Is granule loss considered hail damage?

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Topic:

Topic author: CatDaddy
Subject: Is granule loss considered hail damage?
Posted on: 03/09/2003 16:15:51
Message:

There are lots of opinions on this question and they come up at every hail storm. What is your opinion? Please elaborate for those who might be on the fence.

Replies:

Reply author: ShermaninCO
Replied on: 03/09/2003 17:01:53
Message:

Moderate Granule loss is not damage. The ganules are a wear surface much like the tires on your car a little bit of rubber is lost each time you drive. A small amount of granules are lost with each rain storm and or walking across the roof.

Reply author: KileAnderson
Replied on: 03/09/2003 17:39:34
Message:

Hey, Sherman, that tire example is the same on that I use. And don't forget, the newer the roof, the more granules will be lost becaus of the riders.

Reply author: rugg
Replied on: 03/09/2003 19:44:05
Message:

Haag Eng books are an industry standard and they will tell you that the loss of granules is not considered hail damage. The shingle must show signs of puncture, or a bruise. The use of the tire explaination is a very good one, as it seems to go over fairly well with insureds.

AS well if you are talking about wood shakes and wood shingles need to have been split. A bruise to the wood will not affect the integrity or the life of the shingle. As you may have guessed this is not a direct quote.

Get yourself a copy of the Haag book on shingles.

Reply author: william s cook
Replied on: 03/10/2003 07:47:04
Message:

Please provide all insureds with a copy of the Haag book on shingles so that when a loss occurs they will know what to anticipate in the adjustment of their claim, otherwise they will be relying on their contract of insurance to pay for any direct physical loss to covered property by a non-excluded peril. Explain to a vehicle owner that excess loss of rubber on a tire from a sudden breaking event that causes a flat spot and a bumpy ride is normal wear. The granules are a part of the roof system and any reduction in the shingle covering reduces shingle protection and the remaining life of the roof proportionally. If an insured makes a claim with a cause of loss to be "granules have worn away over the life of the roof" then tell them about the tire story. If a recent hail storm has impacted the roof granules then pay a roof vendor to glue the errant granules back on the shingle to restore the insured to a pre-loss condition. OR, rewrite the policy to exclude granule loss caused by hail. Example UNDER EXCLSUIONS "ROOF GRANULE LOSS CAUSED BY HAIL."
William S Cook
From the Dark Side

Reply author: rugg
Replied on: 03/10/2003 08:56:17
Message:

Sure let me know where I can send you a copy. I suppose that every time wind blows and rain falls that we are to complete replacement on a roof due to the granule loss.
The loss of granule on the shingle, unless it is completely removed does not affect the life of the shingle. You are aware that the shingle is in place to protect the roof, and as such if the shingle still provides water shedding capability like its original intention then there is no loss of life duration to the shingle. The shingle must be physically damaged.

Reply author: KileAnderson
Replied on: 03/10/2003 10:55:58
Message:

So, Mr. Cook. Should we provide coverage for granular loss when there is a 6" rain fall in a single day. After all, more granules are lost in a heavy rain than in a light rain, or should we provide coverage if there is a 60 mph wind gust and granular loss is higher than on a normal day? Exactly where is the line drawn? Granule fall off of a roof as I'm inspecting it from my own footsteps, does this mean that I should pay for everyroof I walk on even if I don't find wind or hail damage to it?

Your tire example doesn't apply because obviously the event you mentioned affected the usablity of the tires. If the hail storm knocked enough granules off of the roof to affect it's usability it would be a covered loss. But simple granular loss simply is not covered.

Let me ask you something Mr. Cook, are you one of those PA's that runs around telling insureds they are owed for granular loss, thus making our job as IA's that much more difficult and causing us to all hate PA's?

Reply author: CCarr
Replied on: 03/10/2003 12:11:12
Message:

Composite asphalt shingles, are composed of three elements. First, a mat core of either an organic material (normally a cellulose product) or a fiberglass product. Second, that mat core is coated with multiple layers of asphalt. Third, pulverized minerals are then inbedded into the final layer of asphalt, on the top side of the shingle.

This third element, the granulation, is there for a purpose, only the coloring of the granulation is cosmetic. The granulation protects the asphalt and mat core, from damaging ultraviolet rays.

This damage (more prevelant in fiberglass mat core) to "asphalt shingles", manifests itself in what is known as cyclic fatigue; and shows itself with premature splitting or cracking.

This granulation on composite asphalt shingles, is an essential component, to allow the shingle to have the durability over the years. Apparently the most effective granulations, are ones that have a concentration of mica, or oyster shell, or a type of slate.

Considering the above, then place those shingles in an insurance scenario.

Hail, a covered peril of a policyholder's homeowners policy, falls on his roof. After the hail stops, the homeowner goes outside as clearly sees at the outflow of his gutters (aka eaves) a deposit of granules from his asphalt roof. He reports a "hail claim".

An adjuster is dispatched, who goes up and examines the roof covering. The adjuster finds no evidence of typical bruising or worse characteristics of "hail damage". The adjuster advises the homeowner that there is no "hail damage" to that roof.

The homeowner turns to the pile of granules at the outflow of his gutters, and says yes there is "hail damage".

An examination of the policy should follow. I'll use my trusty HO3 (ISO 0491).

Under Definitions, #5 Occurrence, ".... continuous or repeated exposure to substantially the same general harmful conditions, which results .... in .... "property damage"".

Under Definitions, #6 Property damage, "means physical injury to .... of tangible property".

So, to this point, with regard to the "hail event", I think we have continuous and repeated exposure to the harmful hail, and further, the loss of granulation (one of the three essential components of a shingle) from the "hail event" is a physical injury to the shingle due to the loss of one of its components from a peril insured against.

Section I - Perils Insured Against, Coverage A, says; ".... we insure against the risk of direct loss ....". I can not see any argument that the hail is not the direct cause of the loss of granulation.

An examination of the exclusions applicable to Coverage A, would be the next step.

Direct loss by hail, being a covered peril, can not be considered as the cause of "wear and tear, marring, deterioration" to the shingles; and hence that exclusion could not be applied.

Direct loss by hail, as a covered peril, can not be considered as the cause of "settling, shrinking .... of .... roofs ...."; and hence that exclusion could not be applied.

I see no other exclusions in that area, worthy of considering.

I do not see anything in Section I - Exclusions, or Section I - Conditions, or Section I and II - Conditions; that would be applicable to the discussion.

So tell me - how, why and where - you feel a granulation loss from hail falling on this roof, is not an indemnifiable loss? It's not suffice to say - "that is how I was told, taught, or thought."

Show me from the policy wording, where you don't feel this is a covered loss; if you think that.

However, the much more difficult exercise, is the determination of the measure of loss. I don't have the answer to that, nor have I heard one worth supporting.

I do suggest, that if you separate the two issues - coverage from damage - that the former will become clearer.

Reply author: KileAnderson
Replied on: 03/10/2003 12:31:16
Message:

The granules are a wearable surface. A roof is designed to shed 2-4% of its granules on a yearly basis. That's why the roof wears out. The granules eventually fall off. The maker of the roof put the granules on the shingles knowing that they would, through ordinary weather occurences be worn off.

I looked out my window just a minute ago and there are granules in the gutters right now. I know that if I go to the downspouts I will find granules on the ground there too. So, has there been a covered loss to the roof on my building? Granules are obviously being shed?

The answer is no. The insurance policy does not cover the normal weathering of a product as designed. Paint eventually fades, cracks and peals, this is not a covered loss.

I have a State Farm policy handy. It is a 7955 homeowners policy. I find under Section 1-losses not insured 1. g. wear, tear, marring, scratching, deterioration, inherent vice, latent defect or mechanical breakdown.

Since shingles are designed to shed granules and they do so at a varying rate dependent upon weather patterns, (less in a dry year, more in a wet year)granular loss from small hail is not covered because it is simply normal wear and tear to a wearable surface.

Reply author: ShermaninCO
Replied on: 03/10/2003 12:45:23
Message:

Loss of granules (moderate loss) occurs with each rain storm, reguardless of Hail. Do we then owe for a new roof every time it rains? If so, I'm going to become a roofing contractor[:o)]. Even here in the high desert, there would be a fortune to be made. In the spring time wouldn't even have to nail them down they would get replaced daily.

Reply author: rugg
Replied on: 03/10/2003 14:24:14
Message:

Kile, I have to agree and state again that if there is no physical damages ( puncturing or bruising of the shingle) granule loss is not covered.

CCarr- I do not agree that this would be covered if you read the policy as you have quoted, loss of granules is not a direct physical loss. If I hear you right you are saying that as soon as an insured calls in a claim and there are granules sitting in there eaves (gutters) that all there is to do is measure the roof and pay the claim, that is complete nonsense.

It all comes down to your definition of direct physical loss. A moderate amount of granules loss should not be covered.

Reply author: CCarr
Replied on: 03/10/2003 14:52:46
Message:

Reg, in your support of Kile's post, are you limiting the determination of any "physical damage" to the shingle, to only a visual observation, of only a puncture or bruise?

In regards to your rebuttal to me, you didn't hear me right .... . My comment, ".... determination of the measure of loss", was just my way of saying how do you determine the amount of loss (not physically measuring per say).

What is your definition of "direct physical loss", regardless of the type of property?

If you are saying, "a moderate amount of granules loss should not be covered", what is 'moderate'; and then what about more than a 'moderate' amount of granules loss?

Aside from any carrier position or directives, given the policy language that is available, what would we do with the scenario I presented; adding the fact that the insured pulls out a paid contract showing his roof was replaced with new product only 3 or 4 months ago, as he points to the piles of granulation loss at the bottom of each downspout?

Reply author: ShermaninCO
Replied on: 03/10/2003 15:03:32
Message:

Clayton, I think I understand your position now. You are saying that the lost of granules after a hail storm is damage but you are not saying that just because of the loss of granules that the roof should be replaced. Did I understand that correctly.
In reguard to the 3-4 month old roof I would expect to see more granules in the gutters due to the lost of granules that were not adhered to the asphalt (riders or clingers).
The amount of granules in the gutter would not determine the severity of loss but an inspection of the shingle as to wether or not the UV protection of the asphalt was intact.

Reply author: CCarr
Replied on: 03/10/2003 15:27:06
Message:

Exactly Bill. I am suggesting - following available policy language - that there is a direct loss to the shingles following a hail storm, causing property damage if granulation loss results (i.e. separation of the roofing product); even in the absence of visual evidence of puncture or bruising. The hail storm does not create the "wear and tear, marring, or deterioration".

I never suggested, and certainly didn't intend my thoughts to be suggesting, that the above situation would result in it being necessary to replace a roof. I refer everyone back to my last two paragraphs of my first post to this thread.

I have no idea how to properly determine the amount or extent, of that loss scenario.

Again, I think it is important to separate the issues - coverage from damage; or my favorite phrase from Jim Lakes - "cause, coverage, cost", and that is the order in which claims must be pursued.

Lets flog the issues of cause and coverage; before we take on what I think is much more difficult to discern in this scenario - cost, because I think there may be a lot more to that, other than replacement of the shingles.

Reply author: KileAnderson
Replied on: 03/10/2003 15:39:28
Message:

Clayton, what do you mean by "The hail storm does not create the "wear and tear, marring, or deterioration"." If due to a hail storm, some granules are knocked loose, then it most certainly does cause wear and tear to the surface of the shingle, as does rain, sleet, snow, wind, heat, gravity, foot trafic, birds and several other factors.

If the product functions as designed, i.e. shedding of the granules from weathering, how can you say direct physical damage has occured? The product is simply performing as designed. If I drive my truck over a ruff road, the tires will wear faster than if I drive over a nice smooth road. Can I file a claim on my auto policy because I believe that even though you can't look at the tire and see any damage, the life of the tire has been reduced by driving over the rough road? I would be laughed out of the claims office if I presented that because wear and tear is not covered by insurance.

Reply author: ShermaninCO
Replied on: 03/10/2003 16:01:16
Message:

quote:

---

Originally posted by KileAnderson

The granules are a wearable surface. A roof is designed to shed 2-4% of its granules on a yearly basis. That's why the roof wears out. The granules eventually fall off. The maker of the roof put the granules on the shingles knowing that they would, through ordinary weather occurences be worn off.

---

Reply author: CCarr
Replied on: 03/10/2003 17:28:54
Message:

Kile, although there may be some planned obsolesence in the manufacture of asphalt shingles, I don't think we will find a manufacturer that would tell us that one of the three essential components of an asphalt shingle; is designed to shed itself at a periodic rate.

Notwithstanding that, I think your reliance (in your 12.31 post) on the "wear and tear ...." exclusion; is incorrect. As has been discussed in this forum previously, insurance is intended to pay for losses that are accidental and not those which are inevitable or arise naturally out of ordinary or reasonable use or ownership of property. The exclusions you refer to are meant to be 'maintenance' type exclusions; to avoid the insurance policy (a contract of idemnity) from becoming a 'warranty' policy.

Further, the HO3 insures against direct loss. A direct loss is the loss of economic value that occurs when property is destroyed or damaged. Again, I cann't see a successful argument being made that a hail storm did not cause damage to the asphalt shingles; when there is a pile of granulation resulting, at the bottom of each downspout.

If one looks to the proximate cause, of the loss of granulation following a hail storm; it should be a quick exercise. Conversely, granulation deposits found at other times, from some of the situations you describe; could not find their way back to a direct loss that would be covered.

This concept of a "wearable surface", is that an invention of the insurance industry, or does it have a definition and applicability in a written Standards relating to construction; specific to roof covering?

In summary, I think you have a cause - hail, which strikes the asphalt shingle roof covering, causing a quantity of an essential component of a shingle to separate from it - resulting in direct damage. I'm still not satisfied anyone has advanced a supportable position - within the policy language - that this is not a covered loss.

Kile, your trip to the claims office, for the wear and tear on your tires, would be unjustified; due to the named perils involved, which has no relationship to this situation.

Reply author: KileAnderson
Replied on: 03/10/2003 18:37:09
Message:

Clayton, of course shingles are a wearable surface, other wise, why would we replace them every 20-30years? They are meant to protect the wood underneath from the ravages of the elements. They are no different than the soles of your shoes or the seat of your pants. They are designed to absorb the friction and impact of the environment in which we live, which is what we call weather. Be it wind, rain, or even hail, a roof sheds granules constantly. The definition of wearable surface you asked about comes from common sense. A wearable surface is one that eventually wears out and needs to be replaced. That's pretty simple.

I spoke with a rep from Certainteed when we had an insured make a hail claim that turned out to be deffective shingles, not hail damage. He told me that the shingles are designed to loose 2-4% of their granules every year. That mean a 25 year roof can be expected to lose between 50%-100% of it's granules in 25 years.

Under your theory, if I clean out my gutters and downspouts and the next day there is a heavy rain and afterwards I notice an accumulation of granules then I must have a claim because my roof has been damaged due to accidental direct physical loss. Heavy rain being the cause and loss of granules he direct physical loss.

But I don't look at the loss of granules as being a direct physical loss because that's what they are there for. The loss of granules is not accidental. It is normal and happens everyday.

Reply author: william s cook
Replied on: 03/11/2003 07:50:27
Message:

Kile
I am the type of PA that uses the policy language to determine if the adjuster has applied "rule of thumb or an insurer oriented source to determine entiltements of the insured." Clayton has explained the issues of coverage very well. It is very likely that Mr. Carr's analysis of the claim damage issue will cause him to agree that the granule loss caused by hail may require that any shingle that has suffered such a loss is a replaceable shingle under the policy terms. If you can separate the missing wear and tear granules from the hail caused missing granules then glue them back on. In the example you gave you indicate loss caused by small hail and then apply an exclusion for wear and tear.

****
Since shingles are designed to shed granules and they do so at a varying rate dependent upon weather patterns, (less in a dry year, more in a wet year)granular loss from small hail is not covered because it is simply normal wear and tear to a wearable surface.
*****
One could surmise that granular loss from large hail would be covered or that the diameter of the hail is controlling the coverage. Will we have to rely on Haag to provide a determination of hail size that will allow an insured to be compensated. I am sure that they will include a formula for time vs size to allow for the policy to provide coverage. Ten minutes of 1/4" hail or five minutes of 1/2" hail.
The above examples are the type of doublespeak that a public adjuster could rely on to become involved in a hail loss that is not a hail loss but a wear and tear loss that happened because of hail.
From your recent post
***"Since shingles are designed to shed granules and they do so at a varying rate dependent upon weather patterns, (less in a dry year, more in a wet year)granular loss from small hail is not covered because it is simply normal wear and tear to a wearable surface.
*****

I note another possible flaw in your logic as noted herein "
*****
I spoke with a rep from Certainteed when we had an insured make a hail claim that turned out to be deffective shingles, not hail damage. He told me that the shingles are designed to loose 2-4% of their granules every year. That mean a 25 year roof can be expected to lose between 50%-100% of it's granules in 25 years."
****
If the granule loss is anticipated to be 2-4% per year on a 25 year roof and the day after a "small hail hit" the accumulation in the gutters appears to be twice normal then the 8% loss has reduced the normal wear and tear life expectancy of the roof by one year. In the year 2027 the insured will have to replace his roof instead of waiting until 2028. Should he then give his adjuster a call and ask him to please come address the issue of the lost year of roof protection. It appears that the Certanteed man has confirmed that in any year that the roof has a granule loss greater than 2-4% the life expectancy has diminished or something has caused a direct physical loss to covered property.

My issue in this matter is confined to "rules of thumbs and undefined industry standards and what happes at my house" that are applied to a written contract. These are the issues that I run around creating extra work for adjuster. I seldom become involved in hail losses due to the low return on the billing schedule. Some of the adjusting methods used extend into other types of losses and coverages and it is worthwhile to participate.
These are my thoughts I could be found to be wrong by other experts in this forum and I hang out here for the education that is provided in these type of exchanges. My purpose in participating in these exchanges are to have my views examined for flaws and errors. I admire your willingness and the others that participate at CADO to share knowledge and would never wish to discourage anyone from posting with personal attacks from the dark side.
William S Cook


P.S. Mr Rugg
It wasn't I who needed a copy of the Haag info, that information should be provided to each insured as it is being used as an industry standard to determine an insured's entitlements. It is good that you opine that any granule loss greater than "moderate" may give rise to coverage and ultimatly replacement of the granules. If you are sincere I would like a copy of the Haag book as I have never attended their classes. In the alternative I will be gald to pay for a copy of "INSURANCE INDUSTRY STANDARDS FOR 2003" or a source that has these standard listed in order avoid conflict with adjusters that may be using an older or outdated version of these standards.

Reply author: JimF
Replied on: 03/11/2003 08:22:42
Message:

First of all, let me say, that I understand what Clayton and Bill are saying, and I agree with them regarding causation and coverage, based on a review of the policy as so beautifully analyzed and outlined by Clayton.

I don't think Clayton is saying that a roof should be replaced simply because there is some extra granular loss, but what I hear both he and Bill suggesting, is that there has been a diminuation in value. And in that I concur as well.

Clayton further suggests that the dilemma for the adjuster, the carrier, and even the insured is measuring the economic value of that diminuation.

In the not so distant past, adjusters were allowed to recommend or pay an 'allowance' for that diminuation, which I have long believed was an excellent tool for claims settlement, although not one without it's own set of underlying problems.

This past summer, in three contested hail claims almost precisely 'on point' to the scenario here, three separate independent adjusters (all senior adjusters possessed of vast knowledge and experience) representing three different carriers here in the Greensboro area did in fact do just that; recommend an allowance for diminuation of value from granular loss, and in all three situations, the claims were paid by three separate carriers for a diminuation of value from granular loss.

I think Kile and others are perhaps not wanting to introduce any complexity into what is generally a simple process in hail storm adjusting.

To me, the absence of observable visual damage to the shingle combined with the absence of any granular loss, would be the threshold to conclude there was no hail damage to the roof system nor diminuation in value to the roof system of an insured property.

And what Bill, Clayton and I are saying is this, even if the insurer doesn't owe a full replacement of the roofing shingles from granular loss, the insured has still suffered a diminuation of useful life and thus economic value, to their shingles from a hail storm event. And for that, the insured is entitled to indemnification for their loss sustained.

Reply author: CatDaddy
Replied on: 03/11/2003 08:37:32
Message:

Here is a link to some information from the Canadian Asphault Shingle Manufacturers' Association, CASMA. They briefly discuss granule loss in a report they drafted.

http://www.iko.com/misc/CasmaPdf/14-EffectsOfHail.PDF

Reply author: JimF
Replied on: 03/11/2003 08:39:51
Message:

As an aside, I could not wish for an insured to have a better Public Adjuster than Bill Cook, and have come to know Bill as reasonable, knowledgeable, logical, ethical and fair.

While it likely never will happen, to have Bill representing 'the other side' of one of my claims would be a pleasure as well as making my job easier.

Public adjusters are like agents, they can be our best friends or our worst nightmares. The good ones are a pleasure to work with and Bill Cook is one of the great ones!

Reply author: KileAnderson
Replied on: 03/11/2003 08:42:08
Message:

Bill, I stipulated small hail in my answer because large hail would do damage to the matting of the shingle and the granular loss would not be an issue.

If the roof lost 8% the entire year of that "small" hail event and then it lost only 2% the following 2 years the 3 year average would be 4%, in the manufacturers specs of 2-4% per year. Normal wear and tear is not covered. Going by your logic, a roof should be repaired or replaced every time the wind blows or rain falls.

I can tell you right away that if a PA told me he wanted to be paid for granular loss and there was no evidence of hail damage I would not listen to another word he had to say because he I would immediately know that he is a sheister and simply looking to screw the insurance company. Probably to make up for the fact that after he takes his cut of an honest claim, the insured no longer has enough money to fix his house. I don't think I could get my house fixed for 30% less than the amount it should actually cost.

Reply author: JimF
Replied on: 03/11/2003 08:55:00
Message:

Kile it is called DIMINUATION OF VALUE and I agree with Bill Cook, so put Clayton and I along with Bill on your shyster list and the list for what is wrong with this country and this industry. I can't think of better company in association.

