Fighting for Fairness: From Partial Denial to Full Roof Replacement
In March 2024, we received a call from a client who was struggling to get their roof claim covered by their insurance company. The loss had occurred in December 2023 due to wind damage which caused shingle loss. After discussing the situation with my roofer, it became clear that replacing strictly the damaged shingles wasn’t a viable option. The roof's age meant any attempt to replace them would lead to further damage, which contradicted the insurance company's initial position.
Upon reviewing both the damage and the insurance documents, I was convinced that the roof should have been covered. I began the process of getting my client signed up and gathering the necessary proofs to challenge the partial denial. The original offer from the insurance was just $802, minus the $2,000 deductible, making the offer effectively useless. The insurer also denied part of the roof on the basis of "wear and tear."
During negotiations, the insurance company sent a letter to my client threatening to drop them as a policyholder if they didn’t replace the roof. I reassured my client that even if they were dropped, the insurance company would still need to pay for the damage, as the claim fell within the policy period. I also advised my client to explore other insurance companies, as this particular one was known for being difficult in regards to claims.
Despite months of sporadic communication from the insurance company, I persistently submitted detailed documentation and multiple proofs of the roof's condition. I reached out repeatedly, escalating the issue to higher management to ensure it received the attention it deserved. After this ongoing back-and-forth, the insurance company finally acknowledged their error and agreed to a full roof replacement, accepting the estimate, which brought the claim total to over $23,000.
This jump from a partial denial and lowball offer to a full replacement was a fantastic outcome for my client, who was extremely grateful. This case demonstrates the value of hiring a public adjuster, especially when dealing with tough insurance companies. Ensuring you’re properly aware of what you are entitled to is what we do best, as shown by getting our client a +2700% increase from what their insurance company initially offered.