Roof Insurance Claims in Atlanta Overview
Approximately 50% of all roofs in Georgia are replaced via a roof insurance claim. Should you file a claim for your roof, or avoid the insurance process altogether? Insurance claims are not for everyone and can have hidden consequences. However, it can be tempting to file an insurance claim when neighbors are "getting free roofs through insurance" and roofers are promising "free roofs" while knocking on your door. The more you understand about this process, the better decision you will make when choosing whether to file a claim and which roofing company to work with.
Equation #1 - Will Your Roof Insurance Claim Get Approved?
The equation below lists the five major components of a roof insurance claim. Any one of these components can make or break your insurance claim on its own accord.
Amount of Storm Damage on Your Roof
This is the most important part of the insurance claim equation. The more storm damage that is present, the more likely your roof is to be covered under an insurance claim. The less damage that is visible, the more you will lean on other parts of the equation for an approval.
You can inspect your home for these components. However, if you don't feel comfortable climbing on your roof, contact a trusted local roofing company, or ask your insurance agent for a referral.
Examples of Storm Damage
What is not storm damage?
- Blistering shingles from improper ventilation (looks like hail, but it is not)
- Old indentations in metal vents and gutters
- This happens when the roof is replaced, but the metal vents on the HVAC and other pipes are not replaced at the same time. This way, you have a brand new roof, but your HVAC cap is dented from hail 10+ years ago
If a roof insurance claim is filed for non-covered damage as listed above, the insurance adjuster will likely deny the claim.
Quality of Your Insurance Carrier
The quality of your insurance carrier is the second most important part of the insurance claim equation. The better the carrier, the less damage that is needed to have the roof approved. Be sure to read our list of best insurance carrier for approving roof insurance claims in Georgia. Just because your insurance carrier has a lot of commercials does not necessarily mean they are a good carrier. In fact, most of the time it means their marketing budget comes from the amount of claims they are denying! Top 10 carriers for roof insurance replacement:
- Liberty Mutual
- State Farm
If your carrier is not on this list (Allstate, GEICO, American Family, etc.), it is because they are not likely to approve a roofing insurance claim unless there is significant damage. Georgia does not often have huge hail like the Midwest, so getting hail claims approved through these carriers is significantly more difficult. If your carrier is not on the list because they are a smaller carrier, they are typically easier to work with and more likely to approve a roof insurance claim.
The Insurance Adjuster Assigned to Your Claim
The insurance adjuster assigned to the claim is an important part of the equation. The adjuster could be experienced or inexperienced, strict or lenient, be in a good or bad mood, etc. Adjusters insert the human element into the claim process. The categories of adjusters assigned to claims are below:
- Local adjuster
- These adjusters live in Atlanta and commute to the home office every day. They are typically the most strict when approving insurance claims, although this varies based on the quality and size of the carrier.
- Cat ("Catastrophic") adjuster
- These adjusters do not live locally and are working when claims loads increase past what the local adjusters can handle. They are the most lenient when approving claims as their pay is typically based on the dollar amount of claims approved. When the "cat team" shows up to your claim, it is a positive sign of an insurance claim approval.
- Third-party adjuster
- Some companies utilize "ladder assist" companies. This means the insurance adjuster will remain on the ground, and send a third party onto the roof to take pictures, create a report, and make a recommendation for approval to the adjuster. The third-party adjusters are typically more lenient than local adjusters, but not as lenient as cat adjusters.
Insurance Claim Timing
Roof insurance claims should be filed within 365 days of initial damage. All repairs should be made within 12 months of the filing date.
How to tell if hail or wind storm has hit your home within 365 days?
- Check the NOAA Storm Site. This site is helpful if you know the specific date of the storm.
- Ask a roofer. Roofers typically have a paid service (such as Interactive Hail Maps) where they can download a report specifically for your address.
Do you have Previous Roof Claims?