If you will take time to read my first post of this morning, you will discover that diminuation in value is not only an economic loss but an insurable loss as well. And while you might not listen to another word Bill Cook or Clayton or I had to say when this was called to your attention at our personal loss, rest assured the carrier managers and State Insurance Commissioner would.

And in the end, insureds would be paid for that diminuation of loss whether you liked it or agreed with it or not!

Get rid of the rather closed minded attitude which only blinds you to understanding and applying new ideas and valuation concepts to the adjustment of real losses with real insureds.

Reply author: KileAnderson
Replied on: 03/11/2003 09:19:01
Message:

No, Jim, I completely understand what you're saying, but I don't agree with it. I don't call in diminuation of value, I call it amortization, depreciation, whatever you want to call it. Just about everything deminishes in value everyday. If you take his theory of yours and Clayton's and Bill's to it's logical conclusion, why don't we have a huge influx of claims everytime it rains? More granules are lost in a heavy rain than on a sunny day. Why is this limited specifically to hail?

I'll tell you why. Because after a hail storm, there is a feeding frenzy of roofers and PA's and yes even IA's. Everyone out there is looking to make a buck, myself included. The problem is, I have morals and ethics, and those two damn things won't allow me to make a living in a dishonest way. I'd love it if the carriers said "go ahead and give everyone with granular loss 25% of their roof value. In most cases that wouldn't exceed the deductible, but it would create a hell of alot more claims, easy ones too.

The problem is, granular loss ISN'T DAMAGE, it is the normal wearing process of the product. Some years you will get 8% of the wear, other years you will get 2%. Granular loss from small hail (because large hail will do real damage to the shingles therefore making this argument moot) is simply par for the course.

I do not have a closed mind, Jim, I have a dicerning mind and I filter out the BS, which is exactly what this is. Keeping an open mind doesn't mean you accept every crackpot theory that comes along, it just means you listen to it and when you realize that it's just smoke and mirrors you discard it.

Now that I have answered your questions, would someone please answer 2 of my questions.

1. Why don't PA's encourage people to file claims for granular loss from heavy rains?

2. How do PA's sleep at night knowing that they have taken their pound of flesh from the insured and now the insured no longer has enough to fix their house?

Reply author: CCarr
Replied on: 03/11/2003 09:50:35
Message:

Kile, I'm disgusted and angered with your abusive tone you have now brought to this thread. We may disagree with each other on the technical issue, and that is fine; but why with a topic like this must you take personal attacks at people? That type of action does nothing to support or reinforce your technical opinion.

You started your abusive tone with your 3/10 reply to Bill Cook, followed by an unjustified closing paragraph in your 3/11 08.42 post and again in your 09.19 post.

Further, you now paint the entire thread as "BS" and a "crackpot theory". I personally do not like to be associated with, more made to be associated with that type of thing.

Very disappointing Kile! You have a good ability to articulate your opinions clearly without resorting to that type of thing. You do not have to lower yourself and abuse others, to express your views.

This is the first meaningful technical discussion on this web site in some time. It is a subject that disagreement would be expected, as was stated in the opening post. It has now gone to hell, with your abusive attacks.

Reply author: KileAnderson
Replied on: 03/11/2003 10:10:58
Message:

But you still haven't answered my questions.

Reply author: ShermaninCO
Replied on: 03/11/2003 10:11:14
Message:

Clayton, I agree this is a controverial subject and there is no need for personel attacks.

Kile, I agree with you, at least in part, I know how much granular loss I see here at home after a heavy rain and don't see a noticable difference after a small hail storm. I still believe that the granular loss would be there if there was hail or just heavy rain. And, is only noticed by insured due to the hail.

Therefore, how do you determine a diminshed value for a roof after a small hail storm? What position is used by most insurance carriers?

Reply author: JimF
Replied on: 03/11/2003 10:12:57
Message:

Clayton, I share your anger, disgust and disappointment with the tone which has been brought to what is otherwise an excellent technical discussion on this thread.

One of the primary reasons that insureds hire and engage Public Adjusters is because of the hard headed close minded attitude witnessed here on the part of some adjusters; adjusters unwilling or unable to understand concepts and aspects of loss which may differ from their own personal, limited, and encapsulated insular dogmas.

Good public adjusters have the knowledge, experience and skills to protect their insureds from adjusters unwilling to listen and to apply policy coverage provisions correctly in the adjustment of claims. And they certainly know how to move past those adjusters who would throw up obstacles to indemnification guaranteed under the insurance contract. And in the end, it is the adjuster and not the public adjuster who is left with the black eye and censure by the carriers, insureds and insurance commissioners in the various states.

Kile, I generally appreciate your postings, even when I disagree with them, but this time you have well overstepped the bounds of decency, and I for one, feel you owe at least an apology to Bill Cook for your reckless and unfounded personal attacks.

Reply author: CCarr
Replied on: 03/11/2003 10:35:04
Message:

Kile, your 3/11 10.10 post, is a silly response, to your noted behavior. I have no further wish to respond to any of your questions, at this time.

Reply author: rugg
Replied on: 03/11/2003 11:00:45
Message:

How is everyone this fine wintery morning. I see that once again the discussion has turned and gone straight down hill. Let us try to stay on the topic and not hurl abuses towards each other. Thanks

Anyway CCarr - what the! [:D] To answer your questions:

(1) Yes
(2) On the shingles a Puncture or a bruise.
(3) Moderate - to keep within bounds; not extreme; limited; these are three definitions of moderate. Of course we have not determined an actual amount of granule loss for this scenario.

As per your scenario concerning the insured with the contract of a new roof a few months old.

" Does hail cause granule loss? Yes, but it is highly unlikely that hailstone impacts cause significant granule loss. Our 15-year study showed that impacts with simulated hailstones which dislodged granules but did not expose asphalt at the moment of impact ( or rupture reinforcements) did not affect the expected service life of the material and, therefore,were not functional damage."

So as to not ramble on and continue to repeat the same tired old sayings, the result is negligible loss of life.

neg-li-gi-ble may be disregarded because small, trifling, or unimportant.

HAAG Engeineering Co.
Asphalt Composition Shingle Roofing Pictorial
(Fifth Edition)2.1.13

2.4 " Asphalt composition shingles are damaged by impacts when they are punctured and when the reinforcements are fractured ( sometimes referred to as "bruised" ). Once a shingle has been bruised, a progressive deterioration ensues and culminates with a hole in the shingle. A puncture affects the water-shedding capability immediately, and a bruise reduces the long-term serviceability of a roof. Both conditions, therefore, constitute damage."

HAAG Engineering

Sorry for the long post!

Clayton I await your response.

Have a great day

Reply author: JimF
Replied on: 03/11/2003 11:01:37
Message:

Let me share a couple of real life claims stories from the road:

A few years ago, I along with many other cat adjusters, was sent to Appleton, Wisconsin for a large area hail storm. In the end, I would guess that 95% to 98% of insureds who reported a claim, were paid for the full replacement of their roofs by many different adjusters working for many different carriers.

A rather physically large male adjuster weighing around 300 plus pounds and working for another vendor was staying in the same hotel with many of us working for our vendor. About a month later, I was in the lobby as this adjuster was checking out to leave for home (most cat adjusters were present for several months for this hail storm). When asked, he whiningly replied that this storm was a bummer and he had not made any money as he only had three claims with hail damage. When asked how many roofs he got down on his hands and knees to inspect, his answer was NONE. For everyone else, it was understood that this hail event was caused by pea sized hail, and while the damages were not readily visable from a standing position, they were clear as one neared the shingles by stooping or kneeling. There were elevated and significant visible levels of granular loss in most gutters and downspout exits, even to the untrained eye.

Did this adjuster treat his insureds fairly?

Did this adjuster fulfill the obligations of the carrier under the insurance contract?

Can anyone understand and appreciate affected insureds who might have hired a Public Adjuster to protect and enforce their rights under the insurance contract?

Does this type of claims handling and adjusting by improperly trained adjusters happen more often than you might think?

In the second scenario, a large fire department with a brand new fire station, had a large long asphalt shingled roof with numerous slopes and offsets. Hail damages in the area were slightly larger than pea sized and all of the vents and metal flashings on this roof were damaged totally. Yet visible hail damage was apparent only on limited slope shingles and generally more on scattered isolated shingles. There was significant granular loss however which the fire department asked be taken into consideration.

Within a one mile area of this claim, 90% of reported claims were paid for full replacement of roofs.

The initial adjuster was unwilling to recommend anything more than the replacement of a couple of slopes which would have constituted a small fraction of the roof surface. Based on complaint, the carrier engaged a forensic engineering firm which inspected the roof, significant metal flashings, metal vents and granular loss. The engineers agreed with the scattered and somewhat isolated visible damages, but also agreed that there was and would be some diminuation in useful life of the roof shingles and thus, the roof systems.

As I mentioned earlier, the dilemma then was arriving at a 'value' for this diminuation of use and of value. While neither the engineers, the adjusters or the owner fire department could argue with any degree of specific certainty, it was generally agreed that this brand new roof with 25 year shingles could no longer be expected to last for the remaining 24 and half years. While different ranges of remaining life were speculated on, it was agreed in the end, that the roof system in it's entirety had suffered a diminuation in useful life of somewhere between 20% (5 years) to 25% (6.25 to 7 years) and in the end, the carrier appropriately paid a diminuation of use/diminuation of loss value of 25% (for the full replacement of the roof) for the value of the damages sustained, to the satisfaction of the engineers, owner and carrier.

Diminuation of value from covered causes of loss to insured risks is a very real problem which should be understood, recognized, reported and applied when encountered by adjusters who would be professionals in the claims handling process.

Reply author: CatDaddy
Replied on: 03/11/2003 11:25:17
Message:

Please explain the "Diminuation of Value" scale and how it should be properly applied to granular loss.

Reply author: CCarr
Replied on: 03/11/2003 14:58:13
Message:

Reg, you and I understand what 'moderate' is. However, applying that to a level of damage, specifically to this granulation issue; is another matter. Jim's posts shed some light on it, but also illustrate it that it can be a rather abstract application.

Your comments, "our 15 year study ....", it is unclear to me if you are saying this is a Haag item, or from some other source. Could you elaborate on that, and where I may review it?

I see now that this discussion has come full circle, and starts now, where an old forum left off last year. Where is Lanny the roofer, remember him?

Diminuation in value (also spelled 'diminution'), aka 'DV', is a concept that has been part of contract and property law for years. In the last few years it aggressively entered the insurance claims world, in the auto insurance sector.

In November 2001, The Georgia Supreme Court ruled against State Farm, regarding DV; relative to auto claims. In summary, the ruling stated that physical damage resulting from a covered event can reduce the value of property (car), even if the vehicle is repaired to pre-accident condition. That case, and others, has caused the ISO to create wordings to specifically exclude DV losses. The inference of that, relative to property insurance, and specifically considering this granulation issue and its non repair or indemnification; is quite clear to me.

DV, is rooted in the "reasonable expectations" rule, at law. Within that concept, is what is known in contract law, as the "Black Letter Law". This law applies where there is a breach of contract conditions, the breach specifically relating to the lack of compliance to the contract conditions (perhaps - not paying for the hail damaged roof, evidenced by an accelerated loss of granulation).

Under the "Black Letter Law", the party not in breach is entitled to the cost of compliance with the contract conditions, unless that amount is grossly disproportionate to the value that would be produced by compliance.

When an amount is grossly disproportionate, the party not in breach is entitled to DV; that being the difference between the value generated by the resultant performance under the contract and the value that would have been generated if there would have been compliance originally.

An amount is considered as "grossly disproportionate" within this concept, when it would not be considered to be proper mitigation to comply with contract conditions.

Consider this within the context of the asphalt shingle roof with a granulation loss following a hail storm. The roofing has suffered an economic loss, even if the only measurement of that is in accelerated loss of life expectancy. However, indemnification is not necessarily replacement of the roofing; but some other amount of loss.

This is where the "reasonable expectations" rule is considered, and its economic value; when there is noncompliance with reasonable expectations.

However, in reality, how do we measure DV, relative to a granulation loss; is it a very subjective exercise?

Fema has an ongoing DV compensation program in NM, as a consequence of the Los Alamos fires in 2000. Some of the fundamentals or principals applied in that situation; may be worthy to explore.

Lannie, you could review the Georgia case, and your companies application of the ruling; to see if there are any parallel applications or any fundamental scale that was utilized.

Reply author: CatDaddy
Replied on: 03/11/2003 16:16:21
Message:

CCarr - Lanny the Roofer? Did I get promoted and not know it?

I am really enjoying reading everyone's points of view on the subject. Its good to see you guys arguing with someone other than me. Its refreshing because I was starting to get a complex.

And yes my Mississauga Ice Dog, the discussion would have started now but most of what I would have said has been said my others previously. Some things were said that I would not have said by the same parties I will note for the record. I am kinder and gentler now.

I will say what others have said, roofs are made to wear and do so based on their respective rating. Granules come off when it rains, when it snows, when the wind blows and yes when it hails. Can hail cause significant enough granule loss that might warrant a roof replacement? Yes it is possible. Never say never. Should you replace a roof everytime you find granules in the gutters after a small hail storm. Certainly not.

This another of those case where bigfoot might exist and maybe some of you have already seen him.

No one has given any type of scale or guidelines that outline DV effects on roofing due to granule loss because there are not any. You can have your opinions. I respect your arguements as they are well researched.

Rugg's quote from Haag's report is good. I would stay with that.

CCarr - I am well aware of the GA ruling. My wife worked on it. Stick with apples to apples.

CD

Reply author: CCarr
Replied on: 03/11/2003 16:48:28
Message:

Lannie, the CD; you are a different person than Lanny the Roofer. Lanny came to CADO last year some time, he is a roofing contractor, who had some pretty specific opinions on things. That is what I meant by 'full circle'.

I certainly haven't argued with anyone on this thread. It had been a good discussion, until the personal attacks came out.

I certainly don't know of a DV scale. But, that is why I mentioned the FEMA DV compensation plan and the GA ruling.

Again, if someone wanted to find and review the FEMA DV plan, perhaps there is some logic in it for consideration of a 'scale'. Why I suggested you, Lannie, to consider the DV auto ruling, is that perhaps there is some logic in the application of the ruling by the carrier that could be transposed from auto to property; with regards to the overall issue of DV and a 'scale'. That is the 'apples to apples', that I was hoping may be found in your basket.

Reply author: mshort68
Replied on: 03/11/2003 17:25:46
Message:

Clayton, how are you going to compare a Yugo to a home. Please help me understand?

Reply author: CatDaddy
Replied on: 03/11/2003 18:00:31
Message:

Wooooaaaaah Mr. Short. Slow down my friend whose heart is bigger than his brain. Jim and Clayton are entitled to their opinion. This has been a good thread with great dialog. Lets keep it civil. Take another Prozac you beast.

I guess I meant to say "defend yourself" instead of arguing. Sorry.

CC, I see the similarities in the situations but I am not ready to make that leap. I am not the auto expert in the family so it would not be fair for me to elaborate having limited knowledge of one side of the coin. Besides, class actions give me a migrane.

Thanks for all of your replies and posts.

Reply author: KileAnderson
Replied on: 03/11/2003 19:06:49
Message:

Clayton, Bill, Jim, and everyone else. Please accept my humble appology. I will try to temper my words in the future. A trip to the doctor this morning confirmed what I migh have expected. My blood pressure was elevated, but now that I'm back on the proper medication I can continue this discussion on a more civilized level.

I don't accept the idea that granular loss seen in the gutters and downspouts and no other visible damage to the shingles is indicative of direct physical damage to the shingle. I also don't accept the idea that said granular loss presents a diminished value situation.

I say this for the reasons I have previously stated. It is a wearable surface and some granular loss is to be expected on any weather event, rain, hail, wind, even excessive heat. That being said, those of you who's opinions differ please explain to me why an insurable loss has occured because of the hail, but not because of a heavy rain? Both loosened granules and both created more wear and tear on the surface of the shingle than a regular sunny day.

Now for my second question and if you think it is too far off topic, maybe we can start a second thread. How does an insured get his house fixed and his possesions replaced when he is given exactly what he is owed by the carrier and then the PA takes 30% of that? If the repairs can made for the lower figure then the claim was overpaid and the PA has helped the insured commit a fraud. If the amount is not enough then the PA made a nice pay check but did a disservice to his client because they are not fully indemnified for their loss. If there is a logical explanation for this, I would like to know what it is.

Reply author: KileAnderson
Replied on: 03/11/2003 19:28:34
Message:

Bill, I want to publicly apologize to you for disparaging your proffesion and you personally. After discussing this with another adjuster who knows you and whom I respect I have come to the conclusion that I have unfairly painted you and your profession with a wide brush. Please accept my appology and refer to Catdaddy's new thread where I will elaborate on the reasons I have for my views on others who share you profesion but not your ethical standards.

Reply author: Catmandale
Replied on: 03/11/2003 20:30:52
Message:

Well, I might as well weigh in for my beating too.

I am somewhere between you folks on this. The majority of my training and experience on roofs comes from Haag, Big Red and hands-on hail cats.

It is my understanding that the granules are applied to protect the felt or whatever the mat is made from. The granules are applied such that there are enough to cover the surface, and some additional are embedded in the emulsion as it varies in thickness.

I have seen gutters containing what appeared to me a tremendous amount of granules. That alerted me to be careful and complete in my close-up inspection of the shingles. I would be looking for voids in coverage by granules (in addition to bruises.) That would mean exposed emulsion or matting. I would call the voids damage in an early stage. Over time, the voids are going to lead to shingle failure earlier than would have occurred in the absence of the event. The degree of accelleration is site and occurrence specific.

Obviously the color of the shingle is a factor, as voids show more in contrast. The size, direction and spacing of the hail is something to be considered. From the roof, I look at the surrounding roofs... as well as the antennas, vents and other indicators of the roof I am on. (More than once I have been treated to a view of a neighbors ball pien loss.)

I think that a part of Kile's position on this is that, if there were enough granules knocked off to create significant voids, they can be seen. We pay for what we can see or prove otherwise, and that's all.

I have not seen many instances of granular voids without accompanying bruises. That is not to say it doesn't happen.

The thing about what Jim and Clayton did though is this. They thought it through and kept an open mind. Listening is an underrated skill.

Even if the PA (or roofer, or contractor)is wrong, you can learn from what they say and how they approach the issue. And they might just be right.

Never say never.

I'm sorry if I rambled. I'm full of NyQuil.

Dale Strain

Reply author: CCarr
Replied on: 03/11/2003 20:35:50
Message:

Thank you Kile, in regards to my specific concerns as noted, for your unnecessary comments earlier today.

You are a better man, in many ways, when you do not exhibit that kind of thing.

Further, the acknowledgements and apologies noted in your last two posts; make you even a stronger man, for recognizing it and adressing it.

I've put it behind me, lets get on with life.

Cheers.

Reply author: JimF
Replied on: 03/11/2003 22:06:46
Message:

Ok, please let me start all over and see if I can clear up some misconception here about what Clayton, Bill and I have said and are saying. And Clayton and Bill, if I misrepresent your positions, please feel free to correct my misunderstandings.

First of all, we acknowledge and concur that granular loss occurs naturaly in the aging cycle of shingles due to such factors as location, temperatures, weathering, slope exposure, etc. Where we differ in our belief is that a greater than average granular loss from hail quickens the life cycle of the shingle thus reducing the value of the shingles and roof systems, and thus creates a diminution of value even if it doesn't meet the insurance 'standard' for roof replacement. And the insurance industry 'standards' for total roof replacement vary from carrier to carrier and adjuster to adjuster so as to render the standard standardless, and thus damage replacement decisions are rendered as broadly subjectively as determination of a standard valuation tool for dimunition of value would be.

We also suggest and agree with the many here, that any granular loss from any causation to include the aging cycle, reduces the ability of the shingle to withstand the ultraviolet exposures which damage shingles further. That too is naturally expected in the roof system life cycle.

We now go further than some perhaps, in saying that from a policy and policy interpretation standpoint, that there are absolutely no exclusions or limitations which would apply to limit coverage for granular loss from a covered loss event.

Now what none of the three of us have said is this, and it is an important point: granular loss alone absent other symptoms of hail damage or hail exposure would not trigger indemnification of loss. In other words, if Bill, Clayton or I were to inspect a claim for a reported loss from a hail event, we would not recommend nor expect an indemnification payment being made to an insured for granular loss alone.

We do believe that the 'broad evidence rule' accepted in most state's courts requires a full review of all evidence on the part of an insurance carrier and therefore an adjuster in making coverage decisions involving damages from a covered loss event.

As an example, suppose you inspected a loss which involved a completely new roof, and discovered extensive and severe hail damages to vents, flashings and other building components, but for the life of you could not readily observe bruising or indentations but did notice significant quantities of granules in the gutters and downspouts. Would you take 'all' of those factors into consideration before deciding whether to recommend payment or non-payment of the claim? Well, the courts have spoken on this issue, and we suggest consideration of all factors in determining loss be considered and not just visible bruising or indentations or whatever other standards you have adopted personally. Sometimes the cumulative nature of multiple factors would suggest damage and hence coverage, and sometimes it would indicate otherwise.

We agree that there is no 'scale' for determination of DV which is set in stone nor adopted as some industry standard, and likely at best is whatever subjective agreement that parties to the insurance contract can agree on.

We would suggest, that given two exactly similar buildings with the same exact roofing systems which differ only by a physical separation of 10 miles, would experience two different life cycles to their roofing systems if one risk experienced hail storms without measurably visible damage several times during a 20 year period while the other roof did not suffer any exposure to hail. A greater loss of granulation, however slight, would speed up the aging process of the shingle and thus reduce the life cycle.

And if you were to inspect a risk where every indicative factor including perhaps granular loss, damage to soft metal flashings and vents was present, yet there was no visible evidence of hail damage to the roof shingles by the unassisted naked eye, and you were aware that 90 plus percent of surrounded risks on all sides of the risk at hand had experienced total roofing loss from hail, what conclusions would you draw? Obviously your answer would be subjective.

How could you possibly argue that this risk had not suffered some dimunition in value?

