When is the right time to make a claim for roof damage?

by Messenger » Fri Mar 01, 2013 03:25 pm

A family member, in need of a roof, got some sort of discount for providing my name to his contractor. So, last summer, a roofer assessed both my home and garage. She said that recent thunderstorms left behind hail damage. I told her after a previous storm, a leak appeared near my bathroom skylight. I said a friend fixed the problem, but I hadn't gotten around to fixing the stained ceiling. But, that I had no roof problems recently. (Quite honestly, I was just having my roofs looked at as a friendly favor.) The roofer continued on saying that my garage was worse than my house, but the house was getting ”spongy” in places. She presented a contract. She said that by signing it, she would be able to fight my battle with my insurance company. Pausing, I told her that I feared paying out-of-pocket expenses. She suggested adding my previous bathroom ceiling issues into this incident and, inflating the estimate. Then, I could re-do the bathroom myself and spread the inflated estimate monies towards other expenses. She told me that although she was “new” to dealing with adjusters, she had a "knack" for getting roofs replaced and paid for outright. All this made me uncomfortable and I’ve never seen her since.

Unfortunately, it now looks like my house roof is wind damaged. My previous leak did leak one night. Viewing from the ground, there appears to be missing shingles mostly on and directly below the ridgeline. I'm not sure about how my garage is doing. The garage roof is much newer than the house roof. But by the roofer's standard, the garage was worse. I don't know if there is any actual "hail damage." However, I can see wind damage on my house. I want to call my adjuster, but I'm afraid to tell them this story. I don't want them to think I knew my roofs were damaged and I did nothing. I honestly thought the roofer was being dishonest, shady, and just trying to make a sale.

It seems that people make roof damage claims right after a weather incident. My area has had some windstorms lately. But, the last recent weather incident that would definitely produce the type of damage I see from the ground, was Super Storm Sandy. I know my house got rocked around the time of Sandy. But that was back in October, four months ago, not long before the snows hit. And, it seems to me that most people get work done, through insurance anyways, after a dramatic weather event. And then, I heard that if damage is because of "named storm" that it might not be covered anyway.

I wouldn't be able to afford to get my roof repaired/replaced without the help of insurance. I know insurance can be dropped if a claim is denied and the repairs are not made. I don't know what I would do if faced with that situation. I've tried emailing local roofers to see if they have done business with my insurance company, Cincinnati Insurance. However, I can't find anyone.

I don't want to keep waiting on this issue since the rainy season is soon upon us. Should I just try and get new roof estimates and go from there? Should I tell my insurance company about my previous roofer from last summer? Should I just keep it all a secret and say all this just popped up now? I've never made a claim against my house insurance like this. I'm confused. I can just picture my adjuster asking, “When did the damage happen?” And, I don’t know what to honestly say. What if there actually is hail damage, but it hasn’t hailed lately? Does that matter to the adjuster? If there is wind damage, but it hasn’t been really windy, can the claim be denied? Or, does an adjuster just want to know when the damage was noticed? Help….

Total Comments: 9

Posted: Sat Mar 02, 2013 02:03 am Post Subject:

. She presented a contract. She said that by signing it, she would be able to fight my battle with my insurance company.


I've not even read any further yet and a voice inside my head is screaming.... RUN AWAY FROM THIS "CONTRACTOR ASAP!!!!!!!".

That is a 100% flat out LIE! You should also look into agencies to report this "contractor". As I said, that is a flat out lie and the person is just trying to get you to sign. They may send the bill to the carrier but they is all. YOU are the only one that can file a claim and the contractor can do _nothing_ is that claim is denied. Well... except leaving you holding the bill. They don't care as they are going to get paid anyway. The contractor is not a public adjuster. They have no rights or say so in the claim process. In that he will flat out lie right to your face tells you what kind of person he is.

She suggested adding my previous bathroom ceiling issues into this incident and, inflating the estimate.

So now in addition to lying, the person it telling you to commit fraud. This person just gets better and better! BTW, they are not committing fraud, they are recommending that _you_ commit fraud.

