You spend a lot of money on homeowners insurance. What does it really cover? And, what do you do if your insurance company denies, low-balls, or simply delays your claim? You have more power than you think.

There are innumerable ways your home can be damaged. You may immediately think of fire and storm damage like a tornado or hurricane. However, there can be water damage from a broken washing machine or ice maker line, vandalism, sinkhole, hidden decay, hail damage, tear gas (yes, tear gas), sewage back-up, damage from blasting nearby or even from vibrations sent through the earth by heavy equipment being used in the vicinity.

I have handled many actual cases involving all these types of damage and many more. I even had a case where someone’s wooden floors were destroyed by someone dancing on them in high heels. It would be impossible to list all the various ways a home can be damaged. As a result, coverage for your home is typically provided as “all-risk” coverage, which means your home is covered for damage from all risks unless there is a specific exclusion.

The most typical homeowners claims in the Central Florida area are:

– Wind and hail damage to roofs.
– Sinkhole damage
– Broken water lines to ice makers, plumbing and washing machines
– Fire damage
– Vandalism and theft

In this article, I will discuss how to identify roof damage, and what to do if you find it.

You Paid for “Replacement” Cost

Your homeowners policy covers all storm damage to your roof. And, not only is your roof covered, it is covered for “replacement cost.” This means that the insurance company has promised you in your policy to replace your roof – regardless of age – if it is damaged by a storm. For example, suppose you have a 20 year old shingle roof that is working fine when it is damaged by a storm. Your policy provides for complete replacement of the roof with no depreciation. Some people feel bad about asking for the entire replacement cost of an older roof. Don’t. You paid for replacement cost in your premium, and the insurance company promised to provide you with replacement cost if you need a new roof.

What if I Suspect Wind or Hail Damage?

If you suspect your roof has been subjected to high winds or hail, you need to have it examined by a qualified and experienced roofer immediately. You can have severe damage to the tiles or shingles on your house even if no tiles or shingles are actually blown off the house. Many roofs look absolutely fine from the ground even though they have been totally compromised by storm damage.

Wind Damage

Shingles have a sealing strip between them. Many times, wind will lift the shingles and break the sealing strip during a storm. After the storm, the shingles simply lay back down in place – looking fine. If that sealing strip is compromised, then your roof likely needs to be replaced. This sealing strip is critically important to the integrity, functionality and longevity of your roof. If the sealing strip is compromised you roof will likely start leaking within a year or two of the wind event. That is why you need to have it examined immediately, before it starts leaking.

Likewise, tile roofs suffer from a similar plight. The tiles themselves on a tile roof system are simply decorative. The water barrier for a tile roof is the underlayment – the paper below the tiles. In a strong wind, the wind can “chatter” the tiles on your roof. This means the wind gets up under the tiles and repeatedly “jiggles” them up and down during a storm. After the storm, the tiles look fine. However, during the storm the chattering tiles have also “jiggled” the nails securing them to the underlayment causing the holes around the nails to open up wider than they should. This allows water to seep in around the nail holes throughout the roof. As with shingles roofer, many times, the water damage does not begin to show up for a year or two from the wind event.

Hail Damage

If your home is subjected to hail, you should also have your roof examined by a roofer. Some hail damage is easy to spot – like when it knocks holes in your pool screen, or dents the metal or lead boots on your roof. But, just as significant is hail damage that can only be seen close up. Often when hail hits a roof it causes what is known as “degranulation” of the shingles. Degranulation can only be seen on close inspection by someone who knows what they are looking for. When hail causes degranulation the integrity of the shingle is compromised, and the serviceable life of the shingle is significantly shortened – all of which warrant roof replacement under your homeowners insurance policy.

Choosing a Roofer

Before allowing a roofer to examine your roof for storm damage, you should quiz him about his experience in identifying storm damaged roofs. Ask him what he will be looking for and how he is going to document the damage. A qualified and experienced roofer will have a camera, video camera, and chalk readily available to document the damage. If you have doubts about the roofer’s ability to be able to identify and effectively communicate the damage to another, then don’t even let him on your roof. Find a roofer in whom you are confident.

If your roofer identifies wind or hail damage, then call your homeowners insurance company. Do not delay. There are certain time limits set forth in your policy that may prevent a recovery if you wait too long after discovering a problem. Ask your insurance company to send an adjuster out to inspect your home. Make sure the adjuster coordinates the visit with your roofer so that the roofer can show the adjuster the damage.

Under the Florida Building Code, if 25% of your roof needs to be replaced, the insurance company is required to replace the entire roof. Under Florida’s Insurance Statutes, even if less than 25% of the roof needs to be replaced, the insurance company must replace your entire roof if the repaired area won’t “match” the existing shingles. This is often the case when new shingles or tiles are interspersed into an older roof. Under either situation above, the insurance company must replace the entire roof with no deductions for depreciation.

What if the Insurance Company Denies, Delays or Low-Balls?

In my experience, most of the times the insurance company does the right thing. Sometimes they don’t. Sometimes, the insurance company will have an “independent” engineer or roofer come to inspect the roof. That “independent” engineer or roofer may say that the roof has no damage, or is simply failing because of age, wear and tear, or poor maintenance. Based on that report, the insurance company may deny the claim in its entirety or offer a nominal settlement. The insurance company’s “no,” is not the end of the inquiry…it is just the beginning.

If your insurance company says “no,” you should contact an attorney who handles roof claims immediately. In a situation such as this, I will always meet with you and review your case for free. Most importantly, in Florida, there is a statute that requires the insurance company to pay your fees and costs if you are successful against your insurance company. This statute is a powerful tool in leveling the playing field between the homeowner and the insurance industry.

Mark Nation is a civil trial lawyer who focuses his practice on helping policy holders in claims against their insurance companies. He has litigated thousands of cases involving homeowners, business owners, life, health and disability insurance against most of the world’s largest insurance companies.