Who do you reccomend i go to to fight my home owners insurance claim roof claim which was denied?

Question

I was denied an insurance claim for roof damage caused by high winds on 04/10/08. Reason for denial, they said it was previous damage from a hail storm last year. The insurance company that denied claim is Texas Fair Plan. The hail storm that they say did the damage (one year ago), i didn't have insurance. I have major wind damage from 04/10/08. They say it doesn't matter because this roof would have been totaled out last year.

Please help. Thanks again.

Do know what type of lawyer would handle this type of case?

Greatly appreciate your help.

Have a great week!

Answer 1

You can file a complaint with the state insurance commissioner, but you'll need some evidence for your case.  I doubt any lawyer would take such a suit - there's no money in it.

Answer 2

Any lawyer will handle this, for $250 an hour.  But if you had an old roof, with prior damage, you're going to lose this battle.

I'm kinda surprised, though, because TX Fair Plan inspects 100%, and they usually require you to replace old or prior damaged roofs within 60 days, or they cancel you out.

Bottom line - the lawyer is going to cost more than the roof, and you'll probably have to pay $5K up front.  NO ONE is going to do this for free for you, because LIKELY you're not going to win.  

Unless your roof was brand new, and you've got receipts/pictures,  the REAL cause of your roof damage was an old, previously damaged roof.  

You have a duty to maintain your house, which you breached, by not replacing an old roof.

Answer 3

You should speak to a qualified public adjuster. A PA works for you not the insurance company. S/he usually charge a percentage of the money recovered as fee and so you owe nothing unless s/he recovers money for you. They are knowledgeable about issues such as coverage, policy language, mediation and appraisals. If your roof has coverage they will get you the money, there is no risk to you.

PS I am a public adjuster for Florida

Answer 4

As a former property/casualty insurance adjuster this is what I would recommend.  

First, get your agent involved in the fight with the company.  Appears the company has made you a soft denial.  Secure in writing the reasoning for their denial.  After securing the letter speak to a claims manager.  Apparently they have dropped the ball on the underwriting aspect of your policy.  Unfortunatetly for the insurance company they had the opportunity to inspect the roof before issuing the policy.  When they didn't, they are agreeing to insure the property as is.  Your argument is the wind damage that was caused to your roof.  If the wind damage requires slopes of the roof to be replaced then that is the way it should be adjusted.  You are not filing a claim for the hail damage.  I could possibly see their point if you had filed a hail claim.  It would be hard to ascertain what was old vs. new.  Still think they would loose that argument.  If you still don't appear to get anywhere, file complaint with insurance commissioner and hire attorney.  

Important....stick to facts......

1)  They had the opportunity to inspect roof before issuing policy or put stipulations on policy requirements (replace roof or policy will cancel in 90 days).  They did not and therefore insure property as is....

2)  Your claim is for wind damage that did not exist before the loss date or the policy went in force.  This is covered damage regardless of existing damage.  

The only time their argument would hold true is if they paid for the prior damage under policy provision they would not owe it again.  Ask them if you had rotten posts on your wood fence and large wind storm came in and blew your fence down the day after taking the policy out, would they cover it?  They should regardless of the rott that occurred before the policy coverage date.

Good luck.