I can't tell you what kind of damage you have to your roof nor what is covered and how many claims it really is. You can feel free to contact your carrier and report the claim to have them determine what is covered. Though, regardless of the coverage be prepared to have any damage repaired as they will probably then require that it be repaired or they will not rewrite your policy (I'd say about a 75% chance of this).

I worked for CinFIn for about 3 years. They had few issues with paying claims. Most of their adjusters know next to nothing about property losses and would simply go by what you tell them. If they can see damages, they will probably pay for it.

Regardless, PLEASE... PLEASE do not use that contractor. That person will LIE and tell you to commit fraud just to get work. What does that say about the kind of work they do.

Posted: Sat Mar 02, 2013 10:49 am Post Subject:

I can't tell you what kind of damage you have to your roof nor what is covered and how many claims it really is.


Does this mean the claims adjuster could determine that I have damage from a Summer hailstorm AND a Fall windstorm for the same roof? And what about deductibles if there are two weather incidents that caused damage?

Though, regardless of the coverage be prepared to have any damage repaired as they will probably then require that it be repaired or they will not rewrite your policy (I'd say about a 75% chance of this).


Like I said, this is something that I'm afraid of happening. But, does this mean that CinFin won't just drop me, but give me until the contract is due to be renewed before I have to show repairs? I just made my 2nd, six-month installment payment. So, does this mean that if for some reason I need to cover all repairs to my roofs, on my own, that I have until the insurance expires six months from now?

Should I keep my experience with the roofing contractor to myself? I won't know if there actually is hail damage to my roofs without getting another contractor up there to access my them. I am now kicking myself in thinking that there may have been actual hail damage to my roofs and I did nothing. However, she was such an awful person that I just discarded her entirely. I now think I should have gotten a second opinion. Are there any websites where I can go to check the integrity of a contractor? Most people I know live in apartments/condos and don't have to deal with this. So, I can't ask for referrals.

I still don't truly think I had hail damage from a Summer storm. But, if she was truthful, could hail damage develop into having missing shingles?

And thanks for the reply/help.

Posted: Sat Mar 02, 2013 03:57 pm Post Subject:

She suggested adding my previous bathroom ceiling issues into this incident and, inflating the estimate. Then, I could re-do the bathroom myself and spread the inflated estimate monies towards other expenses.

Easy for her to say, because you're the one who will spend five years in prison for an insurance fraud conviction. You won't be able to make the repairs from your prison cell.

BTW, they are not committing fraud, they are recommending that _you_ commit fraud.

True, but they are committing conspiracy to commit insurance fraud, and for that can get a few years in prison. You get those extra years tacked onto your fraud conviction.

YOU are the only one that can file a claim and the contractor can do _nothing_ [if] that claim is denied.

There are countless posts in this forum from persons who want to know why they are now being sued by the contractor they signed a contract with prior to having their claim approved by the insurance company, and subsequently having that claim denied.

NEVER . . . EVER!! . . . sign a repair contract for insurance work unless and until your insurance company approves the claim. Then you hire a contractor and have them agree to perform the necessary repairs for the amount of insurance money available. Once you sign a contract, you are obligated to fulfill it unless the other party breaches the contract first.

I don't want them to think I knew my roofs were damaged and I did nothing

So now you want to add a second offense to your prosecution for insurance fraud? Of course you knew there was/is damage, you have the ceiling stains to prove it and whatever repairs you attempted on top of the roof yourself. How much deeper into trouble do you want to sink?

It never fails to amuse me how people pay for insurance then refuse to file a claim because they are worried about being cancelled or having their premiums increase. If you are not going to file a claim, they why waste the money? Take it to the closest Indian Cas-ino, put it all on Red or Black, and hope that Green doesn't beat you.

Your homeowners insurance premiums should go up some every year as the replacement cost naturally increases (labor and materials). Whether your insurance company raises it more because they paid a claim . . . well, that's up to them and there's little you can do about it because it's not your game.