And on the stand as an adjuster/witness, how would you explain your recommendation under provisions of the insurance contract? Would you honestly be able to explain to the court why you had not exercised a broad evidence approach in arriving at your decision and recommendation under such a claim?

Dimunition of value is already an accepted concept in insurance and real property law, and we suggest that you will within the next few years discover that it is one of the new frontiers of valuation and litigation which adjusters and carriers will be wrestling with and adjusters should ignore the concepts at their own peril.

Keep your eyes and ears open to the concept of dimunition of value in claims handling, for it is one of the next and newer trends in property insurance and you'll be hearing more about it in the not too distant future. Don't say you weren't warned.

Reply author: CatDaddy
Replied on: 03/11/2003 22:25:15
Message:

JimF - If I was on a roof and found damage to soft metals and some granule loss and I had totaled the NEXT DOOR NEIGHBORS houses on both sides because I found 6+ hit per square, why would I total the home with no damage? I wouldn't.

UV rays cause aging to composition shingles. There is no acceleration to the aging process from granule loss if the loss is not enough to expose the mat below the granules. If you lose a few more granules in the summer of 2000 due to hail, whats to say the shingle will ever lose another granule throughout it useful life, 20, 25 , 30 years? I've seen plenty of 25 year old 20 year 3 tabs covered in granules.

We get paid to make the tough calls too.

Reply author: CCarr
Replied on: 03/11/2003 22:25:41
Message:

Sounds good to me, and I couldn't have summarized it that well.

I do want to emphasize Jim's last two paragraphs, regarding the future of DV for first party property claims.

Reply author: CatDaddy
Replied on: 03/11/2003 22:32:20
Message:

I guess DV property claims will be the next big legal play. Good luck. There is no relationship between what we discussed earlier and homeowners claims. Atleast try it with mobile homes first; they do have wheels.

Insurance contracts clearly cover actual damage, not "what if".

Reply author: JimF
Replied on: 03/11/2003 22:42:04
Message:

CD, before you rush out to take a class in the coming dimunition in value approach, you might be better served to acquaint yourself with the already accepted broad evidence rules accepted and expected in the court system, which will serve you well later in better understanding dimunition of value.

Reply author: CatDaddy
Replied on: 03/11/2003 22:53:25
Message:

How can you make a claim for a dimunition of value of which you cannot determine?

It sleeps 6 and so does a Winnebago. Use that residual.

"Magic 8 ball, how much is his roof worth now?"

Let me know when you right that first check!

Sweet dreams!

Reply author: Fireman4528
Replied on: 03/11/2003 23:07:45
Message:

I recently attended the HAAG class entitled " Composition And Wood Roofs Damage Assessment " (very good class). It was taught that on a typical composition roof (20/25yr and 200-300lbs per SQ.), approximately 80lbs of the weight is granules. It was also taught that 20% of these granules are referred to as " hitchhiker " granules, meaning extra. That is 16lbs per SQ. These extra hitchhiker granules are placed on the shingle knowingly, by the manufacturers due to the granular loss sustained during shipping and installation.

I believe that some of the granules found in the gutters are from just that, installation. This is not going hold true in all cases but, in some, the first storm big enough to bring these granules out of the gutter and down the downspout just so happened to be the one that contained small hail. Thus the claim being filed. Has anyone worked a claim that was filed when the insured looked into his gutter after a new roof was installed?

Also I bet that if it were a fairly new roof, and it was possible to catch, or gather all the granules that have been lost from the roof, and weighed, It would not reach the 16lbs per SQ that are expected to be lost by the manufacturer. Remember this is without any concideration for loss of ganules from any type of wear and tear. That has not even been addressed in my post.

As far as coverage goes, I think we need to determine whether or not there is damage, before we can address whether or not there is coverage for it.

Just my 2 cents. Be kind.

Reply author: JimF
Replied on: 03/11/2003 23:09:25
Message:

Oh come on Cat Daddy, you know we'll arrive at a determination of value for dimunition of value under the insurance policy in the exact same way we now do in property claims and under most liability claims, as precisely and subjectively as we possibly can.

Valuation appraisal is an art and not a science.

Reply author: Dadx9
Replied on: 03/11/2003 23:10:12
Message:

I think the phrase is 'direct physical damage'. I use the following formula. I've had zero arguments.

How much granules did you find in the gutters and / or on the ground? Would you say a five pound sugar sack full? Maybe two sugar sacks?

A square of 20 year three-tab weighs approximately 210 pounds. 1/3 or 70 pounds is the chat or granules. Let's say your roof is 20 squares. The granules on your roof represent 1,400 pounds. A 20 year roof looses about 5% of its granules every year. 5% of 1,400 pounds is 70 pounds. Did you find 70 pounds of granules?

Of course you can amend this to any type of shingle. It helps eliminate the discussion of the unknown. (You can't prove to me that the granule loss didn't effect the age of my roof!). That question is never raised when I take the bull by the horns.

Saying that. Granule loss when found in additon to collateral damage (especially some hail bruising)helps settle the issue to total the roof. Excessive garnule loss sometimes makes the repairing of the roof very difficult if not impossible.

So, I look for help to substaniate my recommendation, but never on granule loss alone.

Reply author: KileAnderson
Replied on: 03/11/2003 23:11:36
Message:

But the question remains, how do you reconcile your diminution of value from hail with DV from heavy rain. In the summer of 2001 TS Alison dumped more than 20" of rain from houston to New Orleans. That amount of rain, over a 48 hour period and in many areas much more than 20", would have to move more granules than an average spring rain or even a 2 minute pea sized hail event. Are you saying that everyone who experienced this rain on their roofs now is entitled to payment for DV?

Reply author: JimF
Replied on: 03/11/2003 23:17:42
Message:

quote:

---

Originally posted by KileAnderson

Are you saying that everyone who experienced this rain on their roofs now is entitled to payment for DV?

---

Reply author: Dadx9
Replied on: 03/11/2003 23:24:34
Message:

Easy Big Fella. :-)

Reply author: KileAnderson
Replied on: 03/11/2003 23:37:37
Message:

Jim,

You said and I quote:

"Dimunition of value is already an accepted concept in insurance and real property law, and we suggest that you will within the next few years discover that it is one of the new frontiers of valuation and litigation which adjusters and carriers will be wrestling with and adjusters should ignore the concepts at their own peril."

So, follow me if you will.

Hail causes accelerated granule loss, accelerated granule loss leads to early failure of roof so roof has been diminished in value. You seem to believe that this will in the near future be an area of litigation. Well, if it's good for hail, why isn't it good for rain?

Please tell me how that train of logic in incorrect and does not match what you are saying?

Reply author: JimF
Replied on: 03/11/2003 23:53:46
Message:

quote:

---

Originally posted by KileAnderson

Jim,

You said and I quote:

"Dimunition of value is already an accepted concept in insurance and real property law, and we suggest that you will within the next few years discover that it is one of the new frontiers of valuation and litigation which adjusters and carriers will be wrestling with and adjusters should ignore the concepts at their own peril."

---

Reply author: Fireman4528
Replied on: 03/12/2003 00:14:46
Message:

I have to agree with Kile about the heavy rain. If we are talking about an accelerated granule loss that leads to early failure of roofing matterials, Whether it be small hail or a heavy rain, Whats the differance?

We are talking about a storm event that shortens the life of the shingle. Why can you not see a simmilarity in the two?

Reply author: KileAnderson
Replied on: 03/12/2003 00:26:12
Message:

Well, you are right, I don't agree with the courts on DV, they have been wrong an many other issues but that is not the point here. I accept that if that is the way the courts have ruled that is the rule under which we will all live. If you don't believe the courts are sometimes wrong please refer to Plessy v. Ferguson.

This entire discussion is based on granular loss. That's the title of the thread and that is what we are talking about.

I'm not trying to be argumentative, I'm simply trying to grasp what you are saying.

This is what I have so far.

You believe that hail hitting the surface of the shingle causes the granules to fall off. This I will grant you.

I further conclude that you believe, and I don't dispute, that a roof hit by hail, that doesn't damage the layers below the granules, but dislodges granules is less valuable the day after the storm than it was the day before the storm.

Please, correct me if I'm wrong to this point.

I think that we all agree that if we were called to a house and there is no evidence of hail damage to the shingles themselves, but there is a heavy accumulation of granules in the gutters and the downspouts, and nothing else, the house is in the middle of a hay field and no other houses are within 10 miles, none of us would pay a dime for hail damage to that roof. Correct me if I'm wrong.

Now, you said that you believe that DV will be an issue for the courts in the next several years. On this I can agree with you. So far I think we are all in agreement.

Now, the problem comes in when the new can of worms is opened. Would you not agree that if the courts ruled that under the current HO policies granular loss due to hail is a covered DV loss claim under the current HO policy, then any granular loss, due to a loss not excluded, which would include 2 feet of rain in 48 hours, would therefore be covered, would it not?

Reply author: JimF
Replied on: 03/12/2003 00:36:40
Message:

Well, just for the experience I will highlight a few differences between rain and hail:

All shingles are designed and represented to be rain proof. Shingles are not designed nor represented to be hail 'proof' (hail resistant yes, but hail proof no).

Rain is not a covered cause of loss under named perils policy. Hail is.

Insurance companies load their premiums taking into consideration the statistical probablities for hail damage while rain is not singularly afforded such consideration (absent other concurrent causation factors). In other words, carriers anticipate and expect a certain percentage of indemnification losses from hail and not from rain absent other causation factors.

Granular loss from rain events is an expected part of the roof shingle life cycle. Loss from hail damage is not expected per se. Shingles manufacturers will warrant a 20 year life for a shingle with repeated rain exposure but will not warrant for any given life given varying degrees of hail exposure severity.

Again, granular loss alone (regardless of causation) is not "A" single factor or "ONE" single factor which determines dimunition of value, but only ONE OF SEVERAL factors which should be taken into consideration by the adjuster and carrier. And court decisions and case law is already quite clear in advocating that approach (the broad evidence rule) in making indemnification decisions.

While not an exhaustive explanation, this should suffice in a differentiation for purposes of the instant discussion.

Reply author: KileAnderson
Replied on: 03/12/2003 00:47:17
Message:

While your example is true for a named peril policy, I'm reading from a SF 7955 right now and it says:

Section I - Losses Insured

Coverage A - Dwelling

We insure for accidental direct physical loss to the property described in Coverage A except as provided in Section I - losses not insured.

I turn over to Section I - losses not insured. I find no exclusion for rain.

Therefore I conclude under THIS POLICY because of the aforementioned theoretical court ruling that granular loss constitutes a DV loss, then the loss from the heavy rain event I mentioned, which occurs about as often as small hail, would be a covered DV loss.

Where am I wrong?

Reply author: Fireman4528
Replied on: 03/12/2003 00:50:57
Message:

Some insurers require that if an insured has a chimney, that it be cleaned professionally once per year. This is done to insure safety, limit the possibilities of a flue fire and related damages, and have an inspection done to know of any damages present before the next years burning season. This may be due to the one-year timetable given to file a claim. Anyway, sorry for temporarily leaving the subject. I'm getting back.

If the courts rule in such a way that insurers will have to pay DV claims from granular loss from a storm, does anyone think it may come the time that it will be required of the insured to get the gutters cleaned annually, or as far as that goes after each big storm so that the amount of damage from one particular storm can be assessed?

Reply author: JimF
Replied on: 03/12/2003 00:56:08
Message:

Ok Kile, I am with you in agreement until we arrive at your last two paragraphs as follows:

"Now, you said that you believe that DV will be an issue for the courts in the next several years. On this I can agree with you. So far I think we are all in agreement.

Now, the problem comes in when the new can of worms is opened. Would you not agree that if the courts ruled that under the current HO policies granular loss due to hail is a covered DV loss claim under the current HO policy, then any granular loss, due to a loss not excluded, which would include 2 feet of rain in 48 hours, would therefore be covered, would it not?"



I disagree somewhat with regard to the first paragraph above, in that dimunition of loss is already an established concept under insurance and real property law and has been litigated as evidenced by existing case law.

Dimunition of value cases have already been heard by the courts and carriers required to pay for dimunition of value when causation is covered by policy.

We disagree in your last paragraph above in the sense that you want to singularly focus on rain as a causation event, while my focus is on the much broader principle already accepted and acknowledged by the courts that insurers owe for damages when those damages are covered under policy provisions where there are no exclusions or limitations to coverage.

And I acknowledge, accept and embrace the unambiguous position which Clayton has so clearly as well as eloquently outlined which proffers that granular loss is not excluded from coverage by the current ISO HO policy wording.

We disagree with your last paragraph as well for the simple reason you are arguing or trying to argue that granular loss alone is enough to meet a threshold for indeminification whereas, Bill, Clayton and I do not agree with that position.

Let's be real clear here: It is YOU and not us who is arguing that granular loss ALONE should have an effect or be the determinative factor in a dimunition of value; whether you would argue granular loss from rain, hail or bird droppings.

Bill, Clayton and I would argue simply that granular loss MAY be indicative of shingle DAMAGE and economic loss.

We would argue as well that granular loss MAY diminish value of a roof.

And we would argue that granular loss MAY (under some circumstances) be COMPENSATORY under the homeowners insurance contract.

Finally, we disagree in your last paragraph in that you would ask us to make assumptions based on an ability to predict how a court might rule under one legal scenario based on a prior ruling under similar yet very different legal scenarios. We're good but we're not THAT good and doubtless no one else is either.

Whatever other conclusions you arrive at from misunderstanding or misinterpreting of the positions and statements made by Bill, Clayton and I through your own logic or any other means is your sole perogative and provenance, for which we are dispassionately ambivalent.

I hope this helps to ease your understanding.

Reply author: CatDaddy
Replied on: 03/12/2003 08:31:15
Message:

A granule is knocked off a shingle with no damage to the mat and no other collateral damage. What is the difference whether it is done by rain or hail?

Jim, you said the difference in Kile's scenario is that hail is a covered peril and rain is not. Is the difference to you just whether it is a loss you can bill for it or not? Earlier you called it the DV "approach". I think "con" would be more like it.

Newsflash! Everyone welcome in this new legal position into our industry much like you did mold, looking for the big payday. When carriers have to steamline to survive another situation like Texas, who do you think they will kick to the street first to cut their overhead? Walk down the hall, turn left, walk to the sink, and look in the mirror! Ya might want to beat the rush now and pick up that Walmart application the next time you're in town.

Keep feeding the masses with your Pelican Brief. It all sounds real interesting. I WILL miss some of you.

Have a good day!

Reply author: JimF
Replied on: 03/12/2003 08:49:10
Message:

Cat Daddy, you are the one who initiated this thread, and you are the one who asked for opinions on the question. I assumed then, obviously quite incorrectly, that your invitation to share might even include requests for opinions alien to your own.

I could care less whether you like my opinion, understand my opinion, or listen to opinions which I shared at your request.

More interestingly will be whether you listen and heed the opinions of the court.

I don't make the rules which courts insist adjusters and carriers be guided by, I merely report them.

Don't kill the messengers when you don't like the message, and don't ask questions for which you seem unwilling to hear answers different from your own.

Reply author: mshort68
Replied on: 03/12/2003 08:53:36
Message:

What court case considered diminished value on shingles? I haven't heard about it, could you elaborate. Shingles are not cars, get your facts straight Jim!

Reply author: JimF
Replied on: 03/12/2003 08:58:39
Message:

Dimunition of value is well established under case law in both real property and insurance, and no, case law for dimunition is not limited to automobiles (wherever and however you arrived at that conclusion).

Do a little research into case law for insurance and property yourself, and you might discover what we are saying.

Please rest assured I have done my research as I always do, and I have the facts straight.

Reply author: CatDaddy
Replied on: 03/12/2003 09:24:33
Message:

Jim the court reporter, please quote the court opinions on DV concerning homeowners claims and granule loss.

Also, please address my questions in my post prior to yours.

I do not mind opinions. I think everyone should have one and are entitled to it. I mind angles and selfish money making ideas that cost companies billions while other sit back thinking they are gonna get rich off of it.

And I dont kill messengers. If I did, some folks doorbells would already be ringing.

And this is just MY opinion.

Reply author: JimF
Replied on: 03/12/2003 09:38:16
Message:

Cat Daddy, I assume you have access to the same case law research resources that I do, and you have the same opportunity to do your own research and agree or disagree with what your research reveals.

I learned a long time ago that education in any subject is eased by having an open mind and a willingness to listen to opinions and experiences alien to my own.

Do whatever research you want or none at all.

Believe what you read or ignore it, chastising sources as you disagree.

Adopt and maintain the habit of making fun of and attacking personally those who's views differ from your own and remain oblivious to change around you.

Seek awareness of the trends ahead or stay with the comforts of life as you know it.

The paths ahead are as clearly individual as they are treacherous, and only through an individual's research and initiatives in understanding can one be adequately armed to make the tough decisions in choosing among difficult personal paths to follow.

Change comes whether we, you or I like it or not.

My case on the topic is rested.

The rest is up to the decisions of the courts and to the decisions you elect to choose in either following or ignoring them.

Good Luck.

Reply author: CatDaddy
Replied on: 03/12/2003 11:50:11
Message:

What court decisions? I asked you a direct question and I get "changes comes whether we like it or not" and "seek awareness of trends blah blah". Atleast you havent changed.

And Jim, I am not making fun of you. I am asking you questions while stating MY opinion about the DV issue. And certainly this has nothing to do with you. You are reporting things you say you've read. A source, no. I would not expect you to be personally involved. So if you took it personally, that was your choice. As you say so much, I really dont care.

Paint it however you would like. Do you really think most people care if DV is a coverage issue for the insured? Please dont be that stupid and pretend I am too. People want to make it an issue so that they can profit from it. How many cats have you worked and you refused your paycheck because YOU just do it 'cuz you love it and care about people. LOL!

Please! Sell crazy somewhere else.

Reply author: Linda
Replied on: 03/13/2003 01:05:04
Message:

After now reading approximately 4 pages of some very excellent posts and some not so great; I have now forgotten who in the previous pages felt we, as adjusters, should provide the Insureds a copy of the Haag book on composition shingles. Sounds great but who is going to pay the approximately $40 for each one including freight, give or take a dollar or two? Not me. I will show them from my copy but there will never be a day when I furnish them a copy to keep, show their roofer, contractor, etc. One that actually has better photographs and used to be free (I'm assuming still is if it is in print), was one from Owens Corning addressing these same issues. The conclusions from Owens Corning is exactly the same as Haag.

I am not trying to "put down" the person who suggested this, only to make them aware of the cost of these books. All of the material in Haag's books is copyrighted so I don't advised anyone to attempt to copy them.

This is a great thread. I wish we could have more like this.

Hope to see you all at the CADO Convention!

Reply author: Ghostbuster
Replied on: 03/13/2003 09:17:52
Message:

For the fine souls that toil for the Big Red Machine, they put out a pamphlet that touches on the various kinds of roof damage that is and is not covered. It's not only free, but encouraged to be handed out to the Insureds.

Reply author: CatDaddy
Replied on: 03/13/2003 09:51:15
Message:

Ya cant beat free!

Reply author: mgkmrp
Replied on: 03/13/2003 14:00:07
Message:

i agree with the diminuation of useful life and loss of economic value to the insured property. in the case of loss of granule or loss of life caused by the the hail event, an adjuster is operating in grey area like it or not. It is our job to equate the loss to many factors according to the individual circumstance of that loss and the policy-be fair and close the claim.
---i have endured the learning curve to a certain point-i still wrestle with the parameters of this one from time to time on certain losses. i can say though, without be able to put my finger on it, it gets easier with the closing of the next 100 claims or so.

Reply author: LarryW
Replied on: 03/20/2003 07:50:25
Message:

OK, let's accept that dimunition of value is determined on a given loss. While it may be difficult or impossible to measure accurately, that should not matter with the wording in most of the policies we encounter. It is much the same as the old "appearance allowance" which most carriers have abandoned as a settlement tool. If we determine that damage exists(diminished value) then the insurer's obligation under the contract is to repair or replace that damage (the insurer's option). So as an adjuster (insurer representative), it would seem we have one of those two options available to address the damage. Either repair the damaged shingles or replace them as economic logic might dictate.

Reply author: CatDaddy
Replied on: 03/20/2003 08:11:08
Message:

Considering for a moment all the world agrees that granual loss causes DV to an insureds roof after a hail storm. If a carrier is going to address it, it has to be done according to some type of agreed upon scale of measure. You cant have adjusters "haggling" with insureds, "ok, how about $500? Well what about $600? Do I hear $1000?" Doing this leads to compromise and there is no policy language for compromise. That's why you dont see appearance allowances anymore. The claim rep is basically asking the insured to take less than he is entitled to per the contract. It leaves a carrier wide open for a bad faith lawsuit.

Without a scale to determine if and what possible DV a roof experiences due to a hail storm or some other covered loss, no one is qualified to pull figures out of the air to pay for such a loss. We've all climbed 1000's of roofs but without any previous research or additional information from shingle manufacturers, its just a guess, regardless of experience.

Reply author: ChuckDeaton
Replied on: 03/21/2003 18:21:06
Message:

How about submitting shingles to a testing lab to determine whether or not they are damaged. Has anyone had a lab look at a shingle under high magnification? Can anyone comment regarding viewing shingles under high magnification?

Reply author: katadj
Replied on: 03/21/2003 20:28:41
Message:

There is an established amount of granule weight applied to the mat in the final shingle making process. The "supposed" retained weight is a known factor to the manufacturer. This information is redily available.

So, if the "supposed weight" of the retained granules on the finished product is say 200# per SQ, and the shingle is supposed to loose 2-4 % PER ANUM by natural causes, then any loss over and above that published percentage may be a case for a DV claim.

The roof is 5 years old, the normal loss average is 3% per year or a total of 15% OF 200# or 30# per SQ.

SO, if we weigh the shingle and if the weight loss is calculated at 60# per SQ then we have a 50% DV claim?

Or, can we request the manufactures to come up with a methodology that will be acceptable to all parties, that will stand up in court?

Do we need a standard?

There are always two sides to a fence, and we have the repsonsiblity to view both sides and make an informed decision. This can only be done by having the proper substanciated information.

