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Last Post 02/25/2010 10:53 AM by  Ray Hall
Roof too old to repair
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Ryan in Houston
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02/12/2010 12:59 PM

    I was having a discussion with another adjuster about this topic.

     

    Example...

     

    Hip roof about 19 sq.  3 tab, age of shingle is 15 years.  Shingles are in typical condition for their age.  About 1/3 front and rear slopes have broken and missing tabs around the ridge and scattered across the slope.

     

    I say roof cannot be repaired effectively and should be replaced.  Other adjuster says, repair because insured failed to maintain the roof.  He says carrier only owes for what was damaged and age and condition of roof have no bearing on if entire roof should be replaced.

     

    I have always considered age and condition of the roof when making a repair/replace call.  Any other have advice?

     

    Can a roof be too old to repair?  If a roof is too old and worn to repair, does the carrier owe to replace?  The carriers that I normally work for never have issues replacing a roof that's too old to be repaired.  Just show in the photos and narrative why.

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    Ray Hall
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    02/12/2010 4:04 PM

    This is a lesson I learned from the underwriting department of a major insurance company over 50 years old. The adjuster is supposed to approve  losses  to be paid". What is made by a man and installed by a man can be repaired by a man".

    Now you must approve the actual cost to repair or replace the damaged portions of the roof from the INSURED peril. Still having a problem, right.

    You or a repair person must calculate how much to repair/replace the actual damage and any footfall and if it exceeds the cost of new for old you have your answer. Age or condition has NOTHING to do with repairs or replacement.  You must also apply 19/25 depreciation on the shungles and labor.    Big ONE. If they comply with replacement cost coverage(if any) IT"S A FORTUITOUS EVENT, but its not because "they paid for the coverage".

    NEVER confuse replacement cost with coverage, you owe the cost of repair or replace.  Most auto repairs that exceed 75% of the fair market will total a crashed vehicle. This is not a rule on roof claims, but many carriers will not question the field adjuster  estimate.

    "Some one will be paid to settle all of these, It might as well be me."

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    Ryan in Houston
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    02/12/2010 5:15 PM

    I agree Ray, but is there a point of wear on a roof where it would not be considered repairable?  This is something I see often dealing with lots of lower valued dwellings.  Most are TDP1 acv forms, but a few rcv are floating around.  

     

    Of course roofers all the time say a roof is too old to repair and should be replaced.  If shingles are too brittle and falling off, how can a carrier propose to repair something that is clearly not repairable?

     

     

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    Leland
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    02/12/2010 5:31 PM
    In my experience with claims in California, if it is an actual cash value policy the carrier will often insist that they only pay for what is actually damaged. The carrier may have the opinion that if other areas need work to effect the repair, but those other areas weren't damaged, those additional areas are not covered.

    Replacement cost policies are often interpreted much more broadly.

    A good example would be a roof with 2 layers of asphalt comp over wood shake over space (or "open") decking (sheathing). A RCV policy might pay for new sheathing, under the theory that the tearoff of the top layer of damaged shingles will also inevitably result in the tear off of the layers below. Once that is done, the space decking cannot be reshingled without new OSB sheathing applied first. So due to some damage on the top layer, the insured might get a whole new roof, including sheathing they never had before, on that slope. If there is a line of sight/matching issue, the carrier might decide to go ahead and pay for other undamaged slopes, too.

    Now in contrast, if that same roof was an ACV policy the carrier might decide that they owe only for the replacement of the damaged area (per the wording in the policy) and the carrier will not entertain arguments that the repairs cannot actually be done.

    These are my examples from claims that I have handled and I'm telling you how the carriers interpreted their policies.

    If you are used to adjusting RCV HO3 policies and switch to adjusting DP003 ACV (for example) you may be very surprised at how differently the policies are interpreted.

    Also I think there is quite a difference between how RCV HO policies in California are interpreted vs, RCV HO in other states. From my experience, the requirement to allow for very very close matching of materials on an RCV policy is much stricter in California and I think it is due to the case law.

    If you have a different carrier in a different state with a different policy you may have a different experience than I did, in fact I can guarantee that your experience is probably different. Even in California you may have other carriers than I have and your experience could be different.

    You may work in a state where the case law says the decking has to upgraded and someone else may work in a state where the practice is different.

