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Roofing Insurance Claim Question

8,321 Views | 55 Replies | Last: 1 mo ago by NoahAg
Wynn.derong
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My wife and I have filed a claim and we were approved for $16,600. Our deductible is $5400 so the insurance is sending us $11,200. The roofing company we are working with quoted us at $13,000 for a new roof before we got insurance involved but now that we are involving insurance, they are saying it will cost $16,600 to replace costing us $5400 out of pocket. They said it's because they are required to repair the roof at the cost of what insurance says it is.

Is this normal practice for roofing insurance claims? I've never done this before and just want more information. I am simple minded so explain it to me like I'm 5 years old.
Jason_Roofer
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The unfortunate thing is that most homeowners only deal with this stuff once or twice in their life. These aren't always cut and dry and they can be confusing. I've worked with 15 claims just last week. I've seen them all. I can do them in my sleep. It's no problem. Your concern is well founded and understandable. It's smart to double check.

The short answer is, YES, he should charge what insurance says the roof costs. That's normal and legit.

But your roofer gave you a low price being over eager to win the job without having all the information and he might have shot himself in the foot. Is his request still legit?

MAYBE….it hinges on how your claim and payment is set up.

Are you getting your 11,200 as a lump sum up front from your carrier, or is this an RCV policy with a depreciation and you are getting a split payment with partial now and the rest later totaling 11,200? This question will help me help you figure out how this should go.

I can walk you through this free of charge with a phone call if you don't want to do it publicly.

Again, do not hesitate to reach out. I've walked a ton of folks on the forum through this with other roofers just to make sure everything jives.

This is an opportunity to potentially get more for your money.

281-639-0099
Infinity Roofing - https://linqapp.com/jason_duke --- JasonDuke@InfinityRoofer.com --- https://infinityrooferjason.blogspot.com/
CS78
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Does your insurance require you to use that roofer? If not, id be looking for other quotes.
Deats99
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AG
Bull****

Working on three house claims right now from May 28 storm.

Very rarely is it just a roof if it is bad enough for a substantial claim.

If there are 3 trades involved, you are entitled to p&o(profit and overhead 20%) for a general contractor to handle the project.
-roofer
-painter for trim
-carpenter for trim
-electrician if you lost lights
-window guy if you have window or screen damage
-money for stabilization and remediation if active leaks
-gutters if they have to come off or will not be installed correctly after repair

A good contractor will bring the adjuster back out as things show up. A good roofer like I have heard Jason is, is very beneficial also.

But to answer your question, no they have to pay what it costs to repair and the roofer is not entitled to that money just because it was paid.
A good plan violently executed now is better than a perfect plan executed next week.
-George S Patton
springagg
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tell that roofer to F off. The price of the roof should be the same no matter how you are paying for it. Sanchez Roofing.. give them a call for a quote. 281-914-1933. The roofer does not have to charge the price that the insurance carrier says it is. That insurance "cost" is what that adjuster thinks the damage cost. Obviously you can call many roofers and they will all send you a different price. You can choose to use whomever you wish.
eeinoilandgas
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Look up the new Texas HB2102 law.

From some lawyer website I found.

To boil all of that legal jargon down, HB2102 means that in any event where you are using your property insurance, you, the property owner, must pay the deductible outlined in your property insurance policy.

A roofer cannot, according to Texas law, waive or discount your deductible, and they are required to make this law apparent to you in any contract they present.

Edit: this assumes you are in Texas
Jason_Roofer
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springagg said:

That insurance "cost" is what that adjuster thinks the damage cost.

This cost is based on tens of thousands of previously closed claims from a carrier price list usually exclusive to each carrier. The adjuster may impact it because he doesn't know what components should go into it, though. Usually, it's downgraded to be as cheap as possible. It is adjusted monthly. If I get your claim today, and I roof it the following January, insurance gets a new price from me for January when I finish. It is a market price for roofing that house, with that roofing product, for that zip code, in the month the roof was adjusted and/or replaced.

When you have an RCV insurance claim, your one and only concern for picking a roofer should be focused on quality, install techniques, credentials, liability insurance, cost should be last on the list. You are paying the same either way. These are almost always going to be higher priced roofers because they are long term businesses that are established with everything needed to run a business successfully. Select the roofer based on his ability to stand behind the service, and do a good job and not on his price.
Infinity Roofing - https://linqapp.com/jason_duke --- JasonDuke@InfinityRoofer.com --- https://infinityrooferjason.blogspot.com/
Burnsey
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AG
If the roofer charges $13k and your deductible is $5,400, then your insurer will only pay you $7,600. That's all they owe.
Deats99
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AG
Burnsey said:

If the roofer charges $13k and your deductible is $5,400, then your insurer will only pay you $7,600. That's all they owe.


