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What Is The Difference Between Damage Covered By My Insurance And Damage Requiring Out Of Pocket Payment For Roof Repairs Or Replacement?

Feb 23, 2022 | Blog, Roof Insurance, Roof Repair, Roof Replacement

This is one of the most commonly asked questions in our industry and the line between these two types of roof damage is often blurred by dishonest roofing salesmen. In simple terms, your insurance typically covers sudden and accidental loss by a covered peril in a singular event. In our industry these covered perils are usually wind and hail events. Maintenance issues and “general wear and tear” are not typically considered covered perils and thus cannot be filed as a cause of loss for a valid insurance claim.

wind-driven metal roof blowing

For example, a roof leak caused by failed roofing sealant would be considered a maintenance issue and not something you would typically try to file an insurance claim for. This also holds true for a severely degranulated, old failing roof that simply needs to be replaced due to age as this would fall under “general wear and tear.”For losses caused by covered perils (i.e., wind and hail) there are a number of factors that qualify your roof for full replacement under a typical insurance policy. For your average hail claim a test square (usually 10’ x 10’ section of roof) is drawn on 4 roof slopes facing in each cardinal direction: North, East, South and West. The number of hail hits per square on each slope is marked and counted to give a “square count” for impact damage. Most insurance carriers require 8-12 hits per square to qualify that side for full replacement. Some carriers will replace the entire roof after 50% qualifies for replacement and others will require 3 full sides to qualify first. Others often have different requirements frequently unspecified in the policy and these requirements are dictated by unwritten internal guidelines that may vary by carrier or adjuster. Wind damage is even more subjective and difficult with adjusters often attributing installation errors by a previous contractor as contributing factors.

One of the biggest issues with the square count is determining if the blemishes being marked are actually from hail or mechanical damage from a tool or scuff marks from foot traffic. Many contractors will mark blemishes that are not caused by hail. Sometimes this is an intentional deception in an attempt to convince you to file an insurance claim but most often it’s simply the result of improper training of the sales rep. Occasionally an insurance adjuster will discount legitimate hail bruises as a blister or mechanical damage as well. Either way, hail damage has a number of distinct characteristics to keep an eye out for that will help you determine their legitimacy.

  • Hail impacts typically cause granular loss resulting in exposing the asphalt below. The fresher the damage the darker the exposed asphalt will be. This exposed asphalt will turn grey over time when exposed to the harmful UV rays from the sun.
  • Hail creates slightly concave/ dimpled imprints sometimes fracturing the fiberglass mat within the shingle. This can create a soft “bruised” feel similar to that of a bruise felt through the skin of an apple.
  • Impacts from hail are typically round in shape with some degree of granules remaining embedded within the dimple. If there are no granules remaining, then this is often from a popped “blister” or bubble in the asphalt. These can be caused by trapped moisture or air during the manufacturing process and accelerated by an improperly vented attic space.
  • Blisters (not hail damage) also have a distinct raised edge around the imprint whereas hail damage typically will not. You often must feel the impacts to make a proper determination.

Inspect your property for other signs of hail damage to determine if the damage to your shingles is actually from hail. Look for dimples in your soft metals such as gutters, flashings and wobbly turbines. Check the frames around your window screens (and sometimes the screens themselves.) Look for loose granules knocked off of your shingles in the storm. You can find these on the concrete around the home or near the gutter downspouts.

We recommend that you always have your roof inspected by a local, highly rated and trustworthy roofing professional before reaching out to your insurance carrier.

*Please remember that we are not licensed public adjusters or attorneys and all policy specific advice should be discussed with a licensed professional as not all insurance policies are even remotely the same.

Lumen Construction Roofing - Best of HomeAdvisor

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5700 Tennyson Parkway #300, Plano

5.0 114 reviews

  • Avatar T. Cutt ★★★★★ 2 months ago
    I worked with Phillip and it was an amazing experience! We had a rainstorm inside the house after a storm and he came over gave us options, followed up, communicated without making me feel dumb for not understanding roofing. 10/10 will … More use this company when we replace the roof!
  • Avatar Samantha Harrison ★★★★★ 3 months ago
    Very professional and thorough roofing company! Michael and Ross were superb in keeping me informed on everything that was being done throughout the entire process! I am extremely pleased with the work that was done. The roof and gutters … More gave my home a complete facelift! Thanks guys!!! I will definitely refer Lumen Construction Roofing to all of my family and friends!Services: Roof inspection, Roof repair for storm & wind damage, Gutter installation, Roof installation
  • Avatar Rohan Kharwar ★★★★★ 3 months ago
    Ross and Philip provided exceptional service. We had been having roof leaks for more than 2-3 yrs in certain spots in the house.We had this inspected by multiple roofers and no one was able to figure out where the water was coming from … More in the house as there were no obvious signs of roof damage. Ross and Philip were onsite multiple times and helped figure out the issue and fix it. They were always very professional, always came on time and above all figured out the problem.
    They definitely went above and beyond.
    Regarding the work, they went over all the steps in detail. The work was clean and neat. We will definitely call them for any roofing issues.

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