Forum Thread

New Roof? Insurance "Hail Damage" Claim...

8,492 1,297 February 24, 2018 at 07:57 AM
Over a year ago I had a few small drops of water on upper floor ceilings in a few spots. Nothing major but I called a few roofers. I got several estimates to replace the entire roof as the old one is those defective Certainteed shingles and is pushing 18 years old. The estimates were running around $16-$17k. More than I thought but since I got multiple bids, it is what it is.

So anyway turns out a friend of mine is a private insurance adjuster that is very familiar with hail damage. He inspects my roof and says for sure it is an insurance claim and the entire new roof would be covered. Great! He sends one of the companies that he works with and the deal is, as long as I use one of them, his fee is covered. So yeah, I get it, they pad the bill to cover his fee. So they did the estimate and come up with around $35k.

Part of the extra is any ceiling that has water damage is covered under the insurance claim. So it will cover that additional work that my roof-only estimates did not cover. Expected and normal. Meanwhile, the company rep and I do not get along we have a major personality conflict. My adjuster friend said yeah that is somewhat common with that guy. So whatever I just need to put up with him until the roof is done.

This all has been going on for over a year now! I have been getting impatient lately as I referred the same adjuster for insurance claims with my neighbors and they are all done and got new roofs installed many months ago (with the amount of business I threw his way, I should be getting a free roof). I asked what the hold up is and he says the roof company guy put in an addendum for $17k more! WTF, over! I looked at the addendum and they are charging bank for removing the gutters, screens, etc and such which is really minimal work and I would think covered by the original estimate. And again, I understand a little padding to the extent of charging full retail for stuff that otherwise would be discounted, but I am thinking this is starting to get excessive.

My question is should I worry about insurance fraud at this point? I never saw or agreed to this extra addendum, which by itself is more than the estimates I got before I involved my insurance adjuster for the ENTIRE ROOF! The insurance company has been balking and now I see why. For the record, I have already asked for the check the insurance company already gave them but they reminded me that I signed a contract with them so basically I am stuck. The claiml now is up to 3x my original roof replacement estimates.

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Quote from dealgate
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Over a year ago I had a few small drops of water on upper floor ceilings in a few spots. Nothing major but I called a few roofers. I got several estimates to replace the entire roof as the old one is those defective Certainteed shingles and is pushing 18 years old. The estimates were running around $16-$17k. More than I thought but since I got multiple bids, it is what it is.

So anyway turns out a friend of mine is a private insurance adjuster that is very familiar with hail damage. He inspects my roof and says for sure it is an insurance claim and the entire new roof would be covered. Great! He sends one of the companies that he works with and the deal is, as long as I use one of them, his fee is covered. So yeah, I get it, they pad the bill to cover his fee. So they did the estimate and come up with around $35k.

Part of the extra is any ceiling that has water damage is covered under the insurance claim. So it will cover that additional work that my roof-only estimates did not cover. Expected and normal. Meanwhile, the company rep and I do not get along we have a major personality conflict. My adjuster friend said yeah that is somewhat common with that guy. So whatever I just need to put up with him until the roof is done.

This all has been going on for over a year now! I have been getting impatient lately as I referred the same adjuster for insurance claims with my neighbors and they are all done and got new roofs installed many months ago (with the amount of business I threw his way, I should be getting a free roof). I asked what the hold up is and he says the roof company guy put in an addendum for $17k more! WTF, over! I looked at the addendum and they are charging bank for removing the gutters, screens, etc and such which is really minimal work and I would think covered by the original estimate. And again, I understand a little padding to the extent of charging full retail for stuff that otherwise would be discounted, but I am thinking this is starting to get excessive.

My question is should I worry about insurance fraud at this point? I never saw or agreed to this extra addendum, which by itself is more than the estimates I got before I involved my insurance adjuster for the ENTIRE ROOF! The insurance company has been balking and now I see why. For the record, I have already asked for the check the insurance company already gave them but they reminded me that I signed a contract with them so basically I am stuck. The claiml now is up to 3x my original roof replacement estimates.

Maybe it is me, but 35k for a new roof sounds insane unless you are roofing a 10000 sq ft home of something. They should not be quoting estimates 2x the going rate imo. Sounds like someone is making money via a scam\gold-plating, but as long as you are not paying for it (make sure) it probably does not matter.

