If you have ever filed a claim with your property insurance company for a loss to your house, such as weather damage to your roof, you will have encountered references to something called a claim supplement in the correspondence with your insurance company. For those of us living in Florida, under a fairly constant threat of storm damage to real estate and other property, it is integral to maintain a current property insurance policy and useful to know how the claims process works, including the language associated with claims, policies, and all related factors.
While we have addressed other aspects of the claims process in previous posts, this one will deal with an explanation of claim supplements, as they are typically a portion of the claims process that is handled not by the policyholder, but by the policyholder’s contractor.
Toward what is typically the end of the claims process, anyone who files a claim will receive a document called a settlement letter, which is typically accompanied by an estimate of damages incurred and covered. While this document outlines the amounts granted by the insurance company to the policyholder as well as the method of disbursement, it is not necessarily the final word from the insurer about coverage. This is where the supplement comes in. The settlement letter will have language in it which amounts to the fact that if the policyholder or their contractor disagrees with the insurance company’s estimate, then they are free to file a supplement to the claim with a line-item estimate requesting additional funds. If the request is reasonable and properly filed, it will be taken under consideration by an adjuster and the claim will be re-evaluated. Upon evaluation of the supplement request, the insurer may grant additional funds up to the total amount requested in the supplement, although they may grant less money or none at all if they partially or wholly disagree with the supplement request and the reasons laid out in it.
It remains to explain the reasons behind filing a supplement and the process of doing it. We will tackle the reasoning first. You may think that the idea of a supplement creates a loop-hole of sorts for contractors to receive any additional funds they want from insurance companies. This is far from the truth. There are really only two reasons that a supplement can be filed and successfully go through the approval process resulting in the granting of additional funds. The first is if the insurer’s field adjuster missed some damage that was inflicted by the same peril (storm, for instance) in his or her estimate. While this is fairly rare, it is possible and easily rectifiable. For example, the field examiner might fail to note that a roof leak caused damage to the flooring or fail to see storm damage on the gutters in addition to the roof. In that case the supplement would simply consist of a line-item estimate of the costs of fixing the additional damages as well as photo documentation of the damages’ existence.
The other reason behind filing an appropriate supplement request has to do with the process of repairs itself. Oftentimes, there exist building code regulations which govern the way that parts of a house (or any other building) are repaired or replaced. While most homeowners are not familiar with the minutiae of building codes, this is not a problem, since it is a contractor’s responsibility to be well-versed in local, federal, and state building codes. For this reason, it is often the contractor who files the supplement when it is based on code requirements. We will illustrate this in two examples.
For one, did you know that in Florida if a roof repair is large enough it requires, by state code, the replacement of the whole roof? This is generally called the 25% rule. If a claim is filed for wind damage to the roof, and the insurance examiner finds that all the damage is confined to one slope, the insurance company may grant the funds for the replacement of a single slope on the roof. However, it is illegal for a roofing contractor to replace just one slope. Thus, to do the job properly, a contractor will file a supplement for full roof replacement.
Another example has to do with frequent code changes. For instance, starting in January of 2021, Florida requires two layers of synthetic or felt underlayment on each new roof or roof replacement, with the alternative being one layer of peel and seal (a self-adhesive ice/water shielding membrane). If the adjuster is unaware of the new code updates, he or she may grant only enough funds for one layer of felt or synthetic underlayment, in which case the contractor will supplement for the second layer in order to make sure there are enough funds to perform the work up to code.
Having covered the reasons for filing a supplement, it remains to address the process of doing so. A supplement typically consists of three parts: the estimate for additional funds, the justification behind asking for them, and documentation in support of the justification. Frequently, the estimate must be a line-item estimate detailing each step of the repair process and its cost. The cost must conform to the price lists used by insurance companies, which is why most contractors use the same software as insurance companies to put together their line-item estimates. The justification outlines the reasoning explained above, as appropriate, and the documentation typically consists of photos of additional damages or citations of building codes. Once all required documents are submitted to an insurer’s claims department, a response to the supplement is typically sent to the policyholder within 14 business days.
If you have any questions about roofing supplements, we would be happy to help you out. Florida’s Best Roofing, Inc. is a fully licensed (CCC 1325974) and insured, local roofing contractor with decades of experience. If you are interested in roof replacement or repair and you are in the Palm Coast, Flagler, or Volusia area, please give us a call at 386-263-7906 for a free estimate!