In our experience, the best way to get a roof insurance claim approved is on the first try. Insurance carriers generally like taking care of their customers for legitimate claims. However, if multiple attempts are made for the same claim, it decreases the likelihood of approval. This also complicates the claim as, during a second or third filed claim, the adjuster will often state that the damage is "preexisting" and was dated to the last denied claim. Adjusters cannot approve every claim, and will often use the multiple roof claims as a reason to deny a claim.
Equation #2 - Should you File a Roof Insurance Claim?
If you determine your roof has enough storm damage to qualify for an insurance claim, should you file a claim? This will depend on your claim history, policy, and how much would actually be covered if a claim were filed and approved.
Quick note: roofers are not allowed by law to view the insurance policy of any homeowner. Only public adjusters are allowed to read and interpret policies. Therefore, homeowners need to either contact their agent in this case or look at their policy for the items below.
What is the size of your deductible?
Every homeowner must pay a deductible for every claim. The larger the deductible, the less money you receive for a claim. $1,000 deductibles are the most common, but several carriers updated their policies to have specific deductibles for hail and wind claims. We suggest reading your policy to determine your deductible size. If you have questions, it is best to reach out to your insurance agent. Try to avoid calling the 1-800 number for general questions as the insurance carriers will log the event and might use it against you!
Do you have replacement coverage (RCV), or actual cash value (ACV) coverage?
Replacement Coverage Value ("RCV") will pay for the replacement of your roof. Actual Cash Value ("ACV") will only pay for the cash value after depreciation of your roof. This item has the largest impact on your total out-of-pocket amount. The image posted here shows an ACV Allstate policy that will only cover 49% of the total roof replacement (not 100%). For example, using rounded numbers:
$10,000 cost to replace -$5,100 (51% depreciation) = $4,900 (49%) coverage
$4,900 - $1,000 deductible = $3,900 your insurance would provide toward a $10,000 roof.
What is your code upgrade coverage?
If your policy has Ordinance & Law coverage, your insurance carrier will pay to bring your roof up to the current building code. If your roof does not have this coverage, the costs of adding items such as drip edge and valley metal will be the responsibility of the homeowner. Most policies do have this coverage, but if they do not, it can add $1-3k+ to the out-of-pocket costs of an insurance claim.
How many insurance claims have you filed in the last 5 years?
Most homeowners are dropped for their third claim within five years. Therefore, you need to know if you've had tree claims, water claims, vandalism claims, etc. before filing a claim for your roof. If you are dropped after filing an insurance claim, your annual rates could increase while looking for new coverage.
What options do I have if my roof insurance claim gets denied?
There are a couple of options if the roof claim is denied:
- Request a reinspect with a different adjuster. This is the most common and recommended path for roof insurance claims that were denied. This is a free option, and there is still a decent chance of the roof being approved with a different adjuster.
- Hire a public adjuster. Public adjusters are licensed insurance professionals that fight for the claim holders against unjust insurance companies. This person will contract for a portion of the proceeds. This process takes a couple of months, requires lots of documentation, and can sometimes produce reversals. We do not typically recommend this option.
- Sue your insurance carrier. This is also not a recommended option, as it can be costly, take a long time, and is no guarantee you will win.
Will filing a roof insurance claim raise my homeowner's insurance rates?
If this is your first claim over the last five years, and your roof is successfully replaced, it should actually lower your homeowner's insurance rates as you'll have a brand new roof that is less likely to be affected by storm damage.
If this is your first or second claim in the last five years and the claim is denied, your rates should remain unchanged.
If this is the homeowner's third claim in five years, most carriers will drop you from coverage. This means you will have to go back out to the market and pay higher rates for a new policy.
Insurance rates for hail and wind events are set at a regional level, so your individual claim would not be the sole reason your rates would increase. Additionally, if there are a lot of claims being filed around you for weather events, this in and of itself could raise your rates even if you do not file a claim!
What happens if my claim is approved?
Congratulations! Your roof insurance claim was approved by your insurance carrier. Let's go through the steps to properly close out the claim.
Your insurance company will send an initial cost estimate.
The adjuster will use the insurance software Xactimate and apply all line items relevant to your roofing system that are visible at the time of approval.
