After a hurricane or a hailstorm, a quick roof repair might feel like the answer to all your problems. Tarps go up, shingles go down, and it looks like the worst is behind you. But if you’re a public adjuster or contractor, you know the truth: patchwork isn’t always protective for policyholders.
When the insurance company won’t acknowledge the full scope of the damage or delays the claim indefinitely, it may be time to bring in legal support. These red flags indicate that your client may need an attorney to step in.
The Insurance Company Blames “Wear and Tear”
Insurance adjusters often rely on boilerplate language to limit payouts, and “wear and tear” is a common go-to. However, not all roof damage can be simply written off as routine aging. If the timeline, weather event, and pattern of damage point to a covered cause, such as hail, wind, or a fallen tree, then the claim deserves a thorough and fair evaluation.
When an insurer brushes off legitimate storm damage with generic language, it may signal that the claim is being undervalued or improperly denied. A property insurance attorney can help challenge that determination with expert analysis and legal leverage.
Only Part of the Roof Is Being Covered
This is one of the most common pain points in partial denial cases. The insurer agrees to cover only one slope of the roof, even when partial repairs to the roof would result in an inconsistent appearance or violate local building codes.
Most policies include language that entitles the insured to be made whole, not just “patched.” Depending on state law and the policy’s terms, that may include full replacement if uniformity or functionality is compromised.
If the insurance company refuses to acknowledge this, and the client is left deciding whether to pay out of pocket for the rest, it’s time for them to consult legal counsel.
Significant Interior Damage Isn’t Being Addressed
Roof claims often come with water intrusion, such as wet insulation, damaged drywall, mold growth, and compromised electrical systems. If the insurance company covers roof repairs but ignores interior issues, they’re setting the property owner up for issues further down the road.
That’s not how property insurance is supposed to work. When coverage is selectively applied, or when interior damage is chalked up to “delayed maintenance” without evidence, it may require a legal push to get the full scope of damage recognized.
The Claim Has Stalled Without Explanation
Long delays with little to no communication are cause for concern. In some cases, insurers stall in hopes that the policyholder will give up or accept a lowball offer out of frustration or financial need.
If your client’s claim has been in limbo for weeks or months, despite repeated attempts to move it forward, they may need an attorney to compel the insurance company to act. Many states have laws that require insurers to respond and act in good faith within a reasonable timeframe. At Merlin Law Group, we help enforce those rights.
They’re Being Pressured to Sign a Release Too Early
If the insurer is pushing for a quick settlement in exchange for a release of further liability, your client should be cautious, especially if all the damage hasn’t been fully identified or repaired.
Once a release is signed, it may be nearly impossible to reopen the claim. A policyholder should never feel pressured into closing out a claim just to get a partial check. An attorney can review the offer, evaluate whether it’s fair, and protect the client from forfeiting future coverage.
When It’s Time to Refer, Call Merlin Law Group
As a public adjuster or contractor, you’re often the first to spot the cracks—not just in the roof, but in how the claim is being handled. You know when something’s off, when the insurer’s response doesn’t match the damage, or when the policyholder is being left in the dark.
That’s when it’s time to step up and start advocating for your client’s legal rights.
At Merlin Law Group, we work side-by-side with professionals like you to step in when claims hit a wall. Our attorneys focus exclusively on property insurance law. We know how to navigate policy language, build strong documentation, and push back when insurers overreach or underpay. We’ve helped thousands of policyholders across the country recover what they’re owed, and we’re ready to help yours, too.
Reach out today to connect with our team.
