Help! My roof claim has been denied… twice!

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roofing arbitrationThe process to secure an insurance settlement can be both frustrating and exhausting… especially when your homeowner believes they have a legitimate claim that has only been paid partially or denied completely.

While their first instinct may be to hire an attorney, or fire off an angry letter to their state insurance commissioner or attorney general, there is a conflict resolution tool built into most homeowner’s policies to help mediate these uncomfortable situations.

While I’m not an attorney, my advice is for the insured to exhaust all policy provisions before filing a formal complaint with their insurance commissioner… namely, arbitration.

Arbitration

In order to exercise any available arbitration rights, your client will need to consult a copy of their homeowner’s insurance policy. The steps detailing the arbitration process, including how to get started, are spelled out in their policy.

While they may choose to hire an attorney to guide them through this process, the process is usually laid out step-by-step in laymen terms.

While each policy is different, the insured may be required to file a written request for arbitration and send it by certified mail to a specific address. They may also be able to complete the process by phone. If they have a good, local insurance agent, their agent may be able to help them through this process too.

Once your client’s insurance company acknowledges the arbitration request, they’ll select a representative and the insured will select a representative (often, it will be their roofing contractor). Here’s what happens next…

Umpire

Together, these two representatives will mutually agree on an impartial umpire that will settle the dispute. The cost of the umpire’s service will usually be split among the parties. Both representatives will make their case to the umpire with the umpire’s decision being binding.

So, if your homeowner has exhausted their 1st and 2nd roof inspections, and they still believe they have a legitimate claim, their next step is to find their insurance policy and start the arbitration process.

In my experience, most claims are settled within the first two roof inspections or after a follow-up call to the desk adjuster. I have found in the overwhelming majority of cases that cooler heads prevail.

We’ve had three cases this week where the homeowner was not happy with the outcome of their final inspections. That is an unusually high number, but after coaching two of our guys through the process in the last 48 hours, I thought it may be helpful to share the process with you too.

Peace,
Mike

p.s. Thank you again to everybody visiting my Facebook page. If you find these articles to be helpful, will you please drop in again now and introduce yourself?

About The Author

Mike Coday

Mike Coday is a retired youth pastor turned serial entrepreneur, roofing marketing consultant, author, speaker, sales trainer, and sentimental family man.

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4 Comments

  • David

    Reply Reply April 14, 2013

    I just started with a roofing company. The owner said that if the homeowner has AllState it is very unlikely that the roof will be approved even if it has obvious damage.

    • Mike

      Reply Reply April 15, 2013

      Hi David,

      I’m hesitant to make blanket statements about what an insurance company will or will not do.

      One reason why I’m careful about pre-supposing that something won’t get done is that folks have a tendency to treat you the way you treat them. If they feel your negative vibes, you are likely to get a negative return.

      I’m not saying that there aren’t some adjusters who will be very strict… because there are. Just like some umps call strikes on the inside curve, you can expect some adjusters to call a tight game too. That’s a part of the game.

      Good luck to you David.

      Peace,
      Mike

    • Chad Williamson

      Reply Reply February 11, 2014

      Not to encourage rash thinking and heated standoffs…. A*****te adjusters have told me that they can not replace wind damaged roofs that have less than 13 shingles PER SQUARE missing. I personally have had roofs with 50+ missing shingles repaired, not replaced.

      My standing rule to my salespeople is that they are not to advise a*****te (and l****ty mu**al) homeowners to file claims without an inspection of the roof by me. I only advise a claim in situations that fall into a*****te guidelines.

      This is probably not the best course of action, but 3 years of denials and verbal abuse by a*****te adjusters have led to it.

  • Brent

    Reply Reply December 13, 2011

    Thanks for the info Mike. I have a customer who was denied a claim by an adjuster who was obviously picked on in school and couldnt get a job as a cop. Yes he was an arrogant self centered blind man. He had a trainee with him and was really enjoying bossing that poor guy around and talking down to him. The customer has leaks in his home as well as hail and wind damage on his roof. He has been with this insurance company for 12 years. He and his wife did get upset when the adjuster stuck by his guns and wouldnt listen to reason. They told him to get off their property.

    They then called in for a reinspection and the second claims adjuster notified them that based on the first adjusters notes he would not come out for the reinspection. This infuriated my customer and he called his agent. The agent sent out their perferred roofing contracter who agreed the claim should be reopened. I recently checked back with my customer to see if there was any resolution. He said that his agent had gone through 4 channels of mangement and they will not reopen the claim. Do we throw our hands up and move on at this point?

    I got another house totalled down the same road by a different insurance company. I have also had another one denied by the original
    insurance company. I had pretty much washed my hands of this until I read your article. This disservice is very upsetting to both myself and my customer. Is he really in “good hands”?

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