Of course this may not apply to all types of shingles, especially the laminated ones, or the Super heavy weights, or specialty applications, or maybe "T"locks.

Some one please come up with an easy, correct, and viable annser.

What fun........................................

Reply author: CCarr
Replied on: 03/21/2003 21:58:38
Message:

Dave, using your math and applied logic, which I do think has merit; the DV loss would be 15%, and not 50%.

Using your example, you took a product whose age (without prior incident), carried an average accumulated granule loss of 30 pounds, or 15%. Then, you applied an 'event', which after your "weight test", provided a net loss of 60 pounds, or 30%; which is a 50% increase, but only a 15% DV.

Now that the 'dust' has settled in this thread a bit, I might add that I have heard of insurers up here exploring with technical vendors, in regards to some type of calibration system for claimed as damaged composite asphalt shingles. I don't know to what extent that study is at, other than being told it's a fairly new project. It has similarities to ITEL testing of carpet, though the results are being oriented towards calibrating extent of damage; through non-destructive analysis.

Do we need a standard? Yes we do.

If and when a standard is created, that has credibility, I'm sure at first it will be limited to the most common types of CAS; to capture the volume applications.

Reply author: Manmut
Replied on: 03/24/2003 09:03:45
Message:

Actually, before we end the discussion on Diminished Value, I'd like to raise some coverage issues. A challenge went up to quote court cases, so I did some research on the PLRB website in response. It seems that Diminished Value is not necessarily considered covered by the courts. In California, the courts have ruled that diminution of value is not an insurable peril, but rather a measure of loss. In Hoffman v. State Farm Fire & Cas. Co. the appellate court ruled:

"The original claim for diminution of value because of the
property's location in a landslide area was without merit. Property
insurance covers losses caused by covered perils, which are
"fortuitous, active, physical forces such as lightening [sic],
wind, and explosion, which bring about the loss." 19 Cal. Rptr 2d
at 812 (quoting Garvey v. State Farm Fire & Cas. Co., 770 P.2d 704
(1989) [reviewed at PLRB, Prop. Ins. L. Rev. 3084 (1989)]).
Diminution in market value is not only not a covered peril, but is
illegal in California per Ins. Code, sec. 12660."

In State Farm Fire & Cas. Co. v. Superior Court (Aegea), the appellate court made a sharp distinction between diminution of value in liability claims and property claims. It confirmed that the 'cause' of loss in a property insurance contract is totally different from that in a liability policy. Liability policies, the court said, determine whether there was an occurrence for which an insured was liable. Property policies determine whether there was a covered peril. Finally, the court observed that "'diminution in market
value' is not a 'peril' at all; it is a method of measuring damages."

Reply author: CCarr
Replied on: 03/24/2003 09:10:40
Message:

Pat, I don't think that anywhere in this thread, that DV was ever considered as an insurable peril.

The context of the evolution of DV in this thread, was as a measure of loss; as a result of damage from an insurable peril (hail).

Reply author: Manmut
Replied on: 03/24/2003 12:36:54
Message:

Ah, my mistake. Still, it is instructive to see how the courts have addressed the issue of diminished value, even though such rulings are limited to the scope of excluded losses.

I accept that excessive granule loss resulting from hail is a covered loss. The problem, in my humble opinion, is that the insured must prove that the granule loss is, indeed, excessive. Additionally, the insured must prove that the excessive granule loss is a result of the hail storm. Finally, the insured must prove that the granules they are showing me in the gutter are there as a result of the hail storm, and not normal build up from normal wear and tear.

I think that if the insured was able to prove that the hail storm caused excessive granule loss that decreased the life expectancy of the shingles, I would be willing to pay for the loss. I can see hail hits and differentiate them from normal wear and tear (as well as ball-pean hammer hits), however, I cannot differentiate between granules that have gotten into the gutters from hail storms and those that have gotten there as a result of rain storms. The issue becomes especially clouded if you can't get to the roof for several days or even weeks following a hail storm. How much granule loss has occurred in that time that is normal?

Again, I agree that it is a covered loss, but adjusting such a loss is tricky at best. The onus falls on the insured, not the adjuster. to prove their loss. It brings to mind situations where the insured has to hire an engineer to prove to the insurance company that a house is structurally unsound. While it inevitably engenders hard feelings from the insured, it is well within the insurer's perogative to expect the insured to obtain such a report before extending coverage.

Reply author: CCarr
Replied on: 03/24/2003 13:25:31
Message:

Pat, in your acceptance of the principal advanced concerning DV, you then say that;
(a) "the insured must prove that a granule loss is excessive"
(b)"the insured must prove that the excessive granule loss is a result of hail"

What you are saying there, if the policy was interpreted and exercised to its exact intent; is true. However, why wouldn't, in reality, those determinations be made by the assigned adjuster; no different than currently happens thousands of times a year for wind or hail losses to whatever kind of property?

Very seldom in today's claim world, does an insured have to 'prove' anything; especially with weather related claims. It is the common practice of insurance consumers to phone and report a weather related claim, even without having any idea if in fact actual damage exists to their covered property, or what property is covered, or for what it is covered for. Adjusters for years, have gladly accepted these assignments, and gone about their business to determine if there is any damage, and whether that damage is to covered property; and by a covered peril.

I suggest, that when DV becomes an acceptable component of property loss, that there will be "tools" and guides for adjusters to utilize; for their determination of any and all points you suggest an insured would have to prove.

Reply author: JimF
Replied on: 03/24/2003 13:26:37
Message:

The point is not how many granules are in the gutters but the amount of granules missing from the shingle. The former may be indicative of the latter, but the question of DV centers on the latter.

I do think that Dave Hood is approaching the real problem by concentrating the emphasis on testing and laboratory analysis of the shingle to determine granular loss and that Clayton Carr is correctly approaching some processing under such DM loss and value by suggesting the adoption of some accepted determinative standard for measurement of loss and value.

Reply author: Manmut
Replied on: 03/24/2003 14:08:10
Message:

Clayton,

I agree that the adjuster has a responsibility to scope the loss and make a coverage determination. I don't see, however, how an adjuster can determine that a roof has experienced excessive granular loss as a result of a hail storm without knowing the pre-storm condition of the roof shingles or knowing the average amount of granular loss the roof normally experiences.

All I'm suggesting is that, short of some pretty convincing evidence, I'd be forced to deny any claim for granular loss until the insured could prove otherwise. Now, if the insured shows me that the roof is relatively new, and the granular loss is fairly substantial, I'd be happy to pay the claim. I would guess that on a majority of such claims, excessive granular loss due to the covered hail storm, would be a difficult, if not impossible, thing to determine. To me the key is proving that the hail storm caused the excessive granular loss, which would have to involve ruling out all other possible causes, including rain or wind.

I guess all I'm trying to do is find the "accepted determinative standard for measurement of loss and value" that JimF has referenced in his recent post. Beyond having something like that available, and barring an incredibly obvious loss, I don't know how an adjuster could be expected to make a positive coverage determination on such a loss. Laboratory analysis can prove that there is excessive granular loss on the shingle, but can it prove the cause of that loss?

Reply author: CCarr
Replied on: 03/24/2003 16:23:57
Message:

Pat, I fully agree, that at this point in time, the DV issue in regards to property claims; is truly a 'stump the chump' type of problem.

However,
(1) When "tools" and / or an analysis method is available and credible, to consider an asphalt shingle; along the lines of the testing I mentioned in an earlier post

(2) When DV has a defined and credible method and standard to measure its loss, in property claims; specifically for asphalt shingles

(3) When DV is an accepted component of property claims;

it will be a 'new world' in the continuing saga of the adjustment of property claims.

I'm not sure of the exact age, but the concept of "replacement cost coverage", was an equal 'demon' to insurers, when it was being discussed and argued whether or not it should be added to a policy wording. I think that it was only 30 some years ago.

Also, think back about the advent of vinyl siding, and all those that were negative about it ever replacing aluminium siding; that's less than 30 years ago.

Also, look at the "tools" we now have to work with as adjusters. I don't recall any computer estimating programs even 20 years ago.

Also, the Haag data was not as sophisticated, detailed or as credible; 15 years ago.

Also, the function and service ITEL provides, I don't think was around 10 years ago.

There is change going on all around us, that affects the adjustment of claims; the next "tool" or analytical method is not far away.

Reply author: olderthendirt
Replied on: 03/24/2003 20:12:41
Message:

First we have itel. Now we can have r-tel. A bunch of us should get together and sell big red the good hands and FIG on the idea and have them courier shingles to us, we'll identify and weigh them and send a report for $50. Should be able to make money.

Reply author: tomgriffin56
Replied on: 03/25/2003 11:01:50
Message:

We can do better than that, if I'm not mistaken ITEL was charging about $100 bucks per report.

Reply author: katadj
Replied on: 03/25/2003 13:32:56
Message:

The presence of granules in a gutter, may or may not be indicative of excessive loss due to a covered peril, (i.e. Hail).

The way the gutter is installed has much to reveal about the occurance.

IF the gutter is installed properly, and is sloped about 1/4 inch per foot in any direction, then the "normal" granual loss from wind, rain, will be washed out of the gutter, leaving it clean.

IF, when inspected this is the case and you have an excessive amount of granules accumulated, you can be comfortable in determining that this excessive loss is due to the recent occurance.

When the gutters are installed level, and not pitched, all of the granules will not be washed out and you can find as much as 1 inch or more of accumulation. This is not a true indication of the amount of loss.

It is necessary to put a level on the gutter to see if it is, indeed, pitched, this is adviseable if you are going to consider the loss as a reason for repair or replacement.

One of the first steps in the new R-Tec is going to be the inquiry of all of the shingle manufactures as to their expected "loss per anum percentage". This information, when compliled and digested will provide a benchmark for the expected acceptable loss of weight.

Remember that "ALL" of the granules are not ever going to be lost. There are opinions that vary, but for the most part, the shingle will never loose more that 50% of the total applied weight over the life of the product.

Another consideration in the examination is the loosening of the granules from the impact to the mat, but not necessarily the removal due to the impact. The granules will be removed easier by a heavy rainfall, if they are loose.

We have yet to approach a DV claim as a normal occurance , but it will raise its head, one day.

Either the roof is damaged or it is not, Why do we have differing amounts of "hits per SQ" necessary to replace a roof. Which of the carriers wants 6 or 7 or 8 or 10 or 12? These are standards that have been set, but based on what scientific measurement?
IMHO, the whole approach to roof damage and the policy requirement to restore the risk to the pre-loss condition needs an overhaul.

[^][^][^]

Reply author: Newt
Replied on: 03/25/2003 18:53:56
Message:

It seems that with all the different standards and statutes on roofing, its a wonder any one can be sure they wouldn't get a kickback on every one, especially on one with partial damage. Loss of granuals starts happening when the roof is being installed. The trafic and handling also takes a toll. If the roof makes a bad picture it may still be good, and if its a good picture it could still be a bad roof. I agree with KATADJ it needs an overhaul and some specifics spelled out in the policy, with standards. The adjuster is expected to do a job that is not spelled out, other than hits etc.
As it stands, the insured expects a new roof if he has any damage, and a good lawyer will get it.

Reply author: CatDaddy
Replied on: 03/25/2003 21:04:41
Message:

Newt, am I drunk or am I seeing the same post twice from you?

I agree with Katadj that someone will take a stab at this issue some time in the future. The court case from California shows that this is not a new idea and the decisions in that case will be referenced in the future also.

Without any standards or research on the subject, it will all be smoke and mirrors but ya never know. Stranger things have happened. The factors involved are endless and some impossible to determine. Who knows, 30 years from now, an insured can mail in an envelope full of granules and we'll put them a check in the mail.

Reply author: inside man
Replied on: 03/26/2003 07:57:43
Message:

The way an IA performs his job is spelled out by the carrier since ultimately they hold the check book.
The carrier that I primarily work for will not pay for granular loss and will not pay dimished value claims on roof. The shingles themselves must have hail damage to them ie: impacts and/or bruising. The insured is paid the appropriate dollar to repair the roof, replace specific slopes or to replace the whole roof (if over 50% of the roof area is being replaced then the carrier will pay for a full roof)
As long as the carrier's instructions are ethical and remain within a tolerable level of you own personal beliefs of proper claims handling I would suggest you keep your mouth shut and do what you are told. Let's remember who is signing your paycheck.
Adjuster's who stand around the CAT office and try to change the site manager's opinions regarding such a grey area as granular loss will be packing up and going home early.

Reply author: CCarr
Replied on: 03/26/2003 08:53:46
Message:

Hey Steve, the 'inside man', welcome back.

I certainly hope that not too many people following this thread, will be inclined to start twisting the arm of their vendor storm boss; regarding granule loss or DV. This issue has absolutely nothing to do with any vendor adjusting company.

As this issue evolves, well past any discussion on this web site, it will be the carriers who will consider and determine the genesis of the concepts discussed here; and in turn advise their vendors accordingly.

We will look back some day with amusing interest on one of your statements, Steve; that is generally echoed by most at this time. That is, "the shingles themselves must have hail damage to them i.e. impacts and/or bruising". What that statement says, is that damage only exists, when it is visually identifiable, using current and basic means of eye contact; without any supporting technical or mechanical means of measurement.

That is somewhat akin to sitting in a boat on a lake, in 10 feet of water; and not being able to see the bottom, concluding that it must be polluted.

A "tomorrow" ahead of us, will provide more refined technical methods to determine "damage" to composite asphalt shingles.

Reply author: katadj
Replied on: 03/26/2003 09:13:22
Message:

Whomever said our job was easy, must have been under the influence.

We have to please EVERYBODY, the insured, the IA vendor, The carrier, the storm manager, the examiner, and all we have to do is be a robot?

It is incumbent on all of us to "do the right thing", and treat the loss as what it is. A direct physical loss is a covered peril, period.

Hopefully, one day soon, the carriers will start to treat the insured's the way they would want to be treated, had they a loss on their own property.

Those that choose to be led around by the nose are welcome to do so. [xx(]

Those that choose to do the proper job, may find themselves not working for some carriers, but really proud of themselves.[:D]

Sure, they sign the checks, and while they are always the BOSS they are not necessarily always right, nor always ethical.

"Unto thine own self , be true".

Reply author: inside man
Replied on: 03/26/2003 09:15:52
Message:

Thanks for your thoughts CC. It's good to be "outside" again !!!

Has anyone heard of a testing process in which a shingle is removed from a conspicuous area of a suspected hail damaged roof, the shingle is stripped down to the matting (either chemically or by scrapping) and then the matting is examined for holes which would be caused by hail. If holes are present it is concluded that the shingle and therefore the roof is hail damaged and should be replaced (or at least the slope that the shingle was taken from). If the matting was not penetrated the claim was denied. I used this testing process several times while I was a staffer for NW in Charlotte NC. I can't remember the names of the people that did the testing but there were two different companies that did it for us.
In retrospect, after obtaining a great deal more experiance handling hail claims after joining the storm adjuster ranks, it seems to me that this would be a faulty process since only one shingle represents a very small portion of a roof slope and to a greater extent the entire roof. Hail could certainly damage a roof and miss one particular shingle quite easily. This process was successfully used at that time but I have no idea if this practice is still employed.
Anyone have any experiance with this testing method? Does anyone else see the faulty logic that I think exists here?

Reply author: Catmandale
Replied on: 03/27/2003 00:23:51
Message:

Steve,

I think that it is indeed very possible that the single shingle you tested may have been missed entirely by hail. Hail varies in size, force and volume in any given storm. It may be difficult to discern a pattern. It might be prudent to test shingles with obvious hits along with shingles that show minimal mat exposure.

I still say that granular loss that results in exposure of the mat is damage and should be compensated. In that scenario, the issue of Diminished Value is moot because there is a direct phyiscial loss, only the extent of damage is at question, ie...in my opinion, exposing the mat leads to early failure of the roof system, in the same waya bruised shingle does.

It seems to me that the argument over Diminished Value comes up when it is a purely economic loss - such as when a car has been damaged then fully repaired, and the "stigma" of the crash results in a someone seeing the vehicle as less desirable than one which has not been in an accident.

Mold claims may have this effect on homes which have had water damage and repairs. A buyer may be wary of a home that had stachybotrys(sp?)even though it was remediated. This is not really a perfect comparison as there is some evidence that mold spores may remain dormant in a small colony only to bloom again when water is re-introduced.

As to your comment about keeping the mouth shut and doing as you are told...if only I had more common sense and less conscience. If issues are not discussed, things will never change. I think that few of us here are sheep to be led about by the nose. We wouldn't be hanging out here if we didn't see the big picture.

Dale Strain

Reply author: jcc1138
Replied on: 04/09/2003 18:51:26
Message:

In looking at the issue of DV and Granule loss, are we also seeing an issue of possible payments for issues where the policy is being used for what could be minor issues, rather than for the larger losses that it is priced for?

I have seen a rise in the desire for insurance to be used as a maintenance policy, which keeps me busy but makes the costs go up.

In talking to Certainteed on an issue of a roof, they advised me that they did overflood the granules onto the roof and that granule loss is expected. We are talking about grains that rely on the asphalt to hold onto the substrate. I would look at the amount of the granule loss versus the exposure of the substrate before getting into a DV (or cosmetic allowance for the older adjusters) issue.

Reply author: RicVitiello
Replied on: 12/16/2003 11:58:11
Message:

Hail damage on a shingle roof is a specific and identifiable blemish just as a dent in an automobile surface would be. No dent = no damage, even though just like on the roof, sun, rain, snow etc. will weather the surface and all take an unmeasurable toll on the survice life.

Ric Vitiello
Senior Roof Consultant
Donan Engineering Co.
Louisville KY

Reply author: Newt
Replied on: 12/16/2003 18:07:56
Message:

Has any one done a hail claim on damage over six months old? If you have, did you find the damage harder to identify? I did and it was dificult, it reminded me of tracks in the snow, the hits no longer look like hail hits. I think it would depend on the type of shingle as to how the damage shows up after six months. The shingles I had a problem with were laminated, arch.
They had gone through a summer before inspection, I think this made a difference. There seemed to be a greater granual loss around the damage.

Reply author: trader
Replied on: 12/16/2003 18:09:48
Message:

Thanks Ric, but; you did not speak on the biggie "too old and brittle to replace-repair".

Reply author: leoncrow
Replied on: 01/15/2004 12:05:01
Message:

If insured wants paid for granules, pay them a loss of value. Be sure to explain that if a storm takes the roof the following year, the loss of value will be deducted and a second deductable taken.

Reply author: trader
Replied on: 01/15/2004 12:36:09
Message:

Disagree 100% with Leon. Forget loss of value, its 100% or 0%

Reply author: catmanager
Replied on: 01/15/2004 14:13:51
Message:

I agree. How do you accurately gauge granular loss from one event, excluding all prior events and which carrier endorses that settlement method?

Not attacking you Lean, but we shall show you the way.....if you want to follow

Reply author: leoncrow
Replied on: 01/15/2004 16:11:30
Message:

Would you pay 100% if an insured called you after a rain storm. How do you determine loss of value, 20 year shingles cost x-amount. Make your best determination of amount of granular loss aa divide into 20. We make determinations of use life all the time. I in know way think that granule loss without shingle damage should be paid.

Reply author: catmanager
Replied on: 01/15/2004 17:51:12
Message:

Leon, if you had an event that caused granular loss on a five year old roof, if there was actually a carrier that allowed you to do so, your method of determining granular loss is flawed.

You are forgetting that normal wear and tear and prior granular loss that occurred in the first five years is not covered by the single event that brought you to the roof in the first place. Sudden and accidental occurrence, eh?

My point is even if you were to be working for a carrier that would allow that (name them please), since you would have no idea what amount of granular loss occurred after the roof was installed but before your event...do you see where I'm going?

If you do not agree with paying for granular loss anyway, what are we even discussing here?

Reply author: jlombardo
Replied on: 01/15/2004 18:34:57
Message:

Catamanger
He is from South Dakota...He is trying to stay warm by moving his fingers on the keyboard.....and here I thought you were so observant!!!!LOL LOL

Reply author: trader
Replied on: 01/15/2004 19:22:27
Message:

Cold day subject. If the composition roof shingles weight is split like the mfg states in 1/3 rds. matt 1/3, asphalt 1/3, crushed slate 1/3 and per sq. is 220 lbs. How much DV do you have on a front slope with 10 sqs with a full gutter across the front, the roof is 5 years old, the gutters were installed with the roof, and have never been cleaned, and the homeowner/contractor can show you 2 1/4 inches of slate in a 13 oz coffee can??? Lets never hear the word "loss of granules" in Texas . If we do hear this word we will track you down and burn your license with Marvin Zindler (Channel 13) recording the event on the steps of the "mold office"

Reply author: leoncrow
Replied on: 01/16/2004 10:17:29
Message:

sunny and 40 degrees today,trader hows the mold going in texas.

Reply author: Brooks Todd
Replied on: 02/04/2004 13:14:01
Message:

of course excessive granular loss is roof damage. The tire example is ridiculous. A staff adjuster from an un-named carrier, told a homeowner that story and we both had to laugh. Still didnt get the guy a roof though. His is really damaged

Reply author: trader
Replied on: 02/04/2004 13:56:11
Message:

Wish some sleet would come thru Houston, marble size hail would be better. This would stir up all the 10 year and over composition roof owners .And me some work for two months. Mold Gold, Gone Gone Its going to be bacteria from grey water this year. But the HO-A form killed this off also. Theft claims still need eye balls(sometime).

Reply author: KileAnderson
Replied on: 02/04/2004 17:30:37
Message:

Please explain to me how the tire example is ridiculous. I think it is completely analogous. A tire is a wearable surface, a roof is a wearable surface. Please enlighten me.

Reply author: khromas
Replied on: 02/04/2004 18:04:39
Message:

Talked to my State Farm agent the other day and found out that they are requiring 2% deductibles on Windstorm/Hurricane/Hail peril on all renewals they write. Think that will have a significant impact on hail claims getting filed in the last month of the old policy term? {Personally, I need a good hail storm ( a legitimate one! ) here on the near west side of Houston before May 1 so I can get rid of my comp over wood! I say 'legitimate one' because I keep getting the "roofer" letters claiming they got covered roofs for my neighbors for hail damage. While I was staff at Big Blue, I denied many here in the neighborhood 'cause I knew we had NOT had hail big enough to damage. They actually changed their assignment policies so that you would not have to get claims in your own area for your neighbors.}

Reply author: trader
Replied on: 02/04/2004 18:26:46
Message:

-What form HO-3 or HOA-M (Texas) O boy glad I am not a contingency roofer, well that would beat sitting at home, give it a shot Kevin, you have heard the spill many times.