Welcome to the party
A good plan violently executed now is better than a perfect plan executed next week.
-George S Patton
springagg
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Jason roofer.. I'm well aware of how the claims process works and well aware of how costs work. I have owned over 150 properties in the last 17 years. I also owned an insurance agency for 16 years. Roofs are one of the most marked up/inflated items consumers pay for in construction. Look around at all the roofing companies driving around fleets of wrapped/jacked up $80-100k trucks. Every contractor wants a roofing job for the crazy mark ups! Many of these roofing companies prey on homeowners who are not used to paying for rehab projects etc on their house and they are clueless what a roof actually cost. The insurance carriers are known to over estimate the cost of a roof which is one of the many problems on why our insurance premiums are so high! Calling a big roofing company would be like calling John Moore for a plumbing job and people do it all day. I am sure John Moore is a great guy.. but I am not here to pay for his non stop commercials. Common sense tells me it does not cost $2500 to install a hot water heater. Just as common sense tells me what it really cost to replace a roof. You can go online and see what shingles cost.. then add in the labor. You have to know the right people to call for work and unfortunately those that are not in the business have no clue whom to call. These same people call serve pro to vacuum up some wet floors and tear out wet carpet when a leak happens too.
ATM9000
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AG
springagg said:

tell that roofer to F off. The price of the roof should be the same no matter how you are paying for it. Sanchez Roofing.. give them a call for a quote. 281-914-1933. The roofer does not have to charge the price that the insurance carrier says it is. That insurance "cost" is what that adjuster thinks the damage cost. Obviously you can call many roofers and they will all send you a different price. You can choose to use whomever you wish.

Right… but if there's excess money leftover after you pay your full deductible, you have to send that excess back to the insurance company if you aren't paying the roofer else you are committing fraud.

Not only is it fraud, but it's very easy fraud to find under scrutiny of a basic audit.
Jason_Roofer
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What do you estimate those guys profit margin is on an average insurance paid roof? How much is 'too much'? Where should it be?

Infinity Roofing - https://linqapp.com/jason_duke --- JasonDuke@InfinityRoofer.com --- https://infinityrooferjason.blogspot.com/
springagg
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I would easily wager on a $15k roof for example they have $5000-7,500 profit in there. I know exactly how much my roofer makes because he flat out tells me. I know what he paid for the material and I know what he pays his workers. Same for my contractor that does all of my work.. I know exactly what he pays his labor per day. I also know what the material costs and he is always happy to share it with me.
Deats99
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AG
I pay for quality work in a timely fashion. I could give a **** what my guys drive because it is not my business. I think that is one of the biggest problems with our society, everyone is worried about what everyone else is worth.
My mom's crew is currently rebuilding the back porch that the windstorm took off my house. They will be done 3-4 days. I framed and built the original over a couple of months during COVID. I could give 2 ****s what they have or don't have as long as the job is done right, and on budget.
A good plan violently executed now is better than a perfect plan executed next week.
-George S Patton
Diggity
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AG
one of the biggest problems with our society is that insurance costs have gone haywire.

Not blaming it entirely on the roofing business (as that's just a part of the problem) but I have zero doubt that the margins on roofs are ripe. There's a reason why so many folks from outside the industry are flooding in now.

As Spring mentioned, there's a problem when the quotes vary by a factor of two from one guy to the next...and it's not all explained by "quality". We're talking about a commodity at the end of the day. There should be a premium for good work...but not at twice the cost.

They need to figure out how to rein in homeowners costs, and roofs look like low hanging fruit to me.
springagg
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And those people love people like you that just pay whatever.. I know what things cost so no I am not overpaying for a service. I recently did a roof where my roofer charged $7k. Other roofer quoted $12k. My roofer got there at 7AM and was done by 1PM. Has nothing to do with service or quality. It has to do with knowing what something cost and not getting ripped off. There are two different prices out there when dealing with construction.. investor pricing and normal consumer pricing.