That said, if the estimate is that high, do you have an option to take the cash and do the 17k in repairs yourself? That would put a stop to the nonsense. The lesson learned here is to never go with someone whose estimate is 2x the market. Just because they have to replace a little sheet rock and repaint does not give them the right to do that. With friends recommending contractors like that, who needs enemies lol.
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Last edited by YanksIn2009 February 24, 2018 at 01:13 PM.
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#3
Its to late now, but always get the estimates and know what your insurer will pay and then get the check yourself. Then you can deal with add-ons other estimates etc. if you want to.
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The public adjust charges 12% of the claim. When they were doing the estimate and work for the insurance adjuster, they had me sign a contract saying that I would use them. By using them, they cover the adjusters fee. I am stuck at this point. It isn't about the money, my part is my deductible and the rest is insurance anyway regardless of the claim amount. It is the bill padding that looks like it is beyond normal. I get the feeling that the guy from the roofing company is using me as a cash cow due to our sour relationship. I would LOVE to back out of this contract and get the insurance money that is a no brainer! I could get my roof replaced and still come out $15k ahead. I am about to end-run around my adjuster and go directly to the insurance company to see what is going on.
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Quote from dealgate
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The public adjust charges 12% of the claim. When they were doing the estimate and work for the insurance adjuster, they had me sign a contract saying that I would use them. By using them, they cover the adjusters fee. I am stuck at this point. It isn't about the money, my part is my deductible and the rest is insurance anyway regardless of the claim amount. It is the bill padding that looks like it is beyond normal. I get the feeling that the guy from the roofing company is using me as a cash cow due to our sour relationship. I would LOVE to back out of this contract and get the insurance money that is a no brainer! I could get my roof replaced and still come out $15k ahead. I am about to end-run around my adjuster and go directly to the insurance company to see what is going on.

I am surprised the insurance company is even going to allow the 35k. The contractor is almost definitely screwing over the insurance company. Like I said, you should never have signed off on that contract for someone coming in at 2x the other estimates. You know he is a crook right there imo.

As for the price of the adjuster, doesn't the insurance company send its own adjuster? I never heard of an insurance company that does not send one of their own adjusters or contractors to do the estimate or make you go to one of their approved contractors. Either way, you should never have signed off on that deal. Have you looked into reporting the contractor and adjuster to the state or talked to an attorney to see if you just pay the adjuster's fee you can get out of it? I would definitely give your insurance company a call a try to speak to a senior claims manager or someone above the level of the rep you are having issues with and politely ask the status and what can be done to expedite it\what the issues are. Can't hurt, though I would not get into a nasty session about the rep as that will do you no good for sure and make matters worse in all liklihood.
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#6
You won't get the money even if you get out of this contract.

It will be issued to you and the mortgage holder (if you have one)

Any check cut early will not have the depreciation included. That will come after the job is done.
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for those that hate spelling mistakes www.walmarts.comCool

bulb save money by checking your insurance every 2 years (and not every 20) Thanks Liberty Mutual for reminding me to shop. The $842 increase this year sums it up. Across the board increase for Ohio....whatever
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Quote from YanksIn2009
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I am surprised the insurance company is even going to allow the 35k. The contractor is almost definitely screwing over the insurance company. Like I said, you should never have signed off on that contract for someone coming in at 2x the other estimates. You know he is a crook right there imo.

As for the price of the adjuster, doesn't the insurance company send its own adjuster? I never heard of an insurance company that does not send one of their own adjusters or contractors to do the estimate or make you go to one of their approved contractors. Either way, you should never have signed off on that deal. Have you looked into reporting the contractor and adjuster to the state or talked to an attorney to see if you just pay the adjuster's fee you can get out of it? I would definitely give your insurance company a call a try to speak to a senior claims manager or someone above the level of the rep you are having issues with and politely ask the status and what can be done to expedite it\what the issues are. Can't hurt, though I would not get into a nasty session about the rep as that will do you no good for sure and make matters worse in all liklihood.
You may not be aware of how insurance and private adjusters work. Say you have a covered event and call your insurance company. The guy goes up on the roof and sees what is going on and says we'll pay for 100 sq feet of shingles to patch the damage. Total cost: $500. Now steps in the private adjuster who has no affiliation or more importantly allegiance to the insurance company. He specializes in insurance claims. He knows your policy and what is covered and to what extent. He maximizes your claim based on your policy. Insurance companies almost always lose when a public adjuster steps in because they are not interested in saving the insurance company money.