Reply author: rorunner_77
Replied on: 02/04/2004 22:25:00
Message:

Would not granules piled in gutters 2 or more inches thick prove that the loss was due to an event such as hail or would there have to be let's say denting of turbines etc.

Reply author: CCarr
Replied on: 02/04/2004 22:33:03
Message:

Wow rorunner, dig back into this thread a few pages. Your question was - how do I say this - dealt with extensively and with passion and in great detail, in the previous pages of this thread.

Reply author: rorunner_77
Replied on: 02/04/2004 22:36:04
Message:

You all have been incredible in covering this topic. Sorry about my last post I missed Jim's post earlier

Reply author: Tuckernotis
Replied on: 02/27/2004 17:46:15
Message:

First off, I'm a HO not an adjuster. I'm doing my research so I can have a better understanding of the process and my recourse with the insurer. Secondly, we received a hailstorm on 2/27/04, two days ago, in Bayou Gauche, Louisiana. We were hit with 2" to 3" (minimum of golfball size, maximum of baseball size) hail for approximately 4 minutes. I have a 9 yo, single tab, composite shingle roof with a fairly steep pitch. The hail came straight down. Now, the hit marks are easily visible to the naked eye at any angle. It is a medium color brown roof and the hit marks are lighter in color and visibly indented. The inspector came out and said there is no damage to the roof. The hit marks are just the algae that was knocked off changing the color of the roof. He did not pry up any shingles to see if there was dimpling under the shingle. There was not an inordinate amount of granule loss, that is all he wanted to talk about. He said that hail damage was determined by the granule loss. My question therefore is, how can you tell what "bruising" is without lifting the shingle and after reading this entire thread, how does no granule loss affect his decision? Is it possible that 3" hail cannot cause hail damage to a 9 yo roof? Can I get a copy of the Haag Eng. book that defines hail damage besides what I've found on the web? Now I know better than to ask a roofer's opinion. Conflict of interest no doubt. Thanks.

Reply author: Johnd
Replied on: 02/27/2004 22:23:04
Message:

Karen Gray
Call back for a re-inspection if there is visible damage to your roof. Did the adjuster actually climb up on the roof and inspect? Did he do a "test square" with (sidewalk) chalk on a 10' by 10' section of roof? Do you have visible algie covering the entire roof where hail would knock it off at each impact point? Do you have any other damage to your dwelling, ie: doors, screens, windows, soft metal trim or siding, plastic dryer vents, aluminum gutters etc.? Walk completely around your home and look for any other damage. Do you have any weather reports on the hail? AND hail damage IS NOT only determined by granule loss which could be minimal in a large stone brief duration event.

Please supply this information and maybe we can help.

Reply author: KileAnderson
Replied on: 02/27/2004 23:13:49
Message:

Karen, you posted on 2/27/04 and said the hail storm was 2/27/04 and that it was 2 days ago. I can only assume that you meant it occured 2/25/04.

I am an adjuster from Baton Rouge. I am not in the state at the moment, I am working a hail storm in another state. I had not heard of hail damage so close to home.

I noticed you said that the impact marks are lighter in color than the rest of the roof. Usually hail damage is darker in color because it has displaced granules and exposed the asphault underneath. If it is lighter in color it could be just as the adjuster said that mildew has been knocked off the roof and the shingles are not damaged. Being that we have nearly 100% humidity all the time mold and mildew are quite common on roofs in south Louisiana. I have not seen your roof so I cannot make a determination and it may very well be that the adjuster was wrong. I can't tell without actually seeing it.

Is it possible for you or someone you know to get up on the roof or at least to the top of the ladder and feel the impact marks? Don't try this if you can't do it safely, but if you can feel a depresion in the impact mark or if it is softer than the rest of the shingle you probably have hail damage. If the hail was as big as you said it should be fairly easy to find damage to your roof. Were your cars or your neighbors cars damaged? Did you pick up the hail? Some hail is hard as concrete and other hail is soft and almost slushy. Large soft hail could impact a roof and not do any damage other than cleaning off the spot that it hit. Have any of your neighbors had any damage to their roofs? All of these questions as well as John's above would greatly help us help you on this issue.

Just curious, who is your insurance carrier?

Reply author: goose
Replied on: 02/27/2004 23:45:48
Message:

Kile, there was some in LA on 2-25-04.
http://www.spc.noaa.gov/climo/reports/040225_rpts.html
I haven't heard if it did anything or not.

Reply author: gloverb
Replied on: 02/28/2004 09:04:24
Message:

Is granule loss on a roof covered? Only if cosmetic damage is covered. Just attended a Haag seminar directed specifically to roof damage. He spent a large amount of time dealing with granule loss. Conclussion was that the loss of granules is cosmetic does not affect the integrity of the roof. He showed a lot of the engineering behind this conclusion.

The primary purpose of granules is cosmetic, not structural. You could lose 100% of the granules on the roof & still not affect the water repellent purpose of the shingle if it is not otherwise damaged.

The amount of granules represents about 1/3 of the weight of a shingle on a 3-tab roof, less on heavier shingles. This is about 2000lbs of granules on a typical 25sq roof. So, if all of the gutters are filled with granules does this represent a significant granule loss?

Shingles lose granules in every rain storm. Is the roof damaged? Of course not! If an adjuster is determining hail damage by the amount of granules in the gutters he better be looking for a new profession. Damaged shingles are bruised, broken, cracked, chipped, etc.

The loss of granules is normal wear & tear on the roof.

The Haag guy gave some examples trying to illustrate the problems with determining granule loss & how it affects a roof. He said that you can measure the shingles from a new bundle, & there will be a 5-10% difference in the amount of granules in the same bundle.

He stated that they pull shingles to measure for "excessive" granule loss. On the same roof they also pull the starter shingles & measure these. As you know the starter shingles are put down along the edges of the roof & are totally covered by shingles;so, the starter shingles are never affected by the weather. These starter shingles show almost the same amount of granule loss as the so called damaged shingles.

On a test roof Haag installed shingles upside down, granule side on bottom, asphalt side on top. Other than discoloration by the sun the roof is in perfect condition. Roof was put on 11yrs ago.

Kyle, your example of wear & tear on tires is perfect. I think Brooks must be a roofer.

Reply author: Tuckernotis
Replied on: 02/28/2004 11:00:04
Message:

Thanks for the quick replies. In answer to most of the questions. Yes. We've been on the roof, the inspector was on the roof. I've tried to upload a photo of the roof and the hail but keep getting errors. Thee is definitely a depression in the shingle on most of the hits. Everyone's cars were trashed as well. Neighbor even got a nasty cut on his head trying to save his truck. The NOAA website earlier shows the path of the storm. We are the Des Allemands community. I sent photos to NOAA/NWS for confirmation. Even took photos of the hail w/ ruler to show size. Minimum size was 2", most 3". The hit marks are lighter in some places and darker in others and I do understand that all roofs in La. have mildew. But the patio cover roof is a total loss because of the hail as well as the vents being beat up. Gutters are fine as the hail came straight down, AC unit was protected.
I've also been told that it is pretty much SOP for the inspector to try to say no damage on the first pass. He has a conflict of interest too since he works for the insurer. It's like the dance at the car dealership. Of course if it is officially denied by the adjuster we will ask for a reinspection.
Thanks again

Reply author: CCarr
Replied on: 02/28/2004 11:20:28
Message:

It is not the place to debate it in this thread, but note Karen's perception as a consumer; that is the commentary of her last paragraph.

Unfortunately, that is not an uncommon perception by a consumer of property insurance.

"We" can not wash our hands of that negative perception, whether our income is derived from cat claims or day to day claims.

Her perception of the process plays right into the hand of the Bill Cook's of our industry, and rightfully so.

Reply author: Tuckernotis
Replied on: 02/28/2004 11:41:54
Message:

Follow-up. Just got back up on the roof for a more thorough look. We have holes clean through a lot of the shingles [Duh!]. Wonder how he missed that! Should we take preventive measures to ensure there is no more damage to the substrate? What can be done in the meanwhile?

Reply author: Johnd
Replied on: 02/28/2004 11:42:22
Message:

Karen Gray:
By the amount of help that you have received in the past 24 hours, you need to really re-think your statement about it being SOP to say no damage on first inspection. The majority (99%) of the adjusters that are on this site are HONORABLE and would NEVER participate in that kind of scenario.

As adjusters, we are OBLIGATED to do everything in our power to see that you receive EVERY dollar that is due you under your insurance contract. Who ever told you this is "pretty much SOP" is guilty of a gross fabrication. And for your information, we (adjusters) probably "dislike" car dealerships as much as you.

We wish you the best in obtaining a proper settlement on any damages you may have suffered. Please come back and let us know what the outcome was on your claim. WE CARE!

John Durham

EDIT:
Karen, read your policy! It states you must protect your property from further damage. Now, you must consider a contractor or roofer. This can be tricky as you must choose an honest one to represent you and cover any damaged areas of the roof. As Kile asked previously; "Who is your insurance carrier?"

Reply author: Tuckernotis
Replied on: 02/28/2004 11:57:21
Message:

I didn't mean any disrespect to your profession. But having said that, I have spoken to no less than six other people who have had roof claims due to hail in the past and all of them had to go through the same thing. I'm not sure the "inspector" that came out was in your professional league so I wouldn't even make a comparison. Maybe it's just State Farm seeing that's who he works for. I don't know how anyone can say that it not a conflict of interest though if the adjuster or inspector is employed or paid by the insurer. I don't have any wish to get a new roof if it's not needed. It will raise my premiums and be a major inconvenience while being replaced not to mention the $1000 deductible. But I also want to make sure that I'm getting what I paid for, insurance against a loss. Maybe that debate is better left for another thread. I wasn't at all upset by the first pass from the inspector. It was completely expected. But I will get other opinions and not just from roofers since there is a conflict there too. I do have a friend that owns a roofing business but doesn't do residential work. He has the expertise to give me an unbiased opinion but has no commercial interest. Thanks for the input and please do not take it personally.

Reply author: Johnd
Replied on: 02/28/2004 12:11:48
Message:

Karen Gray:
Thank you for understanding where we are "coming from." As I stated earlier, please keep us informed because we really DO CARE that your experience ends on a positive note. As you are no douby aware, there are good and bad in every profession. We sincerely hope that your future encounters are only with the "good."

I sure hope that all who are reading this thread are also reading about the fee schedule discussion and the percieved (and actual) quality (and quantity) of adjusters as it relates to the schedule reductions. How many more insureds will have this perception of our ranks when the schedule is reduced to "burger flippin rates?" I hope all the Insurance Company Executives who are reading this thread can appreciate, and comprehend, the law of diminishing returns.

Professional CAT adjusters, DESERVE BETTER.

NOTE: This may be off topic, but I respectfully request this post be left here INTACT, as what better example could be presented regarding this subject.

Reply author: KileAnderson
Replied on: 02/28/2004 16:37:48
Message:

Karen,

I have worked almost exclusively for State Farm as an independent adjuster over the last 5 years and I can tell you as a matter of fact that no State Farm adjuster has ever been told to deny a legitimate claim. As far as a conflict of interest, the only real person I believe that has a conflict of interst in the adjuster-homeowner-roofer triangle is the roofer. The roofer is the only one that stands to make any money off of this deal, the adjuster gets to do the work, the insured has to pay his deductible but the roofer makes a sale and puts money in his pocket. The adjuster for the most part gets paid the same no matter if he pays for the roof or not.

The adjuster wants to make the right call because if he denies a valid claim he will probably have to go back out and reinspect it and when you already have dozens or even more than a hundred claims to worry about the last thing you need to be doing is reinspecting. It is a big waste of time to say no and have to drive all the way out there again to reinspect(I'm sure the closest claims office is an hours drive from Des Almends). Do you have any idea of the age or experience of the adjuster who looked at your roof? I've been doing this for 5 years and I live in Baton Rouge and I have never worked a hail claim in Louisiana. We just don't get that much hail. Maybe he was inexperienced. Did he pay you for the patio cover? Did he mention seeing any damage at all?

I understand your distrust of adjusters and big insurance companies, it does seem that they are holding all the cards and you are just one person against a big corporation, but keep in mind that the reason that corporation is so big is because they serve their customers. If they made a practice of bad faith claim handling they wouldn't be in business any more. Also, just to let you know, from personal experience, I've never met a roofer that didn't think a roof had hail damage. I have heard from some insured's about them, but I've never actually met one.

If you have a hard time getting a reinspection ask to speak to his supervisor and send them some pictures of the hail damage.

Reply author: william s cook
Replied on: 02/28/2004 19:21:40
Message:

Dear Clayton,
This appears to be a walk in the park for a PA to get Karen paid her entitlements if the circumstances are found to be as described by Karen. Unfortunatly for Karen, she appears to have drawn an adjuster that has poor vision. Unfortunatly for Karen and her six neigbors, they now have an uphill battle to cause insurers to reverse their decisions of denial based on the written report based on a nearsighted adjuster's failure to see the reportedly obvious damages. Unfortunatly for Karen, she may be forced to seek an attorney to enforce the contract terms of entitlements. Unfortunatly for Karen, most attorneys will not take a small property damage case on a continegency fee basis. Unfortunatly for most insureds, they lack the financial resources to to fund an attorney on an hourly basis against a first party carrier. Unfortunatly for Karen, anyone other than a licensed attorney can not advance her cause or give advices on contracts that impact legal rights in Lousiana. Unfortunatly for Karen, she must acquire the knowledge to level the playing field with insurers while maintaining her normal duties and lifestyle. Karen can retain and pay a non-reimbursable fee for a consulting engineer's report to substantiate her claim with insurers. Karen can demand an appraisal but unfortunatly for her she will be liable for the apprasiers fees as well as one half of the expenses of the umpire. Unfortunatly for Karen she must mitigate her damages while preserving the damages for inspection by the appraisal forum. I would volunteer my assistance but unfortunatly for Karen Lousiana has stiff fines and punishment in the UPL regulations. Sorry Clayton, my hands are tied in this instance. Karen may get lucky on her draw for a re-inspection and none of this unfortunate described scenario will apply.
William S. "Bill" Cook
Public Adjuster in seven other states

Reply author: KileAnderson
Replied on: 02/28/2004 19:34:21
Message:

Mr. Cook, has it even crossed you mind that their may not be any damages at all? I'm not saying that Karen is wrong, but you have automatically assumed that she has damage. It is possible that there is no damage and what Karen and her neighbors are calling hail damage is something other than hail damage. Karen also said that her roof was 9 years old. I know that we have had some tropical visitors in Louisiana in the last 9 years, Isadore and Lili just over a year ago. Maybe the roofs of her and her neighbors were paid for from those storms and never replaced. I'm not saying that I know any of this, but I also can't rule it out because I don't have access to her claim history.

Once again, I'm not saying the adjuster is right and Karen is wrong, I'm just saying that none of us here have the full picture, just the parts of the picture that Karen is giving us.

Karen, please fill us in on this issue, have you had a roof claim before? If so did you replace the roof that you were paid for? I'm not accusing you of anything, just trying to make some sense out of the situation you are in.

Reply author: KileAnderson
Replied on: 02/28/2004 19:54:06
Message:

I tried to upload an image but it didn't work.

Edit by admin, to upload photos use the paper clip icon found below the message box. The image icon is for an images already on the web. Roy

Reply author: Tuckernotis
Replied on: 02/28/2004 20:43:23
Message:

Ok, maybe this will work. I've loaded all the pictures into Webshots. Hope the links work. Some of the pictures of the actual hailstorm are dark because it happened right at dawn, 6:15 am. I don't have photos of the holes yet. Will try to get those tomorrow and load them up.

http://community.webshots.com/album/121821794DfGyzh


BTW, the six people I was referring to weren't neighbors. They were co-workers and relatives that all live in different areas and were referring to different incidents. The surrounding neighbors all said nothing like this has ever happened here. My home is 9 yo and the roof is original. The neighbor to one side (the one with the bump on the head) has been here for 20 years. Granted, we have been visited by two tropical events in the last two years. None of which had winds greater than tropical storm strength. A good Nor'Easter has worse. To answer a question about the patio roof, yes, he said that was a total loss. I actually disagree. It is dinged up but appears cosmetic. There are no punctures and it is insulated (actually a sunroom). I don't want a new roof on it. Figures.
I have learned a lot from this forum especially about the relationship of the adjuster and insurer. Also about what to look for since I'm not a roofer. I believe in being an informed consumer. Thanks to everyone for their help and concern. I'm sure everything will be worked out to an equitable resolution.

Reply author: KileAnderson
Replied on: 02/28/2004 21:21:40
Message:

Karen, those are very interesting pictures. I noticed you said that you believe that the damage to your patio roof was only cosmetic. In actuality fresh hail damage is mostly cosmetic. But this damage can accelerate the deterioration of the material and early failure. If I were you I would wait until you get the estimate from the adjuster. He may have gotten back to the office and shown the pictures to someone and they advised him to pay for the roof. Once you get you estimate, if he has not paid for the roof and you firmly believe that your roof is damaged, have a roofer inspect your roof and right an estimate for it's replacement. Make sure that he indicates on the estimate that it needs to be replaced due to hail damage. Then take this estimate down to your agents office and have him fax it to the adjuster. The adjuster should contact you and the roofer and set up an appointment to meet with the roofer and reinspect your roof. The roofer will be able to point out what he believes is damage and the adjuster can give his opinion on whether it is or is not damage. If it is hail damage I'm sure the adjuster will make good on your claim. Just be patient. No one is trying to deny you what is rightfully owed. Everyone makes mistakes.

Just a little word of advise. Be patient and polite at all times. I probably don't have to tell you this but it is alot easier to catch flies with honey than vinegar. Be patient, be polite and if you are not happy with the results of the reinspection get your agent involved. He wants you to be happy.

Reply author: william s cook
Replied on: 02/29/2004 08:25:49
Message:

The majority of my claims history has not been in handling hail losses. Accordingly I yield to the experts, I will sit down and shut up.
William S Cook
Public Adjuster

Reply author: katadj
Replied on: 02/29/2004 09:20:18
Message:

Well, perhaps some can remember Jan, 2000 in New Orleans when a freak storm damaged almost all of the French Quarter and out as far as Kenner.

I have been involved in appraisals there since the event and am STILL working files there in excess of $10,000,000.00.

SO, Louisiana does get hail, not often, but it does happen.

Karen, from a cursory review of your photographs, and in agreement with Kile, you do have substantial damages, which you may be entitled to be compensated for, and the Insurance contract is one of adhesion and indemnity.



Protect your assets with tarps or poly.

A PA is allowed in LA, but only on an hourly wage basis, not on a contingent fee basis, at the present time, although this is being litigated.

Maybe the squeaky wheel will get the grease, nice is nice, and Wrong is wrong.

Reply author: KileAnderson
Replied on: 02/29/2004 09:54:54
Message:

Mr. Hood,

I am very much aware of the January 2000 hail storm in New Orleans. I'm also very aware of the 2001 storm in Alexandria as well as the one in 2003. There have also been several in Shreveport and Monroe. My point was that in south Louisiana hail is very rare. I didn't say it doesn't happen. I was just pointing out that staff adjusters in south LA will have significantly less experience with hail damage than say adjusters in Dallas or Omaha or OKC.

Reply author: trader
Replied on: 02/29/2004 14:16:21
Message:

Adjusters have two worst nightmares:
1. To recommend a payment that is not owed; BUT a far greater fear is to NOT to recommend a payment that is owed.

Reply author: Tuckernotis
Replied on: 02/29/2004 14:39:54
Message:

Hail is rare in Louisiana and when it does happen, it's usually of the small pea size variety. This event was very unusual to say the least. It is a good observation that maybe an inspector that only works this area may not be very experienced in hail damage. I have appointments with two roofers (God help me) and if they both point out the same damage and concur I will take it to the insurer. Not sure what to do about the holey shingles. Too big an area to cover with tarp. We have a 3000' sq ft house and God knows how much roof area. Thanks for all the help. It is truly appreciated.

Reply author: katadj
Replied on: 02/29/2004 18:17:08
Message:

Kile, You are correct in the statement that the staffers will not have the experience that someone such as yourself has.

The comment that was made was not to criticize youin any way. Are you still having fun on the almost one year old storm in Paducha?

Reply author: KileAnderson
Replied on: 02/29/2004 19:36:27
Message:

Yep, still handling cleanup here in Paducah. Since I've been here an empty lot has suddenly sprouted and fully functional Sam's Wholesale Club. I remember when it was just a grass field, now I'm shopping there.

Reply author: stormchaser1
Replied on: 02/29/2004 20:04:34
Message:

granular loss decreases the life of the shingle. The whole purpose of the granules is to protect it from the exposures of the sun and weather. Granular loss depreciates the life of the roof therefore depreciates the value of the house, isn't that what insurance is for????

Reply author: KileAnderson
Replied on: 02/29/2004 21:24:20
Message:

Here we go again. If wind blows granules off the roof which it does all the time, is that a covered loss? If rain washes granules off the roof, is that a covered loss? What about the granules that are dislodged when the roofer is installing the roof? Granules are shed over the life of the roof. It is the natural state of the product and part of its life cycle. Granules in the gutter do not a hail loss make.

Reply author: Todd Summers
Replied on: 03/01/2004 11:21:15
Message:

Ms. Gray,
Truly interesting photos, especially the photos of the hailstones themselves... ck out the crystal like protrusions. Looks pretty hard to me and although I have not seen the roof (as Kile said), I would look at them closely on my hands and knees. One thing I would suggest is to take some better close up photos of any bruised or "holey" shingles as the photos you have posted don't really show any actual damage. The light marks that are visible appear to be mildew marks as mentioned earlier.

