I do not work for insurance companies. But I deal with a lot of roof storm damage claims – mostly the ones that are rejected by insurance companies.
The quote above typically describes why the insurance claim is rejected.
My advice to home owners is to submit an insurance claim if a storm has caused water ingress into the house and caused internal damage. A home owner will stand a good chance of insurance coverage to repair all the internal damage – since these are all the result of a storm event.
Mostly, any internal damage will be repaired by the insurance company under the claim. It is the roof repair work that is usually challenged by the insurance companies.
If the insurance company sends out their assessor, this person will assess the internal damage and also do a roof inspection to see what caused the leak. This is where problems will arise. The assessor will often state that there is no storm damage to the roof … and that the leakage problems have been caused by lack of roof maintenance.
Some insurance companies even go as far as saying that since the leaking and subsequent damage is because the roof has not be maintained properly, the whole claim is rejected. They will not even do the repair to the internal damage!
Some examples of roof maintenance issues are: