Why Insurance Won’t Cover Some Roof Claims

Agents all across America deal with this situation on a regular basis. There tends to be some confusion on the matter. So let’s talk about some basic insurance principles to get a handle on the topic.

Keep in mind; every insurance claim includes individual details and circumstances that make it nearly impossible to render a single judgment on the subject. Insurance is designed to balance out covered events that cause physical or other damage. A homeowners policy generally covers a wide range of risks not limited to fire, water backup if you opt into it, and much more.

Roof damages may qualify for some claims, but only when a covered hazard is involved. Otherwise, it’s considered routine maintenance that eventually affects every house. Homeowners are responsible for this type of work.

How is insurance different than a warranty?

When it comes to different types of insurance, whether property, casualty, or health (life insurance is almost inarguable from a claim standpoint), there are certain things that are not covered, as they are considered maintenance rather than actual losses. This is where most of the confusion lies. Many homeowners assume a roof leak must be covered. What they don’t realize is you need a qualifying event.

For example, an insurance company will not pay for new wiper blades or tires for your car because these items are designed to wear out over time. Your roof, plumbing system and electrical system are also designed to wear down over time. With regular maintenance, though, it can last a lot longer.

Additionally, you cannot expect an insurance company to pay for your car’s motor ceasing as a result of not changing the oil. If you notice a leak or a roofing contractor alerts you to problems, the ensuing damage may not be covered.

These are all maintenance items the property owner needs to take care of to ensure things keep running smoothly. An agreement from an organization to fix, or pay to replace those items, is a warranty. Generally, warranties are limited to specific parts of your home or car. So you’d need a roof warranty, an electrical warranty, etc. If you had a covered event like hail damage, insurance would kick in.

Insurance is supposed to make you whole again, not make you money. In addition, insurance premiums would be unaffordable if insurers agreed to repair or replace any item that was damaged regardless of the cause. If, on the other hand, you cover things like routine roof repairs, you can shop around and still find reasonable homeowners insurance rates.

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What about my roof?

When it comes to your roof, similar to car tires and oil changes, your insurer expects you to cover the costs to maintain it. Roofs have what is referred to as a functional life, which is the amount of time (which varies greatly by its construction materials and where you live) it should last under “normal” circumstances.

If your roof is older or has been exposed to hail, you can certainly expect to have to replace shingles, if not the whole roof, in order to keep it from leaking or collapsing. It is part of the “hidden” costs of homeownership. Depending on the age of your home, insurance companies may even request a roof company inspection before issuing a homeowners insurance policy.

You will be out of luck if you call your insurance company and file an insurance claim to have minor repairs done to your roof unless they are a result of a documented windstorm.

(Why is a wind deductible higher than a regular deductible?)

Keep in mind too, that insurers are generally protected from minor property damage claims by requiring a deductible on your policy for property damage claims. Typically, insurers require at least a 1% deductible when it comes to areas where tornadoes, wind and hail damage are frequent. You would be hard-pressed to exceed your policy’s deductible to have a few shingles replaced on your roof.

One example of a claim that is usually denied along these lines is water damage resulting from “wind-driven rain.” You will likely be denied coverage for water damage resulting from rainwater that’s pushed under shingles (by strong winds) if you have an old, leaky roof.

On the other hand, if a nasty wind or hail storm destroys part or your entire roof in one particular event, your insurance company would likely pay to repair or replace it (assuming that coverage is not excluded in your homeowner’s insurance policy language).

What are common roof exclusions?

Some insurance companies go as far as excluding roof coverage altogether if a home’s roof has not been repaired or replaced within a certain time frame in a particular geographic area (15 years for example). They are not interested in trading you one year’s premium for a $10,000 roof we all know is going to blow off the house in the next serious storm.

Additionally, some insurers will only offer actual cash value coverage (versus replacement cost) on a roof over a certain age – even when the structure itself is insured for replacement cost. If your roof is 20 years old, they’ll give you the money for its value at the time of loss rather than enough money to replace it completely.

(Top 10 homeowners insurance companies.)

Some individuals opt for the ACV roof coverage as a way to lessen their overall insurance premium. Agents do not recommend opting for this coverage restriction unless you have enough money on hand to replace the roof in the event of a total loss…but if you have that kind of money laying around you should just pay for the coverage!

Insurers also offer potentially HUGE discounts for homes that have hail-resistant roofs installed on them, so be sure to ask your agent about that discount if you coughed up the money for an indestructible roof on your home. There are many different roofing material options.

For the record, your home’s foundation falls into the same category (foundation insurance). It is normal for homes to settle and cracks in a basement or foundation or sinking of piers (if pier and beam) to appear over time, if not immediately after being built.

Contact your insurer or independent agent to determine your exact coverage for your roof and foundation on your current policy.

Read more: Losses that aren’t typically covered by a homeowner’s insurance policy.

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