Just as Diggity mentioned.. a large problem with out insurance rates has to do with roofs. Hopefully the carriers are cracking down more and more on how much they pay out on roofs and the age of roofs they exclude etc. Once the carriers really crack down, you will see many of the high dollar roofers fall.
Deats99
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AG
Just like pricing there are 2 job types, investor/crap, and the right way. Sorry not sorry. For a rent house, get it done is fine, for my house, I want it done the same way I would do it.
A good plan violently executed now is better than a perfect plan executed next week.
-George S Patton
springagg
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the people south of the border are putting that roof on no matter whom you hire. Paying more does not mean anything is done differently. You either know the right people or you don't. In fact anyone that buys a new house has no clue who put that roof on. Anyone in the industry knows roofs are some of the most marked up construction items. There is a reason the roofers will travel across states for the work when there is a storm!
Jason_Roofer
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I Don't see profit margins like that but if I did, I'd install an upgraded product until my margin was more reasonable. Either way, I'm charging insurance the full amount. Then the next time that customer needs a roof, insurance will have to eat the upgrades I put in and I'll upgrade him again.

If you don't think a more expensive roofer provides a better product, install, service, and support, that's ok. You should select a discount company that better aligns with your budget or comfort level. I encourage this all the time. I don't look at, bid, or estimate every job that comes across my desk. I ask a lot of questions first.

When you got two estimates that were 5,000 dollars apart, what did the expensive roofer tell you when you asked him about the price? How many squares was the house with waste? Single story? Predominate pitch? 5,000 is more than just a profit issue. As someone that does this professionally, I LOVE eating up estimates of roofers. There's no way I can pass up not asking 10 questions on a 5,000 additional expense or a an estimate that comes in 5,000 less.
Infinity Roofing - https://linqapp.com/jason_duke --- JasonDuke@InfinityRoofer.com --- https://infinityrooferjason.blogspot.com/
highpriorityag
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besides the homeowner the people really getting screwed are the installation crews!!

TXTransplant
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Dealing with this right now (new shingles were literally just dropped off in my driveway).

My agent initially told me to get three "evaluations", just to be sure that I did need a new roof before the adjuster came out. However, this was not good advice.

1) Since it's an insurance claim, roofers didn't want to waste their time looking at my roof if they weren't guaranteed my business. All three I talked to said, just file the claim and get then adjuster out. If the claim is denied, "I'll talk to him".

2) The quotes are useless because (at least with my claim) the adjuster determined how much will payout. When mine was approved, the adjuster said I'd get one check (about 40%) up front, with the rest (about 30%) coming after completion (the remaining 30% is my deductible). Well, both checks were mailed to me by the insurance company within days of each other, and before any work had been done.

Why would any roofer not adjust his invoice to match the full payout? And homeowners don't care because we are bound by law to pay the deductible anyway.

So, of the roofer gets $20k or $28k, why should the homeowner care, because you're out the 2%? Once the roofing co sees the adjuster's report, they are going to expect the full amount. It's not like homeowners are going to be sending that second check back.

I totally get that this is extremely detrimental to homeowners when it comes to premiums, but this is the game BOTH sides are playing (insurance AND roofing cos). What is a homeowner supposed to do about it, other than pay out of pocket for the lowest price roof you can find? But even if you do this, you're still going to get hit with premium increases every year. So, why forgo coverage you're paying for just to "make a point"? You'll be the only sap on your street paying OOP for a new roof.

Seems to me, the only solution is to have a separate deductible for the roof that's tied to the replacement cost of the roof. Something like the homeowner pays 50% of the replacement cost (and you can adjust your premiums by raising/lowering this percentage). That way the homeowner has some skin in the game.
Deats99
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AG
If you can't appreciate different levels of workmanship, even on a roof then this discussion is pointless
A good plan violently executed now is better than a perfect plan executed next week.
-George S Patton
springagg
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You guys keep supporting those over priced roofers.. while your at it, be sure to call John Moore for some plumbing help! He too will appreciate it.
springagg
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It's all about contacts to the right people.. as I have said over and over in this thread. Homeowners get screwed left and right because they are not aware of what construction items cost.
Jason_Roofer
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springagg said:

It's all about contacts to the right people.. as I have said over and over in this thread. Homeowners get screwed left and right because they are not aware of what construction items cost.


