies and concerned about their customers, they are also a business required by corporate executives to make a profit. It is very rare that an initial insurance scope will include all necessary line items required by local codes and manufacturer warranties. By leaving many of these line items off the claim, insurance companies save millions of dollars over the year on insurance payouts. Most homeowners and unfortunately, most roofers are not savvy enough or knowledgeable enough to recognize these missed items.

A knowledgeable and experienced roofer might identify several items or areas of damage that an insurance adjuster could overlook or decide not to include, such as:

• Matching Issues
• Underlayment
• Ventilation
• Gutter and Downspout Damage
• Code Upgrades
• Accessory Structures
• Ice and Water Shields
• Complete Replacement vs. Spot Repair
• Debris Removal
• Drip Edge Flashings
• Starter Course
• Ridge Cap
• Kickout Flashings

Read on to learn about each of these elements, why there often overlooked by insurance adjusters, and why they’re important to address during a roof damage claim.

Matching Issues

If part of the roof needs to be replaced, a good roofer might argue that the new materials should match the existing ones in quality, color, and age, which could be overlooked by an adjuster. Many states including Tennessee have matching laws that require insurance to cover a full replacement if quality, color and age cannot be matched with just a repair. Even if your state doesn’t have a matching law, it’s a red flag if your insurance company tries to replace your shingles with a lower-quality option.

Underlayment

Damage to the underlayment can be easily missed or deemed unnecessary for replacement by an insurance adjuster. However, a diligent and experienced roofer will recognize that compromised underlayment can lead to severe issues such as leaks and further structural damage. It’s crucial to inspect the underlayment thoroughly to ensure the roof’s integrity. If the roof’s pitch is under 4/12, building code mandates a minimum of 2 layers of underlayment. This critical detail is rarely included in the initial insurance scope, leading to potential oversights during repairs. Homeowners should be aware of these requirements to advocate for proper repairs and avoid future problems.

Ventilation

Proper roof ventilation is crucial for the longevity of the roof, as it helps to regulate temperature and moisture levels, preventing issues such as mold growth and structural damage. If the damage has impacted the roof’s ventilation, a roofer may argue this needs addressing, while an adjuster might not consider it part of the claim, leading to potential disputes. It’s important to note that local building codes often require a certain amount of attic ventilation to meet safety and health standards.

Additionally, certain insurance policies may cover this upgrade if specifically requested, highlighting the importance of understanding your policy’s details and advocating for necessary repairs.

Gutter and Downspout Damage

These components are sometimes overlooked by adjusters or not fully covered in policies, but they are essential for proper water drainage and to prevent extensive damage to the property. Without them, water can accumulate, leading to issues such as mold, structural damage, and costly repairs. Ensuring these elements are adequately addressed can save homeowners significant time and money in the long run.

Code Upgrades

Building codes evolve over time. If a roof needs to be updated to meet current standards, a knowledgeable roofer might point out this requirement, known as a code upgrade. Code upgrades may not be fully covered by insurance unless there is specific evidence of their necessity and extensive knowledge of local codes—something that is uncommon among insurance adjusters whose coverage areas are usually quite large. Commonly overlooked items include solid wood sheathing instead of spaced decking, ice and water shields in valleys or at eaves, chimney crickets for wide chimneys, and various other components.

Accessory Structures

Accessory structures are additional elements not built into the roof but interact directly with it. These include skylights, solar panels, and satellite dishes mounted on the roof. Though they might be overlooked or not fully covered by an adjuster, they have a significant impact on your roof’s health. They can often be entry points for water intrusion if not properly installed or sealed by a professional roofer. Make sure to consult with a professional roofer about these elements, as your roofer might otherwise avoid discussing them altogether.

Ice and Water Shields

In colder climates, an ice and water shield is essential for preventing ice dams and water penetration, which can cause significant damage to the underlying structure of the roof. This protective layer is especially crucial during the winter months when snow and ice can accumulate and create pressure points.

