Disputing a home hail insurance claim - Calgarypuck Forums - The Unofficial Calgary Flames Fan Community

Southside · 09-27-2016, 05:46 PM

If you've ever disputed a claim, or have knowledge of the process, we would be curious to hear from you.

We have lived in the same home for 11 years now. We moved in when the home was about 18 months old so the roof was new like the rest of the house. We have also had the same insurer all of that time.

In 2011 when several neighbors made successful claims for hail damage, we also made a claim and we were denied. We were told that there was no hail damage to our roof. When quizzed as to why so many of our neighbors had made claims and received new roofs, the response was that "those adjusters don't know what they are talking about." Who am I to argue, right? My knowledge of the roof is that it's over our heads and pretty much ends there. We let it go. The insurance company is on our side and would surely know, right?

In 2014 the situation repeats itself. It seems many that didn't get a new roof in 2011 are this time getting a new roof. We heard again that the adjusters that bless us are the smartest people on the planet and nobody else knows what they are talking about. Again, we let it go.

Queue 2016. It hailed both of the July and August long weekends. This time we can see that our microwave range vent is smashed to #### and one of the slats in the clothes dryer vent is also broken and that there is a piece broken off of our vinyl siding. While I'm still not about to get on my two-storey roof and wouldn't know what to look for anyway surely this damage to the side of the home must mean the roof also took another beating, right? No, according to our insurance company the roof was not damaged by hail. Again, several neighbors have already, or are in the process of having new roofs installed, in a few cases for the second time since we have lived here. The damage that is visible and within my knowledge is the only damage the adjusters acknowledge (the vents and siding) and they are not of sufficient value to support a claim given our deductible. How convenient.

We have stopped trusting the insurance company. We are not about to believe that the adjusters they send out are smarter than every other adjuster. We are also not about to believe that there is some devine intervention at work, protecting the humble abode while our neighbors are smitten.

So, I ask the guy roofing one of my neighbors homes to have a look. He has a look, takes some pictures and says, "yes you have hail damage, new and old." I go back to the insurance company and they forward me official dispute paperwork. You have to appoint someone to represent you (a lawyer, appraiser or licensed tradesperson) that can speak on your behalf about your property and claim with the insurance company representative in an effort to find resolution.

The roofing guy seems reluctant. He has a business to run and work to do, right. Other people don't have to fight this fight. He is frankly surprised by their findings. He just can't commit to being available to represent us at their whim.

So, I'm really wondering what we should do. We want to proceed with the dispute, why have insurance that doesn't provide coverage to you? We are however wondering who to seek as representation and what that might cost? Who does this type of thing? Engineering consultants? Perhaps a larger roofing company has more senior people that aren't involved in the day-to-day stuff that could commit to working on your behalf? I can't imagine this is a lawyer thing despite the suggestion in the paperwork.

If you've ever been down this road and/or know what's involved and where we should turn to, please let us know.

Once we turn the corner on this, we will be looking for a new insurer too, so if you're an insurance broker, we may be interested in speaking with you. We weren't going to name names, but if you find that your insurance provider has your back we would also appreciate hearing who your carrier is.

Thanks. Go Flames Go!

Peanut · 09-27-2016, 05:53 PM

Interested to see what advice results. We are in a similar situation - everyone on our street got their roofs replaced after the 2015 hail storms. Our claim was denied. I've let it be but it doesn't sit right with me. We can also see visible damage to the gutters.

FlamesKickAss · 09-27-2016, 06:55 PM

Speak with a manager or supervisor.....

What area are you in? Neighbors damage doesnt always mean you have damage.

Instead of just a roofer look for a roofer that is haag certified inspector.

calgaryblood · 09-27-2016, 07:15 PM

Let me guess...TD insurance?

These scumbag insurance companies need to be disciplined/fined for cases like these where they blatantly miss/lie about what they find and see.

Southside · 09-27-2016, 07:26 PM

It isnt TD and for what it's worth a neighbor with TD got a new roof.

I would like to believe them but all circumstances suggest I should not.

cupofjoe · 09-27-2016, 07:40 PM

You have a PM

Fobby · 09-27-2016, 07:47 PM

It depends on your shingles. IKO had a line of organic shingles that was #### and there's a class action going on right now.

I was blessed with these ####ty shingles, and i had a couple of roofers saying it's not hail damage, just crappy luck.

The life of these shingles are 5 to 15 years. My house is in the 13 years range.

Southside · 09-27-2016, 07:55 PM

We may be in similar circumstances but if you have hail coverge the issue should not be the make of shingles on the roof, rather were they compromised by hail. See nobody asked or checked what make of shingles we had when they insured us. Right? So, you can't very well say now that we aren't providing coverage because of the make of shingles. I've been paying premiums on a policy that covers those shingles. One of the adjusters made reference to this, so my wife made note of it. Make of asphalt shingles is not a policy exclusion. We're covered for hail damage.

