The insurance roof assessor looks for There are some things that the immediately obvious storm related damage to the roof first.
If the roof inspection by the insurance company finds none of the above, then the assessor will ‘make up’ reasons why the roof leaked. And the majority of these ‘stab-in-the-dark’ reasons will result in the following:
“…unfortunately the roof repairs are not storm related and are due to lack of roof maintenance.”
Most homeowners pay insurance on their homes every year and do not make any claims for many years. They then think that when the roof leaks and there is damage to the house, their insurance policy will cover all the costs associated with the storm repairs. Surely, if they have paid all these annual premiums – then the insurance company has the money to pay for the full claim.
An insurance company has certain obligations. Their main obligation is to their share holders for making a profit year after year. This has a ‘double-edged sword’ effect.
A lot of their shareholders are the very homeowners who has any form of investment (like superannuation) in the share market. So, the homeowners gain every time the insurance company makes a profit.
… and if your insurance company loses money and goes ‘broke’ – you will be left uninsured. So, it is in everyone’s interest to let the insurance company keep making money.
…which means when it is your turn to make an insurance claim, the insurance company will make all efforts to limit THEIR losses – by reducing the ‘payout’ as much as possible.
So, if your roof leaks and you make a claim against the insurance company for repairs, you can expect some resistance for a full ‘payout’.
I do not work for insurance companies.
But I deal with a lot of roof repair storm damage claims – mostly the ones that are rejected by insurance companies. And I think I have exposed the ‘un-written’ rule when the insurance company makes an assessment on your storm-related roof repair.
It goes like this…
If there is physical damage to the roof caused by the wind, hail or any falling objects, then the roof damage is ‘directly storm related”. There will be no arguments, and the claim will be approved. If the leaking roof is not caused by any of these causes, then the roof problems are just so called ‘roof maintenance’ issues that is totally the homeowner’s responsibility.
However, water ingress into the internal parts of the house would not have happened if there was no rain/storm event. This means that water damage to the internal parts of your house is indeed “storm-related’. That means you will usually get your internal work repaired under your insurance claim.
It ‘bucketed down’ over the weekend and the roof leak returned with a vengeance. It was out with the towels and buckets. That was the leak that the roofer had tried a couple of times to fix.
So on Monday, Mike put in an insurance claim.
It took a few weeks to get an insurance assessor out. He was really just a builder and made a good assessment of the internal damages. When it came to the roof, he as ‘clueless’ as to why the roof leaked. But he saw the repair work that Mike’s roofer had done and (rightly) noted that the roof leaked because of maintenance issues. A proper roof should be able to withstand any rain. This roof was not one of these.
The verdict was : Mike had to repair the roof (at his own cost) before the insurance company approved the internal repair work to the ceilings and walls (at the insurance company’s cost).
Mike had given up on his original roofer.
He got another roofer to quote for and perform the roof repair. Hoping that this time around, a proper roof repair would be carried out…
He waited for some rain.
Some minor storms came and went. No leaks.
So, he told the insurance company. And they came out and did all the internal repairs.
Then, 2 months later, the roof got a proper drenching.
It leaked at the same spot again! The ceiling and walls got a soaking again.
“Sorry.” The insurance company said when Mike made another claim. “we will refuse any ‘payout’ this time because you have not fixed your roof properly…”
The insurance company had limited their exposure.
If the insurance company had agreed to do the roof repair under the first claim, there would have been a good chance that the roof repair would not have been better that the one that Mike had organised himself.
That would have put the insurance liable for the second repair to the roof leak. And this has the potential to loop several times…
Insurance companies have learnt from their past mistakes – and that is why they will not tackle any roof repairs. They would rather replace a roof if their backs were against the wall.
So, what to do if the ceiling is leaking?
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.
Some insurance companies even go as far as saying that since the leaking and subsequent damage is because the roof has not been maintained properly, the whole claim is rejected. They will not even do the repair to the internal damage! But this is quite rare.
So, if there is substantial damage to the inside of the home, a homeowner is better off making a claim and pay the excess.
However, if the internal damage is only slight staining to the ceiling, then the excess may be more than the cost of a re-paint. And now that the homeowner knows that most insurance claims for the actual repair to the roof (if it is not obviously caused by storm damage) will be rejected… it will be cheaper NOT to make a claim.
Just find a good roof repairer and get the roof fixed first. Then wait a (long) while to be confident that the roof repair is good – before repainting the ceiling.
It is easier to describe what is NOT roof maintenance and under these circumstances, the insurance companies will classify these as storm events:
… Anything else can be classified as ‘roof maintenance issues’ and give the insurance companies grounds for rejection of the claim.
Some examples of roof maintenance issues are:
Other roofing problems that are due to faulty installation or design are also lumped into the ‘roof maintenance’ category:
It is not smart to have your insurance find out that your roof has maintenance issues. If you have any signs of roof leaks – you should get these repaired properly yourself.
Then, you should organise to have gutters and valleys cleaned out on a regular basis.
Some roofing companies will do maintenance inspections and provide a report. These reports should be taken as ‘cursory’ – since most tricky roof leaks will not be picked up by these ‘fly-by’ roof assessments.
The trick is to get in early.
Roof repairers are in high demand after big storms. It is better to catch them before the storm arrives…