the insurance roof claim process, explained.
You suspect your roof has been damaged and you’re thinking of filing a homeowners insurance claim, but you’ve never been through the process before. Here is what the full process looks like, from start to finish.
Step 0 – before you file a claim
Before filing a claim we always recommend our clients take these two steps.
Confirm how much your wind/hail deductible is with your carrier
When filing a claim, it is important to know how much your deductible is. You can find this information in your policy paperwork, or you can call your insurance carrier to confirm. Some carriers may have separate deductibles for wind/hail claims so we always recommend you confirm.
The deductible is your contractually obligated portion of the claim to pay. Think of it like a co-pay when you visit your doctor. You cover the “co-pay” (roof deductible), and your homeowner’s insurance covers the rest. The deductible is often a pre-set amount, anywhere from $500-$2000, but some homeowners may have their deductibles set as a % of their home value. For example, if your home is valued at $300,000 and you have a 2% deductible, your total out-of-pocket expense will be $6000.
We recommend our homeowners find this information out prior to filing a claim so there are no surprises, and to decide if filing a claim is worth it. If a deductible is too high to manage comfortably we do offer in-house and third-party financing options to assist all of our homeowners.
Note: It is illegal in all 50 states for any contractor to waive the deductible. Waiving a deductible is a felony in North Carolina and will result in fines up to $2000 for homeowners and contractors, but also will revoke our license to work in the state. Yellow Sun Contracting does not, and will not waive any deductible. It’s simply not worth the risk.
Have a trusted roofing contractor inspect the home for roof damages.
Our experienced project managers will start on the ground level, taking photos of all 4 sides and corners of the home, looking for any storm-related damage to your siding, windows, gutters, fencing, and anything else. If there is any interior damage, like a ceiling or window leak, please let us know. We then climb the roof and look for storm damage, take photos of what we find, and compile a photo report for you and the insurance carrier. Once the inspection is completed, we will go over our findings with you and recommend whether or not to file a claim. We will also be present at the adjustment in order to assist the insurance adjuster and point out all of the damages we found.
Our project managers at Yellow Sun Contracting have years of inspecting and managing hundreds of roof claims. Our promise to you is to treat every claim like we would our own families. We’ve handled hundreds of claims with a full replacement rate of over 90%. For more information on our roof inspection process, please read our article: Our 30pt Roof Inspection.
step 1 – filing the claim
There are multiple ways to file a claim. You can call the insurance carrier’s claim hotline, you can fill out a form on their website or app, and for some smaller carriers you would have to call the local office and file a claim by phone. Most insurance agents are not able to file claims themselves, and they would direct you to one of the above options.
When filing the claim we always recommend you be as honest as possible. Most insurance companies will ask you the same standard questions: Did you lose power, were any belongings damaged, did any food spoil, etc. The most important questions however are what kind of damages were found on the home, and when did the damage occur.
If you’ve already gotten a roof inspection, please let them know all of the damages that the inspector found to the roof, exterior, gutters, or any interior damages if there are any. Also, if the inspector found any kind of hail damage on the roof, we always recommend filing for wind AND hail to give you the best chance of approval.
If you do not know when the damage occured, please let them know so. In North Carolina we experience multiple wind and hail storms every year. If you do not know the date of the storm, which many of our homeowners don’t, we recommend you let the insurance company know just that. You don’t know when it happened, only when the damage was discovered. Most insurance companies call this the Date of Discovery, and often times this leads to a more favorable outcome as insurance adjusters cannot deny any damage that does not line up exactly with any one particular storm date.
Some may ask if you are working with a contractor. If so, please provide them with your project manager’s Name, phone number, and company name. This will help us help you down the road.
Once the claim is filed it will be assigned a claim number, please record this number. The claim will be assigned to an adjuster or adjusting firm, and one of their representatives should reach out to you within 24-48 hours to set a date and time for the adjustment. Please let us know that date and time so we can meet the adjuster there.
The adjusters work for the insurance companies, we work for you.
Step 2 – the adjustment
On the date and time of the adjustment, a YSC project manager will meet the adjuster at the appointed time. If possible, we will show up early and already have the ladder set up and some of the damage marked and ready for documentation.
Adjusters normally start on the ground level, take photos of any interior and the exterior of the home, then they will climb the roof and assess the damages present there. It is no coincidence that this process is identical to our 30pt Roof Inspection.
