A lot of things are wrong with insurance companies, but this topic is going to specifically address the growing number of covered Hail Damage claims that are being denied by insurance companies. Almost all residential and commercial insurance policies today provide coverage for Hail Damage. Common insurance policy language states that the policy covers "Direct Physical Loss" from hail. Recently the insurance industry has tried to re-define what "Direct Physical Loss" actually is. Since most insurance policies do not define what "direct physical loss" or "damage" is, lets look at Merriam Webster Online dictionary:
Direct:
To cause (something or someone) to turn, move, or point in a particular way
Physical:
Existing in a form you can touch or see
Loss:
Failure to keep or to continue to have something.
Damage:
Loss or harm resulting from injury to property, person, or reputation
So we can conclude that loss or harm to property, you can see or touch, is damage; therefore, damage is Direct Physical Loss.
Can you spot the damage, "Direct Physical Loss" in the above photographs? Let's face it, a blind monkey could find the hail damage on these roofs, but for some strange reason, the insurance industry and their bought and paid for, one-sided, subjective engineers can't seem to find anything wrong with metal roofs that are damaged by hail. Any reasonable person would conclude that hail damage to a metal roof is direct physical loss and would therefore be covered under the insurance policy. Unfortunately, the insurance industry today is not reasonable. Does it take a structural engineer to find hail damage?Over the last decade we have seen a major shift in the insurance industry concerning structural engineers. Today, insurance carriers are using structural engineers on a significant number of their hail claims. The ironic thing is that the insurance companies keep hiring the same engineering firms over and over again, and these "bought and paid for" engineering reports continue to say that hail "impacts" to metal roofing is not "functional" damage. All of a sudden engineering firms have helped the insurance industry to re-define the word damage and create a whole new criteria for paying hail claims. In most insurance policies you will not find the word "functional." Yet, claim after claim is being denied by companies claiming that the hail damage you have is not functional damage.
Engineers do not even want to use the word "damage" so they replace the word damage with "impacts" in their report. This sleight of hand word manipulation only helps fuel the insurance companies desire to undervalue or deny a legitimate hail claim. Day after day reports are issued from engineering firms that regurgitate the same propaganda. Insurance companies routinely use the same group of engineering firms, because the "opinion" of their engineers benefits the bottom line of the insurance company. Regrettably their customers are the ones who suffer from this entire dog and pony show.
Below you will find examples of why this is beginning to be a huge problem for policyholders.
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This video shows a prime example of what we as Public Adjusters deal with on a daily basis and you can see that our challenge is not limited to metal roofs. Even shingle roofs that are clearly damaged by hail and that should be replaced under the insurance policy are being denied on the fictitious notion that no "functional" damage has occurred. The video is lengthy but the 11:00 minute mark says it all.
So does it take a structural engineer to find "functional" hail damage to your roof.......HAIL NO! What it takes is an insurance industry determined to maximize profits at any cost and a group of engineering firms willing to facilitate this illusionary scheme that hail damage isn't functional damage.
If your insurance company tells you they are going to have an engineer come out to inspect your roof for wind or hail damage, this should be an obvious red flag and you should immediately contact a Public Adjuster or a Policyholder Attorney.