Roof Insurance Claims: How to File, What's Covered, and How to Avoid Denial

Filing a roof insurance claim should be straightforward, but it rarely is. I've watched homeowners lose thousands of dollars because they didn't know the rules of the game—or because they trusted a contractor who promised to "handle everything" and then made things worse.

Here's the reality: insurance companies are in the business of paying as little as possible. That doesn't make them evil, but it does mean you need to understand how to document damage properly, what's actually covered, and how to push back when a claim is unfairly denied.

What's Typically Covered (and What's Not)

Type of Damage	Usually Covered?	Notes
Wind damage	✅ Yes	Lifted/missing shingles from storms
Hail damage	✅ Yes	Dents, granule loss, cracked shingles
Fallen trees/debris	✅ Yes	Storm-related impacts
Fire damage	✅ Yes	Complete coverage typically
Lightning strikes	✅ Yes	Structural and electrical damage
Ice dam damage	⚠️ Sometimes	Interior water damage yes, prevention no
Normal wear and tear	❌ No	Age-related deterioration not covered
Neglected maintenance	❌ No	Damage from ignored problems
Gradual leaks	❌ No	Slow deterioration, not sudden
Cosmetic damage only	❌ No	Many policies exclude non-functional damage
Flood damage	❌ No	Requires separate flood insurance
Poor workmanship	❌ No	Contractor errors not covered

⚠️ The "Cosmetic Damage" Loophole: Many newer policies exclude coverage for damage that affects only appearance, not function. Hail dents on metal roofing, for example, might be denied if the roof still sheds water. Check your policy for cosmetic exclusions BEFORE you need to file.

Step-by-Step Claims Process

Document Everything Immediately

Before you touch anything, before you call anyone, grab your phone and document:

Wide shots of the entire roof from multiple angles
Close-ups of specific damage areas
Interior water damage (ceilings, walls, insulation)
Date/time stamps on all photos (phones do this automatically)
Video walkthrough narrating what you see

Prevent Further Damage

You're required to take reasonable steps to prevent additional damage. This might mean:

Tarping exposed areas
Placing buckets under active leaks
Moving furniture away from water intrusion

Important: Keep receipts for any emergency supplies—they may be reimbursable.

File Your Claim Promptly

Most policies require claims to be filed within a reasonable timeframe (often 1 year, but can be as short as 60 days for some coverage types). Contact your insurance company:

Call the claims number on your policy
Provide basic information: date of damage, type of damage, your contact info
Get a claim number and adjuster assignment
Ask about the timeline for inspection

Get an Independent Inspection

Before the insurance adjuster arrives, get a trusted roofing contractor to inspect and provide a detailed written estimate. This gives you:

An independent assessment to compare against the adjuster's findings
Documentation of damage that might be missed
A realistic repair/replacement cost estimate

Meet with the Insurance Adjuster

When the adjuster comes out:

Be present. Don't let them inspect alone.
Share your documentation. Show them your photos and contractor estimate.
Point out all damage. Don't assume they'll find everything.
Take notes. Document what they say and do.
Ask questions. If they say something isn't covered, ask them to cite the policy.

Review the Settlement Offer

You'll receive a written estimate from your insurance company. Review it carefully:

Compare line-by-line with your contractor's estimate
Check if depreciation was applied (ACV vs RCV policies)
Verify the scope includes all damaged areas
Note any excluded items and the reasons given

Negotiate or Appeal if Needed

If the settlement seems low:

Request a re-inspection with your contractor present
Submit a written appeal with supporting documentation
Ask for a detailed explanation of any denied items
Consider hiring a public adjuster for complex claims

ACV vs. RCV: Understanding Your Payout

Policy Type	What You Get	Example (15-year-old roof, $15,000 replacement)
Actual Cash Value (ACV)	Replacement cost minus depreciation	$15,000 - $7,500 (50% depreciated) = $7,500 payout
Replacement Cost Value (RCV)	Full replacement cost (paid in two parts)	$7,500 initial + $7,500 after work completed = $15,000 total

      RCV Payment Structure: With replacement cost policies, insurance typically pays the depreciated (ACV) amount first, then pays the remaining "recoverable depreciation" after you complete the repair and submit documentation. You must complete the work to get the full amount.
    

Average Roof Insurance Payouts by Damage Type

Damage Type	Average Claim Payout	Typical Deductible	Net to Homeowner
Hail (full replacement)	$10,000-$18,000	$1,000-$2,500	$7,500-$17,000
Wind (partial damage)	$3,000-$8,000	$1,000-$2,500	$500-$7,000
Fallen tree	$5,000-$15,000	$1,000-$2,500	$2,500-$14,000
Fire damage	$15,000-$40,000+	$1,000-$2,500	$12,500-$38,000+

Common Reasons Claims Get Denied

1. Pre-existing Damage

Insurance only covers sudden damage, not existing problems. If your roof was already failing and a storm made it worse, they'll deny the claim. This is why regular inspections and documentation matter.

2. Maintenance Neglect

If the adjuster sees evidence of long-term neglect (clogged gutters, moss growth, unfixed previous damage), they may deny the claim as a maintenance issue.

3. Improper Installation

Damage resulting from poor workmanship isn't covered. If your 5-year-old roof fails because it was installed wrong, that's a contractor issue, not an insurance issue.

4. Filing Too Late

Most policies have time limits for filing. If you wait too long, you may lose coverage—even for legitimate damage.

5. Cosmetic-Only Damage

Increasingly common: policies that exclude purely cosmetic damage. Hail dents that don't affect function may not be covered.

⚠️ Storm Chaser Warning: After major storms, out-of-state contractors flood affected areas offering to "handle your insurance claim." Many of these are scams or result in poor-quality work. NEVER sign over your insurance check to a contractor, NEVER let them file the claim for you, and ALWAYS verify contractor credentials with your state licensing board.

When to Hire a Public Adjuster

Public adjusters work for YOU, not the insurance company. They charge 10-15% of your settlement but can be worth it when:

Your claim was denied and you believe it's valid
The settlement offer is significantly below repair estimates
You have extensive damage affecting multiple systems
You're dealing with a total loss situation
The insurance company is non-responsive or difficult

✓ Public Adjuster Results: Studies show homeowners who use public adjusters receive settlements averaging 30-50% higher than those who don't—even after the adjuster's fee. For large claims, this can mean tens of thousands of dollars in your pocket.

Tips for a Successful Claim

Know your policy BEFORE you need it. Understand your deductible, coverage type (ACV vs RCV), and any exclusions.
Document your roof's condition annually. Photos showing good condition before a storm strengthen your claim.
File promptly but don't rush repairs. Get estimates, meet with adjusters, and negotiate before committing to work.
Be honest. Exaggerating damage or claiming pre-existing issues as storm damage is fraud and can void your entire policy.
Get multiple contractor estimates. This gives you leverage if the insurance estimate is low.
Keep all receipts. Emergency repairs, temporary fixes, and accommodation costs may be reimbursable.
Don't accept the first offer. Initial settlements are often negotiable, especially with documentation.

The Bottom Line

Roof insurance claims are a game, and the insurance company knows the rules better than you do. Your job is to level the playing field with thorough documentation, realistic expectations, and a willingness to push back when the numbers don't add up.

Most legitimate storm damage claims do get paid—eventually. The key is persistence, documentation, and knowing when to bring in professional help. Don't let a low initial offer or a denial stop you from getting what you're owed.

Know What Your Roof Should Cost

Use our roofing calculator to get an independent estimate before dealing with insurance adjusters. Knowledge is power in the claims process.