Once all of the damages have been documented the adjuster will write up a report and either send it in to a desk adjuster or print out a report and check right there and then. Some adjusters may not be able to disclose the damages they found to the homeowner. Many third-party adjusting firms’ policies prevent them from doing so. This is one of the reasons it is important to have a project manager there, so they can let you know how the adjustment went if the adjuster can’t.
Step 3 – adjuster decision
The adjuster or claim manager reviews the report and make the decision to approve, partially approve, or deny the roof replacement.
Once their decision is made, they will compile an estimate with a dollar amount and contact you with their decision. Please let your project manager know when they reach out and send them the insurance estimate once you receive it.
If the roof is fully approved, the project manager will arrange a time to go over the insurance estimate and next steps.
Step 3.5 – appeal and supplement
If the roof is NOT fully approved, there are ways to appeal the carrier’s decision. The first step is to go over the insurance estimate with your project manager to confirm what damages were paid for.
Then the project manager will be able to advise the next steps. More often than not, all it takes is sending our report and replacement estimate directly to the claim manager.
If the carrier wrote just to replace or patch a few shingles, then we may attempt a shingle replacement on the roof to prove repairability. If we cannot replace a shingle without damaging those around it, then the shingles are deemed un-repairable and must be replaced.
If the carrier did not find “sufficient” damage to the roof, we may send in photos of all the damage we found or ask them to send a second adjuster out. Often times adjusters or adjusting firms are not able to fully approve a roof on the first adjustment so a second adjustment may be required. We recommend our clients request a different adjuster or adjusting firm, ideally a supervisor or lead adjuster. Supervisors often have more authority to push a claim from denial to approval based on their findings.
Step 4 – install agreement.
Once the carrier has approved the roof in full, a project manager will review and explain the estimate to you. The insurance estimates are often broken up into tables full of numbers, line items, totals, subtotals, and such.
Our YSC project managers will be able to review the estimate and confirm that the carrier has paid for all of the items necessary to replace your roof and bring it up to code.
RCV, ACV, and Depreciation explained
When you receive your estimate from the insurance carrier, they will have the estimate separated into 3 separate amounts: The RCV (Replacement Cost Value), the Depreciation, and the ACV (Actual Cash Value).
The RCV is how much the insurance carrier is estimating that the total project will cost. Let’s use an example of an RCV of $10,000.
Depending on the age of your roof and what kind of policy you have, the insurance carrier may choose to withhold up to 50% of the total project cost until the work is completed. They withhold depreciation in order to protect themselves just in case you choose not to get the work done. If you do not complete the work, they don’t have to send the second check for the depreciated part of the claim. Let’s say they withhold $4,000.
The ACV then is the remainder after they deduct the depreciation from the RCV. In this case, $6,000. This is the depreciated value of your roof.
Finally they deduct your deductible, let’s say $1,000, and your net ACV is $5,000.
Your first payment from the insurance carrier will be $5,000, even though the roof is approved for $10,000.
the insurance estimate is just that, an estimate.
Most insurance companies use an industry-regulated estimating software called Xactimate. This software contains line items that have built-in pricing so that the insurance adjusters can easily write estimates to repair damages to your home.
Our estimators at Yellow Sun Contracting also use Xactimate to produce our estimates. This means that the only difference between the insurance carrier’s estimate and ours is the number of line items and the quantity of each.
For example, if the insurance carrier says your roof will require 2000 square feet of shingles to replace the roof but it actually requires 2400 square feet, or if they did not include items that are needed to bring the roof to pre-storm condition and up to current building codes, we can adjust or add line items and send our estimate for correction.
This process is called supplementing and is sometimes a necessary step as many insurance adjusters come in from out of town and do not know the local building codes. We do.
If the carrier’s estimate is written well enough, where maybe they’re only missing a line item or two, or have some measurements slightly off, then we will agree to begin work on the roof.
Once the install agreement is signed, we will request a deposit to begin work.
At Yellow Sun Contracting, we ask for the ACV and your deductible as a deposit. Once the roof is completed, we submit the Certificate of Completion (CoC) and photos of the completed work to the insurance carrier and wait for them to release the funds to you. In this example, we would be doing the full $10,000 worth of work for the $6000 down and waiting for the $4,000 Depreciation check to arrive to make us whole.
Step 5 – Replacing the roof
Replacing a roof is a pretty straightforward process. It really comes down to 3 steps: Remove Old Roof, Install New Roof, and Clean Up.
But within these three steps, there are lists of sub-steps that need to be followed in order to ensure a quality installation.
The below example is of a standard asphalt shingle roof replacement.
| Before the install: |
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| Remove Old Roof: |
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| Install New Roof: |
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| Clean Up: |
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