Hail Damage Roof Insurance Claim Denied: Reasons, Appeal Steps, Checklist

If your insurer denied a hail damage roof claim, ask for the reason in writing. If the damage appears worse than the original estimate, you or your contractor can ask the adjuster to raise the estimate. For an amount-of-loss dispute, appraisal may be available under your policy. Take the dispute to your state insurance department if the answer still does not add up. The Texas Department of Insurance says that if a company denies a claim, it must tell you why in writing. State guidance addresses issues including late reporting, damage below the deductible, wear and tear, and permanent repairs before inspection.

Start with the step-by-step hail damage guide for the order of tasks on your property, then use this page for the claim itself.

Where hail comes from and why it hurts a roof

The National Severe Storms Laboratory at NOAA describes hail as solid ice that forms inside thunderstorm updrafts, and says hail can damage aircraft, homes and cars (NOAA hail basics from NSSL). Hailstones form when raindrops are carried upward into extremely cold air and freeze, then grow as liquid drops collide with them and freeze onto their surface. NOAA also notes that very large hailstones, with diameters exceeding 4 inches, can fall at over 100 mph.

How big is hail, and how often does it hit?

NOAA compares hail to everyday objects so people can estimate its size. Use these to describe what fell on your street:

NOAA says comparisons to known objects are good, but a ruler, calipers or tape measure gives the best measurement. If you can measure a hailstone, write the number down with the date.

On frequency, NOAA says Nebraska, Colorado and Wyoming usually have the most hailstorms, and the area where those three states meet, called hail alley, averages seven to nine hail days per year.

Is hail damage covered by my insurance?

The Texas Department of Insurance lists windstorm, hurricane and hail among the damages most policies cover, but says that if you live on the Texas coast or in Harris County on Galveston Bay, your home policy might not cover wind and hail damage. The Virginia State Corporation Commission explains that a named peril policy covers damage only from the causes listed in the policy, and that hail is on the list for the HO-2 form. Read your policy’s coverage section and ask your agent to confirm your exact coverage for hail on the roof, since policies and state rules vary. The examples on this page come from Texas, Missouri, Colorado and Virginia.

Many insurers also set a separate deductible for wind, hail or named storms. Virginia homeowners insurance guide says these can be a flat amount, such as $2,000, or a percentage of your dwelling coverage. In Virginia’s example, a $5,000 covered loss with a 2% deductible on a $200,000 dwelling leaves the homeowner responsible for $4,000 and the insurer paying $1,000.

Why hail roof claims get denied or paid low

The table below lists issues to check, each beside what a state regulator says about it. The right response is the same each time: get the reason in writing and compare it with your policy.

What to do first after hail hits your roof

Call your insurance company to report the damage as soon as you can. The Missouri Department of Insurance tips for filing claims advise contacting your agent or your company’s toll-free claims number right away.

Then protect the house without making permanent repairs. Texas advises you to make temporary repairs to prevent more damage, remove standing water, and cover holes to keep rain out. Missouri’s regulator says a hole in the roof should be covered by a tarp or other materials, and warns that further damage “will likely not be covered by your insurance policy.” Texas also lists a continuous water leak among the damages most policies don’t cover, so report any leak that starts after the storm right away. For the order of protection steps, see roof leak triage.

Stop and call a licensed professional for live electrical, gas, structural problems, and anything suspected to be asbestos or lead. Those are the points where do-it-yourself work stops being a good idea.

What to photograph and keep for the claim

Good records make a claim easier to review. Texas says to take pictures and video of the damage, and not to throw anything away until your adjuster says it’s fine. For the full list of what to capture, see home insurance repair claims.

• Pictures and video of the damage, taken before any repairs.
• A list of the repairs you made, with receipts for every temporary repair and for materials you bought.
• A written record of everyone you talked to at the insurance company, with dates.
• Proof that you paid your deductible, such as a receipt or canceled check. Texas says insurers can ask for it.
• Receipts for living expenses if covered damage means you cannot live in the home, since most policies cover some of those costs.

How long the insurer has to answer your claim

The Texas Department of Insurance lists the deadlines Texas law sets for insurers after you file. The company must confirm it received your claim within 15 days, send an adjuster to look at the damage, and accept or deny the claim within 15 business days after it has all the information it needs. The 15-business-day accept-or-deny deadline may be longer after major disasters. If it denies the claim, it must tell you why in writing. If it agrees to pay, it must send a check within five business days. A company that needs more time can take 45 days to decide, but it must tell you the reason for the delay.

