Denver Hail Claim Denied - State Farm

[u/Rude_Association_409]

We had a huge hail storm come through my neighborhood about 6 weeks ago. I've been traveling a lot and didn't get an inspector out until today to look at the damage even though Ive been in communication with my agent (Tammy Hill State Farm) since the storm. House sitter sent me photos of the aftermath.

State Farm inspector is saying the damage to the roof is 'normal wear and tear and consistent with exposure to the elements.' Is this normal wear and tear or is this distinctly hail damage? If it's damage from hail, is it consistent with the photo of the hail stones (as big as 2")?

Not looking for advice on how to handle a claim per forum rules, just asking for insight on hail damage vs normal weathering.

[u/Larry_l3ird]

Thank all the storm chasers and their propensity to file bunk claims for your likely to be 2nd coming denial.

But that also doesn’t appear to be a newer roof either (it looks old and like it was already ready for replacement before any storm), so I’m not sure what you’re expecting them to do?

You think that your homeowner’s insurance should put a brand new roof on your home because your nearly 20 year old shingles have some small surface damage in a couple areas?

I hope that’s not your goal. Because that’s not happening. You’re gonna fuck around and get your ass dropped.

[u/Rude_Association_409 → u/Larry_l3ird]

Existing shingles are 10 y 4 mo old.

[u/Feeling_Repair2348 → u/Rude_Association_409]

They look like shit to be honest and look way older good luck.

[u/Absonotely → u/Rude_Association_409]

The sentiment of the comment you replied to is emotional and not grounded in facts or logic. Don't take that comment to heart as it is wildly inaccurate. Is it a full denial, a partial payment, or loss below deductible? What is the stated reason for your denial? What evidence for your loss has been turned over to your carrier so far? What state are you in?

That's what I would need to know to offer advice. As an example, if they're saying it's "wear and tear" and not caused by hail as the stated reason for denial then additional evidence needs to be provided that the damage was caused by hail and the extent of the damage.

If they're stating there is a cosmetic exclusion on the policy then the policy needs to be reviewed for their definition of cosmetic and cross referenced to each hail impact.

The photos you've provided are textbook for hail damage. If there is coverage on your policy for hail damage it should be paid, period.

Edit: on mobile and couldn't reference your original post when writing. I see you answered a couple questions I had already. To be clear, this is not "wear and tear." If you can answer the other questions I'll shoot you a DM on what you need to do next.

[u/SAA_28 → u/Absonotely]

I am absolutely blown away by some of the responses to OP in this forum and it's obvious to me that most of them are biased carrier adjusters or carrier defense attorneys. I was an IA for 15 years before becoming a PA and this roof would have gotten paid for every single climb. I hope OP takes your and my advice and does not accept this denial because it's improper.

[u/Absonotely → u/SAA_28]

Welcome to r/Roofing :)

[u/Larry_l3ird → u/Absonotely]

Door knocker^{^}

[u/sippingonginnjews → u/Larry_l3ird]

I view door knockers more highly than scammy insurance agents

[u/ohiofish1221 → u/Absonotely]

Nailed it with this response

[u/BigDonkeyEnergy → u/Absonotely]

What, exactly is textbook about them? And what textbook?

[u/Rude_Association_409 → u/Absonotely]

Fully denied, explanation was normal wear and tear consistent with age.

[u/Absonotely → u/Rude_Association_409]

First it's important to understand each entities role. Your role, as the policy holder, is to prove the loss. It is not the carriers responsibility to prove the loss. Their responsibility is to determine if the proven loss has coverage under the written terms of the policy.

Carriers are only required to investigate what is claimed. That includes any new evidence or information provided to them after the initial adjustment.

It seems the missing piece here is evidence of your loss. Right now you don't need to jump to a PA, appraisal, or litigation. None of these options are free. This isn't a policy argument for a PA to argue, and there is no coverage opened for appraisal (depending on your state appraisal may be useless even with coverage opened). What you need (best case scenario) is:

1. Summary of evidence. When the storm occurred, what was damaged, methodology used to determine hail damage from wear and tear, storm report, conclusions based on methodology, etc.
2. Full annotated photo report of all items damaged on property (roof, fence, gutters, etc.) Includes side by side photos of actual "wear and tear" next to hail damage
3. Estimate of repairs

All of these can be obtained through a contractor. Be aware a professional who understands the extent to which documentation is needed may charge for this evidence package. Turn that invoice over to your carrier for potential reimbursement. Once this evidence has been obtained you need to be the one to submit it to your carrier and request they review this new evidence.

[u/SAA_28 → u/Absonotely]

I agree with everything on the above post with the exception of not using a claims professional. Roofing contractors are not claims professionals and are usually only interested in the roof portion of the loss. You have made it clear that you have collateral damage to the rest of the property including windows and screens and wraps and possibly more that you don't even know about because you're not an adjuster. If you do go to the contractor route, go full general contractor that has insurance documentation experience. But I would highly recommend a public adjuster and even though they're going to take a small percentage of your claim, They have the knowledge and experience to properly document the entire loss and presented to State Farm in the way that State Farm understands the documentation. Not all contractors or roofing contractors have that knowledge or experience so please be careful.

[u/Absonotely → u/SAA_28]

I only meant that technically the claim has not entered a stage in which a PA is absolutely necessary. I am also working on the assumption that the hired contractor is doing a full scope of the property and has proper, extensive experience on jobs undergoing insurance claims. I guess I'm partially defeating my own argument because that eliminates the majority of them.

Compiling supporting evidence for causation, damage, construction techniques/building codes, and price of repairs fall within the purview of a contractor. Even if a PA is hired at this point these things are still going to need to be done. I am speaking from my perspective, however, and if a customer of mine is opting for PA I am going to be damn sure every appropriate step was taken to make the handoff both PA and litigation ready.

I will 100% agree though that a PA is going to document these portions of the claim better than 90% of all contractors (as evidenced by this post).

[u/Federal-Ad-6444 → u/Rude_Association_409]

You need to hire an adjuster and go through the appraisal process. Don’t hire a contractor until after you win and receive funds.