That's fine. How many squares did you have roofed for 7,000?
Infinity Roofing - https://linqapp.com/jason_duke --- JasonDuke@InfinityRoofer.com --- https://infinityrooferjason.blogspot.com/
springagg
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If I recall correctly it was about 24 squares. But I really do not remember. 1800 soft 1 story house with built in 2 car garage. Built in 1997, normal pitch roof.
TXTransplant
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springagg said:

It's all about contacts to the right people.. as I have said over and over in this thread. Homeowners get screwed left and right because they are not aware of what construction items cost.


I've been a homeowner for 20 years and this is my first claim and my first roof replacement.

Given the infrequency with which most homeowners deal with a roof replacement, and the amount of time that elapses between replacements (if a homeowner even has more than 1 or 2 in their lifetime), its obvious why homeowners are not educated in this area.

How in the world would a homeowner know if they are truly getting a fair deal on something that they may never have purchased before or have not purchased in 15+ years? You can't go to Home Depot and Lowes and compare the price of a new roof. And most homeowners don't know enough to be able to go up on the roof and supervise or inspect the work.

This is a transaction where you have to trust the contractor, but even recommendations and word of mouth can fail you. Most homeowners aren't going to be able to look at the work and know if it was done correctly. They figure that out if/when the roof leaks.

I would say the same for A/C replacement, but since that's pretty much never covered by insurance, you at least don't have that complicating factor.

If you're not in the industry, you simply don't know what it costs, nor does the average homeowner have "contacts". Same with car repairs. Both are ripe for taking advantage of both the consumer and the insurance company. Not to mention, natural disasters that cause widespread damage are known for causing temporary spikes in the cost of repairs, making fair comparisons even more difficult.

And if the damage is catastrophic, you just want it fixed ASAP, in order to minimize future damage.

Insurance company makes up for it by jacking everyone's premiums up.

Homeowners lose on both sides.

JP76
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springagg said:

I would easily wager on a $15k roof for example they have $5000-7,500 profit in there. I know exactly how much my roofer makes because he flat out tells me. I know what he paid for the material and I know what he pays his workers. Same for my contractor that does all of my work.. I know exactly what he pays his labor per day. I also know what the material costs and he is always happy to share it with me.



100% margin on roof on an insurance claim ?

Wow send me some of those claims because I have never seen that in the field. If it could really be done correctly for 50% less then why would insurance companies pay 100% more ? Most won't even pay 10/10 overhead and profit on a claim even when 3 or more trades are involved yet you claim they are paying 100% markup to the roofer?


I see cheap roof jobs all the time, ones where they leave 20 year old drip edge on and reuse lead vents painted to look new and spray paint 20 year old flashing and don't tear down to the decking, and make your furnace and water heater flume touch the decking and char it, and use cheap shingles and also shoot your freon, electrical, water and gas lines as well as flood your house and cause 20-40k worth of damage.

JP76
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springagg said:

If I recall correctly it was about 24 squares. But I really do not remember. 1800 soft 1 story house with built in 2 car garage. Built in 1997, normal pitch roof.


That seems really low for squares unless it has an under 3 and 12 pitch.


Last few i did were


1100 sq ft, 4 /12 pitch 22 squares

2000 sq ft 4/12 pitch 43 squares

1700 sq ft 6/12 pitch 32 squares

1600 sq ft 5/12 pitch 28 squares

1800 sq fr 5/12 pitch 33 squares

2300 sq ft 8/12 pitch 54 squares

1500 sq ft 8/12 pitch 44 squares



Deats99
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AG
Not in reply to anyone
Just commentary
A good plan violently executed now is better than a perfect plan executed next week.
-George S Patton
springagg
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It may have been 32 squares.. either way what is that about $1k material difference. Anyone can do the math on what 32 squares cost, what 4-5 guys labor cost, profit etc. Roofers make a killing and that's good for them! As I have mentioned John Moore on here.. I am sure he is a great guy and built a wonderful company. Just as some of the roofers, he has nice fleet of vehicles, buildings, commercials, etc. I am not looking for the companies with all that overhead to pay for. They have to pay for all of that overhead somehow and it comes from the prices they charge me. Sure the average person may buy 1-2 roofs in their lifetime.. I have bought 4 this year. This whole post started with OP asking about a roofer who gave a bid for work, insurance came back with their price, and now roofer wants to raise their price.. if OP wants to pay that roofer an extra profit then by all means do it! Personally, I would tell them to hit the pavement. I would imagine many roofers are not touching a job unless they are making $5k plus profit.. just like John Moore isn't touching a water heater install without a $1500 plus profit.