Replacement cost, depreciation and what you actually receive

Texas says that if you have replacement-cost coverage, most companies pay in two checks. The first, after the adjuster looks at the damage, covers the estimated repair cost minus depreciation and your deductible. The second covers the depreciation after the company gets the bill for the finished job.

If your mortgage is involved, the Consumer Financial Protection Bureau guide on insurance payouts says the insurer generally writes the check to both you and your mortgage servicer. The servicer typically releases part of the money before work starts, more as work progresses, and the rest once the job is finished and passes inspection.

What the roofing contractor should and should not do

Colorado’s Division of Insurance points to the #NoRoofScams campaign for choosing a contractor after a hail storm. Missouri and Texas regulators add these rules:

• Be there when the adjuster visits and point out all the damage, and have your contractor with you if you can. Texas says a good contractor can talk with the adjuster about estimates.
• Do not let a contractor inspect your property when you are not watching. Missouri warns that some companies cause damage to increase the repair cost, and the insurer will likely not cover that added cost.
• Do not pay the whole bill in advance. Missouri says to pay in full only when the work is completed according to your agreement.
• Do not accept a deductible waiver. Texas law makes it illegal for contractors or roofers to offer to waive your deductible or promise a rebate on it.
• Get multiple bids and compare them with the adjuster’s report before you settle the claim.

For checking a contractor’s license and insurance before you sign, see contractor license and insurance checks, and for picking a pro, see how to hire a contractor.

Can an insurer choose not to renew my policy after a hail storm?

Colorado’s Division of Insurance says there are no laws that address non-renewal after a hail storm, but if you have had multiple losses, including hail, an insurer may consider non-renewing the policy. The Texas Department of Insurance states that a company may not refuse to renew your policy because you filed a claim for something your policy does not cover.

If the claim is denied, what are my next steps?

1. Ask for the denial in writing. Texas requires the company to tell you why it denied the claim in writing. Ask for the policy language it relies on and a copy of the adjuster’s report.
2. Ask for a higher estimate. Texas says that if the damage appears worse than the original estimate, you or your contractor can ask the adjuster to raise the estimate. Be present for the visit and point out every area.
3. Check whether appraisal is available under your policy. The Texas Department of Insurance says appraisal is an option for disputes about the amount of a claim, not about whether the policy covers a loss. Each side hires an appraiser, the two choose an umpire, and the umpire’s decision is binding. You pay your own appraiser and half the umpire’s expenses.
4. File a written complaint with your state insurance department. In Texas, use the Online Complaint Portal. In Missouri, call the Insurance Consumer Hotline at 800-726-7390. The Missouri department will determine whether the company followed Missouri law in handling your claim. The NAIC consumer resources say every U.S. state has a department of insurance that takes complaints.
5. Consider a public adjuster. The Pennsylvania Insurance Department describes a public adjuster as a person or business a policyholder can hire, at a cost, to negotiate a claim with the insurance company. The Texas Department of Insurance says public adjusters work for you, charge fees you should understand before you hire one, and cannot give legal advice or perform repairs. In Texas, they must hold a TDI license, which you can check with the Help Line.
6. Consider an attorney or small claims court. In Texas, if the damage was caused by a disaster, you must tell the company in writing at least 61 days before you sue. If your claim is for less than $20,000, you can use Justice Court, which handles small claims. You do not need an attorney there, but you pay a filing fee and other court costs in advance.

Who to call and when

Can I fix a hail-damaged roof myself?

Temporary protection may be appropriate only if you can do it safely from solid, dry ground; otherwise, call a licensed professional. Avoid permanent repairs until the insurer has inspected the damage; Missouri and Texas warn that repairs made earlier may not be reimbursed. Keep every receipt. If the roof work touches the points listed above, such as live electrical or structural problems, stop and call a professional.

Before you call your insurer: a quick checklist

• Note the date the storm hit and the date you first saw damage.
• Take photos and video from several angles before any repair.
• Protect the house with a temporary cover and keep the receipts.
• Find your deductible, including any separate wind or hail deductible.
• Get the claim number and the name of the adjuster in writing.
• Ask for any denial in writing, with the policy language.

The next small step is the phone call to your insurer today. Report the damage, ask for the claim number, and start your photo list.

By HomeRemodelingAndRepairs.net Home Research & Editorial Team