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Supplementing Denied Claims

Has the adjuster denied your homeowner’s insurance claim for storm damage? If the answer is yes, then you actually do have some options to salvage the job. Some roofing contractors and sales reps view a denied claim as the end of the road for that particular job, potentially missing out on thousands or even millions of dollars per year.  Savvy contractors who understand what damage looks like and perform thorough inspections view a denied claim as just another minor setback and actively work to appeal a denied claim and convert it into a profitable job. Supplementing a denied roof or siding claim is the best way for contractors to bring an insurance storm claim back to life, but as Kenny Rogers used to say, “You’ve got to know when to hold ’em, Know when to fold ’em, Know when to walk away, And know when to run.”

Denied Insurance Claim

F.A.Q.

About Roofing Supplements

A denied claim supplement is when a contractor attempts to convert a roofing insurance claim from a denial to a full replacement. There are 3 main options when it comes to dealing with a denied claim: Reinspections, Engineer Reports, and Public Adjusters.

A reinspection is when a homeowner requests that a different adjuster perform a second, full inspection of the property. Contractors should come to the reinspection prepared to walk the adjuster through all of the documented damage. Clearly marking damage and performing test squares can give you credibility with the adjuster but be careful and know your local adjusters; this can sometimes backfire if they want to be the ones to mark any damage found. When reinspections are done correctly, you can expect conversion rates as high as 50%.

Engineer reports are another tool to challenge a denied claim. If the adjuster and contractor cannot agree on whether or not the damage is storm related or if there is enough damage to warrant replacement, then  in most cases the homeowner may hire an engineer, at his or her expense, to inspect the property. In most cases if the engineer determines that the damage warrants replacement then the insurance company will reimburse the cost of the engineer. However if it is determined that there is not enough damage to warrant replacement, then the homeowner will likely be out the expense of hiring the engineer.

Another option is to get a public adjuster involved. The public adjuster works on behalf of the homeowner to provide another expert inspection and has the ability to negotiate with the insurance carrier. It is a good idea to have a few vetted, trustworthy public adjusters ready to recommend. Public adjusters can be very expensive and typically should be a last resort as in most cases if there is valid damage on a property then any one of the other items mentioned in this post should ensure a similar outcome at a fraction of the cost.

The denied claim supplementing process involves submitting a detailed Xactimate estimate with corresponding photo documentation and educating the homeowner on how to challenge the adjuster’s initial findings.

Most importantly, the contractor should be selective on which denied claims to challenge and which ones to let go. Experience and good documentation makes it pretty easy to know which denied claims have potential to turn into jobs.

The answer is simple: to get paid what you deserve. Converting a denied claim into a full replacement is a great way to significantly boost revenue and also demonstrate your expertise to the homeowner. There are a variety of reasons WHY an adjuster denies a roofing or siding insurance claim; they dispute the storm date, they didn’t perform a thorough inspection, there wasn’t enough damage to warrant a replacement, or maybe they felt that the roof could be repaired instead of replaced. The WHY doesn’t really make a difference. What matters is what the contractor can do about it. Roofing contractors have several different options and tools to effectively challenge a denied claim with a supplement.

What makes supplementing a denied roofing or siding claim different from a standard roofing supplement is that a denied claim requires more buy in from the homeowner. Requesting a reinspection or hiring a public adjuster are some of the options that may require the homeowner to take action. Sometimes the homeowner will not want to move forward with the claim but when they do, they often become more emotionally invested and determined to get the denied claim overturned. Homeowner buy-in is essential for supplementing a denied roofing claim but the contractor needs to educate their client on the process, set expectations and communicate every step of the way.

When it comes to denied roofing claims, the contractor needs to be more selective on which ones he/she decides to move forward with. This is where the contractor’s experience and expertise comes into play. If there are clear signs of storm damage, and enough of it to require replacement, then the contractor should supplement. Denied claims require more work, so you want to be sure you are not wasting your time with frivolous claims. Since the denied claim supplementing process involves the homeowner taking action, you also want to be respectful of their time as well. By choosing the right denied claims to challenge, you will increase the likelihood of getting approvals, but even if you eventually lose the fight, you will likely have gained a long-term customer and even get referrals.
A 3rd party supplementing company is a great option for contractors who do not have experience challenging denied claims or lack experience writing Xactimate estimates. Having a well written Xactimate is the first step in the denied claim supplement process. During this stage, a 3rd party supplementing company will also be able to quickly look at the existing documentation and determine if there is enough of a case to move forward. An honest 3rd party can save contractors time just by helping them avoid denied claims that have a low probability of approval. As previously mentioned, denied claim supplements require more time from the contractor as they have to coordinate more appointments and follow ups than a standard roofing insurance claim. These types of claims can be a real time waster if not chosen correctly; time that could be better spent selling your next job!

Suggested Pages

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