Your insurance company will send the first check.
The insurance company will send the amount equal to the ACV (actual cash value) of the lines approved to you. This will come in the form of direct deposit or a check in the mail. Sometimes, the check will have the mortgage company listed which will require an endorsement from your bank prior to the funds being released.
Install your new roof.
Work with a local roofing contractor experienced in insurance work to install your new roofing system. If the company is reputable, you should be able to understand your out-of-pocket expenses prior to installing the roof. Most often, your out-of-pocket is limited to your deductible. Additional expenses not covered by the insurance company scope are as follows:
- Rotten decking. Insurance companies consider this a "maintenance" issue not caused directly by the storm, so this is not normally covered.
- Shingle upgrades. The insurance company will pay to replace the shingles that currently exist on the home, and are not responsible for installing upgraded shingles.
- Manufacturer warranties. Insurance companies do not cover extended warranties.
- Other upgrades. This could be upgrading to ridge vent from the existing ventilation system, or making changes to the existing roof.
- HVAC, Siding, and Other Roof Components. If the insurance company did not cover replacing HVAC flashing or rotten siding that will be disrupted during flashing replacement, these will likely be additional costs on top of the deductible.
If the initial insurance estimate is lower than expected, you or a roofing contractor can send an estimate for approval prior to construction to see what items would be approved. From our experience, it is best to communicate with insurance companies using the approved insurance system, Xactimate for any estimates to be preapproved.
Send a final invoice to the insurance company.
The final invoice will almost always include items not originally approved by the insurance company. This is due to a couple of standard operating procedures insurance companies use, as seen below.
- Paid when incurred items. The initial estimate will only include items found during the initial inspection. If items are installed to bring the roof up to code (such as drip edge), the insurance company will cover these costs with a citation of the building code, and pictures of the items during installation. The price will come from the insurance software, Xactimate.
- Hidden roofing components. The adjuster almost always includes items that can be seen during the initial inspection. This means the step flashing (which is hidden behind the siding, and under the shingles), cannot be seen and will not be included. If the flashing is replaced, and pictures of the installation and code are provided, these items will be covered using Xactimate pricing. Other items are chimney flashing, apron flashing, and any other items that were left off of the original estimate, but pertain to installing the roof correctly.
What happens if the insurance company does not cover all submitted items?
The roofer should provide an out-of-pocket cost to the homeowner prior to work starting. If items come up during installation that would change this amount, this should be communicated to the homeowner immediately. We find that this is not common if the proper steps are taken before the roof is installed, such as examining the flashing, and looking in the attic for rotten decking.
Can the homeowner keep extra funds that approved?
It is illegal to profit off of an insurance claim. This means if additional work was performed and approved by the insurance company, the homeowner cannot keep this money above and beyond their required deductible.
The final check is issued to the homeowner by the insurance company.
The final check will be issued to the homeowner once the insurance company has proof the work was completed. The final check will include:
- Depreciation. This is the amount originally approved, but held back until the work was completed.
- Paid when incurred items. These items will be included in the second check to the homeowner.
- Additional approved scope items. These items will also be included based on the pictures and code submitted to the insurance company during construction.
Final roof insurance claim pointers.
Choosing to file an insurance claim for your roof can be a tedious and long process. Working with the correct contractor can make this process go a lot more smoothly, limit out-of-pocket costs for the homeowner during construction, and save customers money by getting a damaged roof covered by the insurance company. A couple of final tips:
- Use a local and trusted roofer. Reputation is probably the biggest determining factor to keep roofers honest. Use companies with good reviews that operate on a referral basis.
- Avoid roofers that knock on your door. These roofers are typically not in good standing with the insurance companies and will create potential headaches throughout the process. Also, these companies are knocking as people are not likely to refer them after a roof is completed.
- Never give a roofer money prior to the day of construction. There are a lot of news stories of roofers taking the insurance money and never returning to complete the work.
Insurance claims are common in Atlanta, and the process can be rewarding if everything is done correctly. Good luck!