I am now kicking myself in thinking that there may have been actual hail damage to my roofs and I did nothing

I'm not trying to beat you up, you're doing a swell job of that on your own. But your insurance contract requires that you mitigate future losses by taking all reasonable steps to prevent future damage when a loss/damage to your property occurs. So if you had doubts about what one contractor tells you, you need to get a second opinion . . . from another contractor or your insurance company.

Insurance companies are in business to make money -- everyone knows that. But they stay in business by paying claims. And most people don't understand that. They think most insurance companies stay in business by denying claims. That just isn't true. An insurance company that takes premium money and never pays a claim would be put out of business by the state insurance regulator.

I just made my 2nd, six-month installment payment. So, does this mean that if for some reason I need to cover all repairs to my roofs, on my own, that I have until the insurance expires six months from now?

This, too, is another misconception. Your insurance can be cancelled by the insurance company at any time. Their only obligation would be to refund your "unearned" premiums and pay for any claims they are liable for prior to the termination date.

I still don't truly think I had hail damage from a Summer storm.

What are you so afraid of when it comes to filing a claim? It will either be approved or denied, then you'll know for sure where you stand. All this wishy-washy nonsense is not helping your situation at all.

Should I keep my experience with the roofing contractor to myself?

ABSOLUTELY NOT!! You need to file a complaint with the state contractor licensing entity. Contractors such as this need to be stopped. Like bad insurance agents do to me, they give other contractors a black eye. Only by reporting them will you be part of the solution instead of doing nothing to solve the problem.

Are there any websites where I can go to check the integrity of a contractor?

Unfortunately, no. Integrity is a personal matter, and the contractor whose references are sterling can still be in financial trouble by the time he/she comes along to your job, takes the money and runs or performs shoddy work to save a buck or two. I know this from personal experience.

You just can't protect yourself from it 100%. The best you can do is to check their licensing and their references, and you can still get burned.

Call your insurance company, be 100% honest with the adjuster who comes to verify your claim, and accept whatever the outcome is. Next time, file your claim immediately.

Posted: Sat Mar 02, 2013 05:56 pm Post Subject:

This, too, is another misconception. Your insurance can be cancelled by the insurance company at any time. Their only obligation would be to refund your "unearned" premiums and pay for any claims they are liable for prior to the termination date.


It can't simply be cancelled... there needs to be a breach of the contract in some way. Something like material misrepresentation. Otherwise it's a binding contract. If insurance companies could cancel contracts whenever they wanted they would cancel thousands when a large storm approached or a large fire started. This is also one side. The insured can cancel the policy whenever they want.

Posted: Sun Mar 03, 2013 01:24 am Post Subject:

Actually, the insurance company needs only give five days advance notice of a cancellation. The contract may be "binding" but it is a cancellable contract.

Posted: Mon Mar 04, 2013 06:00 am Post Subject:

First off, I'd like to say another "Thanks Again" for the responses.

Secondly, I'd like to take a moment to respond to MaxHerr.
I've worked in enough governmental agencies to have a good working knowledge of Fraud. Like you said:

You need to file a complaint with the state contractor licensing entity. Contractors such as this need to be stopped.

I can assure you that I did shoot-off an email to an "insurance board" in my state. I gave them info and let them know that they should look into the situation. Also, I told them if they wanted/needed more information to get in touch with me. I never heard back to know what came of it all.

So now you want to add a second offense to your prosecution for insurance fraud? Of course you knew there was/is damage, you have the ceiling stains to prove it and whatever repairs you attempted on top of the roof yourself.

The damage that resulted in the ceiling stains was easy 3 years before I crossed paths with this roofer. And, I didn't 'attempt repairs myself.' The repair was completed by a friend who was a roofing contractor. (Unfortunately, he summered down-south and never moved back home.) The stains are all that remain...its only cosmetic at this point...I've had no leaks since the fix or currently.

It never fails to amuse me how people pay for insurance then refuse to file a claim because they are worried about being cancelled or having their premiums increase. If you are not going to file a claim, they why waste the money? Take it to the closest Indian Cas-ino, put it all on Red or Black, and hope that Green doesn't beat you.

