how do insurance claims work

How Do Insurance Claims Work?

Insurance coverage is absolutely critical for anyone who owns property like a car, home, or other valuable asset. 

The entire point of having insurance coverage at all is that you’ll be financially protected in the event of covered losses. These losses can take the form of damage, theft, vandalism, or other causes. 

According to the terms and conditions laid out in your insurance contract, your insurance provider is obligated to give you a payout that is in-line with any covered damages your insured property incurs. However, this payout is never guaranteed, and it’s your responsibility to take action after a loss in order to ensure that you are fairly compensated for your claim. 

When it comes to homeowners insurance in particular, most coverage clauses related to the roof are, generally speaking, similar. Let’s dive into some of the main concepts, and then we’ll give you a few tips for when the time comes to file your own insurance claim. 

Insurance Claim 101

Any time you have insurance coverage and you experience a covered loss, the very first thing you’ll want to do is start the claim process. It’s called a process for a reason: it can take some time, so prepare yourself for a little back-and-forth. 

[Note: Having a roofing technician with you when you visit with your insurance adjuster often results in identification of covered damages that the adjuster might not have seen!]

Starting an insurance claim typically begins with an email, phone call, or direct message you send to your insurance company. Most of the larger, national insurance companies have mobile apps that allow for paper-free claim procedures; check with your insurance provider to see if such an app is available to you. 

After you file a claim, the insurance company is likely to call or email you to schedule a time for an insurance adjuster to make a visit to your property. Alternatively, some insurance companies will outsource this visit to a repair company of their choosing. It all depends on the terms and conditions of the insurance policy. 

Assessing the Damages

When the adjuster shows up, he or she will walk the property and document damages. The adjuster will often schedule a roof inspection in the case of roof damage, and then they’ll have all they need to determine a fair estimate for the money it will take to repair damages or replace the roof outright. 

how do insurance claims work 2

Don’t forget! Having an A-to-Z Roofing & Exteriors team member with you during the damage assessment visit is always a good idea. 

Claim Offer

After a short period of time (typically less than a few days), the insurance company will provide you with an offer to settle your claim with a payment; 

  1. Partial prepayment, also known as the ACV, for the required repair work is immediately paid to you once the damages have been assessed. 
  • Full payment, also known as Depreciation, for the entire scope of work is provided immediately upon completion of the roof repair or replacement, the full balance of the claim payment is remitted to you.

The money the insurance company pays for the damages to the roof will always be separate from any Additional Living Expenses (ALE) compensation they might pay. 

For example, if your roof sustained serious damage from a hail storm and made the building unlivable during roof replacement, your insurance company would send you an ALE check to cover the costs of hotel stays, car rentals, etc. (again, according to the terms and conditions of the policy). 

Insurance Claim Tips

To help smoothen the claim process and to ensure you get paid fairly for your losses: 

  1. Never agree to a claim settlement without having a trained roofing technician inspect the roof, first. 
  2. Remember that insurance claim settlement offers are offers. It is your right as a consumer to counteroffer, contest, or appeal any judgement the insurance company makes about the damages sustained to your property. 
  3. Having a third-party repair estimate is highly valuable. You want to have as much objective input on the real damages as possible. 
  4. Act quickly any time you suspect roof damage has occurred. All insurance policies limit the amount of time you can take between when damage occurs and when you content them to start a claim. So, act fast!
  5. Get to know a reliable, proven roofing company like A-to-Z Roofing & Exteriors. Having us in your corner during the claim process positions you for a more positive outcome. 

Have more roofing questions? Contact us today, and we’ll be happy to help!

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