Imagine this: A severe storm sweeps through your city, battering your commercial property with wind and hail. Your roof takes a hit, and leaks begin to appear. Confident in your insurance coverage, you file a claim—only to receive a denial letter from your insurer. The reason? “Wear and tear” or “pre-existing damage.”
This is the reality many commercial property owners and roofing contractors face when dealing with insurance claims. Insurers are quick to dismiss valid storm damage, leaving businesses struggling with costly repairs. But here’s the truth: many of these denials are based on weak or misleading justifications.
If your commercial roof insurance claim has been denied, don’t accept defeat. This guide exposes the real reasons insurers deny claims, how they use wear and tear as an excuse, and—most importantly—how to fight back and get the payout you deserve.
Why Insurers Deny Commercial Roof Claims
Insurance companies use various strategies to deny, delay, or underpay claims. Here are the most common excuses:
1. “Wear and Tear” or Poor Maintenance
The most common denial reason. Insurers argue that your roof damage existed before the storm or that age and lack of maintenance are to blame. While normal wear does occur, many storm-related damages worsen pre-existing conditions, making the insurer liable for repairs.
2. Pre-Existing Damage
If an insurer claims that damage was already present before the event, they may demand proof that the storm caused it. Without proper documentation, policyholders struggle to counter this argument.
3. Policy Exclusions & Technicalities
Many policies have fine print exclusions, such as:
- No coverage for cosmetic damage (even if it affects functionality).
- Higher deductibles for wind/hail damage, making payout thresholds harder to meet.
- Code upgrade exclusions, preventing payouts for legally required repairs.
4. Partial Denials – Offering Cheap Fixes Instead of Full Repairs
Instead of replacing a severely compromised roof, insurers may approve only minor patchwork—forcing owners to cover the rest. If the damage is widespread, a full roof replacement should be covered.
5. Insufficient Documentation
Without properly documented inspections and repair estimates, insurers claim “lack of evidence” to dispute your claim. If you don’t document the damage thoroughly, they will use it against you.
The Cost of a Denied Claim – For Owners & Roofers
Denied claims don’t just affect property owners—they impact roofing contractors as well:
- Property Owners: A denied claim means paying out-of-pocket for expensive repairs, potential lawsuits with tenants, and long-term property devaluation.
- Roofing Contractors: If insurers refuse to pay, roofers lose contracts, struggle with unpaid work, and deal with frustrated clients who blame them instead of the insurer.
The bottom line? Insurers know most owners won’t fight back—and that’s how they get away with it. But if you follow these steps, you can turn the tables.
How to Fight Back & Get Your Claim Paid
1. Get a Professional Inspection – Independent of the Insurance Adjuster
Never rely solely on the insurance company’s adjuster. Hire an independent expert—a roofing contractor, engineer, or public adjuster—to conduct a thorough inspection.
- Use drone imaging to capture high-resolution damage evidence.
- Core samples can prove hail impact and structural damage.
- Professional damage reports from roofers strengthen your case.
2. Leverage Local Building Codes to Demand Full Repairs
If your damaged roof must be upgraded to meet new codes, insurers are often required to cover the cost. Check if your policy includes “ordinance or law” coverage—this can force insurers to pay for a full roof replacement instead of cheap repairs.
3. Invoke the Appraisal Clause & Call in a Public Adjuster
Most insurance policies allow policyholders to challenge a claim through the appraisal process. This involves:
- Hiring an independent appraiser to assess damage.
- The insurer also appoints an appraiser.
- If they disagree, a neutral umpire makes the final decision.
Public adjusters specialize in negotiating these disputes and often recover significantly larger settlements than what insurers initially offer.
4. Provide Bulletproof Documentation
Your best defense against a claim denial is evidence. Have these documents ready:
✅ Before-and-after photos of your roof.
✅ Maintenance records proving upkeep.
✅ Weather reports from the storm date.
✅ Roofing contractor estimates detailing required repairs.
✅ Historical inspection reports showing no prior damage.
The more documentation you provide, the harder it is for insurers to dispute your claim.
5. Don’t Accept Lowball Offers – Push for a Fair Settlement
Insurance companies lowball settlements because they assume policyholders won’t challenge them. Fight back by:
- Submitting a formal appeal with supporting documents.
- Enlisting an attorney if necessary—especially for large claims.
- Using expert witnesses, such as engineers or roofing specialists, to counter insurance adjusters’ claims.
The key is to be persistent. Insurers profit when policyholders give up—don’t let them win.
Prevent Future Claim Denials – Be Proactive
To avoid future issues, commercial property owners should:
✔ Schedule annual roof inspections – This prevents insurers from blaming “poor maintenance.”
✔ Keep detailed maintenance records – Proof of upkeep can refute wear-and-tear claims.
✔ Work with a claims specialist before disasters strike – A public adjuster can review your policy, identify gaps, and advise you before a claim arises.
✔ Establish relationships with reputable roofing contractors – Having an expert ready before damage occurs ensures fast documentation and claim support.
Final Thoughts – Take Action & Fight Back
A denied commercial roof claim is not the end of the road. Insurers count on owners accepting low offers or giving up altogether—but knowledge is power.
If your claim has been denied, don’t accept their first answer. With evidence, expert support, and persistence, you can overturn unfair denials and secure the payout you rightfully deserve.
Need help fighting back? A public adjuster or claims consultant can tip the scales in your favor—before you spend thousands out-of-pocket on repairs. We’d love to help you out. If you suspect you could use professional help, send us a message through our home page or contact page.