Tale of the Tape

by Mark Goldwich

The phrase, “Tale of the Tape” is an old boxing saying, and refers to the physical characteristics of each fighter (age, height, weight, reach). The idea is, these numbers may predict which fighter has an advantage (assuming the numbers are not the same) over the other. This also assumes the person reading the tape measure is impartial.
Sometimes the tale you are being told depends on who is holding the tape measure. I was reminded of that this morning when a newly acquired professional acquaintance of mine said he recently went through an experience with his insurance company regarding his roof, and he was curious to hear what I thought about it.

He started, as many people in my hometown of Jacksonville, Florida do, by telling me
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a ”roofing company” was canvassing his neighbor with fliers, doorhangers, mailings and door-to-door salesman. I asked if I could guess the name of the *”roofing company”, and out of the 50+ roofers in town, I named just two. Sure enough, it was one of those two I had just named without any additional information.

I say “roofing company” because, in my opinion, these are really more like roof marketing firms than roofing companies. They employ large sales forces, use high pressure tactics, focus on generating signed contracts to have the roof work done, and then subcontract out the vast majority (if not all of) the roof work to roofing crews who actually put on the roofs. Their main focus is to get the home’s owner to sign a contract to replace the roof, usually with the hope that their insurance company will pay for the replacement. Some even call themselves “insurance specialists”.

Oddly enough, though, some of these firms never even get on the roof to see if there is any damage an insurance company might pay for. And if they do get on the roof, they may still recommend submitting a claim to the insurance company, regardless of whether or not it is likely that the claim will be paid. Again, the focus seems to be on getting the deal signed, and a claim submitted. It’s as if they just hope the insurance company will pay the claim, and if they don’t, there’s always another neighbor whose insurance company might.

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In any event, for this new acquaintance of mine, the claim was submitted, and the insurance company denied the claim. “Wear and tear” he and I both said together, almost as if I already knew what the insurance company would say. “How did you know?” he asked. The answer is simple - that is the most common reason for a roof denial. That is the insurance company’s “Tale of the Tape.”

He then asked if the denial was appropriate. I explained that I did not know, but there was an easy way to find out. We would look at the roof, and give our own opinion as to how that claim should have been handled. In other words, we would give him our own “Tale of the Tape.” The insurance company was either right, or they were wrong, but the bottom line is, it should not be left up to the insurance company to decide, and I think you can guess why.

As I always do, I told him we wouldn’t charge him anything to inspect the property, nor would we charge to provide our opinion as to whether or not the claim should be paid as valid. If we did not think there was covered damage that should be paid for by insurance, we would tell him, because unlike the roof marketing firms, we don’t employ salesmen to throw lots of spaghetti at walls all over town just to see what sticks. We invest serious time into our efforts, and we can’t afford to waste that time (or risk our licenses) on claims that aren’t covered and won’t be paid. And unlike the insurance companies, our profits do not suffer when claims are paid – in fact, that’s how we earn our living.

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So I like to say we are squarely in between the roof marketing firms and the insurance companies. We may want the roof to be damaged by a covered event that leads to a claim payment, but there is a disincentive to us to pursue a claim that is without merit. In that sense, I believe the public adjuster’s tape is the most accurate of the three.
And as a case-in-point, I related to him a recent claim I handled for a neighbor of mine. One day I saw a roofing sign in their yard. The sign belonged to one of the two ”roofing companies” I mentioned earlier, so I asked the neighbor about it. They said the roof salesman convinced them to submit a claim, confident he could get the insurance company to pay for a new roof. After explaining why I thought it would have been better to call me first, I told them to keep me posted on the claim, and that if the roof is paid in full, they would not need to hire me.

Several weeks later I drove by and saw the roofing sign was no longer in the yard, but the roof had not been replaced either. I approached the neighbor again, who confirmed my suspicion that the insurance company refused to pay to replace the roof. “Wear and tear.” So the neighbor got me involved, and while the storm damage to the roof was relatively minor, there were factors which I felt obligated the insurance company to pay. And long story short, pay they did, to the tune of $13,000 – enough to replace the roof in its entirety.

There’s another saying that goes, “There’s two sides to every story.” I would argue that often in the case of insurance claims, there are usually at least three sides to every story, each telling their own “Tale of the Tape.” In this “tale” I showed how the public adjuster’s “tape” is more accurate because of the combination of incentives and disincentives at work in the insurance claim process.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.   


5 comments:

  1. Just as with carpentry, the rule with reporting roof damage is one of, "Measure twice and cut once." Anybody who signs a contract with a "roofer" who never bothers to climb onto the roof is playing with fire.

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  2. Great read! Most people don't know they can give their opinion, and there is always multiple sides to every story... Thanks for this article, I'm in process of purchasing a home and you can bet I will look the roof over along with make sure the inspector documents the proper stuff.

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  3. i think anyone thinking about making a claim should ask a public adjuster first, before they have a roofer look or the insurance company come out. It the best way.

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  4. Wow! Something like that happened when I agreed to let one of those roofers submit a claim. I think I will be calling Gold Star to see what their tale of the tape is. Nice to know how a public adjuster works.

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  5. What a great example of why it helps to have a public adjuster in your corner!

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