You have received some excellent advice here and the only other thing I have to add is that you have brought up another common misconception regarding hail claims and premiums. For the most part, as far as I know, premiums are increased by underwriting departments based on criteria such as living in a hail proned area. If it is determined to be a high risk area then premiums in that entire area are increased, whether you personally have had a hail claim in the past or not. This is how hail and other weather related events are handled by underwriting, whereas, several liability or theft claims for example might be handled on an individual basis.

Good luck with your reinspection, and maybe the adjuster will find damage with a closer look and maybe not. I always explain to my insureds that the damage has to be there to be touched, felt and photographed or it is simply not there or has not shown up yet.

Reply author: Manmut
Replied on: 03/01/2004 12:51:39
Message:

I would agree that a closer photo of the damage is required. You'll notice that there is no damage evident, at least in your photos, in those areas of the roof below the metal stacks. In fact, the roof is discolored in that area in a way that is similiar to the disputed damage areas. As an adjuster, I would want a close-up of a single shingle, then one of a bruise, and finally one of the underside of a bruised shingle.

Reply author: Tuckernotis
Replied on: 03/01/2004 13:24:57
Message:

From what I understand, the discolored area below the stacks is caused by the mildew not growing there. The lead or other metal inhibits the growth. So the lighter colored areas will show up lighter since the mildew is scraped off. We did take close up pictures of the holes in the shingles. On the bruises, I'm not sure I know what I'm looking for except that the bitumen is showing through at the impact sites and there is a depression. Even where the bitumen shows, the overall color is lighter than the surrounding area. So, we'll see. I'll try to get the other photos loaded on webshots tonight. Thanks again.

Reply author: rbryanhines
Replied on: 03/01/2004 15:07:54
Message:

According to most of the posts on this topic it appears the consensus is that granular loss unless accompanied by hail bruising or impacts should not be considered hail damage.

I'm not sure that the insurance carriers previous claims handling concurs with this consensus.

Questions to think about!

Do the manufactures of shingles consider granular loss to be damage to the shingle?

Is hail considered a normal weather event?

Who should one ask to define damage to a product, the insurance comapany or the manufacturer of the product in questions.

Reply author: KileAnderson
Replied on: 03/01/2004 16:59:35
Message:

I would have a 3rd party engineer, like Haag, or some other engineer, what constitutes damage to the product. I don't think the manufacturer would exactly be objective on the subject. All engineering texts that I have seen say that a shingle is not damaged unless the matting is bruised.

If hail isn't a normal weather event then I don't know what else you would call it. It is produced by the weather and it happens every year all over the country. That would be pretty normal to me.

Reply author: rbryanhines
Replied on: 03/01/2004 18:54:22
Message:

I've noted many post allude to roofers and PAs being biased . I agree with this , However all parties involved in the insurance claims process have some sort of bias. This includes Haag!

I don't think hail is a normal weather event. Weather sources such as the weather channel and NOAA's stance is that hail is not a normal weather event. In that if you take the sum of all reported weather events and divide that with the nubmber of hail events . The percentage of hail events to weather events is quite low. Think of it like this , at my house in the Woodlands Texas in a ten year period (5,256,000 minutes) it has hailed a total of about 12 minutes. I would not define a hail event in my area as normal , more like abnormal.

I think this is why the shingle warranty reads as follows:

Limitations
This warranty provides protection against any shingle defects that arise in the course of ordinary and everyday wear and tear to the roof caused by normal exposure to the elements. It does not provide protection against damage caused by situations and events beyond normal exposure conditions, such as, but not limited to:

winds, including gusts, greater than those listed in Table 1 for each product, lightning, hurricane (see Limited Wind Warranty for hurricane wind exception), tornado, hailstorm, earthquake, fire, explosion, flood or falling objects.

Notice the verbage everyday "wear and tear"

Hail does not fall into this catagory! It may happen everyday but we are not talking about anywhere in the world. We are are talking about one specific insured's address!

Someone stated in an earlier post that "2 to 4 % of the granulars fall of the shingle every year". I agree with this statement. However this figure does not include the loss due to any hail events. I have researched this info from GAF and Certainteed. I've spoke with Haag and Rimkus and the studies of the amount of granulars lost did not include those lost due to hail damage. Test roofs were put under the mock conditions of sun and rain. Hail was not simulated on these roofs.

Based on the above info and my understanding of the insurance policy. If my investigation reveals hail damage did contribute to accelerated granular loss my recommendation to the insurance carrier is that a covered loss occured and roof repalcement is needed.

Reply author: gloverb
Replied on: 03/01/2004 19:36:38
Message:

rbryanhines,
Most of us probably agree that there is more granule loss due to hail, but I think there is an inherent problem in determining the extent of granule loss. How do you measure it, & how do you establish proof of loss if there is no other damage to the shingles?

The terms that I have seen relating to granule loss are moderate or excessive. What is moderate & what is excessive? Is excessive 1/4" in the gutters or 1/2", & what if there are no gutters? I would love to consider only granule loss to determine hail damage. I could make a lot more money.

Probably most manufacturers & most roofers would consider granule loss as damage to the roof. After all they are in the business of selling shingles.

Reply author: KileAnderson
Replied on: 03/01/2004 20:08:17
Message:

We can play this what if game all we want, but what if, as I said in an earlier post, you get 20 inches of rain in a 24-48 hour period? That isn't an everyday occurence, but it can and has happened. So does the carrier now have to replace the roof of every house that had that kind of rain?

The bottom line is a line must be drawn. Standards must be set. Has anyone ever proven that the minimal amount of granular loss that a pea sized hail event causes actually causes a roof to fail prematurely? Have you ever been on a roof that was damaged by hail 9 years ago and never replaced? I was, and it didn't leak. The homeowners were paid for a roof in 1995, and they never replaced it. They saw their neighbors getting new roofs this year so they filed another claim. Sure enough they had new hail damage, along with old hail damage. When I asked about it they admited to not replacing it in 95. The roof is now 18 years old and has been damaged by 2 hail storms and is still water tight. I'd be willing to bet that if I come back in 2 years when the roof is at the end of it's useful life, it will look and function pretty much the way it does today.

So, I have seen a roof, damaged by real hail and it will still manage to serve out it's useful life. Where is the loss? Now, this is a roof with REAL hail damage. I seriously doubt that a roof that lost a few granules is going to fail earlier than a roof that was never touched by small hail.

Reply author: rbryanhines
Replied on: 03/01/2004 21:33:00
Message:

Most of the posts on this topic have been the "what if game". Insurance is the ultimate what if game!!!!

A line has been drawn, However it is frequently moved by the carriers. This is usually done during the reinspection process by the staff adjuster.

Haag and Rimkus agree that a shingle exposed to hail (even small hail)
may fail earlier than a shingle not exposed to hail.

Please explain the point of your story about the roof that had earlier sustained hail damage. It appears that your opinion is that a roof is not damaged unless it leaks. Carriers pay millions a year on roofs that do not leak.

(Kile,please reread your post concerning the damage to the patio cover. It states:
Karen, those are very interesting pictures. I noticed you said that you believe that the damage to your patio roof was only cosmetic. In actuality fresh hail damage is mostly cosmetic. But this damage can accelerate the deterioration of the material and early failure.)

Kile, you asked in your previous post "Where is the loss? The loss is that there is a probability that the useful life of the roof has been accelerated.(The same reason why carriers pay for hail impacts and bruises.)

This post is not a slam on anyone. I'm just being honest about what I have seen during my years in the industry. We do not always show consistency in claims handling. The way we handle claims is set by the expectations of the carriers we work for.

Reply author: trader
Replied on: 03/01/2004 22:03:29
Message:

Hey gang: Dont knock public adjusters and plaintiff attorneys. Why? if these guys were not out there... you would not be climbing roofs... because the homeowners would have to send thier readable digital photos to New York City, Bloomington, Schamberg, Northridge or Madison for the adjuster to inspect before the proof of loss is accepted.

Reply author: KileAnderson
Replied on: 03/02/2004 16:43:12
Message:

The point of my previous post was not to say that the roof that had 9 year old hail damage but didn't leak wasn't damaged. The point was that if this roof with obvious hail damage has not failed (yes the only way for a roof to fail is for it to stop doing what it was put there to do, repel water)then a roof with damage so minor, if you can even call it damage, that it can't be seen is not going to be adversely affected. If you apply your logic of hail dislodging granules then there is no reason to even inspect the roof. Call the NOAA and ask them if hail fell in the area. If they say yes then just pay for the roof. That is the logical conclusion to the granular loss argument.

Reply author: Johnd
Replied on: 03/02/2004 18:12:31
Message:

Kile is right, ..... this granule loss thread has just about run its course. Maybe we should all switch gears and have a discussion on the effects of the sunshine on a home's paint job and how we should pay for the fade. Is chalking paint grounds to powerwash and repaint a home OR is all this just a "pigment" of our imagination?

Reply author: KileAnderson
Replied on: 03/02/2004 20:09:55
Message:

A drought is not normal weather conditions. If that drought caused the paint to fade, chip and crack prematurely we may have a covered, weather related, loss. Don't you think?

Reply author: rbryanhines
Replied on: 03/02/2004 20:29:39
Message:

I have now took the time to read all the posts concerning this topic. It is eazy to see the IA , PA , and roofers. (JimF appears to be an old school multiline IA,Thats not a knock- I really enjoyed your posts)

There have been many posts stating hail is a normal weathering event. My earlier post and simple math proves this wrong. If you don't believe this call NOAA,Haag(not that they are unbiased)and do the math for yourself.
(I think the best way to see this ,is to put yourself in the shoes of 70 year old insured. Imagine that you have had your HO policy with the farm for 50 years. Now you file your first hail claim and some out of towner tells you hail is a normal weather event!)

There is also some posts stating there is not a difference between rain and hail. I think JimF said it best. To rephrase :
The shingle warranty covers rain events (any and for any duration )
The shingle warranty does not cover hail (any ,size and duration does not matter)
Rain alone does not cause the granules to fall off.(the formula is sun+rain+time=granule loss)
However hail alone can cause granules to fall off.

(Someone stated that granules were for cosmetic value only . This is absurd!)

There is a value of the roof that is lost even if the hail damage causes accelerated granule loss only.(I do believe that there has to be evidence to substantiate that hail was the cause of the granule loss!) Even Kile believes this as he stated to a homeowner on this site: "In actuality fresh hail damage is mostly cosmetic. But this damage can accelerate the deterioration of the material and early failure."

The bottom line is that roof damage from granule loss caused by hail is a grey area . If the adjuster approaches it any other way he is not serving the insured in a professional manner.

One must get past the personal feelings towards PA's and Roofers. As I stated earlier that all parties involved in the claims process have some bias.

Reply author: KileAnderson
Replied on: 03/02/2004 20:56:28
Message:

All you do by broaching this "gray area" is create more problems. Granular loss is not covered by any insurance company that I know of and if you go around telling insureds that their roof is damaged because you saw granules in the gutter but their insurance isn't going to pay for it, who are you helping. Your are creating a file that will never close and making insureds angry and probably shortening your career a great deal more than the hail shortened the life of the roof.

I believe it was said earlier that a line must be drawn and I think a very sensible line has been drawn by the carriers. Granular loss happens every day. And contrary to what you say, rain alone can and does cause granules to collect in the gutter. So does wind. The sun helps accelerate this and so does inadequate ventilation and a million other things.

Because granules are lost everyday then granular loss is an everyday event. Shingles are not bruised everyday. That's what makes REAL hail damage a covered loss.

Another point to ponder. If you want to go down the road of granular loss being damage, would walking the roof to inspect for hail damage be considered destructive testing. It does cause granular loss. Unless you can rig up some sort of pulley and trolley system so that your feet never actually touch the roof.

Reply author: rbryanhines
Replied on: 03/02/2004 21:22:11
Message:

Kile , based on your earlier post you work mainly for the farm. They have bought many roofs for granule loss alone.As I stated before the line has been drawn - the carriers keep moving it (including the farm!!)
I understand what you are saying and when it make sense I use your approach. However, I've done my research, watched how carriers handle reinspections, and always keep an open mind!!!

If you stay in the business long enough(which at this time I bet you will: You seem to know your stuff,your on someone's roster, and you believe everything the carriers tell you!)
You'll learn

Reply author: khromas
Replied on: 03/02/2004 21:50:59
Message:

Mr. Hines, (I assume that it is your name)

You may be interested to know that a high percentage of property adjusters (male AND female, CAT or staff) actually have substantial backgrounds in the construction industry, many times as owners of companies. We have not been brain-washed by the 'evil-empire' and by the same token, do not park rational, common sense at the curb when we show up for work. Our skepticism with positions put forth by current members of the trades often is born out of experience and informed knowledge rather than what will sell a job to a homeowner. A case in point... while I was staff at a major carrier I inspected a roof with a salesman from one of the largest roofing companies here in the Houston market. I agreed there was hail damage and that we would be paying for replacement. As we were about to get on the ladder, I asked him to prepare an estimate for my consideration and that it should be based on what it would cost IF INSURANCE WAS NOT INVOLVED BUT THAT HE WAS BIDDING WITH OTHER ROOFERS TO GET THE JOB.

His response? (I quote!) BUT WE CHARGE MORE IF ITS INSURANCE!
( I would like for you to explain why that should be the case? The carrier did not contract with that company. It has nothing to do with the contract between the homeowner and the roofing company.)

As adjusters, we not only have the moral obligation to handle the claim properly, we have a substantial legal requirement with all of the penalties attached as well. Few states also impose those standards on members of the construction trades. It is left up to the personal honesty and integrity of those members of the trades, which, I'm saddened to say, is in short supply.

Sincerely,

Reply author: CCarr
Replied on: 03/02/2004 21:54:49
Message:

Bryan, the concept of diminished value will evolve in time, to have applicability to property insurance claims. I've enjoyed your fresh appraoch to this thread, it has been civil and an easy read.

You might want to review the contents of the "Hail damage visibility" thread, found in the "Tips & How to" forum.

When there is a way ( i.e. an accepted technical standard) to measure granular loss after exposure to an insured peril, diminished value will then have its needed measuring cup with which to dispense additional indemnity dollars.

Reply author: Roof_Dr_Sr
Replied on: 03/03/2004 06:28:57
Message:

quote:

---

Originally posted by rugg

Haag Eng books are an industry standard and they will tell you that the loss of granules is not considered hail damage. The shingle must show signs of puncture, or a bruise. The use of the tire explaination is a very good one, as it seems to go over fairly well with insureds.

AS well if you are talking about wood shakes and wood shingles need to have been split. A bruise to the wood will not affect the integrity or the life of the shingle. As you may have guessed this is not a direct quote.

Get yourself a copy of the Haag book on shingles.

---

Reply author: Cecil
Replied on: 03/03/2004 06:55:05
Message:

As the thread indicates, there is a lot of subjectivity here regarding hail damage. Although we try, it is not black or white, we can adjust all hail claims the same. The "Haag" method is the standard but there are exceptions to every rule. Judgement, "Common Sense" has to came into play here.

Example, hail falls for 1/2 hour in an area, size of marbe, some bigger. Roof inspection reveals roofs 50% void of granules. No real bruises. How could someone say the roof hasn't been damaged if 50% of the granules were worn off is this 1/2 hour event. This actually happened in Houston, TX. After the big companies surveyed the damage they even agreed.

On the other hand, when you look at a roof hit by marble size hail and you see some granular loss, no collateral damage and the shingles look normal with no bruising etc., then you are not going to replace it.

Granules are there for color, protecting the matte from untraviolet rays etc. About 300% more granules than are needed are impregnated on the shingles at the factory. When bundles are delivered and opened on sit, usually anhand full or more of granules run out on the ground.

Clear hail damage is easy to adjust. Marginal hail damage is very difficult to adjust and always be right. All factors must be considered.

Reply author: Roof_Dr_Sr
Replied on: 03/03/2004 09:29:18
Message:

In response to the granule loss. I have read most of the responses on this subject and failed to hear the answer to the real problem. I know one thing, it's not that PA's are always starting problems, I know it's not Ad's are avoiding work, and I don't think it because roofing contractors want to make money. The problem in my opinion is the inconsistency from the insurance industry. For example, at the beginning of a hail storm, most insurance companies will pay a claim for 5 hits per square. Later on after the storm has been going a while, they change their guidlines rules to 8-9 hits per square then to 10-15 hits per square after that. At this point, they add "per slope" to the deal. This shows what "no consistency" means. No wonder they can't get a grip on granule loss. Here is my opinion: if the granule loss is a direct result from a hail storm it should be replaced. If it is not replaced then, the adjuster should set the home up for a re-inspection in 6 months to see if hail damage is more visable. Repairing the granule loss is a tough nut to crack. Do you know anyone who does this? Do they do the whole roof or just sections? Who retains the warranty on their work? What about the color difference? Would the insurance companies waive the deductable? Any more questions just ask "The Roof Dr." or visit our web site at www.accutechroofing.com
2 story ladders available during storm work. Thanks for your time........... Jack Keeton

Reply author: khromas
Replied on: 03/03/2004 11:57:40
Message:

I am still waiting on someone from the roofing business to answer the question I posed in my post on 3/2 regarding pricing differences if insurance is involved.

Anyone willing to try?

Reply author: Tuckernotis
Replied on: 03/03/2004 15:54:25
Message:

First: What exactly does a "bruise" look like?

I like the post about small prolonged hail removing 50% of the granules being hail damage. As a consumer, I don't see how granule loss would not be hail damage unless these granules have no value except for cosmetic. I have places on some of the hit marks that are bare to the matting where all the granules were knocked off. Is this normal wear? It wouldn't be this way except for the hail event. Is a bruise the indentation in the shingle that the impact left? I have lots of these. I also have some holes clean through the shingles. Don't know where these could have come fro except for the hail. Anyway, I have two roofers that are going to come out and look and I will ask specific questions about any damage that is alleged. I did my homework thanks to this forum. Someone on the board has generously offered to swing by and have a look and give his unbiased, unpaid opinion. And if it is decided that a new roof is needed, I will get bids from three reputable contractors.

Second: Kevin, you must have been kidding? This is America, capital of the free market enterprise sytem. Number one rule, if insurance is paying, you get a premium on the job. Same is true of automobile work or roofing. Not fair, doesn't make sense, drives up the cost of insurance, true as the day is long. Maybe they deserve the premium for having to deal with the insurance companies. I can certainly sympathize.

Third: Roof Dr., you mentioned "hits per square". Is that just hits alone or hits with bruising, etc.? And a square is 10 X 10 area, ne c'est pas?

Thanks

Reply author: khromas
Replied on: 03/03/2004 17:20:39
Message:

Ms. Gray,

Your comment that 'if insurance is paying, you get a premium' underscores the major problem facing the marketplace today. I am a consumer as well and your blanket acceptance of "that's the way it is" costs ME (and your relatives, and your friends, and your neighbors, etc., etc.) in OUR personal pocketbooks. The insurance company is not a party to the contract for the repairs to your home. They are not responsible for overseeing your repairs, you are as the owner of that home. It is your duty to monitor the progress of the work and whether it is done to your satisfaction and per the contracted agreement. Offer and acceptance is the basis of a negotiated contract and the prime requirement. (Contracts I - UH Law - 1986) No where does the insurance company come into play in that scenerio. It is not bound to use the amounts you negotiated BUT MAY CHOOSE TO DO SO AT IT'S DISCRETION!

Please do not think I am trying to discourage what you have sought to learn by getting involved in this forum. I have admired your succinct questions and observations and for heavens sake, I wish more homeowners would take a little of the effort you have to become a better educated consumer. Continue to stay involved in this forum, it is important for us as adjusters to be constantly reminded of who it is we all really work for.

Sincerely,

Reply author: Tuckernotis
Replied on: 03/03/2004 17:58:56
Message:

I was being facecious about "that's the way it is" in America. I don't like any better than you or anyone else for that matter. It's just a matter of fact not principle.
But your comments about

quote:

---

It is not bound to use the amounts you negotiated BUT MAY CHOOSE TO DO SO AT IT'S DISCRETION!

---

Reply author: khromas
Replied on: 03/03/2004 19:10:51
Message:

The insurance industry uses a vast amount of research from multiple sources in determining the estimated amount of a particular repair. Contrary to popular belief, the amounts are NOT just 'pulled out of the air'. I can't think of a single estimating platform out there used by any carrier that is not also available for use by the construction industry itself.

The fact that a high percentage of adjusters came from the construction industry is also considered as often carriers will allow price overrides under certain circumstances. (From experience, you have to do some serious 'splaining to your manager to justify the override but it can be done.) I was expected to use my 20+ years of construction experience in adjusting a claim, that's why I was hired at a higher salary level than a newbie out of college. When I started with a major carrier back in 1996, I was appalled at the price being paid per square for roof replacement by the insurance industry because I KNEW from business experience what the my cost for installing a new roof had been. It was impossible to change due to the shear inertia involved in the processes.

Since you have already shown you are very hand's-on in the entire situation, let me suggest you do this, regardless of which roofing company you ultimately use.
1) Make sure the roofing company clearly outlines ALL of the materials they will be using on your roof. (They don't have to reveal their prices but they should provide you with a material list.) Go to Home Depot or Lowes and price these items yourself.
2) Keep an accurate count of the number of workers on the job and break them out by whether they are laborers (clean-up, hauling stuff) or 'roofers'.
3) Ask them point-blank what they are getting paid. (You will probably need to be able to speak spanish or have someone translate.)
4) Ask them if they are covered by insurance if they get hurt on the job. (You will probably get a blank look in response!)
5) Ask where they take the tear-off debris to. Call that landfill and get the price involved.
6) Try to think up any other costs you think may be involved.

Add up for yourself the value of all these items.
Come back here and share with us what you discover.

Thanks,

Reply author: gloverb
Replied on: 03/03/2004 19:51:58
Message:

khromas,
I have a partial answer to your question regarding differences in pricing by a roofing contractor, & there may be reasons that are not as "sinister" as you think. In addition to being an adjuster I also own a construction company that specializes in insurance homeowners losses; so, I can see it from both sides of the fence. I rarely ever do roof work because there is simply no money in it if you do it the right way, unless you do a ton of them.

