Insurance Claim Process

Many homeowners’ are unfamiliar with the insurance claim process. We make sure that you are given what you are owed.

Here is the process followed by a much more simplified version.

Schedule a storm damage evaluation with Ray Gilbert & Sons, Inc. It is not required that you are home. We will evaluate the roofing system, all elevations of your home and also any personal property around the home for storm damage.

If your home’s roofing system was compromised, file a claim with your insurance courier by calling their claims department directly. If you call your agent, they may try and convince you otherwise.

Understand if you have an Actual Cash Value (ACV) policy or a Replacement Cost Value (RCV) policy. If you have an ACV policy, you will be looking at paying more out-of-pocket. If you have an RCV policy, the only out-of-pocket cost will be your deductible.

Insurance claim representatives ask you several questions such as the following: 

  • The storm date/time
  • Where the storm damage is
  • Type of roofing system
  • Age of your roof
  • If you have any pictures of the hail
  • Have any interior water damage
  • If your home is 1, 2 or 3 stories
  • If your roof is steep
  • If a tarp or immediate repair is necessary

Once you answer all of the questions to the best of your ability, a claim number will be given to you. Make sure you write down that number.

An adjuster will also be assigned to you. Make sure to write down the adjuster’s name and number. The adjuster will then call you, usually between 24-48 hours, to set up a time and date to come inspect your home. You are not required to be home during the inspection, but it is highly recommended especially if you have interior damage. Immediately call your Ray Gilbert & Sons inspector and let him know the date and time of the scheduled adjuster’s meeting.

We will arrive for the inspection and go over everything with the adjuster. This is an important step because we want to make sure that they are giving you a fair evaluation. We will make sure that they do not miss any damage on any component. We will use our knowledge to best support your case of total roof compromise.

Once the claim has been approved, most adjusters will let you know what your insurance company is going to cover. He will then write up an estimate and issue you an actual cash value check (ACV).

After you receive your estimate, immediately send it to your RGS inspector or schedule an appointment to go over it. We will explain all of the line items and check system so you fully understand the estimate. Understand that what the estimate states and the numbers are just that—an estimate. The ACV check may have your mortgage company as an endorsee on it. Call your mortgage company and ask where you need to take or send the check to have it endorsed.

Most insurance estimates are not accurate and components are forgotten. This leads to the replacement cost value (RCV) proceeds to be too low to complete a proper replacement.

Now we complete a contract stating that we will complete all repairs per your claim. In some cases, you may not want to complete a specific line item for a plethora of reasons, and that is your choice so we can leave that item off of the contract, and you will not be charged for it.

The contract allows us to contact your insurance courier and request additional funds or additional components to be paid for. We will provide them with the reasoning’s, pictures and a re-written estimate. Ray Gilbert & Sons, Inc. is not a public adjuster and cannot legally act as one, so in some cases, we highly recommend stating your case to the adjuster over the phone.

As soon as the negotiations process is completed, work will commence immediately. You will always know when materials will be delivered, and when the crew will arrive.

When ALL of the work is completed, we will send the adjuster a certificate of completion, and request the depreciated funds to be released. Once the final check is received, repeat the same mortgage process if needed. A final invoice will be sent to you, and once you are completely satisfied with all of the work, we will finalize payment.

 

 Simplified Process

  1. Set up an inspection with Ray Gilbert & Sons, Inc.
  2. File a claim
  3. Set up adjuster meeting
  4. Go over paperwork with RGS inspector
  5. Complete a contract
  6. Negotiations with insurance courier
  7. Work will commence
  8. We will send insurance certificate of completion
  9. Final payment and warranty issued

Insurance companies no longer issue one large check like they used to. They now use a 2 check system comprised of an Actual Cash Value Check and a Depreciation Check.

The only cost to the homeowner with a replacement cost policy is their deductible. If the homeowner chooses to add any upgrades or additional work, those costs would be added to the deductible.

If you choose to get bids from several contractors, any bid that is lower than the insurance estimate is good news for your insurance company. Your insurance courier will keep the difference between their estimate and the bid of the contractor you choose and cannot be used towards your deductible.

According to Missouri Senate Bill 101 homeowner’s are required to pay their deductible in full to the company that is performing the work or it is considered insurance fraud.

 

Actual Cash Value Check – The value of the damaged items on your home. This decreases over time. They will also take your deductible out of the first check. Your deductible is paid to your contractor at the completion of the project.

Depreciation Check – The amount of money withheld due to age of the components. If you have an RCV policy you will receive a depreciation check once all repairs are completed.

 

ACV + Deductible + Depreciation = Replacement Cost Value

 

What happens if the adjuster denies your claim?

You are allowed to file for a re-inspect with a different adjuster if you feel that you were not given a fair evaluation. If the second adjuster also denies your claim, you may enter arbitration and may require a structural engineer and a neutral “umpire.”

Do I have to pay my deductible?

Yes, according to Missouri Senate Bill 101 all homeowners have to pay their deductible in full or it is considered insurance fraud. Insurance companies deducting your deductible from your ACV check is not paying your deductible. All deductibles must be paid to whoever is performing the repairs.

When hail hits an asphalt shingle roof, it will bruise the shingle and leave an indentation that knocks the protective granules loose. The granules purpose is to reflect harmful UV rays away from the home. UV rays heat up your home and will eat through the asphalt of your shingle causing a hole over time.

Wind damage is usually more obvious from the ground, as you can see missing or torn shingles from the ground. Even if you aren’t missing shingles, your home could still have wind damage. Shingles can be lifted up by wind and bent backwards, or can be lifted up in sheets and set back down to the roof. Now, your shingles are not adhered properly anymore and can be easily ripped off in the next storm leading to costly water damage.