Because of how insurance company bean counters figure claims to pay as minimal as possible, most, if not all states allow a private adjuster to represent your claim. They asses the damage and go to bat for you with your insurance company. They are like your lawyer. Insurance companies are the reason private adjusters exist.

All that said I am not upset at all about going with a private adjuster. I also did not have much choice to sign a contract with the roofing company. Someone needs to put together the quote and work involved to what the insurance company needs to support the claim. They do put out time and expenses so they are entitled to recover at least that. Of course they want you up front to agree to use them for the roof repair once everything is approved.

All of it is approved with the initial @$35k claim. It is this extra $17k+ addendum that I am having trouble understanding.
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Quote from stufine
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You won't get the money even if you get out of this contract.

It will be issued to you and the mortgage holder (if you have one)

Any check cut early will not have the depreciation included. That will come after the job is done.
No - I will get the money had I set it up this way from the start but you are correct, less depreciation. Going direct to the roofer the full replacement amount is approved.
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You may not be aware of how insurance and private adjusters work. Say you have a covered event and call your insurance company. The guy goes up on the roof and sees what is going on and says we'll pay for 100 sq feet of shingles to patch the damage. Total cost: $500. Now steps in the private adjuster who has no affiliation or more importantly allegiance to the insurance company. He specializes in insurance claims. He knows your policy and what is covered and to what extent. He maximizes your claim based on your policy. Insurance companies almost always lose when a public adjuster steps in because they are not interested in saving the insurance company money.

Because of how insurance company bean counters figure claims to pay as minimal as possible, most, if not all states allow a private adjuster to represent your claim. They asses the damage and go to bat for you with your insurance company. They are like your lawyer. Insurance companies are the reason private adjusters exist.

All that said I am not upset at all about going with a private adjuster. I also did not have much choice to sign a contract with the roofing company. Someone needs to put together the quote and work involved to what the insurance company needs to support the claim. They do put out time and expenses so they are entitled to recover at least that. Of course they want you up front to agree to use them for the roof repair once everything is approved.

All of it is approved with the initial @$35k claim. It is this extra $17k+ addendum that I am having trouble understanding.

Did not know that. That being said, I find it inconceivable that their guy says $500 and they just take a private adjusters quote for 35k. The numbers are so far apart it is laughable. You would think at a min, they would send another guy back out to review what the private adjuster wrote up and get a real world estimate for it and not just take a 2x one from the private adjuster. That said, as I noted originally, if they have paid that already, then I would not care.

The additional work of 17k for removing and replacing gutters and screens sounds even more ridiculous imo.
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Quote from YanksIn2009
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Did not know that. That being said, I find it inconceivable that their guy says $500 and they just take a private adjusters quote for 35k. The numbers are so far apart it is laughable. You would think at a min, they would send another guy back out to review what the private adjuster wrote up and get a real world estimate for it and not just take a 2x one from the private adjuster. That said, as I noted originally, if they have paid that already, then I would not care.

The additional work of 17k for removing and replacing gutters and screens sounds even more ridiculous imo.
They do have their own guys validate the claim. You think this is bad? A friend of mine had a deck fire that burned most of his kitchen as well. Insurance pegged the claim at $40k. He went to a private adjuster and when all was said and done, the claim was close to $200k. For instance, the insurance company will replace 20 year old no longer made windows that were punched out by the FD with a new "similar" window if you let them. The private adjuster says no f'n way he has a matching policy so guess what, you are going to replace every single window in the house. Private adjust also got every single electronic device in the house replaced due to smoke damage. Insurance company doesn't give a shit about that and then 2-3 years down the road when these things fail prematurely, you are out of pocket.

Often times the difference between the private adjuster and the insurance adjuster are light years off. My $35k claim was already approved and paid. It is the extra addendum that we are dealing with now. I told the roofer I want to know exactly what this is for and why it was not included in the original bill. I suspect some monkey business is going on at this point. We've gone from "really high retail" to "wtf, over".
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#11
new roof costs $4,000 to $10,000 on average


Your mortgage holder is likely listed as a "loss payee" on your home insurance policy, so payments for rebuilding are issued to both you and your lien holder. And don't expect your mortgage holder to sign the check over to you.
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Last edited by phillint February 25, 2018 at 02:01 PM.
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Quote from phillint
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new roof costs $4,000 to $10,000 on average


Your mortgage holder is likely listed as a "loss payee" on your home insurance policy, so payments for rebuilding are issued to both you and your lien holder. And don't expect your mortgage holder to sign the check over to you.
Again, I already got the check and it was given to the roofer.
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