However, an insurance adjuster might exclude this from the scope of work if the existing roof did not already have it installed, arguing that it constitutes an upgrade rather than a replacement. On the other hand, a roofer might advocate for its necessity, stressing that adding this layer is a proactive measure to protect the home from future damage and minimize the likelihood of costly repairs. The inclusion of an ice and water shield significantly enhances a roof’s durability and longevity, especially in regions with harsh winters. In many cases, skilled roofers successfully persuade the insurance company to cover this addition, safeguarding the insurance company’s investment.

Complete Replacement vs. Spot Repair

Sometimes, an adjuster may prefer approving repairs for a small section of the roof, while a roofer might contend that a full replacement is necessary to maintain the roof’s integrity and match existing materials. Depending on the roof’s age and the brittleness of the shingles, a roofer can conduct a Brittle Test to determine if spot repairs would cause more damage than a complete replacement, ultimately costing the insurance company more in the long run. We have successfully argued this point on behalf of our clients many times, resulting in new roofs for them.

Debris Removal

The cost of removing old materials and cleanup might not be fully accounted for in an adjuster’s estimate. However, debris removal and cleanup are crucial steps in the roof repair or replacement process. Professional contractors will dispose of old materials properly and leave your property clean and tidy after completing the job. It’s essential to confirm that these costs are included in the insurance company’s estimate and not an additional expense for homeowners.

Drip Edge Flashings

Drip edge flashing is a metal component installed along the roof’s edge to prevent water from infiltrating under the shingles and damaging the underlying structure. Without it, water can seep in, leading to rotting or mold growth. Despite being a commonly overlooked item, current codes in most regions and manufacturers’ guidelines require drip edge flashing. Although it adds to the overall project cost, ensuring proper installation is crucial to both protect your property and avoid unnecessary expenses. This step is vital in the roof claim negotiation process.

Starter Course

A starter course is a vital component of any asphalt shingle roof installation. It is the first layer of shingles installed along the eaves and rakes, creating a solid base for the rest of the shingles to be placed on. However, this element is often overlooked or not fully covered in insurance policies, leading to potential issues such as wind damage or water intrusion.

Ridge Cap

On a 3-tab roof, many adjusters may not itemize the ridge cap separately and instead include it in the total bundle count, since most roofers cut the shingles into three ridge cap pieces. However, the labor involved is significantly higher due to the time required to cut and install these pieces compared to field shingles. This can result in a substantial discrepancy between the insurance adjuster’s claim amount and what a reputable roofer would charge.

If a roofer overlooks this detail and doesn’t advocate for it on your behalf, they may be aiming for a low-cost installation. This could lead to corner-cutting elsewhere in the process to offset the price difference or result in poor workmanship, leaving you vulnerable.

Kickout Flashings

A kickout flashings are a critical element in preventing water intrusion in homes with adjacent roofs and walls. They divert water away from the wall and into the gutter, minimizing the risk of damage to your home’s structure. However, this important feature is often not included in insurance adjuster’s estimates, as they are unaware of its necessity or consider it an upgrade. As a homeowner, it’s important to be aware of this component and advocate for its inclusion during the roof claim negotiation process.

Why a Professional Roofer is the best way to Protect your Roof Claim against an insurance adjusters

A seasoned roofer can provide valuable insights and justification for these and other items, potentially influencing the insurance company’s decision on what will be covered under the claim. It’s also beneficial for homeowners to have a roofer present during the adjuster’s inspection to ensure all damage is documented and accounted for.

If you’re in Tennessee or Georgia, Roof MD specializes in Xactimate estimating and insurance scope writing. We use the same software as insurance companies to ensure clear communication and to secure everything homeowners are entitled to under their policy. We advocate for our clients and have a track record of successfully negotiating and securing coverage for items that may have otherwise been overlooked or excluded. Visit our insurance claim help page or book a free roof inspection today to get the help you derserve.