Insurance Claim vs Paying Out of Pocket for Roof Storm Damage

The storm has passed, a roofer has looked, and you have an itemized estimate in one hand and your insurance declarations page in the other. Do you file, or do you pay? Nobody can make that call for you, and under South Carolina law a roofing contractor is not allowed to try; this guide gives you the vocabulary.

Our roof repair and maintenance page says we can inspect and document roof damage for your insurance claim. That means photos and an itemized estimate you can use with your insurer. You handle the claim with your insurer, and we do the approved work. Our older post Benefits of Having a Professional Inspect for Storm Damage explains why that inspection comes first; this guide covers the decision that follows it.

The SC Department of Insurance (SC DOI) describes the deductible as the amount you have to pay out-of-pocket on each claim, and says the amount appears on the declarations page of your policy. Its Home Preparedness Guide adds that in some cases a separate deductible applies to damage from a specified peril such as a hurricane. SC DOI Regulation 69-56 requires an insurer that uses a separate named storm or wind/hail deductible to disclose it on the policy face and declarations page, so look there first.

Set the estimate beside the deductible. If the repair is a flashing, a few shingles or one panel, the claim may pay little or nothing after the deductible, and the claim may still be recorded on your insurance history. If the damage runs across several slopes or has reached the ceiling, the math usually points the other way. Ask your agent how a claim is recorded on your policy; this guide cannot tell you how it will affect your premium.

This is the term that surprises people at settlement time. SC DOI defines the two this way: replacement cost is the amount it would take to replace or rebuild your home or repair damages with materials of similar kind and quality, without deducting for depreciation. Actual cash value is the amount it would take to repair or replace damage to your home after depreciation. SC DOI's homeowners brochure puts it more bluntly: actual cash value means payment is limited to the depreciated value of each item at the time it is damaged.

For a roof, depreciation tracks age and wear. An older roof covered at actual cash value may bring a payment well below the cost of a new roof, which changes the claim-or-pay decision. The policy language decides, so read your loss settlement section and ask your agent to point to it. SC DOI also advises checking with your agent at least once a year that the policy still fits.

Policies impose duties after a loss, and missing them can cost you. The wording differs by company, so read your own. SC DOI's consumer guidance covers the common ones:

• Report promptly. SC DOI's severe weather page says to immediately file a claim with your insurance company once the area is safe.
• Document first. Photograph or video the damage before cleanup or repairs, and keep the photos with your receipts.
• Protect the property from further damage, but only with temporary repairs until you have your insurer's advice. SC DOI says not to have permanent repairs made until the insurer has inspected the property. Covering a roof opening is a job for a crew, not for you.
• Keep every receipt for temporary protection and give them to the adjuster.
• Prepare for the adjuster. SC DOI's disaster guide suggests recording the adjuster's name, phone number and company, preparing a list of structural damage, keeping copies of everything you submit, and obtaining written, itemized bids from licensed contractors.
• Keep damaged materials. SC DOI says not to discard damaged items because the adjuster will want to see them. The sibling guide on how to document roof storm damage turns this into a checklist.

South Carolina Code Section 40-59-25 governs residential roofing work paid from an insurance claim. Subsection (D)(1) says a builder or contractor shall not represent or negotiate, or offer or advertise to represent or negotiate, on behalf of an owner on any insurance claim in connection with the repair or replacement of roof systems. Subsection (D)(2) says you are free to consult a contractor for an evaluation of your roof and use that evaluation in your negotiation. That is the line we work within: we inspect, document and estimate; you negotiate.

The same section bans deductible games. Subsection (E) says a contractor shall not advertise or promise to pay or rebate all or any portion of any insurance deductible as an inducement to the sale, and makes a violation a misdemeanor and grounds for license action. It also gives you a way out: under subsection (A), if your insurer notifies you in writing that all or part of the claim is not covered, you may cancel the roofing contract before midnight on the fifth business day after you receive that notice, and under subsection (C) the contractor may not require payment before that period ends, except for emergency services you acknowledged in writing as necessary.

You can check a residential contractor's registration through the SC Department of Labor, Licensing and Regulation's licensee lookup, linked from the Residential Builders Commission page. Anderson Metal Roofing and Shingles states that it is licensed and insured; ask any contractor for the licence number and insurance certificates and check them yourself.

Storm damage brings people to your door. The Federal Trade Commission and the SC Department of Consumer Affairs (SCDCA) publish overlapping lists of what to watch for:

• Someone who shows up uninvited after the storm and pushes you to decide now. SCDCA warns about those who just show up at the door and use high pressure tactics or a sense of urgency.
• A discount only if you sign today, or a promise to cover your deductible. The FTC flags the first; the deductible promise violates S.C. Code 40-59-25(E).
• A request to pay everything up front, in cash, by wire, gift card or payment app. The FTC says to pay by credit card or check and never make the final payment until the work is done. SCDCA says do not pay in full up front.
• A blank contract, or one without the contractor's licence number, a payment schedule and a description of the work. The FTC says to get a written contract and read it carefully.
• Anyone who asks you to sign over your insurance check. The FTC says never do it.
• No copies of licence and insurance on request. Both agencies say that is a red flag. Our post 7 Easy Steps to Recover from Roof Hail Damage covers the claim steps in more detail.

Paying yourself tends to make sense when the repair is small relative to your deductible, when the damage is cosmetic and your policy excludes cosmetic damage, or when the roof is near the end of its manufacturer's stated life and is covered at actual cash value. A claim tends to make sense when damage is widespread, when water has reached the inside of the house, or when a tree has come through. Either way, the estimate comes before the decision, and the roof repair vs replacement guide helps you read it.

If you want us to look, contact us or call (864) 287-2378 during business hours, Monday to Saturday 8:00 am to 10:00 pm and Sunday 1:30 to 6:00 pm. We will inspect, photograph and give you an itemized estimate. If you are not sure the roof is the problem at all, a repair inspection answers that before any claim is opened.