Policyholder Question – What are my options when my insurer says I have cosmetic damage from hail?
Q. My insurance company’s adjuster is saying that they don't pay for "cosmetic damage". After many conversations with him and the contractor, he finally admitted some hail damage but estimated almost exactly the amount of my deductible, $1,000. The contractor I hired is very reputable and had all kinds of chalk marks on my roof which the adjuster dismissed as "cosmetic." I tried to get my agent involved and he said the same thing about cosmetic damage. I really don't want to let this go. There are about 20 houses in my neighborhood getting work done due to the golf ball sized hail damage. Please let me know if I have any options.
A. There has been a push by insurance companies to refuse to pay for this type of damage. In some states they have court rulings or state regulators that agree. If the damage you are describing is excluded in the policy, you may be out of luck. If there is no exclusion, then it should be covered by your policy.
Write a letter to the insurer’s Claims Manager and send it certified mail return receipt requested. In the letter, ask that person to tell you the page and paragraph where this damage is excluded. Send a copy to the President of the insurance company and the Insurance Commissioner in your state. It may sound simple but these letters often get the results you are looking for. And that is all that matters.
Lastly, if they cannot confirm that the damage is not covered by the language in the policy, look for an Appraisal provision in your policy. Tell them you want your whole loss appraised per the policy, by an outside appraisal panel. This will cost more money for them and who knows the panel may decide the loss is covered.
Good Luck and thanks for contacting us a Publicadjuster.com. If you have questions regarding any property insurance claim related issues please call 866.300.0829 or contact us to submit a question to one of our public adjuster insurance claim experts.