Insurance ClaimsBased in Fort Worth, TX

The Difference

Worth knowing before the inspection.

Texas gives carriers set time frames under the prompt payment rules in Insurance Code Chapter 542. In general, your carrier has 15 days after you report the claim to acknowledge it, start its investigation and ask for anything it needs from you. Once it has everything it asked for, it generally has 15 business days to accept or deny the claim, with up to 45 days if it tells you why it needs more time, and extra time is allowed after a declared weather catastrophe. Somewhere in that stretch, an adjuster inspects the roof. The adjuster works for the carrier, or for a firm the carrier hired, and their job is to measure the roof and record the damage. If you would like us at the roof during that visit, we can walk it with the adjuster and point out the damage we documented.

After the inspection, the adjuster writes a scope and an estimate, usually as a long list of line items. A roof estimate typically covers tearing off the old shingles, underlayment, drip edge, starter strip, the shingles themselves, ridge cap, vents, pipe boots and flashing, each priced by quantity. Read it slowly. The measurements should match the size of the roof, the pitch affects labor, and a second layer of old shingles or a detached garage should appear if the house has them. We compare the adjuster's scope with what we found on the roof, and we build to the scope your carrier approves. If the two do not line up, that is the point where a supplement comes in, and it is far easier to raise before the work starts than after it is finished.

Most payment confusion comes from the difference between replacement cost and actual cash value. On a replacement cost policy, the carrier usually pays in two parts. The first check is the actual cash value: the full replacement cost, minus depreciation for the age of the roof, minus your deductible. The depreciation is held back until the work is done and the final invoice is sent to the carrier. As an example, on an $18,000 replacement with $5,000 of depreciation and a $3,500 deductible, the first check would be $9,500 and the remaining $5,000 would follow after completion, which leaves your deductible as the part you pay. An actual cash value policy stops at the first check. Some policies settle older roofs this way, so check which kind yours is. Checks often name your mortgage company too, and it has to endorse them before the money can be used.

Adjusters work quickly after a big storm, and items get missed. A supplement is a request to the carrier to add work that the original scope left out or that nobody could see until the old roof came off. Common ones are drip edge or starter strip missing from the estimate, a second layer of shingles under the first, decking that turns out to be rotten or damaged once it is exposed, and items that local building code requires on a new roof. For each one, we provide photos and the line items for what was missed, and your carrier reviews them and decides whether to add them to the claim. A supplement is never guaranteed, and the carrier makes the call, but a well documented request with clear photos gives the adjuster what they need to review it fairly.

Deadlines run through every stage of a claim, and they vary by policy. Your policy sets how long you have to report storm damage, and many also set a time limit for finishing the work and claiming the depreciation held back from the first check. Find the conditions section of your policy and read it, or ask your agent to walk you through it. If the carrier denies the claim or the scope looks short, you can ask for a re-inspection, and many Texas policies include an appraisal clause for disputes over the amount of a loss. The Texas Department of Insurance also takes consumer complaints. For the roof itself, the first step is the same: call (817) 988-9509 or send the form, and we will set up a free inspection.