    The best thing to do is to ask the carrier.

    Covering the additional labor and materials needed because the roof is so old that undamaged areas need to be replaced may be what your carrier wants. If so, I would say that more depreciation is often appropriate in such cases. If the slope is way beyond its expected life and so old that it crumbles, depreciation of 50% might be appropriate. More than 50% I would get an OK from the carrier.
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    Leland
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    02/12/2010 5:39 PM
    Your TDP1 is probbaly ACV and is probably similar to my copy of a DP0001. Here's the words the carrier looks at:

    ...we insure for DIRECT PHYSICAL LOSS to the property.... [my caps]

    Carriers will often interpret that to mean that if you have to remove 10 sq feet of something undamaged to get to 5 sq ft of something damaged, the carrier will only pay for the 5 sq ft. (Only the 5 sq ft has "direct physical loss")

    That's how it has been explained to me, I know it may be very surprising to hear this if you are used to HO policies. I had a hard time believing it when I first heard it.

    I am off to a fire loss (on a DP1 no less) in Los Angeles, so I am signing off.
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    jdacree
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    02/12/2010 7:23 PM
    In my short experience dealing with wind/hail damage, talking with adjusters, and reading policies, I have yet to see any veriabge on age of material entered into the loss settlement EXCEPT as a function for the caculation of depreciation. In the comments above the question was raised about the age of material, making that insured damage non-repairiable. Experience gained over time is one of the keys to be able to determine if a insured damage can be repaired. This experience may be gained from personal efforts as a repairman, working with older adjusters and getting that experience through osmosis, or requesting the opnion of a repairman that you trust.

    Most policies state that the carrier will repair or replace..... The call on what will happen is determined by the adjuster on site, in most cases. I have worked with a majority of adjusters (both staff and IA), that even though the roof was completly shot, have deemed the cost to repair higher than the cost to replaqce. Part of this determination was also based on the amount of non-event damaged material that will be rendered damaged in the process of effecting the repair. In each case these adjusters documented, both by statement and photo, the basis of thier decision. In all of the above cases, other than as an aside between us girls onthe roof, no comment has been made about the lack of proper maintence of the material(s). I HAVE had saff adjusters for 2 specific carriers deny a valid claim (thier comment) simply based on the fact that the materials were old.

    I believe Ray had a good statment that in paraphrase stated ,that it is not your job to determine anything other than insurable damage, and a determination of either repair or replace. Not said was to document your finding accordingly, and if you do not know get someoe that you trust to provide guidence. There was no comment about basing that decision on the age of the materials in question.
    Jim Acree Stupidity is the art of not trying to learn Ignorance is the lack of opportunity to learn I am ignorant
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    Ray Hall
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    02/12/2010 10:09 PM

    Go back to my post. I was lold by the insurance carrier that help write the first replacement endorsement to the EC coverage on a standard fire policy. This endorsement is not COVERAGE to replace old for new. IT is purchased coverage to be reimbursed for the DEPRECIATION only, AFTER tthe restoration is complete. Go to a DP! and take 99% depreciation if the roof is worn out from age.

    I was working property claims in Texas when the "nailable surface" lawsuits were filed, they were really an Ins. commissioner strongarm for a higher office and all the carriers , but three went along. Guess who I worked for as an IA from 1992 until now, you are correct I still depreciate the nailable surface 99% (because it bwill not show up on the computer as a 0) and The carriers will not allow haul off on the 2nd layer if its a comp over a comp. And they are right , went to court and won.

    Now all states are differant, but these 3 carriers won in Texas and the rest rolled over. Some very good adjusters still think a package policy(Homeowner) with RCC built into the premium structure give new for old coverage, this COVERAGE can NEVER total a roof that can be REPAIRED... I saw a Farmers Supt. in 1995 in a room with 100 Pilot adjusters(most from Texas) in Pleasanton, CA tell the whole room "any thing made by a man, can be repaired by a man", and I better never hear the words" It was too old to repair, therefore I totaled it". Yes we slipped a lot of 24 inch thick butt wood shakes into 40 year old roofs with green mold. That gig only lasted 7 months for the one.s who paid attention.

    Do they still have these meetings with all the know it alls from Texas?  Is betterment involved yes or no. It is in 95% of all losses I have seen.

