Common roof denial reasons
Wear and tear
The insurer says the roof failed from age or deterioration, not the storm. Read more
Cosmetic only
Dents or marks are said to affect appearance, not function. Read more
Prior damage
Damage is blamed on an earlier storm or a prior policy period.
Below deductible
The estimate leaves out items, so the total falls under the deductible.
Installation defects
Workmanship or manufacturing defects are blamed instead of hail or wind.
Late notice
The insurer argues the claim was reported too late under the policy.
What we look at
- The policy. Roof surface ACV schedules, cosmetic damage exclusions, matching language and notice conditions.
- The inspection. Who inspected, how long they were on the roof, what test squares and photos were taken, and whether the method followed a recognized standard such as ASTM E2018.
- Weather data. Storm reports for your location and date of loss.
- The estimate. Line items, quantities, waste, code items and pricing. Roof waste and dump fees.
- The denial letter. Under Tex. Ins. Code § 542.056(c), a rejection must state the reasons for it.
Options after a roof denial
Depending on the facts, options can include asking for reconsideration with more documentation, invoking the policy's appraisal clause for amount-of-loss disputes, sending a Chapter 542A pre-suit notice, or filing suit. Which path fits depends on the policy and the dispute. About appraisal in Texas.
Texas law on claim handling
The Texas Prompt Payment of Claims Act (Tex. Ins. Code ch. 542, subch. B) sets claim-handling deadlines. After the insurer receives notice of a claim, it generally must acknowledge it, start investigating and request what it needs within 15 days (§ 542.055). It must accept or reject the claim in writing within 15 business days after receiving the items it requires (§ 542.056), and pay within 5 business days after notifying you it will pay (§ 542.057). Surplus lines insurers and declared weather catastrophes have different periods (§§ 542.055, 542.057, 542.059). If an insurer that is liable for the claim does not comply, it may owe statutory interest and attorney's fees (§ 542.060).
Chapter 541 prohibits unfair settlement practices, including misrepresenting policy provisions and failing to attempt in good faith a prompt, fair and equitable settlement once liability has become reasonably clear (§ 541.060). See our bad faith page.
Statute references are to the Texas Insurance Code and are summarized for general information. The full text controls. Laws change; check the current version.