I am required to have homeowners insurance as part of my mortgage. And, I am worried about cancellation for that very reason. (We've all heard the horror stories.) Not to mention, the possibility of having to go insurance shopping if I'm suddenly dropped. I have had this insurance company since I bought my house and years earlier for auto insurance. While I understand I need to file a claim now, I don't think I needed to file a claim when I had that leak. It was an inexpensive fix.

Your insurance contract requires that you mitigate future losses by taking all reasonable steps to prevent future damage when a loss/damage to your property occurs. So if you had doubts about what one contractor tells you, you need to get a second opinion . . . from another contractor or your insurance company.

Until now, I didn't have any doubts regarding that wonderful roofer I met or her telling me I had hail damage. I didn't call her to my home because I was having any roofing issues. Like I said previously, I was just helping a family member get some sort of discount by letting her come check out my roof. When I realized how dishonest, or Fraudulently she was acting, I thought she was just outright lying about my roof just to make some money. I wouldn't know a problem currently exists now, if I wouldn't have noticed that some shingles were missing off my roof. And, I only saw the missing shingle because I was looking at my house from a slight hill above my house as a passenger in a car. If I wouldn't have been paying attention to my house from above, I never would have recognized the damage. But yes, now I see that I probably should have gotten a second opinion. You got me there. LOL.

Posted: Mon Mar 04, 2013 06:06 am Post Subject:

Now in a related question, has anyone had any good look with using the services of Angie's List or Home Advisor? I have gone to my local online Better Business Bureau for some info on roofing contractors, but don't find it incredibly helpful. I know I have to get roofers out to my home... I just wish I knew which roofer to trust. I guess if a roofer comes in and offers to inflate the estimate or pressures me to sign a contract, I know to stay away. And, I did get some good advice in these recent posts.

Posted: Mon Mar 04, 2013 09:13 am Post Subject:

Now in a related question, has anyone had any good look with using the services of Angie's List or Home Advisor?

Like the Better Business Bureau, these "lists" are useless. Although they may provide contact information for contractors who are reputable, experienced, and will do a good job for you, they are not reliable sources. Anyone can post whatever they want there.

Hiring a contractor requires due diligence on the part of the homeowner. Getting referrals from friends or relatives is likely to be a better source than the BBB (which is 100% useless when it comes to anything insurance- or construction-related -- they have no regulatory authority at all, and they can only mediate issues that occur between one of their paid members and the public), Craig's List, Angie's List, Home Advisor, the Pennysaver, or a local newspaper's list of service advertisers who pay money to be listed. Someone has to pay for that advertising, and whom do you think that will be?

And, guess what, even those recommendations from family and friends don't always work out. And even more importantly, you may or may not get what you pay for. The highest priced contractor is not necessarily the best, nor is the lowest priced one the worst. The best, however, is likely to be somewhere in the middle. If you have an idea of the cost of construction or repairs, you will be able to discard bids that are too low or too high because they just don't "feel" right.

Posted: Mon Mar 04, 2013 09:43 am Post Subject:

I can assure you that I did shoot-off an email to an "insurance board" in my state.

Not the same as filing a formal complaint. You have no idea who monitors email, or whether it was actually received and read. I've sent numerous emails to the CA Dept of Insurance, only to have to send second or third requests when I did not get an answer to the first message I sent.

Complaints, however, are a formal matter and handled by someone in authority to recommend further action. You also get a written response to let you know they received your complaint, and eventually at least one more to tell you whether they are going to act on your complaint or not. But this incident also needs to be reported, as I said, to the contractor licensing entity, too.

The damage that resulted in the ceiling stains was easy 3 years before I crossed paths with this roofer. And, I didn't 'attempt repairs myself.'

Actually, regardless of who did the work, when your insurance company is not involved in the repair, you did the work "on your own" -- it's a term of art, as an attorney would say. Kind of like putting a Band-Aid (R) on a laceration that probably needs sutures. Why use your health insurance to pay for something that minor, right? But they'll have to pay big bucks down the road when your "little cut" -- attended to by some under $1 Do-It-Yourself wound care -- turned into a major infection requiring you to be hospitalized for several days. Would they have preferred you to spend $30-$50 to go to your doctor or to the Urgent Care Center instead? Absolutely.

