How can my insurance company deny my claim?
The insurance companies will use any reason to deny coverage on insurance claims. In some cases, they will partially deny a claim just to get out of paying an expensive barrel tile roof. Common reasons they use for denial of a barrel tile roof claim can be thermal expansion, maintenance wear and tear, and foot traffic.
Foot Traffic: Many of us on the public insurance adjusting side of the industry laugh at this denial and call it the Santa Claus denial. We have seen roofs with senior citizens who have not been on the roof since it was installed but magically they must have been climbing a roof in their 70’s or 80’s and cause all the damage that our engineer clearly provides an opinion that it is either caused by wind or hail and based on our insurance claims experience we are able to support that opinion.
Thermal Expansion: Specifically in Florida and the Southern States you will never find “Thermal Expansion” as an exclusion or reason for denial in a policy. Furthermore, the insurance company covered the property and the barrel tile roof in an extremely hot client so if they did not want to cover sun damage then they should write only policies in Alaska because unless they write an exclusive on for “Sun Damage” or “Thermal Expansion” in their policy then essentially they have committed to a contractual obligation to cover the barrel tile roof for “Thermal Expansion” We in the industry would like to hear the scientific explanation for what thermal expansion is and how it is the cause for what is obvious wind or hail damage. But never be shocked about how ridiculous and the insurance company is and will go to look for a reason to deny an expensive item on a home.
Maintenance wear and tear: They use templates in my opinion for denials. We will see this denial not just on asphalt shingled roofs, but windows, barrel tile roofs, plumbing loss, HVAC losses, and other what we would deem as covered claims. Remember insurance companies operate for one real reason to maintain a profit and to provide superior shareholder value. We have actually seen a denial for maintenance wear and tear on a water loss that was caused by a shower drain and shower pan on a 2-year-old new construction home. Let’s just say through the help of litigation we won this insurance claim, and we smiled when we received this denial because it was a gross attempt to intentionally deny and underpay an insurance claim. This claim settled for over $110,000 dollars when it originally paid around $15,000. The worst part was this adjuster was incompetent and he knew Experienced Public Adjusters would never let them get away with such a “partial denial.”
If we have learned one thing it is that you can never be surprised at how grossly negligent and insurance adjuster and the insurance company they represent can be. And if you can prove it is intentional the act to underpay the claim then you have what an Attorney loves to hear which is bad faith that may allow a jury to pay you a multiplier on your damages.
Every insurance claim at any stage of the process would benefit from a free “no-cost” claim evaluation or claim review to advise the insured of the possible options they have to seek to recoup pre-loss condition damages. It does not cost you anything but a short meeting for you to at least get some invaluable free to advise. And if you hire Experienced Public Adjusters we work on a contingency fee on only what we can recover. So what do you have to lose? Call on or our local public adjusters today!