Yes the insurance carriers pay out many times much higher then what it cost to replace a roof.. I owned an insurance agency for 16 years... well aware of what they pay out which is part of the problem with our high rates! Roofers go around claiming to be "insurance experts".. also known as full of Sh$$... the stupid carriers pay out hail claims left and right and roofers are happy putting on roofs with insurance claim money. Once the insurance carriers buckle down on roof payouts (which seems to be already happening), the roofers will be scrambling on a new sales scheme on how to get customers to buy a roof. Most of the people out there cannot afford a roof so I guess there will be more financing roofs in the future.
scrap
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AG
Yes indeed, if you are a newbie at roof replacement it is easy to be left frustrated and confused.

Here it is in a nutshell. Insurance policy has a deductible. You will pay that based on your insured property amount. Usually, 1 or 2% of the value of the insured property. So, if your deductible is $3000 and a roofer charge only $3000 for the roof, you will pay all the cost. So by getting a cheaper quote when using an insurance claim saves you NO MONEY. The higher quote does not cost YOU MORE.
However, there are some work arounds. I have to be careful because what some people think I am about to say might be considered Insurance fraud…..so I won't say what they are thinking. I will say THIS instead:
If I have a roof claim, I will First tell the roofing company to give me their best price on replacing the roof (they will ask if you are using an insurance company, tell them NO as they want to work directly with the insurance company, they will make more money). I also make them quote me better quality shingles and are normally on my rental units. Usually there bid comes in lower than the Insurance company estimated. For example, the insurance company comes in with 15k but your deductible is 3k so they cut you a check for 12k.
Your roofing company says they can do it for 12k. I tell them great, but I am NOT going to pay you 12k, I am going to pay you 15k instead……. Happy faces all around (this is when I tell them I am using an insurance company) I am going to have to pay my deductible but because the ROOFERS are getting more than quoted to me originally, I ask them to throw in extras, like paint the house, blow in more insulation, install gutters or do some landscaping ect. You get the sweetener of a few extras but they are not legally obligated to do so.
Why should the roofers benefit because you had the insurance. Seems crazy doesn't.

Now some of you thought I was going to ask the roofers to not charge me my deductible…..how crazy is that…….that would be insurance fraud.
Cadet05
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AG
FYI- that is insurance fraud as well.

(2) Provides a good or service to an insured under a property insurance policy knowing that the insured will pay for the good or service with the proceeds of a claim under the policy and, without, the insurer's consent:

(A) Pays, waives, absorbs, or otherwise declines to charge or collect the amount of the insured's deductible;

(B) Provides a rebate or credit in connection with the sale of the good or service that offsets all or part of the amount paid by the insured as a deductible; or
Jason_Roofer
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This is always an interesting dynamic.

It's best for the customer to send me the full scope of work and let me do all of the upgrades I do anyway without the extra gamesmanship. There is just no reason to make a crappy system harder than it already is. We can and do get audited. There is only one right way to do this so that it is legit and legal where you end up with a quality product.

I know there are a few folks that think the roofer is just trying to hose everyone and make 100% profit so they can pay for their new truck and boat. I'm not going to argue that. There are. However, many of us have been doing this a long time and understand the ins and outs better than the insurance agent and adjuster in a lot of cases. We want to do a good job and make the customer whole and bill accordingly so the process moves along as designed. I try to educate all of my customers on what we do and why. I ask a ton of questions up front so that I can see where we are in the process and how the insurance has estimated their damage so that I can do a better job for them. There are claims that take MONTHS to close out because of sluggish adjusters. Adding delays by withholding necessary information is completely unnecessary.

As for the 24sq roof above for 7,000, that is well below cost for legit labor and materials done at a level I require on my projects in 2024. I will be very up front and let them know I must respectfully decline the project.

I'm not mad about it. It's fine. There will always be people that will do it cheaper, I'm just not willing to sacrifice materials and workmanship to make it happen be it out of pocket or insurance.
Infinity Roofing - https://linqapp.com/jason_duke --- JasonDuke@InfinityRoofer.com --- https://infinityrooferjason.blogspot.com/
Choward4
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AG
Let us not forget that the roofer also owns the warranty and liability of the roof should it leak, etc. Paying for a legit company that will stand behind their workmanship is money well spent, that you have to spend anyway if an RCV policy!

SpringAg, just get an ACV policy and enjoy shopping lowest bidder.
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