     Read the policy, it does not read the way YOU think it should. Get into law and have the law change the contracts to read your way of thinking.

     

     Kinda had a bad day with "No English" and they will get a letter in English ONLY.

     

     

     

     

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    Ray Hall
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    02/12/2010 10:20 PM

    We hear a lot about case law. But seems we never get to read the case law. Most of the "case law" I hear about is from water suckers, roofing salesman, public adjusters and people with a license and discredit our profession.

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    Leland
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    02/12/2010 10:30 PM
    re case law- I can give you some of the case law that my carriers are following, Trust me on this Ray, they know the names of the cases. I believe the case in California that says total loss ACV claims are paid at FMV (like an appraiser would figure) is the Robertson case.

    The calif assoc of independent adjusters used to have the most important case law listed out, i'll try to find it.
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    BobH
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    02/12/2010 11:42 PM
    Posted By Ryan in Houston on 12 Feb 2010 12:59 PM

    (1)...  Other adjuster says, repair because insured failed to maintain the roof.  He says carrier only owes for what was damaged and age and condition of roof have no bearing on if entire roof should be replaced.

     (2)... Can a roof be too old to repair?  

    (3)... If a roof is too old and worn to repair, does the carrier owe to replace? 

    1). Roofs become aged, brittle, and manifest thermal cracking, heat blisters, etc.  Maintenance is not typically needed to a roof, aside from proper ventilation (which begins with responsibility for the builder).  Think about the tires on your vehicle.  You can rotate them every 3,000 miles, but they are only going to last so long.

    2). Yes.  It's a pliability issue, lack of.

    3). You don't owe anything for non-damaged slopes.  Some carriers have criteria that can vary, and it is their sand box.  Assuming there is direct accidental damage to a specific slope, and the surrounding shingles are TRULY non-pliable, it can be non-repairable.  Run it by mgmt if you want to CYA and ensure that you are doing what your principle is asking

    Bob H
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    Ray Hall
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    02/13/2010 1:43 AM
    We all know insurance company's get beat up in court cases. We all know most hurricane losses, (like99.9%) in Texas never see a jury trial. Why do attorneys take hurricane cases and file suit. Yep to get a good settlement. If the suit is for damages of 224,717,43, $50.000.00 punitive and $250,000 attorney fee,s what to you think the court ordered mediation first settlement offer will be by the plaintiff....hmm about $300,000. thats in the ball park, the counter is about 5 times the estimate of 6 to 10 k. Its not settled in mediation. But some day it is settled for about $100,000.00, but we never did hear about the jury verdict on the .01 that will be tried, but that cost $450.000.00 to win that case and it could be settled for $100,000. Now you know what bodily injury adjusters and lawyers do all day.

    You young guys/gals go to law school, both sides are milking the hurricane IKE cow. If all the cases filed in hurricane IKE was to go to trial in Harris, Galveston, Orange and Jefferson county it would take 50,000 court room days or 138 years. IT would also take 600,000 jurors and you can not recycle a juror that many times in these counties. Oh Jefferson and Galveston has the most suits so they will need more courts and judges etc etc
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    Ray Hall
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    02/13/2010 1:48 AM
    I agree with Bob H in his example, however I think betterment is in ever loss . The new slope would have betterment withheld by me and I think I am doing what the contract said.
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    sbeau4014
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    02/13/2010 7:05 AM
    Ray, Leland and others,
    Just playing the devil's advocate here and not on exact par to the roof replacement issue but, lets say you have a room 20x20x10'h. total wall space =800sf, ceiling 400sf. You have a covered water spot on wall that is 1 sf and 1 sf on ceiling that req. s/r to be r/r. Do you just take out s/r, of just that exact damaged area, replace it and only paint the 2 sf of new s/r. Keep in mind that it is virtually impossible to replace only the 2 sf of actual damaged s/r due to stud/joist issues, but that is the only "damaged area". Paint is of a color that fades a bit over a few years and sunlight in room, and is virtually impossible to match up. Last painted 3 years ago. Don't consider m/c issues on this room as there are plenty of other covered damages in the house that m/c isn't an issue. Do you allow the 2 sf of s/r repair, and then 2 sf of painting of the new s/r? Do you allow replacement of the s/r to patch to the studs and joists, and depreciate a part of the s/r patch? Do you even consider painting more then the 2 sf of damaged area, and if so how much and why? If you paint the ceiling and walls completely, what would be your reasoning, and would you apply a 99% depreciation factor on 3 year old paint? As per the contract the same principles apply to this type of repair as it would a roof. Just curiious on what some people's opinions on this would be, and keep in mind I can't remember ever reading in a policy anything right on point as to what the contract says about painting anything other then the "direct physical damage".
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    RandyC
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    02/13/2010 8:49 AM
    Excellent discussion. I believe age of a roof is important to consider, but not alone. The condition of the roof per age is also important in determining depreciation.
    Ray is right that anything made by man can be repaired by man. The scripture says all things are lawful but not expedient. The repairability of an old roof is important to consider when attempting to indemnify.

