Property & Casualty Insurance/hail damage
QUESTION: I had a roofing company come out and check my roof. We had a bad hail storm in our area and noticed a lot of roof changing in my area. The roofing company told me it needs to be changed. Made the claim with travelers and the insurance person was not sure so he scheduled for a project engineer. It was declined. Just yesterday I had another roofing company check my roof without giving them any history. I let the roofer assume this was my first roof inspection. This is a one owner company and I picked him because he checked 4 other houses on my street and he only recommended one for replacement. Result in about 10 min. of checking my roof he told me it needs replacement. He showed me the areas where the hail hit and made dents and how if you feel it with your hand the granuals come off. I value the second roofers opinion more then the first roofer, he seemed to be very honest. My question is how do I handle this with travelers?
I'm sorry to hear about the hail damage to your roof and that the claim was denied.
I first must say that I've not seen your damaged roof, nor have I reviewed your policy to see if you are covered for hail.
Assuming that you are covered for hail and your roof has been damaged, I'm concerned as to why the Traveler's insurance adjuster is denying your claim. Even sending out an engineer isn't necessary. Are the hail hits not visible? Adjusters pay on new roof everyday without hiring an engineer. They count the number of hail hits within a 10' x 10' area to determine if it warrants a replacement. Unfortunately, the engineer works for the insurance carrier, so there's a chance that their report is biased.
What you need to do immediately, if you haven't already done so, is form a timeline and take lots of photos (of all the slopes on your roof, both overall photos and close up photos). Bring chalk with you to circle all of the hail hits and label each slope N (North), S (South), E (East), W (West). It might be safer if you have the roofer take lots of photos and to document your hail damages with chalk and write up a statement on their letterhead along with an estimate.
Your next step should then be to get in touch with your insurance agent to show them the photos, statements and estimates to see if they can assist in getting a different outside adjuster assigned to the claim.
There's a chance that the new adjuster will also side with the previous adjuster, however he/she may go ahead and pay on the roof. Either way, now is the time for you to review your policy to see if there's an appraisal clause, mediation clause, etc.. Those are paragraphs within your policy which can help you resolve your claim. Your agent can help you in determining if you have those clauses within your policy or at least arrange for a copy of your policy to be sent to you.
Worst case scenario is that your claim remains denied or they low ball a settlement offer (like giving you 30% of what you're needing to replace the roof). In that case, you should hire an experienced trial attorney or public adjuster to assist. Make sure you provide the attorney and/or public adjuster with all the information (photos, statements, estimates, timeline, etc.).
I hope this information helps!
---------- FOLLOW-UP ----------
QUESTION: Thanks for the reply. My policy clearly states hail damage is covered. Here is the letter from Neill Casper the Claim Representative from Travelers. This roof is only 5 years old with a rating of a 30 year shingle. They are sending me a check for $464.93 even after I told them I don't want it. Neal claims it's Ohio law and I can do whatever I want with it. I won't tell you what I told them what I will do with it. Again thanks for your reply.
Please forgive me again for sending this email during your vacation. I understand the importance of your file and as a result, I wanted you to have the claim documents asap. I have also mailed paper copies of these documents to your residence to be there upon your return.
Based upon my review and my supervisor’s review of the EES report, a coverage letter is attached noting it is the opinion of EES Group that the marks on your roof’s shingles are the result of heat blistering rather than attributable to hailstone impacts. The policy of insurance unfortunately does not provide coverage for heat blistering which is considered wear on the shingles.
I then completed a damage estimate based on the damaged metals EES Group included in their report. The estimate is attached along with a settlement letter that shows the payment would be $1,464.93 if you would like payment issued. While the letter states payment has been issued, please note that I am holding the payment pending your review of the claim documents. Payment would not be issued unless you give the approval for payment. The settlement letter was drafted only to help demonstrate the claim breakdown at this time.
With your family being on vacation, I will not follow up again for at least 3 weeks as I believe your return was set for around 7/3. I apologize again for the email during your vacation.
Neal Casper | Claim Representative | Property Claim Services
Great Lakes Claim Center
PO Box 50473
Indianapolis, Indiana 46250-0473
Thank you for sharing your denial letter from your adjuster. Unfortunately, you're hitting up against a brick wall with this adjuster. For some reason, this adjuster doesn't want to pay on this loss and has brought in his supervisor and an engineer to show you 3 people that are in agreement and feel that you shouldn't have a new replacement roof.
Your best solution right now is to hire a trial attorney or public adjuster to assist you further. Help your attorney or public adjuster by forming a timeline, photographing the damages (circle the hail hits & label the roof slopes in your photos), asking for written statements & estimates from roofing companies, getting in touch with your agent to show him/her your photos and roof estimates, ask that your agent request another adjuster to look at your loss, etc..
I hope this all works out for you, however you need to know that it can take a few months or even a couple of years if it goes through a full blown trial with depositions of key witnesses, etc.. During that time, your attorney or public adjuster will have opportunities to settle the loss (usually for less then your damages, but for more then they're offering you now).
If you want to fly solo and don't want to hire an attorney or public adjuster, work with your agent to see what he/she can do to get the loss reassigned to another adjuster and also you want to look to see if there's an appraisal and/or mediation clause within your policy. At the end of the day, though, I've always felt that insurance agents are insurance salespeople that work for the insurance companies that are paying them. I know they're supposed to be neutral, but they're not going to bite the hand that feeds them.
The only people that can represent your best interests are attorneys and public adjusters. The sooner you hire one the better. Feel free to keep me posted!!