We are approved contractors for a number of carriers, & none of them pay enough for roof work. I can't back this up, but I would bet you that the large majority of roofing contractors don't carry workers' comp, they treat their workers as contractors, & carry the very minimum liability limits. This means that the ligitimate contractor pays 12-15% more because he carries these, & the others do not.

For 3-tab, 25 yr shingles most carriers that we deal with pay about $100.00 per sq.(No O&P on roofs) Thats on/off, includes shingles, felt, & drip edge. Just material costs alone will run about $40.00 per square. 2 yrs ago material costs were about $30.00 per sq. in fact if you check back 10-15 years ago I believe you will find that carriers were paying $90-95 per sq. 10% increase in 10-15 yrs. That is not much. My liability premiums from last year to this year alone almost doubled.

Labor rates generally run $20-25 to take off & $20-25 to put on. So, $40-50 in labor, $40 in materials & $12-15 in indirect insurance premium costs, & you still have to make a profit. That's $92-$105 per sq in cost, & you get paid $100 per sq. Most contractors, & businesses, try to run 35-40% profit margin. 3-tab needs to pay $130-140 per sq for the contractor to carry wc, liability, & pay his employees a reasonable amount.

I have talked with several of the carriers about the this, & the answer is always, "Because we can get roofs done for this amount"

Now to really answer your question, it may have more to do with competition than with "dishonesty". What I mean is, most homeowners could care less what it costs as long as it means no more out-of-pocket expenses. Contractor comes to them & says, " I'll do it for the amount of the adjusters estimate." The homeowner says, "OK".

However, when you throw that same contractor into a competitive bid situation then the game changes. The contractor thinks, "I would rather reduce my profit rather than lose the job."

This is where the contractor that has less overhead(ie-wc,liabilty,etc) has the advantage over the contractor that carries all of these.

My company is an approved contractor for several carriers. I will work from their estimate, or in many instances, they accept mine; however, I have no competition in these cases. If i did the same work, say as remodel instead of covered loss, my estimate would probably be less because now I have 10 other contractors to compete against.

I hope this helps to at least give you a view from the other side. Most contractors are honest & depend on referals & repeat business. It is the few bad apples that give all contractors a bad name.

Reply author: CCarr
Replied on: 03/03/2004 21:05:59
Message:

Kevin, let me remind you as one of the "us adjusters", that you do not "work for" the Karens' of our claims world. It is important for adjusters "to be constantly reminded of who it is we all really 'work for'"; and we do not "work for" the policyholder.

We can be supportive of the Karens' on behalf of all insured people, we can have empathy for the Karens' of the claims world, we can help the Karens' of the claims world; but we do not "work for" Karen or any other policyholder in our capacity as an independent adjuster.

Karen and her problem, like any other policyholder who has presented a claim, is the medium through which we apply our craft; so a determination can be made by an adjuster if money is owed under a contract that the adjuster is not a party to, but was hired by a party to that contract.

I do believe I recognize the intangible intent of your statement, in regards to "working for" Karen. But, aside from Bill Cook thinking we may be ploding into his pasture; there are a lot of people who may have read your comment, and taken it as "insurance gospel", as some may say.

Reply author: Ghostbuster
Replied on: 03/03/2004 21:11:04
Message:

Yeah, yeah, yeah.

Let's flip the coin over and go at it from the other direction. It is not a matter of the carriers pulling a price out of the air, (with the exception of Metropolitan P&C that I witnessed in Dallas in 1995 when it hailed), it is more likely a case of the contractor pulling a price out of the air. I have seen this game played often where any kind of contractor will mentally estimate a job cost, take a look at the customer and size them up for things like wealth, gullibility, are they anxious to get it done?, etc, and then add a 'sucker factor' to the total. Then, when the customer squawks, they can fudge and hem and haw and act all hurt when they knock off $50.00 from the phony $500.00 sucker factor. Then they giggle all the way back to the truck and drive off with a check in hand.

Now...who's the bad guy? The adjuster, the customer, or the contractor? In this wicked little drama we act in, life can get very confused. And, we haven't yet shone the light on the games the customer plays on us all.

Reply author: khromas
Replied on: 03/03/2004 22:02:08
Message:

Responses in order -

Ben -
I am not going to recap my construction resume' extending over 20 years. Suffice it to say I am intimately aware of ALL the costs you have referenced. I do question your assertion that "some" carriers are only paying $100 per square off/on. Care to name names as validation? I question the accuracy of the labor costs stated. The typical roofing crew (general laborers at least) are rounded up at the 'day labor' sites or the corner Stop-N-Go in the lower socio-economic neighborhoods of town. Reality isn't pretty. (I didn't say any of this was fair.)
Also, your profile states that you are both an IA and a contractor? I hope there are no conflict of interest issues at stake. Surely you are not assigned claims to both adjust and then repair?

Clayton -
My reference to "work for" was offered in a nebulous fashion. The insurance policy (product) is manufactured by the insurance industry and offered for sale in the open-market to the homeowners (consumers). The adjustment of a claim is the "servicing" of the product. Substitute 'automobile' for 'policy' and the business paradigm always come back to the principle that if no one buys the product, no one involved anywhere in the chain benefits, so we actually do work for the policyholder. (Not to be confused with the "working for" services of a PA.)

Reply author: KileAnderson
Replied on: 03/03/2004 22:19:58
Message:

I have a theory about why so often we find that an insurance price book for roof replacement is off by several hundred or sometimes thousands when applied to the real world. When pricing specialists are putting together their pricing surveys it is pretty easy to call Lowe's or Home Depot and say what are you getting for a square of 3-tab 25 yr shingles? What about a roll of felt?
Nails? Drip edge? Those prices are usually right on, most of the time I have found they are a little higher than the big home improvement stores and when high volume roof contractors buy their shingles by the truck load they get them even cheaper. Material prices are never at issue.

What is at issue, however, is labor. Some contractors have local reputations that many homeowners are more than willing to pay for (especially when they think the insurance company should foot the bill, "I have replacement cost coverage that means you have to pay whatever it costs to replace it"). Unfortunately nowhere in the insurance contract does it say we will pay whatever your favorite or the most highly thought of contractor in town is charging. There are also the contractors who charge exactly what the insuance price book says is the going rate for the area and they are the ones who answer the survey when the pricing specialist calls. The problem is I believe that very few contractors actually give a fully accurate estimate. I firmly believe that most roofers, when insurance is not involved add 2 or 3 or 4 squares to their estimates. I mean, how many average homeowners know exactly how many squares they have on their roofs or even how to figure it out? So these roofers make an additional $500 or so on every roof because they are just overestimating everything. They get used to this and eventually it gets figured into the pricing. If they did every roof at the price they tell everyone they are charging and then charge for the work they actually do they wouldn't make a profit. Then along comes Mr. Insurance Adjuster with his dad-blasted tape measure and knowledge of geometry and the Pythagorean theorem and suddenly this house of cards collapses.

I had a roofer come into the office the other day. He said he'd been doing roofing for 30 years and he looked like he was telling the truth. His estimate was $1000 higher than mine and he said it was because mine was 8 squares short. So I pulled out my sketch and my calculator and we sat down and I did the math while he watched, added the required 10% and came to the same total used in my estimate. He said but you forgot to add for starter and ridge caps. I looked at him and said yes I did, that's what the 10% is for. He said no, that's the waste, you have to add a square for each valley too, you loose alot there in the overlap. There were only 2 small valleys and the roof was not very steep. I just looked at him and said "Sorry, that's not the way it's done."

I called the insured and asked him to get a couple more estimates, which he did and they were pretty much in line with my estimate. It's just a theory, but I'm firmly convinced that overestimating is a standard practice in the roofing industry.

Reply author: Roof_Dr_Sr
Replied on: 03/04/2004 03:53:15
Message:

[:D]You guys are funny... It's like reading the funny papers in the morning. I sit here and read about all the skum bucket roofers like we are just a bunch of trash. Ok I will admit our industry doesn't have the best reputation but neither does yours! There are bad adjusters just like there are bad contractors. I knew 2 adjusters from one of the big three insurance companies who would start drinking everyday with people he hung out with at an auto repair shop. Of course they would refer all their clients to this repair shop and the owner would always buy the 2-3 hour lunch at the local pub. Does that mean all the adjusters are bad? I don't think so, I know plenty that are very concerned about their clients and their well being. The quality roofing contractors have tried our best to get roofers in Texas lisensed in the State of Texas but have had no success in Austin. We even went as far as certifing ourselves by setting certain standards like being in business for over 3 years, having good credit, have knowledge in the business by passing a 5 hour test. etc. Everyone forgets about the yellow pages ad we spend over $50,000 each year just getting to the homeowner to give them a FREE ESTIMATE. As far as picking up guys on the street to do the work...not at our company. Our men are on staff and get paid good wages to do what they do. How about the $30+ we spent this alone on matching withholding taxes? Where does that come in to your equation of profit? The other day I got my son to sub contract a job for me at his cost. It was a tile repair job and his labor cost to me was twice what I figured for the job. Who pays that? The roofing business is just that, it's a business with all types of expenses that are never figured in when trying to figure out what a job cost to do. It's almost impossible for a solid company to figure this out exact. What about this problem... If I put on 50 squares today and it gets hit by a storm tomorrow, why does the insurance company only pay 43 to remove? Go ahead tell me the answer... I have heard it all before but the fact is we still remove 50 squares and the insurance companies saved about $150 per home times hundreds of homes. Now who is the skum bucket? Now who is being honest? What about headwall flashing and counter flashing the insurance doesn't pay to have replaced? To do the job correct it should be replaced each time. I saw figures the other day where a roofing contractor was being the exact same money for a job done in 1981 that we are getting paid today? Is that fair? Maybe that's why all the roofers you know dress the way they do...they can't afford anything else.Roofing is a hard dirty job and yea your right it's done by people who would do something else if they were smart enough to do it in most cases. I love you guys & gals and I respect what you do for a living ... do your best to respect the good contractors in the field and help me run out the dogs! Thanks..

Reply author: gloverb
Replied on: 03/04/2004 04:50:23
Message:

Kevin,
I don't mind naming names. I pulled these prices right off Xactimate for my area. I have to use these prices for Encompass & MetLife. These prices are for day-to-day, do not reflect pricing for cat work.
RFG 220 3-tab 20 yr inc. felt R&R $100persq
RFG 240 3-tab 25 yr inc. felt R&R $104per sq

SF
RFG 220 3-tab 20 yr inc. felt Remove $20
RFG 220 3-tab " " Replace $75.08

My point was not to debate pricing. You are exactly right. The typical roofing contractor goes down to the local labor pool finds 1 guy that speaks English (he's the supervisor), gets 3 or 4 other guys, & he now has a roofing crew.

My question is "Why is this typical?" Why does roof work have so many of these types of contractors? Because the contractor that tries to do it right & carry all of the insurance, use employees, etc just has a difficult time showing any kind of profit simply because the pricing is 30%+ too low.

I did 1 roof last year. It was tied to a fire restoration job; otherwise, I would not even consider doing it. I lost money on the roof portion. I subbed the labor to an insured roofing contractor. Off/on cost me $50/sq, & when the contractor finished, he said that he wouldn't work for me anymore because I was too cheap.

As long as carriers have the attitude that "We can get it done for $100; so, that's all we are paying", the better contractors will continue to stay away from it.

I know I have painted contractors with a pretty wide brush. There are some real good roofing contractors, but not many.

In reference to Roof DR Sr's response. He is exactly right. In many cases they pay today for roofs what they were getting 20yrs ago. A friend of mine, actually my tile contractor, started out in Florida in 1984 on a roofing crew. He was amazed when I told him some of the roof pricing. He said "That's what we were getting in 1984."

I am an adjuster, but because I am also a contractor I have much empathy for the roofing contractor that is trying to bo it the right way.

Reply author: MysteryCat
Replied on: 03/04/2004 07:19:44
Message:

originally posted by RoofDr.
What about this problem... If I put on 50 squares today and it gets hit by a storm tomorrow, why does the insurance company only pay 43 to remove? Go ahead tell me the answer... I have heard it all before but the fact is we still remove 50 squares and the insurance companies saved about $150 per home times hundreds of homes. Now who is the skum bucket? Now who is being honest?

C'mon Doc,
We've hashed this over too much (see Lonnies posts) Where did all those scraps you hauled away come from ? The 10-15% waste factor covers all ridge, starter and valley. This is the way it is. When I was a roofing contractor , I LOVED redo's like this because I didn't have to climb and measure it....all required info was already in the file including the material takeoff and the job work order and I knew exactly what the profit was (usually around 33%). If that's not enough, change professions.

Reply author: MysteryCat
Replied on: 03/04/2004 07:28:51
Message:

BTW,
Headwall and counterflashing definitely do NOT have to be replaced each time... that is ludicrous. After supervising thousands of reroofs, mostly insurance claims, I can tell you that these can mostly be reused if your roofers are careful. (Imagine that). When it is impossible to save it, then supplementals can be addressed with the adjuster.

Reply author: Tuckernotis
Replied on: 03/04/2004 08:32:44
Message:

No one has answered my question: Exactly what does a "bruise" look like?

Reply author: KileAnderson
Replied on: 03/04/2004 08:37:01
Message:

Glover, those prices you quoted are just part of the roof job, they don't include drip edge, steep, 2 story charges, vents, flashings, base service charges, material sales taxes or any other elements that adjusters include when they write their estimates. When you read the estimate you will see that there are way more than just 2 line items listed under the heading roof. Most of my estimates run anywhere from $105-$175 per square depending on the roof.

Dr. Roof, You said somebody was being paid exactly what they were paid in 81. I've only been doing this job for 5 years and I've seen prices go up in that short amount of time. If that roofer is getting paid the same thing today then he must have overcharged for it 23 years ago.

Reply author: Roof_Dr_Sr
Replied on: 03/04/2004 09:08:48
Message:

Kile,
You said you have been doing this for 5 years. I know for sure we have had at least 12 increases in shingles over 5 years. Five years ago we were getting $70 per sq. and now we have finally got insurance payment of $80 (from some ins. co. most are still between $73 & $75) felt has gone thru the roof, metal is super high, etc. I enjoy the roofing business but I would just like to make enough to cover my expenses as well as show some small profit. I'm not interested in changing jobs. Thanks for your reply

Reply author: Roof_Dr_Sr
Replied on: 03/04/2004 09:23:17
Message:

Mystery Cat,
According to the NRA (The National Roofing Association) these flashings should be replaced with each job. Sorry I'm not one to dispute someone like that, I just try to follow some type of guidlines. As far as changing professions, Iam not interested in that as well. I believe it was you that mentioned I was making a 33% profit on each job? Get real ...no way can a real roofing contractor (one who has a business location with office staff, yard staff, really paying real taxes on employees, buying over $50,000 worth of yellow pages advertising each year because everytime we turn around there's another new book we have to be in, material cost always going up on a regular basis, etc.) show that kind of profit in Texas. Texas is the key word out of all that Mystery Cat. When I worked a storm in Kentucky, the insurance companies paid $145 for 3 tab shingles plus $12 for felt, and $1.10 per ft. for drip edge. In Texas for some unknown reason the insurances believe we can do this for $75-$80 per sq and we have to furnish the felt & drip edge. I haven't found a supplier yet that throws in felt & drip edge when I order material. Still waiting for someone to explain the differences because the material cost the same and the cost of living is the same. Anyway thanks for the reply ......

Reply author: rbryanhines
Replied on: 03/04/2004 10:25:16
Message:

The last few post are way off the topic but I feel the following should be said in response:

I consulted for roof/siding companies for about a 2 years . During this time I was able to see how good companies produce it's jobs. I can tell you this: there is no way they went down to the corner store and picked up day labor to be applicators of roofing/siding. The insurance carriers shouldn't set prices to force roofers to do that. I wouldn't want a day labor to install my roof. I've been on many storms in my years of adjusting and seen vendors let any warm body with a tape measure adjust when there was a shortage of adjusters. I don't want to be judged by the worst in our industry. Let's not judge other industries by thier worst!!!

Reply author: Roof_Dr_Sr
Replied on: 03/04/2004 19:56:26
Message:

Hay Mystery Cat... One more thing I forgot to mention.. Your 33% profit sounds real good. 10% goes to the estimator, 10% goes to the material and labor and the other 10% is profit. That would be ok except for a few more things... What about all the rain days we don't get to work. What about days when there isn't any business and we still have to pay our employees? We are not like most roofing contractors who get their labor from under a bridge as someone suggested, our men are trained professionals who do excellent work. They show up for work on a regular basis, have their own transportation and make an excellent wage. Where does all this money come from?
Again, thanks for your imput [8D]

Reply author: khromas
Replied on: 03/04/2004 20:09:25
Message:

A final remark and then I am through trying to argue a dead issue.

In a free-market society, the MARKETPLACE determines the value/cost, not some 'big company'. If someone, anyone, can do a job more effeciently for a lower cost, they will always have market niche. Why? Because for a large number of people, that is the ONLY determinate factor. In the roofing industry if you want to force higher prices (and supposedly a higher quality) on the American public, then close the US borders, mandate a stringent set of standards with no allowable deviation and guarantee ALL of your workers total health care.

Ms. Gray,
I have looked back through my HAAG manual to try to find their actual definition of 'bruising'. A bruise is more accurately defined as a 'fracture'. HAAG's wording - (typical engineer-ese) Fractures in shingles initiate in regions of maximum tensile strain at bottom sides of shingles and propagate toward the top side. (page COMP-29)
In layman's terms it is a crack in the asphalt core of the shingle and will start on the bottom side of the shingle and work it's way up.

Hope this helps!

Reply author: gloverb
Replied on: 03/04/2004 21:08:33
Message:

Kile,
Understand, I rarely do roof work as a contractor. As an approved contractor I write roof estimetes for free for the carriers. I only write damages that I see. I can't assume that there is damage. I cannot include replacing drip edge or flashing unless I find damage on these items. These items should be add-ons, supplements for the contractor if he finds damage once the shingles are removed.

What is not considered is that the contractor has added expenses, labor & materials, also.

How many "catastrophe" roofing companies are there? There were roofing companies from Minnesota working the Dallas, TX storm last year. The catastrophe roofers beat the adjusters to the site. They send out 4 or 5 estimators adjusters; they hire a roofing crew at the site for the cheapest price possible; & I'll betcha a dollar to donuts that none of these companies carry even the basic insurance.

The established roofing contractor has a hard time competing with these guys because his overhead is so much higher. I wish that all roofing contractors had to be licensed & insured. I reiterate, as long as carriers have the attitude that "We can get it done for this amount" all we will ever get is the lowest common denominator to do our roofs.

You cannot pay labor $8.00 an hour an expect professional work, & with the pricing, that is all that reputable contractors can afford & still make a profit.

From an adjusters standpoint, I will pay what the carriers allow. From a contractor's standpoint I cannot make a profit doing insurance roofing work if I do it the way it should be done. There is no money in it!

Most of the good roofing contractors make their money doing new construction. This way they do not have to deal with insurance pricing.

Don't take my word for it! If you have time just check the costs: material, labor, insurance, ss, unemployment, etc. & then come back & tell me I am wrong. There is simply not enough money in roofing work to attract the good contractors. Until this happens just keep expecting the same fly-by-nights that we have been getting.

I am really not arguing this issue. I truly believe that the pricing for roofing is too low to attract many good roofing contractors.

Reply author: Tuckernotis
Replied on: 03/04/2004 22:02:50
Message:

Thanks Kevin for the explanation. Not what I thought "bruise" would be. I'm thinking more along the lines of a skin bruise where there is no break in the skin. Now I understand the need to lift some of the shingles to look at the underside.
Thanks again.

Reply author: KileAnderson
Replied on: 03/04/2004 22:22:02
Message:

Karen, It's pretty simple. Does the impact mark have a depresion? Is it softer than the rest of the shingle. Press it with your finger if you feel it give more than the rest of the shingle you have a bruise. If you want to go further, take a putty knife and carefully pry the shingle up from the bottom. Work the knife along the entire bottom of the shingle before trying to lift it, otherwise you will tear the shingle. Once you have it lifted see if you can feel the bruise from the back side as well. Be sure to press the shingle back down when you are done. You will probably want to put some roofing cement under it, but if the sun is out and the temps are in the 70's it should reseal all by itself.

Reply author: trader
Replied on: 03/05/2004 11:58:04
Message:

OK move my post in getting started over here. My point is "they" carrier/vendor/temp agency/tpa does not know or does not trust the person who they sent out to inspect the roof. It seems "they" feel/belive, "thier" filter system will catch the flaws that occur when you send this type adjuster out in the field. "They" will not get" big hits" because most states do not have punitive measures or short time frames (Texas accepted) and "they" are correct. And the supply of roof climbers is inexhastable.

Reply author: Brooks Todd
Replied on: 03/06/2004 14:05:39
Message:

Roof Doctor:
Glad to see you. I worked with one of your sons buddies, this summer. We attended the NTRCA luncheon at Pappasito's y'all were there also.
I also framed Cheddars Restaraunts and worked with you guys there.
Accutech is a solid legitimate company!
These guys know everything though Roof Doctor Senior.
Later

Reply author: Roof_Dr_Sr
Replied on: 03/10/2004 05:36:44
Message:

Thanks for the flowers Brooks! I would like to make one correction. It is my son Bryan Keeton that is the owner of Accutech and has made our company outstanding with honesty and knowledge. He decided a long time ago he wasn't going to be just another dead beat roofing contractor who was always trying to get the money and run. In fact, one time while I was working a storm in Kentucky, things were really excellent. Sales were booming, profits were high and I was doing great. I called Bryan back in Texas where I know things were very slow and ask him to come sell for me in Kentucky. I Guaranteed him at least $100,000 in the next 6 month if he would just come up and do nothing but sell. His answer was,

"Dad I would love to come up and make the money cause God knows I need it right now, but I have a responsibility to the clients I have here who have warranties with Accutech".

What a son! It's that kind of attitude that makes an adjuster want to refer our company to a client. They know he will be there if anything goes wrong in the future. Watch for our radio show which may be coming out very soon. It will be "All About Roofing" and will take questions on roofing your home, products and services, along with insurance questions about claims. It's going to be great and will be heard by hundreds of thousands all over the US!

