How a Storm Roof Claim Works in New York

The general pattern of a storm roof claim

A policy generally covers sudden storm damage, such as wind lifting shingles or a storm opening a roof. The homeowner reports the loss, the insurer inspects, and the policy decides the payment.

A standard homeowner policy is written to cover sudden and accidental losses, and a storm that lifts shingles or opens a roof is generally of that kind. The homeowner reports the loss to the insurer, the insurer sends an adjuster, and the adjuster inspects the damage. The policy and the adjuster's findings then decide what is paid.

The process is the same in principle across the state, but the policy wording is different for each insurer and each policy. The homeowner should read the policy and ask the insurer to explain how it applies to the loss.

What a policy generally excludes

Wear, lack of maintenance, gradual deterioration and damage caused by insects and animals are commonly excluded. The exclusions are described in the policy and should be read with care.

A standard policy generally excludes damage that develops over time, such as the ordinary ageing of a roof, the slow rot of the decking from a long-running leak and damage that results from a lack of maintenance. Damage caused by insects, such as termites, and by animals is also commonly excluded.

These exclusions are described in general terms here, because the wording of each policy decides the answer. A homeowner who is unsure whether a loss falls within an exclusion should ask the insurer to show the relevant section in writing.

What to photograph and keep

The damage from the ground and inside, with a scale object and the date, the roofer's dated report, the receipts for any repair and every letter or email with the insurer.

Photograph the damage before anything is cleaned or repaired, with a scale object in each frame and the date. The roofer's dated report, with the findings and the repair recommended, is the record the insurer will look for.

Keep the receipts for any temporary or permanent repair, and keep a copy of every letter and email with the insurer. A written timeline from the storm to the claim helps the file make sense to anyone who reads it later.

• Photographs of the damage, with a scale object and date
• The roofer's dated report of the findings
• Receipts for any temporary or permanent repair
• Every letter and email with the insurer

What mitigation means and why the insurer expects it

Mitigation is taking reasonable steps to stop further damage, such as a temporary cover, and it is expected by most policies. It does not mean repairing the whole problem before the insurer has seen it.

A policy usually expects the homeowner to protect the property from further damage once a loss has happened. A tarp over an open roof, buckets under a leak and the moving of belongings are reasonable steps. The insurer expects the homeowner to take them and to keep a record.

Mitigation is not the permanent repair. The permanent work is normally done after the insurer has inspected, or with the insurer's agreement, and the homeowner should ask before replacing damaged material.

What the adjuster asks and what a homeowner should expect

When the damage happened, how it was noticed, what was done about it, what the cause appears to be and whether the damage was sudden or gradual.

An adjuster will ask when the damage was first noticed, what the homeowner did about it and whether any earlier repair was made. The adjuster will want to know whether the cause was sudden or gradual, and whether any maintenance was carried out.

The homeowner can help by answering clearly, providing the photographs and the reports, and saying when information is not known. A guess presented as a fact can weaken a claim, and an honest gap is better than an invented answer.

What to do if the claim is denied

Ask the insurer for the reason in writing, read the policy section cited, respond with evidence and, if the matter is not resolved, take it to the state regulator's complaint process.

A denial should come with a written reason that refers to the policy. The homeowner can ask for that reason in writing, read the cited section and respond with the evidence and the reasons for disagreement. A reply in writing is the record of the dispute.

If the dispute cannot be resolved with the insurer, the state insurance regulator takes complaints about insurers. The New York Department of Financial Services is the regulator, and its complaint process is the next step for a homeowner.

What this guide does not say

It does not state deadlines for reporting or disputing a claim, coverage limits, deductibles or statute numbers. Those depend on the policy and the state's rules, and they change.

This guide does not give a number of days for reporting a claim, nor any coverage limit, deductible or statute. Those details are set by the policy and by state rules, and a homeowner should read the policy and ask the insurer for the exact terms before relying on any of them.

A roofer who documents the damage is not deciding the claim, and the roofer's report is evidence rather than a verdict. The homeowner should keep that in mind throughout the process.

Common questions about wear and tear

Wear and tear is the gradual ageing of a roof, which a policy generally excludes. The question in a claim is whether the damage came from a sudden event or from long-term wear.

An insurer looks at the cause of the damage. Sudden damage, such as a shingle torn by a storm, is generally treated differently from damage that developed over many years, such as a brittle covering or a slow leak at a valve. Some damage has both causes, and the adjuster decides how the policy applies.

The roofer's report helps by showing what the roof looked like before the storm, where the report exists, and by separating the signs of recent damage from the signs of older wear. That separation is the core of most roof claims.

Working with a public adjuster or an attorney

A homeowner can hire a licensed public adjuster or an attorney to help with a dispute. Those professionals have their own terms, which should be agreed in writing before they act.

A public adjuster represents the homeowner in a claim, and an attorney can advise on a dispute. Both charge for their work, and the terms of their engagement should be agreed in writing before they start. This guide does not recommend a particular professional, and the homeowner should check the credentials and the terms of any professional before hiring.

The homeowner remains responsible for the decisions in the claim, and the professional works on the homeowner's instructions. A homeowner who is unsure whether to hire help can ask the insurer or the state regulator for guidance on the process.

Keeping copies and a clean file

A complete copy of the claim file, kept in a second place, protects the homeowner if the original is lost. The file should be in date order, with every letter and email included.

The file should contain the policy, the photographs, the roofer's report, the receipts, the timeline and every letter and email with the insurer. A second copy kept outside the house protects the file if the house is damaged in another storm.

A homeowner should also keep a note of every phone call with the insurer, with the date, the name of the person spoken to and what was said. That note is useful if the claim is questioned later.

Timing and the first call to the insurer

Report the loss to the insurer promptly, in writing where possible, and keep a record of the report. The policy sets the time limits, and the homeowner should check them in the policy itself.

Report the loss to the insurer as soon as it is noticed, and follow the report with a short letter or email that states the date, the damage and the steps taken. That record shows the homeowner acted promptly, which helps the claim.

This guide does not state a time limit. The policy sets it, and a homeowner should read the notice provisions of the policy and follow them. If the time is short or unclear, ask the insurer to confirm it in writing.

Keeping the claim in order from the start

A simple rule keeps a claim in order: one folder, one timeline, one list of every contact with the insurer, and a copy of every document sent. The order matters most when the claim is large or disputed.

Set up the folder on the day of the loss, and add to it as each document arrives. The timeline grows with each event. The contact list records the date, the person and the subject of each call. A file kept in that way can be handed to a public adjuster, an attorney or the regulator at any point without delay.