Possible Appeal: Partial Coverage Due to “Pre-existing Damage”?
I’ve posted a more detailed account of my situation on Reddit, but here’s the gist: I filed a claim for wind damage to my roof, and after several weeks, I received a response from my home insurance company.
In summary:
The insurance company acknowledges that my roof has wind damage; however, they are only offering to cover 10 squares out of a total 27 squares because they claim the remaining damage is “pre-existing” and not related to the storm.
Due to my high deductible, this partial coverage means I won’t receive any payout. I do have replacement cost coverage (not actual cash value), and my roof features discontinued 3-tab shingles. The adjuster even stated that I need to replace the entire roof, yet they won’t cover the full cost due to the alleged pre-existing damage (I’ve requested written evidence of this).
I’m seeking your advice, particularly from adjusters or anyone who has faced a similar situation:
- Should I consider appealing or pushing back?
- Is it common for insurance companies to only cover part of a roof replacement even when wind damage is confirmed?
- Does wear and tear on older shingles automatically justify denying full coverage? After all, every roof will show some level of wear over time—it’s not like they’re brand-new right after installation.
Any insights or shared experiences would be greatly appreciated. Thank you in advance!
It sounds like a frustrating situation, and it’s definitely worth pushing back against the insurer’s decision. Here are some thoughts on your questions and situation:
Should I appeal or push back?
Yes, definitely! If the adjuster acknowledged that there was wind damage but still claims that part of the roof is pre-existing, it’s worth appealing their assessment. Gather any evidence you have, such as previous inspections, photographs, or reports showing the roof’s condition before the storm. If the adjuster advised that the entire roof needs replacement, that may help your case for a full payout.
Is it common for insurance companies to only cover part of a roof replacement even if wind damage is confirmed?
While it’s not uncommon for insurance companies to try and minimize payouts by citing existing wear and tear, they should cover damages directly related to a covered peril (like wind in your case). If they admitted there’s clear storm-related damage, it strengthens your position to argue against their assessment that the remaining damage is pre-existing.
Does the presence of wear and tear or older shingles automatically justify denying full coverage?
Generally, the presence of some wear and tear shouldn’t negate coverage for storm-related damage. Insurance policies often cover damages caused by specific events, and just because a roof is older doesn’t mean it can’t be damaged further by a storm. The key is proving that the storm was the primary cause of the needed repairs.
In addition to gathering your evidence, you might consider:
Good luck, and I hope you can resolve this to your satisfaction!