Roof insurance claim disputes are on the rise because insurance companies are closely monitoring the scope of roof repair. Roofing contractors and public adjusters call me with novel arguments made by insurance adjusters to limit amounts paid following roof damage. I pity the unfortunate insurance claimant with no expertise trying to handle their own roof claim and roof repair.
One recurrent issue is damage to a roof built on top of an older or overlaid roof. Insurers typically refuse to pay for removal or replacing the older or overlaid roof.
This was addressed in Gutkowski v. Oklahoma Farmers Union Mutual Insurance Company, 176 P.3d 1232 (OK APP 2007), where the Court was faced with this common situation:
[I]nsureds purchased a home with an “overlaid” or “comp over wood” shingle style roof. The roof was comprised of an outer or top layer of composition (asphalt) singles and an underneath layer of wood singles that served as the “nailable surface” or “decking” to which the composition shingles were attached…
…a hail storm damaged the Insureds' roof. Hail was a covered peril under the policy. The Insureds submitted a claim to Farmers for the total loss of their roof. While the claim was pending, the Insureds sold their house without replacing the roof. Farmers “totaled” the Insureds' roof because of hail impact marks on the composition shingles, but only agreed to pay for the direct physical loss of the composition roof.
…Farmers remitted a check in the amount of the cost to tear off and replace the damaged composition shingles with new composition shingles, less a deduction for depreciation of the existing composition shingles.
The Insureds rejected Farmers' remittance and demanded that Farmers also pay to tear off and replace the wood shingles with plywood decking. The Insureds claimed the policy provided such coverage because the wood shingles would become a non-nailable surface once the composition shingles were torn off. Farmers agreed the removal of the composition shingles would destroy the structural integrity of the wood shingles to the extent the wood shingles could not be reused as decking, but nevertheless denied Insureds' claim. Farmers alleged the wood roof was not a covered loss because it was already in a deteriorated and inadequate condition prior to the covered peril and the wood roof did not sustain a direct physical loss as a result of the hail storm.
The Court provided an enhanced version of Farmer’s argument and what it would have to show to win:
Farmers' repeatedly contends the Insureds had two separate roofs, ie. the wood shingles constituted a divisible and separate roof from the composition roof. Therefore, because the wood roof did not sustain direct hail damage and the policy does not cover damage not caused by a covered peril, Farmers was only obligated to pay for the damage to the composition roof. In order to prevail on this theory, Farmers would have to show the necessary components that make up a single roof are divisible and separate.
The Court disagreed and found coverage to apply reasoning as follows:
[W]e hold a roof is a unified product comprised of all its component parts and materials, including felt, flashing, sheathing (decking), valleys, nails, caulk, drip edges, and shingles. Because the wood shingles in the instant case served as the decking, we hold the wood shingles were an integral component of the roof. We therefore reject Farmers claim that the anticipated damage to the wood shingles (an integral portion of the whole roof) was not a covered loss under the policy.
…the undisputed evidence revealed the Insureds had a “nailable surface” immediately prior to the hail storm and that such “nailable surface” would be destroyed when the old composition shingles were removed. Thus, we hold there was a clear “risk of direct physical loss” to the wood shingles as a result of the covered peril, and to properly indemnify the Insureds, Farmers was contractually obligated to pay for the tear off of the wood shingles and the re-decking of the Insureds' roof.
We conclude the policy language in question was unambiguous and that it provided coverage for the disputed loss.
Roof insurance claims require a lot of knowledge about roof construction and history of the roof in question. Our view is that many roof damage claims result in poorly repaired roofs. Insurers sometimes share in that blame because they drive down price using unrealistic preferred vendor pricing, hire outcome oriented insurance experts that fail to fully explain the loss, and not allowing proper scope of work.
Positive thought to start off the week:
“The mind is everything. What you think you become.”
And today is the birthday of the Kink’s co-Founder Dave Davies. Enjoy: