Every insurance policy is made to meet a property owner’s needs. This means that every policy is unique and that no two are truly the same. That being said, the structure of every policy is the same; it is just the fine print and details within the structure that varies. This page will go over some key definitions and then the five different parts of the policy. Every policyholder should know about these general ideas when agreeing to and utilizing a policy. These are the things you should read up on when considering making a claim for they are key in determining the outcome of your claim. Contact Us for a free policy audit where we will go over all of these things for you or to receive answers for any questions.
Important Definitions to know!
Deductible - This is the amount you agree to pay out of pocket before dipping into any insurance money. There is a different deductible depending on the cause of your damage. Some policies have wind deductibles, hail deductibles, general deductibles and hurricane deductibles. These can be determined by a price number or percentage. You should read your policy to see how your deductible is applied to any form of loss.
Limits - This is the max amount of money that you can negotiate from your insurance company on any given claim. There is a different limit on every individual coverage.
Perils - The potential causes of damage that you may encounter.
Exclusions -These are the hazards, perils, circumstances, or property not covered by the policy. Exclusions are usually contained in the coverage form or causes of loss form used to construct the insurance policy.
Endorsements - This is the name for any altercation that you make to your insurance policy. The declaration page aka the front page of your policy should list your endorsement for you. You will need to request these in addition to your policy.
Proof of Loss -Proof of Loss is a sworn, notarized document “stating your claim.” When you submit it, it starts a process that requires your insurer to provide you with an answer of coverage within ninety days, which leads to payments. Turning in claim material without a Proof of Loss will slow down your claim.
Mold - This is a popular and separate category on most policies. You usually have a separate limit and deductible when it comes to dealing with mold. This can be used on top of any coverage. We recommend reading into and utilizing this section of your policy when needed.
Code Upgrades -
Debris Removal -
Umbrella Coverage -
Estimate - This is the official document that both sides of the insurance claim submit to help determine the payout of an insurance claim. This is the starting point of negotiation of payout. Your insurance will not inform you that you can submit an estimate.
These 5 coverages are a part of every insurance policy. We can not stress enough that every policy has its own fine print of when these coverages are applied and to the extent that they can be applied. You should read your policy details before submitting any insurance claim.
Coverage A - Structure - This coverage covers the cost to repair the main structure of your property.
Coverage B - Other Structures - This coverage covers the cost to repair any structure of your property that is not physically connected to your home This includes but is not limited to a detached garage, shed, or gazebo.
Coverage C - Contents - This coverage covers your personal belongings that were affected by a covered peril. Any item that is damaged, destroyed, or stolen is subject to this coverage.
Coverage D - Additional Living Expenses - This coverage covers any added living expenditure as a result of a covered peril. This means hotels, eating out, and any travel service used to work around the inconveniences of your claim can be repaid using this coverage. This is a very important and useful coverage to the point that we have an entire page covering it which you can find here.
Coverage E - Liability - This coverage protects insurers when they are found legally liable for damages caused by a covered peril. These damages can be bodily injury or property damage.
What to be aware of based on your roof type…
- Shingle - Shingled roofs are nailed and bonded together with an adhesive that formulates one unified sheet. This roof is made up of hundreds or thousands of individual sheets. It has a high potential for an opening that may lead to damage. These openings may only be intruded by rain that comes down in a certain direction depending on the wind. This leads to unpredictable water damage.
- Clay/Cement Tile - The clay and cement on a roof are not the only things protecting your structure from the outside elements. The prime material protecting your structure is the underlayment or the base that the roof is built upon. This rubber material is what is applied onto the wood of your roof when your roof is first made. If you have this type of roof and you’re experiencing a leak that means that you have two areas of damage: the tile itself and the underlayment.
- Rubber/Torched down/Flat Roof - This is the most basic form of a roof. It consists of a base that is applied to the wood structure of the roof. Then an asphalt product that is similar to a shingle, but it comes in a roll is then stretched out across the roof surface. It is then torched where the material meets for a water tight seal. This roof is prone to damage from wind blown debris and hail that may puncture the rubber. It is also a victim of high winds. These winds can move the rubber around.
When to make an insurance claim on a roof?
First, you should determine the source of the damage, and what may have caused the damage. Then you should hire someone (i.e. home inspector, contracter, or roofer) to assess the damage and determine a price. In this step you should ask to get a certified document that represents this evaluation. You should read your policy with the insurance company to see the terms that are agreed upon to minimize any risk of improper handling of the claim on your behalf. When ready you should proceed with the official estimate and file a claim with your insurance company. They may try to be slick and improperly judge and categorize the cause of damage on your roof. This can lead to a higher deductible, lower recovery limits, and potentially a denial of coverage all together. Contact us to get in touch with an insurance expert that can walk you through this journey.
What to do if my insurance company denied my roof claim?
The first thing you should do is determine if you are facing a true denial. A true denial is a claim that does not fit the named perils in the insurance policy; in other words, the cause of the damage does not meet the listed possible covered causes in the policy. For example, if a policy excludes weather related damage, and your roof was blown off by a tornado then your insurance policy would not qualify to cover for a new roof. In this situation you should contact a public adjuster or property casualty attorney to review your claim and circumstance. A denial may be the result of human error so it is always recommended that you double check with a professional you hired, not the one your insurance company hired. Contact us to get in touch with an insurance expert that can walk you through this journey.
I have brown spots on my ceiling. What should I do?
If you have brown spots and or mold on your ceiling that means you have a form of a leak from either your roof, your plumbing, or your air conditioning. Your first step should be locating the source of this drip and stopping whatever is causing this damage from getting any worse. Any qualified property inspector could be used to help assist in this situation especially if the leak is hidden.
If it is your roof you should attempt to put a tarp on the area until you can figure out how to fix it. This can be done by a licensed roofer. An issue we commonly see when it comes to insurance company’s is that they say to repair or patch the problem area but then your roof may still have unseen issues in other areas that may not have been discovered and your roof will look off with unmatching materials. You should get a new roof all together from your insurance company.
If your plumbing or AC has failed you should turn it off until properly repaired by a licensed professional. With any claim that you face you should see what your estimated cost of repair should be. Your insurance company is going to low-ball you so you should have an idea of what you want to receive. Contact us to get in touch with an insurance expert that can walk you through this journey.