Top 10 Roofing Insurance claims denials by Adjusters

Like a good neighbor, State Farm is there…

… except when they’re not.

Roofing insurance claims denials are not all that uncommon.

It’s no secret that insurance companies are notorious for denying and shorting their customers’ claims.

And for major companies like State Farm and Allstate, it’s confounding when they elect to be so stingy.

Consider that major insurance companies routinely gross around $60 billion per year in revenue, yet they only pay out between $1-3 billion in claims.

Of course, insurance companies have other expenses as part of their overhead, but it still makes little sense why they are so uncooperative with their customers.

In the roofing industry, shady tactics from the insurance companies often leave contractors fuming.

Throughout the years, Roofing Insights CEO Dmitry Lipinskiy has tried to uncover the reasonings behind insurance companies’ denials, and he has a few theories.

“Because we see the same patterns, the same identical denials all over the country from several insurance companies, we have a theory that there are trainings taking place inside insurance companies, where they are teaching their adjusters to say certain things,”

he begins.

“We here at Roofing Insights want you to be educated and prepared for those denials when they take place so you know how you can respond, and that you’re not the only one who hears those objections or those denials.”

To help, Lipinskiy has listed the ten most common responses that insurance companies give to their opposition when they’re trying to cut costs.

In no particular order:

1. “You’re the first contractor who has ever mentioned that or tried to get paid for that”

Many insurance companies will try to claim a contractor is asking for outrageous items in their estimate, but the ironic part is that the requested items are all generated from an industry-leading software called Xactimate.

Plus, the insurance companies also use Xactimate, meaning there should be little to zero variance, unless the insurance companies forgot to update their app (joking!).

“25 insurance companies are using Xactimate or will accept Xactimate estimates,”

Lipinskiy says.

“It’s an independent software not run by insurance companies, and not run by contractors.”

Need help using Xactimate?

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2. “We already have that included in this other line item on your estimate”

Warning:

Insurance adjusters are not looking out for your best interests, so when they tell you they’ve already accounted for a particular item, odds are they’re simply trying to brush the added expense under the rug.

A great example can be seen with starter shingles.

Adjusters often lump starter shingles in with regular shingles, but every contractor will tell you the two aren’t the same, and thus can’t be included in the same price.

“If they [extra materials] require different labor, if they cost more money, they have to be separated,”

says Lipinskiy, but of course insurance adjusters want to cut corners because the long-term savings they’ll get by doing so on hundreds of jobs will benefit both their bottom line, as well as their company’s.

3. “I have five other contractors right now who would be willing to get paid for that”

“Here’s how it works,”

states Lipinskiy.

“Insurance owes you what they owe. If it [the job] costs you $20,000, they owe $20,000.”

Seems simple, but adjusters often will try to short estimates by a few thousand dollars, knowing that later on they will likely be forced to tack those few thousand dollars back on.

“A lot of times, they [adjusters] don’t see what they don’t see. We don’t see what we don’t see. We can’t just say `well, it’s guaranteed to be a $20,000 job’ because a lot of times you have extra damage, you have stuff that they missed.”

Again, when adjusters pull these types of stunts, they’re simply trying to cut costs, but this can hurt a customer’s roof, especially if they go with another contractor just because that price is cheaper.

Homeowners: to avoid this problem, simply hire your preferred contractor and let them deal with your insurance company.

4. “The price this contractor is charging is way too high. You should get more estimates”

The question you have to ask yourself is this:

“Would you rather save money for the insurance company, or would you rather do the job right?”

asks Lipinskiy.

“I promise you this: insurance companies never overpay. They pay what’s fair, but a lot of times we [contractors] have to beg to get paid for what’s fair.”

5. “We have never paid for that line item before”

As a contractor, if an adjuster says you’re asking for unprecedented items, shrug your shoulders and laugh, because you’re the latest in a long line of contractors to be subjected to an adjusters’ attempted manipulation.

“They [adjusters] lie all the time,”

says Lipinskiy.

“They always come up with this line when they don’t want to pay for something extra.”

This often happens in siding when only one part of a house needs replacement. Per regulation, all aspects of a home’s siding have to match, but insurance companies will try to save money and only cover the damaged portions of the home.

Contractors: don’t let adjusters get away with this!

6. “No roofer has ever asked for OSHA safety ropes”

If you value your safety, then you likely value the equipment that lets you and your crew go home at the end of each day.

And yes, you should be compensated by the insurance companies when you bill them for safety equipment.

“The insurance company owes for everything. Your labor might be the same, but sometimes there are extra costs,”

Lipinskiy says in reference to safety materials.

7. “We don’t pay for that because that is included in the waste”

In the same vein as #2, insurance companies don’t like paying for more expensive materials, even if those materials will ensure the long-term viability of the roof.

“We want to install the best roofs,”

Lipinskiy says, then adding that

“if you have a roof right now with starters, with hip and ridge shingles, those items cost more money to install and remove.”

Remember: cheaper does not equate to better.

Make sure your customers are taken care of, and don’t let adjusters swindle you into installing the cheapest materials.

8. “Just submit your estimate and we will look over it”

This is another popular tactic that insurance companies use to save money because they figure that the longer the process of settling for a new roof takes, the more a contractor will be willing to settle for a cheaper price.

Don’t fall into this trap.

Demand fairness and expediency from the insurance company so you can better service your customers.

“It takes time, but that’s the best process for moving forward,”

assures Lipinskiy.

9. “There’s no hail or wind damage”

Yes, these words have been spewed by delusional adjusters, even when the damage is right beneath their shoes.

“It gets to the point where you can both look at something and the insurance adjuster will just say `no, I don’t know what it [the damage] is.’”

Homeowners, please be aware: if this happens, you have a right to second and even third assessments.

Lipinskiy highly encourages homeowners to take advantage of this because usually insurance companies will cave after being forced to go to extra lengths to re-estimate a roof.

10. We need your help!

Says Lipinskiy of dealing with adjusters:

“Sometimes what we do is very frustrating. We feel like we’re talking to idiots in a cubicle. I don’t know if they’re trained that way or if they’re just plain stupid, but a lot of times their arguments make no sense.”

We’ve already listed ten of the most common responses homeowners and contractors receive from insurance adjusters, and we easily could have cited dozens more.

Which ones did we miss?

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