Reply author: Ghostbuster
Replied on: 03/10/2004 07:59:24
Message:

Would you please take this self serving palaver over to the roofers web site? This is not only off topic, it is out of a different book.

Reply author: Roof_Dr_Sr
Replied on: 03/22/2004 07:02:14
Message:

That’s good Ghostbuster, especially coming from someone who uses a ficticious name and claims to live in the Bermuda Triangle. The purpose of me being here is to have both sides of an issue represented. I don't know what book your referring to but the one we use is the one furnished by the "National Roofing Association", not the one furnished by an insurance company called "The many ways to save money when adjusting a hail claim".
As Anna DeLong once stated, "I thought it was the job of an adjuster to help a policyholder in times of need, not see how much money I could save the Insurance Company". What's wrong with that attitude Ghostbuster? Why not have better employees who are trained to put a roof on properly? Doesn't that save the insurance company time and money in the long run?

Reply author: alanporco
Replied on: 03/22/2004 11:01:12
Message:

Roof Dr. Sr., you need understand that if you are as honest as you say you are, then you are a very rare bird indeed. Adjusters are constantly battling roofers statements to homeowners that the roof should be paid for by the insurance company because it has damage and needs replacement. The problem usually lies in the fact that the damage and the need to replace the entire roof are two separate issues - one covered, one not. BUT, since the ROOFER said ...

Reply author: Ghostbuster
Replied on: 03/22/2004 11:43:40
Message:

And, the National Roofing Association website is where you should be sharing these items of interest to others of your ilk.

Reply author: JimF
Replied on: 03/22/2004 18:41:43
Message:

Alan, since you mention the battles we as adjuster sometimes have to fight with roofers, let me share a few tidbits from a real live claim up here in Connecticut which I am now handling.

Risk has had interior ice dam water infiltration damage in the rear kitchen.

Risk is located in Old Greenwich (the "Beverly Hills of the East Coast"). Roof is 7/12 with 18" red cedar shingles, and in my opinion, there is no damage whatsoever to the roof system or cedar shingles.

Now let me share what the Insured's roofer writes in his proposal to the Insured and insurer. These are the exact quotes:

Due to the most extensive ice damming since 1934, thousands of roofs were irreversibly damaged beyond repair.

Fortunately, yours can be repaired. Instead of a new $45,000.00 roof, your repairs are only $15,000.00.

The roofer goes on to mention that this terrific bargain for 9 squares of Number 1 18" red cedar shingles is only $15,000.00.

His price of course includes the 72" GAF "weatherwatch" ice dam protection system, which of course the insured does not have now.

And, his price includes 36" ice and water valley barriers which the insured also doesn't have now.

And, his price also includes copper chimney, vent and valley flashings, which again, the insured does not have.

Now has anyone ever seen or heard of felt or cedar shake shingles failing or being damaged due to freezing temperatures? (There was no significant build up of ice on the wood shingles by the way).

Now what's wrong with this picture?

Reply author: KileAnderson
Replied on: 03/22/2004 19:59:28
Message:

Sounds like a typical roofer to me, Jim.

Reply author: Janice Toll
Replied on: 03/22/2004 20:03:46
Message:

What's wrong with this picture is - Roofer needs money!

Reply author: Ghostbuster
Replied on: 03/22/2004 21:16:09
Message:

Obviously, this loss was mis-assigned to you, Jim. By all manner of current, correct, executive rationale, this loss SHOULD have been assigned to Apu at the customer crisis call center in Bombay for complete handling by phone. Apu would have had the Insured get two more estimates and then paid the lowest bid and closed the file. (Thank you...Call again!)

The days of the field adjuster are over...yours is an irrelevant function. If the ilk ofRoof Dr Sr and their ego-maniacal, profit gorging practices want $15,000, then they should have it. That the Insured will actually be keeping about half that to put down on a new car, is quite beside the point. The Insured and the roofer are deserving of having Santa Claus come to visit in the merry month of March.

It's a brave new world out there, Boys & Girls!

Reply author: JimF
Replied on: 03/22/2004 21:47:21
Message:

Ghost I acknowledge that some of these claims no doubt accidentally slipped through the cracks into my hands, but I am wondering how our friend Apu is going to handle one of these disputed sticky contents claims when one of these slick New York area Public Adjusters presents his rather inflated and grossly exaggerated UPP list?

One can never settle these claims without the customary social introduction by way of a little face to face discussion of family genealogy and the family gene pool history. I doubt Apu is going to understand some of the insurance words we reserve for those discussions with our Big Apple PA friends.

It's an alpha thing that Apu beta learn.

Reply author: alanporco
Replied on: 03/22/2004 21:55:24
Message:

Shakespeare just hadn't met any roofers or he'd feel the same way about them that he did lawyers.

Reply author: Tom Toll
Replied on: 03/22/2004 21:59:50
Message:

Stephen King could explain all our insurance problems to Apu.

Reply author: Czar
Replied on: 03/25/2004 23:40:40
Message:

I am new to this forum and web page in general, but I had seen that you are talking about my favorite subjects, hail and hail damage. To adjusters there is a difference between the two, although my difficulty is making the insured understand the difference after they have had a long discussion (sales pitch) with their contractor. Any suggestions on how to communicate this to the insured in a way that they lose the "FREE ROOF" mentality, and understand that I am at their house to give a fair and honest assessment of the damage, if any.

The background of my frustration is that I work as a IA in Columbus Ohio, and within the last 1 1/2 years we have had 2 hailstorms, to, what I consider, a minimal degree of hail size. I would estimate that on the couple hundred roofs that I have inspected, that about only 20% needed partial replacement. Since 99 times out of 100 the contractor has already been in the insured's ear promising them a new roof, new siding, and money to cover their deductible, I feel that I am fighting an uphill battle. After about 6 months I finally got to the point that I started thinking about buying every roof to just get rid of the headaches and phone calls from the agents, insureds, and roofers. Thank god for winter and the snow (cuts down on inspections). Thanks for any suggestions given.

Reply author: MysteryCat
Replied on: 03/26/2004 01:32:48
Message:

My suggestion is that you should either 1) move to an area that has REAL hail or 2) Become a roofer since it only took six months for you to give up your ethics and give in to the con man roofers.

Reply author: MysteryCat
Replied on: 03/26/2004 01:39:39
Message:

Oh and with regard to "Thank God it's winter"... If you want to do less inspections ... go to work flippin burgers or somethin... please.

Reply author: LarryW
Replied on: 03/26/2004 01:40:12
Message:

Czar, Welcome to the hectic world of cat adjusting. Fortunately or otherwise, Columbus has not had a hail storm during the last 30 years. Now you get two of them in 1 1/2 years. I can only imagine all the battles with roofers that you may face. I can only try to imagine the contradictory positions taken in the local claim handling community.
Good luck over the next two years dealing with those problems. Warm regards to the Columbus Claims Club. Go Buckeyes.

Reply author: Czar
Replied on: 03/26/2004 01:55:32
Message:

Mystery Cat

Did not mind the 8 to 10 inspections a day. The problem that I had was that after getting off a two story roof to meet with the insured to tell them that they did not have damage to their roof, I could look across the street at the neighbor's house and see a staff adjuster from the biggest insurer in the city getting an agreed price from the ground with the contractor and not conducting an inspection. Also, did not mind the work load and did not give into roofers, just needed a break to catch up on my casualty work. I know that it will start up again this month.

Reply author: LarryW
Replied on: 03/26/2004 02:07:29
Message:

Czar: Ignore MysteryCat, he is so knowledgeable about this business and so confident of his postings that he won't even give his real name. His words mean nothing. His reference to moving to an area that has real hail is a giveaway, he is not an adjuster. He is a probably a hail adjuster only (probably in that big state). You can bet he has never handled any claims in his life other that residential property hail claims and has no concept of what you do for a living (adjusting real claims). Mr. Mystery Cat should spend a winter in Columbus, then lets see how he BRAGGS about all the inspections he did or how much he enjoyed it. HE would likely resort to flipping burgers for a living if he had to endure that far a couple months.

Reply author: MysteryCat
Replied on: 03/26/2004 02:34:29
Message:

Czar... yes ... WELCOME
Larry ...
Thanks for that.
I was only responding to what limited info that was posted originally. I wish you both a successful career.

As far as the rest...
I am a real adjuster, multi-lines and have actually worked claims in a BIG state, and have endured YEARS of claims handling in wintery states and am somewhat proud to announce that it was NOT worthwhile, in hindsight (Scarce bikinis).

Reply author: LarryW
Replied on: 03/26/2004 02:37:21
Message:

MysteryCat: You are a real credit to this profession, if you even know what the word profession means. Someone posts an intelligent inquiry about a real claims situation and your only response is to disparage, criticize and demean. One that acts within a profession should bear a professional demeanor, you are not among those ranks.

Reply author: LarryW
Replied on: 03/26/2004 02:45:21
Message:

MysteryCat: Thanks for the good wishes for a succesful career. I have already had a successful career. Good luck to you in yours.

Reply author: MysteryCat
Replied on: 03/26/2004 02:53:37
Message:

Larry you are correct, "MysteryCat" is on a rampage tonight. For those who have suffered "MysteryCat" apologizes.

Czar, as I said before, WELCOME.

You will get good and bad info on this site. It's up to you to differentiate it all.

My suggestions above #1 and #2 above still apply.

Reply author: LarryW
Replied on: 03/26/2004 03:32:14
Message:

Czar: In response to your original post, about discussing your findings with a policyholder: You inspected the roof and you present your opinion of that which you observed. No hail damage on the roof? The policyholder (or their roofer) disagrees? You are entitled to your opinion. In the event a roofer disagrees, then you need to resolve the disagreement. Offer to meet with the roofer on the roof and invite the policyholder to be present. With all parties present, ask the roofer to identify everything he/she considers hail damage. Discuss each presentation of hail damage and make your points, pro or con. If the roofer convinces you that the roof is hail damaged, then pay for that damage. If the roofer cannot convince you of hail damage, then respectfully disagree. You may then want to get a roofer whom you trust and respect to inspect and give his/her opinion. Present that secondary roofers opinion to the Insured, 95% of the time the claim is then settled. At that point, if there is still disagreement, leave it up to the policyholder to prove their claim. Preferrably with an assessment from someone who has no financial interest in the outcome of the dispute. If you still don't buy their arguments, stand your ground. Lawsuits are based on disagreements and that is their option.

Reply author: alanporco
Replied on: 03/26/2004 09:41:48
Message:

Czar, definitely get, the roofer on the roof if you can. I've found that if their claim of covered damage is bogus, they won't show. If they are ignorant, you can educate them as to what is covered and what is normal wear & tear, deterioration due to age, etc. And maybe you missed something. Reinspecting a roof at a different time of day can help locate damage that was unseen on the first inspection due to the difference in lighting conditions. If you are still unable to resolve the claim, notify your supervisor of the problem (basically, let them make the call). If you disagree, be sure there is a notation in your file that the decision to replace was made by the supervisor (standard CYA).

Reply author: Johnd
Replied on: 03/26/2004 10:38:37
Message:

Actually, I have had pretty good luck by getting the roofer on the roof, handing him/her a piece of chalk and telling them to make me a test square to prove the damage. You would be shocked at some of the "test squares" I have had the pleasure to "review." AND, a few times a GOOD roofer has shown me a very good test square that has immediately changed my mind.

Reply author: trader
Replied on: 03/26/2004 11:35:52
Message:

Only comment after reading Alan and JohnD is: If you find no hail damage with poor light conditions such as dusk or cloudy days, and everyone is upset I suggest you reinspect on the next bright sunny day and you will see what you could not see under poor light conditions. I have apologized several times to the "upsetee".This was on light color shingles. In any light conditions
charcoal or black singles are very trickey, you may need the putty knife to feel underneath. I have been wrong so many times on new charcoal that I request permission to inspect the house next door sometime.

An ole timer said he would have a poor year if he was not inspectiong on Easter morning.

Reply author: Czar
Replied on: 03/26/2004 18:16:25
Message:

JohnD/alanporco:

I usually meet with all roofers, as they are running around forcing uninformed insureds into signing a contract that basically entitles them to their first born and in some cases their second. The one problem with handing a roofer a stick of chalk, is that once he has completed circling every defect, tool mark, foot traffic, deterioration mark,(heck I've even had a roofer circle a mark that he made when he dropped his tape), the insured notes all of these circles and comes to the conclusion that its an early Christmas this year, and there never seems to be a way to get this out of their mind.

Reply author: alanporco
Replied on: 03/26/2004 19:44:54
Message:

Czar, The scenario you just described in very common. After the roofer has marked everything he considers to be damage, you can either point out the marks that are wrong or kick it over to a supervisor. If the roofer has marked a lot of stuff that is not covered damage, your supervisor will probably think better of you for not just caving in, albeit the supervisor might authorize you to pay more but, at least, then it's the supervisor's call. (Do not forget the CYA note.)I've had a roofer try to tell me that bullseyes on wood shakes are caused by hail hits and that curling of shakes is caused by high winds.

Here's another thought (something I've done): Many CAT adjusters are former roofers. If you have a really problem claim and the supervisor can't or won't help you, see if one of the adjusters at the CAT site has a roofing background. Offer to buy dinner if that adjuster will go with to show the roofer what's what. It is well worth it to able to close a problem claim.

Reply author: KileAnderson
Replied on: 03/26/2004 21:16:17
Message:

I don't see the problem. Inspect. If no damage, deny. If they call back and say there is a roofer who says there is damage and "everyone on my street got a new roof", meet with the roofer. If he can show you hail damage and convince you that the roof is in need of replacement, pay for it. If not, deny again and close the claim. If they call back, just say "Sorry, I've inspected, reinspected, no damage found, claim is closed." If you are in this business to make friends, maybe you need to find another business.

Reply author: KileAnderson
Replied on: 03/26/2004 21:17:32
Message:

Oh, and another thing, remember, when the roofer is circling every blemish on the roof, you don't have to explain what it is, just what it isn't. If it isn't hail damage and you are sure of it, say so and move on.

Reply author: rbryanhines
Replied on: 03/26/2004 21:31:42
Message:

The bottom line when adjusting a claim is to follow the guidelines in claims handling (time tables, documentation, ect..). Assuming the above mentioned is done, then all that’s left is to make the right call. Your job is to adjust the claim properly. It is not to make the Insured feel "warm and fussy". Inspect once, if there is no damage then submit the file with no damage. If the insured or his roofer feels there is damage then reinspect. If your reinspection confirms your first opinion, explain to the insured your position and his right for appraisal under the policy. You've done your job, so sleep well.

Reply author: LarryW
Replied on: 03/26/2004 22:17:43
Message:

rbryanhines: The appraisal process outlined within the homeowner's policy is only meant to be used in the event that there is a disagreement over the amount of the loss. Not the cause of loss and not the fact that a loss occured. If everyone agrees the roof is a total and disagree about the cost to replace it, then the appraisal process is appropriate. If the disagreement is over the cause of the loss, the appraisal process is inappropriate. If the disagreement is over the fact of a loss (as in whether the roof was damaged or not), then the appraisal process is inappropriate.

Reply author: alanporco
Replied on: 03/26/2004 23:08:48
Message:

LarryW, What policy provision would be available to a policyholder per your post @22:17:43 if there is disagreement involving cause or something other than the cost? Don't say the policyholder can sue. Oh, they can sue, BUT the court will send it back to the appraisal process because that must be done before one can sue.

Reply author: LarryW
Replied on: 03/26/2004 23:31:38
Message:

alanporco: The appraisal process is purely optional. Both parties have the option to invoke it. It does not have to be utilized. It can or should only be utilized only for its stated purpose which is to resolve a disagreement about the amount of the loss. The only option I am aware of, other that the policyholder filing suit)is that arbitration may be undertaken, but then only if both parties agree to do so. And that is typically outside the adjuster's scope of authority. I am no attorney, but i doubt the court would send it back. The court cannot invoke the appraisal process, only the two parties to the contract may do so.

Reply author: alanporco
Replied on: 03/27/2004 00:09:09
Message:

LarryW, I don't know of any policy that provides for arbitration. Appraisal is basically arbitration. The insurance industry likes to use their own jargon; unfortunately, they choose words that have different meanings to the rest of the world. As an example: Depreciation. Ask any CPA what depreciation is to an accountant, it is different than the depreciation used by the insurance industry. I started in this industry as a broker of primarily commercial insurance. I can remember many an accountant going nuts trying to figure out what information was needed to complete Loss of Earnings applications; same or similar words, different definitions.

I have seen 2 claims where the policyholder sued without first going through appraisal. In both cases, the court said that, per the policy, all terms of the policy must complied with before suit can be brought. Here I refer you to the policy section titled "Legal Action Against Us." I live in California, maybe the courts here do it different than where you reside.

The Appraisal clause states that if there is a disagreement about cost, either party can invoke appraisal. If the adjuster/insurance company says only half the roof is damaged and make their settlement offer based on that and if the insured believes that the entire roof is damaged, obviously there will be a disagreement about the cost. Thus appraisal. I have also seen insurance companies use appraisal in these cases when they feel they are right. Often times they win because the insured based their position on what some contractor had told them.

Reply author: rbryanhines
Replied on: 03/27/2004 01:56:43
Message:

Actually Larry, it depends what state your in. Some states don't allow arbitration. In those states, everything (cause and cost) is handled under appraisal. You're correct that in some cases appraisal is optional. However, a judge will typically send the case to arbitration/appraisal before he/she hears the case. My point was that as an IA adjuster just handle the file in a professional manner and make the right call. After that let management handle it.

Reply author: LarryW
Replied on: 03/27/2004 02:45:19
Message:

Alan: You are right, I guess, appraisal is similar to arbitration. But it is different. Arbitration is a process where a panel of people or an arbiter will hear both sides of an issue and the panel or arbiter will determine which party is correct. The policy does not provide for arbitration. I was responding to your question concerning an insured's options, but re-reading your earlier post I see that you asked what policy provisions are available to the Insured. The insured has one option (in the case of disagreement)under the policy: Invoke the appraisal clause of the policy. All of his other options are extra-contractual. If an insured files suit without invoking the appraisal process, the company may invoke the appraisal clause and may make that point in their responsive pleadings. That being the case, the courts will, as you point out, require compliance per the "legal action against us" provisions of the policy.

If both parties agree that half of the roof is damaged and they agree on the "amount of loss" or cost to repair that damage, there is no dispute. The insurance Co. should pay the undisputed amount of the claim. Concerning the other half, the dispute is not about the "amount of loss" or cost of repair, but instead the fact of loss or cause of damage is being disputed and that is not subject to the appraisal clause of the policy. As you point out, jargon comes into play or gets in our way here. The first thing the adjuster hears when he/she offers settlement is "I do not agree with the amount of the loss which you are offering. My roofer says it will cost $5,000 to replace my roof, but you say my loss is $2,500 to replace half of it".

I guess the best way to explain it is that you have to agree on the loss (damage) before you can agree on or dispute of the amount of that loss. In this example, the loss is not agreed. Unless or until you can agree on the scope of the loss, the amount of the loss can neither be determined nor disputed.

Suppose a roofer insists the roof is hail damaged and needs to be replaced and gives you an estimate of $5,000. You inspected it and you found no hail damage. Is your dispute over the amount of the loss? No, you are disputing that there even was a loss. A question of fact for a court to decide.

On the other hand, if you agree the roof needs to be replaced because of hail damage, but your estimate is $4,000, then you disagree on the amount of the loss. Now lets go to appraisal.

Reply author: LarryW
Replied on: 03/27/2004 03:13:38
Message:

rbryanhines: Hurricane strikes with major flooding. Policyholder has no flood insurance. The insured's oceanside house is insured by your homeowners policy in the amount of $300,000. There was one inch of rain with the storm, but six feet of floodwater (with a clear water mark) inside the insured dwelling. You agree with the insured's contractor that the wind damage on the roof will cost $250 to repair, but he says the interior damage of $260,000 is form roof leakage. The insured demands appraisal. Now what?

Reply author: Czar
Replied on: 03/27/2004 07:13:05
Message:

Thank you all for your replys and suggestions. As a multi-line local independent, I usually have more then just hail claims on my plate running around after truck losses, house fires, and the occasional slip and fall. I will attempt to apply the suggestions that I have received here, but unfortunately I do not alway get the backing from the carrier when I report no damage. It seems they want the insured to feel "warm and fuzzy".

Thanks again

Reply author: katadj
Replied on: 03/27/2004 08:01:56
Message:

The Appraisal process is one that is mis-understood by many.

A)The process can be invoked by any party to a policy which contains the clause. ( most P&C policies contain the clause, and the verbiage may differ)

B)The process is required, prior to bringing suit, but suit can be filed prior to the process.

C)Depending on the State, a local official of jurisdiction (Judge) can require compliance even if in suit.

D)The process is used to bring a swift resolution to the claim, in lieu of the bringing of suit.

E)The process is to resolve any dispute between the parties, except COVERAGE.

F)Both parties do NOT have to agree to the process.

G)Either party can invoke the appointment of an umpire, (required prior to inspection) without the consent of the opposing party, if the appraisal timelines are not met, or if the opposition “fails to act” the appraisal can be terminated.

H)The ONLY decision the umpire is required to make is the differences between the appraisers. (i.e. they agree on everything except the price of a teacup, or they disagree on the entire loss)

I)Any two (2) signatures on an appraisal award are binding and if accepted by the carrier is normally paid. However the appraisal can be vacated for proper cause or the carrier reserves the right to not pay and then the process of suit will follow.

The CADO convention of 2000 had a lengthy discussion on the topic and supplied all interested with documented information.

There finally is a book written on the subject and is available from the author. It is excellent and notes many references to case law.

Reply author: fivedaily
Replied on: 03/27/2004 08:58:19
Message:

This thread is far off topic. I have copied posts concerning appraisal into:
http://www.catadjuster.org/forum/topic.asp?TOPIC_ID=916

This thread is now locked.
If you wish to continue the discussion on what is or what isn't hail damage please begin a new thread.

Jennifer, moderator

CatAdjuster.org Forum Archives : http://www.catadjuster.org/forum2/