And even if the stains have been painted over, an interior inspection of the attic would reveal the prior water damage, and, who knows, maybe wet-rot that set in which you have no idea exists. You have no idea what the drywall or lumber looks like on the attic side of the stain.

I am required to have homeowners insurance as part of my mortgage.

As am I and nearly 100% of all borrowers. But this doesn't change my response one bit. Whether you are mandated to have insurance (remember, the state requires you to carry auto insurance or post proof of financial responsibility) or not, if you pay for it, you should not fear using it.

There are laws or regulations in most states that prohibit cancellations just because a claim was filed. And there are laws which uphold the right of insurance companies to terminate or not renew a policy when fraud or other breach of contract has occurred. NOT USING YOUR INSURANCE could actually result in one of those breaches, especially when physical damage to the structure may have occurred.

I don't think I needed to file a claim when I had that leak. It was an inexpensive fix.

Well, that's the function of the deductible -- to allow the insurance company to not pay for small claims. But it doesn't mean you cannot or should not file a claim. You can always use your insurance company's adjuster to help you determine whether you need to pursue a claim or pay for a minor repair yourself.

My response was intended to show what can happen when a person fails to take the proper corrective action. My words of choice might have been a little different had you mentioned that a licensed contractor performed the "minor repairs", but the import of my response would have remained substantially the same. I've seen roofs that had four or five different layers of shingles (and one that had as many as seven in some places!), which did nothing to correct the underlying damage caused when the very first layer initially failed 30-40-60 years earlier. It's much less expensive to nail new shingles over the existing cover than to tear off down to the bare wood and start over, but the roofer can charge exactly the same amount for both jobs, and the homeowner thinks all is OK because it "looks" new.

I was just helping a family member get some sort of discount

LOL! That's the same sort of technique we use in insurance to obtain referrals. Only we are in a business that is far more highly regulated than construction, and cannot lawfully offer "discounts" to anyone on our own in most cases. But the average person would never know that. And even "above average" persons, like attorneys and physicians and corporate executives often don't know either.

But guess what? A contractor who offers a "discount" has inflated his or her price to begin with. You agreed to meet with that person because, in the back of your mind, I have little doubt, you already suspected there might be some roofing work that you needed to have done. Otherwise, if you're like most people, you would not have taken the time to meet with them, even if it meant someone else would get a discount.

[ Here in Southern California we don't typically get the kind of punishing hail that causes damage in "Tornado Alley" throughout the midwest -- the biggest I've ever seen personally was maybe 1/8" in diameter. But if we did, you can be sure that following one of those storms, I'd either climb up on my roof (or enlist someone else to do that for me) to make sure that none of my concrete tiles had been damaged. A single broken tile could mean an entry point for water that could result in thousands of dollars' worth of damage my insurance company would not pay for because I failed to reasonably mitigate the damage. Would I file a claim to have one tile replaced? Of course not. I carry a $500 deductible. But if I have reason to suspect damage, I understand my responsibility to inspect for and repair it. ]

I thought she was just outright lying about my roof just to make some money.

No better way to identify fraud than that. A textbook definition of fraud discusses how it is a form of misrepresentation ("lying") intended (the key word) to gain an advantage over another person.

We trust state-licensed persons to be honest -- doctors, dentists, attorneys, insurance agents, building contractors, and others -- because they tend to have expertise that we usually don't. They are supposed to be knowledgeable professionals who put our interests above their own. And the majority of the time, that's exactly what happens. But simply having a state license does not provide any guarantees.

When we get connected to the wrong person, and do business with them anyway, all sorts of things can and do go wrong. That's why I'm devoting most of my time these days to assisting individuals and/or attorneys whose clients have been harmed by insurance agents and insurance companies. Because I want to see my profession represented by true professionals, not scam artists.

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