    Haag has a protocol for this http://www.docserver.nrca.net/pdf/t.../;6854.pdf After considering the age...and condition of a roof, you choose an appropriate RDF or repair difficulty factor. Those factors generally range from 1 to 2 depending on age and condition.

    So to access a slope, you would count the number of damaged shinges and multiply by the factors 1, 1.5, or 2.

    The formula is expressed as: RC=DxUxRxA

    RC = cost to repair entire slope
    D= number of damaged shingles or shakes per square.
    U= unit cost to repair a shingle or shake
    R= the repair difficulty factor (how many shingles will likely be destroyed in the repair process)
    A= the actual area of the slope in squares

    So if 1/3 of the slope is damaged multiplied by 2 would =2/3 of the slope' shingles to be replaced on an individual basis. Such a roof could be repaired, but probably not as efficiently as just replaceing the whole slope. When people say, "too old to repair" that is really what they mean...or what they should mean.

    Bob says a roof does not ordinarily require maintenance. I agree...up to a point! If a roof begins to leak. It now requires maintenance as per policy. If it is allowed to leak over a period of time, I believe the exclusion is triggered.

    The only old roofs I have denied have been roofs with old leaks upon leaks over time. If those roofs are beyond the useful life and have not been maintained, I will check with my manager for guidance.

    Ray speaks of depreciating a roof 99%. I usually depreciate those crumbling roofs (no leaks present) at 80%. JIT meetings usually set that as the benchmark, but some allow 100%. My QC on last storm said I should only go 50% to give them money to get it repaired. These are RCC. That is a consideration for some people, but most of my 80% depreciated roof insureds were happy. They were going to get a new roof....for past paid premiums. They knew their roof needed replacement.

    Even a roof with 99% depreciation with leaks on various parts of the house, still offer some form of functionality. Hail can damage the parts of the roof that are not yet leaking....thus the new physical damage is real. However, I believe if they have allowed the roof to leak over time, they trigger the exclusion. I wouldn't deny the roof because of depreciation...but because of leakage over time...or whatever similiar policy language.

    These are the criteria I take with me to the inspection. It is a starting point only. I adjust my position to that of the carrier I work for so long as it fits the policy.
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    BobH
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    02/13/2010 9:17 AM
    Posted By Ray Hall on 13 Feb 2010 01:48 AM
    I agree with Bob H in his example, however I think betterment is in ever loss . The new slope would have betterment withheld by me and I think I am doing what the contract said.

    Of course, and an example would be replacing an entire run of fencing (even if it is only one of 3 long runs in the rear of the property).  If a slope is allowed to be replaced in the estimate, it will be depreciated based on age & condition.

    ACV policy, that first settlement is all they will ever see.  Most homeowner policies are RC, so once a signed contract is presented (or work completed) they can collect full replacement cost for that slope (less deductible).

    POSTED BY STEVE: Good point about interior paint - and of course virtually all carriers will allow paint of the room, not 2x2 Square Feet.  That is fairly uniform by virtually all carriers.  But with roofs (and fencing) it isn't the same.  Mankind has patched roofs and fencing for centuries, and it is a situation where matching is less of an issue (but SOME regions of the country do have matching statutes that can have local implications).