Fobby · 09-27-2016, 08:24 PM

Yes. But if the adjuster deems the damage is not done by hail, and it's wear and tear due to ####ty shingles. Insurance doesn't cover wear and tear. Crap shingles dried up, cracks and curl. I made a claim in 2012, and was denied. I was advised by my insurance to get a roofer to check it out first this time, so there's no record of another 0 payout claim, and that's what I was told by a roofer outside of insurance this time in 2016

You would have more luck if high wind took some shingles off the roof vs hail as I was told by another roofer back in 2012.

Southside · 09-27-2016, 08:35 PM

Right. Given other neighbors had hail damage to their roofs and that other parts of our exterior were damaged by hail seems more than likely our roof was damaged by hail as well.

Fleury’sOTGoalCelebration · 09-27-2016, 09:42 PM

OP, similar thing happened to me, my next door neighbour claimed hail damage in 2012 and was approved by his insurance. I tried to claim it the following week and was denied. Fast forward to this year, put a claim in after the July hail storms ( switched insurance companies since) and was denied again even though other houses in the area were approved. When I called the inspector he said there was no visible damage but said if I could get a HAAG certified roofer to state there was actual hail damage then he would re-open the case. Still waiting for the HAAG roofer to do the inspection.

GoinAllTheWay · 09-28-2016, 09:58 AM

Quote:

Originally Posted by Southside

Right. Given other neighbors had hail damage to their roofs and that other parts of our exterior were damaged by hail seems more than likely our roof was damaged by hail as well.

Not necessarily. Metals can suffer cosmetic damage that does not impact their ability to do their job. Damage to area like gutters, whirly birds at the likes does not automatically mean damage to the shingles. They have more "give" in them then metals do.

I'll be the first to admit, insurers did themselves no favours back in the day where hail damage to a part of the roof meant they'd replace the whole thing. But that was back before hail storms where almost a weekly event during summer in Calgary. Insurers are really cracking down on roof claims now. They are putting the onus on the homeowner to insure that their roof is in good condition.

FlamesKickAss · 09-28-2016, 12:49 PM

I was actually at a house today that the roof had no damage yet I could see the neighbor had damage.... As did the person's garage..

Shazam · 09-28-2016, 12:54 PM

My PIL's house had the roof replaced. The next door neighbour had his siding destroyed - on one side.

Hail's weird. My friend's house roof was fine, but he had 4 inch holes all over his siding.

One dead giveaway you had hail damage: You have piles of asphalt by the end of your downspouts.

undercoverbrother · 09-28-2016, 12:57 PM

OP, it as been mentioned before in this thread. Take a run up the ladder to speak to a supervisor.

This is some info on the process dispute resolution process:

http://www.finance.alberta.ca/public...n-process.html

I am surprised you are at this point so quickly.

undercoverbrother · 09-28-2016, 01:00 PM

Quote:

Originally Posted by Shazam

One dead giveaway you had hail damage: You have piles of asphalt by the end of your downspouts.

That's isn't a slam dunk. A big rain can produce the same.

Also, most insurers will not cover granular loss, there needs to be pitting/bruising.

The asphalt could indicate damage, but asphalt doesn't mean you have hail damage.

undercoverbrother · 09-28-2016, 01:02 PM

Quote:

Originally Posted by calgaryblood

Let me guess...TD insurance?

These scumbag insurance companies need to be disciplined/fined for cases like these where they blatantly miss/lie about what they find and see.

Lying and misrepresenting information during insurance related matters is most assuredly a scumbag move.

IliketoPuck · 09-28-2016, 01:03 PM

OP - I had an identical situation at my previous home. And it dragged on for almost two years.

After much unsuccessful back and forth with the insurance company (about 18 months), I took matters into my own hands.

I commissioned an engineering firm to do a report on my roof for ~$500 dollars (IIRC). The report confirmed the extent of the damage.

I then proceeded to hound the insurance company until they agreed to replace my roof. I also made them cover the cost of the report.

If you have questions I would be more than happy to help. Insurance companies can be really difficult to deal with, and require a lot of persistence.

Shazam · 09-28-2016, 01:07 PM

Quote:

Originally Posted by undercoverbrother

That's isn't a slam dunk. A big rain can produce the same.

Also, most insurers will not cover granular loss, there needs to be pitting/bruising.

The asphalt could indicate damage, but asphalt doesn't mean you have hail damage.

A... big... rain...

Yeah, when it happened to me you could shovel the amount of asphalt and pave Stoney Trail with it.

Fuzz · 09-28-2016, 01:20 PM

Quote:

Originally Posted by Shazam

My PIL's house had the roof replaced. The next door neighbour had his siding destroyed - on one side.

Hail's weird. My friend's house roof was fine, but he had 4 inch holes all over his siding.

One dead giveaway you had hail damage: You have piles of asphalt by the end of your downspouts.

Maybe it is the 2 beer lunch, but WTF is a PIL? The only one I know is spelled Pil, and certainly doesn't have a roof....