Roof Insurance Adjuster: What They Do and Whose Side They're On
"Roofer thinks a full replacement would be possible and says to get a public adjuster to start the claim with insurance."
That is how a homeowner who started a thread on r/Insurance described the pull between a roofer and a claim.
The adjuster your insurer sends is a company representative who inspects property damage to determine how much the insurance company should pay1. So the visit is where your preparation counts. Below: what to prepare, who the other adjusters are, and what to do if you disagree.
Quick answer:
- Take pictures or videos of the damage before any repairs, and in Texas keep damaged items until the adjuster has seen them2.
- Read your policy to see exactly what your responsibilities are1 in a claim.
- Be present while the adjuster assesses the damage, and point out all affected areas3.
- Contact the insurer to explain your reasoning if you disagree, and get your own estimate4 to back it up.
On this page
All of these steps are yours to take, and none of them needs you on the roof.
What does a roof insurance adjuster do at the visit?
Your insurer will probably arrange for an adjuster to come and inspect your home1. The adjuster puts a number on the damage. That number is only as complete as what they see and what you show them.
Have a few questions ready for the adjuster:
- Which areas did you inspect, and does the estimate include each one I pointed out?
- If something is left out, what is the reason?
- Is a second visit planned, and when?
Whose side is each kind of adjuster on?
In Missouri, company and independent adjusters are paid by insurance companies, and public adjusters charge the consumer5. A public adjuster is the only one of the three you hire and pay yourself. An independent adjuster is an outside adjuster whom the insurer pays.
A public adjuster cannot get you more money than your policy provides6. One reply in an r/Insurance thread on the subject was blunt: "No you should NOT NOT NOT always hire a public adjuster." Hiring one is a choice with a cost, not a requirement. Before you sign with one, ask for the fee in writing: what percentage, of which amount, and how you can end the agreement.
Weighing whether to hire a public adjuster, and how to check one out? What a public adjuster does for a roof claim.
Before the visit: the order to follow
- Document the damage. In Texas, take pictures or videos before making any repairs, keep damaged items until your adjuster has seen them, and make only temporary repairs2 to protect the house and belongings. Keep receipts for what you spend on them.
- Know your deductible. It is the amount you pay before the insurer pays the rest. In Texas, on a home insured for $200,000 with $7,000 of hail damage, a 1% deductible means you pay $2,000 and the company pays $5,000; at 3% you pay $6,000 and the company $1,0007. The percentage applies to the insured amount, not to the claim. Your numbers will differ. In Texas, get repair estimates: if the cost of repairs is about the same or less than your deductible, you may decide it's not worth filing a claim8. If you doubt the damage is above your deductible, a written estimate from a roofer you choose helps you decide.
- Hold off on permanent repairs. In Texas, don't make permanent repairs before the insurance adjuster sees the damage9.
- Stay with the adjuster and show your photos of each spot you want counted.
If you have not opened a claim and only want to ask about coverage or your deductible, say that is all you are asking. In Tennessee, insurers report to a claims database both the claims they pay and files they set up for a possible claim10.
Want a roofer on your side to see the roof before the adjuster does? Is a free storm roof inspection safe to accept.
Does your roofer need to be at the inspection?
When the visit is set, ask whether a roofer you hired may join. A roofer can document the damage and give you an estimate, but the adjuster's estimate is what determines how much the insurance company should pay1.
Roofers and adjusters can read the same roof differently. A reply in a hail-damage thread on r/Roofing put the suspicion bluntly: "TO a roofer, EVERYTHING is hail damage." So ask any roofer to show you a photo of every problem they say they found. In Iowa, seek estimates from at least two registered contractors3 for repair costs.
From the ground, spatter marks or impact indentations on other items around the building11, such as metal flashing or air-conditioner fins, are good indicators that hail has occurred. Installation marks and weathering can look similar, so treat them as a sign, not proof.
If you disagree with the result
You have three next steps, in this order:
- In Kansas, contact the insurance company to explain your reasoning4. The company may make adjustments, or you may hire a contractor or other professional to obtain your own estimate.
- In Texas, if the policy has an appraisal process, you and the company each hire an appraiser, and the two choose a third as umpire12. If the two estimates differ, the umpire makes the final decision, which is binding on both you and the company12, and you pay for the appraiser you hire and for half of the umpire's expenses12.
- In Texas, if you think an insurer has treated you unfairly, you can file a complaint with the state insurance department12. Wherever you live, ask your own state's insurance department how to file one.
When you write to the insurer, ask for the estimate and the reason for any item left out, in writing. You can send this:
Please send me your estimate for the roof, and tell me in writing why any damage I pointed out is not included. If a second visit is needed, please tell me when it will be.
If a roofer or a public adjuster pushes you to sign today, ask them to send the terms in writing, then read them and compare with your other options.
Did the adjuster's estimate leave out part of the job? What a supplemental roofing estimate is and who asks.
Quick questions
What is a public roof adjuster?
Someone you hire to negotiate with your insurer13 on your claim. In Texas, public adjusters are licensed by the state insurance department13 and can charge up to 10% of the total amount the company will pay for your claim13. In Texas, you can ask the state insurance department whether the public adjuster is licensed13.
What is the 25% rule for roofing?
It is a Florida building-code provision. In Florida, it applies to a roof built, repaired or replaced under the 2007 Florida Building Code or later14. When 25 percent or more is being repaired, replaced or recovered, only that portion14 must meet the code in effect. Ask your roofer whether it applies to your roof; outside Florida, ask your local building department.
How does insurance work with roofs?
The adjuster estimates the damage, but your payout comes down to the policy. Your deductible is part of that, as the example above shows. Ask your insurer to explain how the policy applies to your roof.
What if the visit felt rushed?
In California, when an adjuster is short on time, a brief inspection needs a second visit to complete the inspection15. Wherever you live, ask whether the visit was only a first look and when the next one is, and use it to point out anything missed.
Sources
1. Triple-I (Insurance Information Institute), "How to file a homeowners claim
2. Texas Department of Insurance, "When are water damage and mold covered by insurance?
3. Iowa Insurance Division, "April Consumer Connection: Hail Claims
4. Kansas Department of Insurance, "Homeowners Claims Settlement (checklist)
6. Triple-I, "What is a public adjuster?
7. Texas Office of Public Insurance Counsel, "Decoding Residential Property Deductibles
8. Texas Department of Insurance, "Will my premium go up if I file a claim?
9. Texas Department of Insurance, "Help after a storm
10. Tennessee Department of Commerce and Insurance, "C.L.U.E. (Comprehensive Loss Underwriting Exchange)
11. Insurance Institute for Business & Home Safety, "Is It Hail Damage?
12. Texas Department of Insurance, "What if my insurance isn't paying enough?
14. Florida Legislature, Florida Statutes 553.844, subsection (5)
15. California Department of Insurance, "Residential Property Claims Guide
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