    POSTED BY RANDY_C: Yep and that concept of allowing some additional shingles for damages that will occur to additional shingles is a "tool" that can be pulled out of the tool box prior to buying the whole roof.  I think the easiest way to visualize this dilemma is when there is a large slope with only a small area of damaged tabs.  What would a reasonable person do?  When you get up on a roof that is hammered with lots of missing shingles approaching 50% it is easier to justify totaling out that slope.  When you talk about failure to maintain a roof that has leaked before... that exclusion (improper maintenance, construction, etc.) is going to speak more to the claimed damage to the interior than "lack of maintenance to the roof".  Roofs simply deteriorate, and will be depreciated based on age & condition.  People that settle total loss vehicles will understand that the valuation of the vehicle will be "adjusted" if the paint is shot, tires worn, upholstery torn.  But you aren't going to deny the claim cuz the guy didn't wax his car & rotate the tires.

    Bob H
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    Ray Hall
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    02/13/2010 10:52 AM

    Well we now have 4 very experienced adjusters agree on a real world roof claim nd an interior ceiling loss(I am in the four)

    My 99% depreciation on the wood shingle deck(nailable surface) is for the three carriers who filed the lawsuit and the policy is an ACV. All this blather can be elimated on this topic by the afjuster working the loss to explain WHY he scoped the loss this way. I can,t recall ever being over ridden by the carrier ot the coverage attorney, except one time on a large pollution clean up claim when motor oil leaked into the ground. (and they were correct)

     

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    Ray Hall
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    02/13/2010 11:00 AM

    We hear football words like "the ground can not cause a fumble" basket ball words like "dont foul a jump shooter. When working roof losses remember Its: "age alone can not total a roof"

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    RandyC
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    02/13/2010 12:08 PM
    There is always the extreme case. Let's say we have a 20 year organic 3-tab that looks like it might be 23 years old. Usually a roof only lasts about 80% of the warranty years, so this is an OLD roof. Inside there are leak stains in many places, leaks upon leaks on a wooden ceiling with peeling wallpaper. The shingles are like over-fried bacon. It's hard to identify a hail hit because the roof doesn't bruise, it breaks. There are broken shingles laying all over the roof. There is delamination everywhere of all sizes, some even hail shaped. You have to draw your chalk over it lightly or the shingle will crumble. You can barely walk this roof because of the crunch.

    Now let's make it even better. Let's say the owner tells you, it's been leaking now for six months (it might have been longer). "I knew if I waited till spring a hail storm might come."

    What if there is collateral damage? What if the only damage to the metal is rust?

    Now, maybe he's paid RCC premium for 23 years! What is the right way to handle a claim like this?

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    RandyC
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    02/13/2010 3:05 PM
    Bob, you were correct. The failure to maintain the roof resulting in leaks over time speaks more to the interior damage than the roof. Old leaks might indicate wear and tear existing before the storm, but would not be any "trigger". The language for exclusion might be, "We do not cover, however, for loss caused by... wear and tear."

    I don't have a problem depreciating ACV to 80% or even 99% if the condition is that bad. I have a problem denying a 99% depreciated roof with RCV. If I can find any justification for just depreciating it and then paying on replacement, I do it. However, once in a while I get these really bad roofs. Not having the experience you guys have, I send the pictures to my superiors and let them advise me.

    As an adjuster I am trying to develop a tolerance for ambiguity. This is one of those areas I have to live with a bit of uncertainity, but I constantly weigh the opinons of other seasoned adjusters.
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    Ray Hall
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    02/13/2010 3:45 PM

    Randy and others in his example the hail was a windfall, he was just praying for a hail storm and got his wish. It all works out you depreciate enough not to exceed the Ded. so some small check will be sent, and the hold back if he PAID for RCC which he did when he piurchased the HO. My argument is with adjusters who think-say "itwas so old.............now if its ACV I go 50-to 75% on non recoverable betterment like most adjusters. I work a lot of ACV losses and most insureds get the feeling I am doing my best for them.

    If you start saying betterment, non recoverable and thinging this way life become much less stressful.

    You may see this someday. The house is covered with double felt with disk and nail fastners and was blown away with high winds and the inside was wetted down extensivly, ceilings , walls, floors and UPP. You notice some of the felt has turned grey (age). The insured was roofing his own house, had illness or $$ problems. Yes the entire loss is covered as the felt membrane did its intended job, turning water for months before the windstorm.

    Its human nature not to penalize honest insureds. I think most of us do that. We just can not interpret the written policy wrong. For the new people Just always keep in mind photographs, measurements, wind driven rain, surface water and not returning phone calls has ruined many adjusters reputation.

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