Published by Keys Roofing · a St. Louis roofing contractor, not an insurance adviser The six clocks in a Missouri roof claim
Roof Insurance Claim STLThe procedure, metro St. Louis
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After a no

When a roof claim is denied in Missouri

Most of what homeowners call a denial is not one. Telling the difference is the first move, because a denial, an underpayment and a scope disagreement are three different problems with three different routes out, and only one of them starts a five business day clock.

First question
Is it a denial at all, or an estimate you disagree with?
What a denial must contain
The specific policy provision the carrier relied on.
Free routes available
Reinspection, then a complaint to the state regulator.
Paid routes available
A licensed public adjuster, or a lawyer.
Triage

Three things that all feel like a rejection

Sort your situation into one of these before you do anything else. The route out is different for each, and starting on the wrong one wastes weeks.

Formal denial

The claim is denied

A letter saying the loss is not covered, citing a provision: a wear and tear exclusion, cosmetic damage language, a roof surfacing endorsement, a finding of no storm damage, or a date of loss the carrier does not accept. This is the only one of the three that starts the RSMo 407.725(3) cancellation clock on a contingent roofing contract.

Partial

Repair rather than replacement

Coverage is accepted but the carrier writes a repair, or one slope, where you expected a roof. Not a denial. This is a scope argument, and it is worked line by line, usually with a measurement and photographs alongside the carrier's estimate.

Sticker shock

The number is just low

Coverage accepted, scope broadly right, and the amount is far below your contractor's price. Often depreciation and the deductible, which are normal, and sometimes missing line items, which are not. Check the arithmetic before assuming bad faith.

Read the letter for one thing first. A denial should identify the specific policy provision it rests on. If the letter is vague, ask in writing for the provision relied on and the factual basis for applying it. That request is reasonable, it is normally answered, and the answer tells you which argument you are actually in.
Route one, free

Ask for a reinspection, in writing, with something new

A reinspection is a normal part of claims handling, not an escalation. Carriers grant them routinely. What makes one productive is arriving with new information rather than the same disagreement in a louder voice.

New information looks like this: a measurement that differs from the carrier's aerial report and says how; photographs of a slope the adjuster did not access; documentation of the roof's actual age where the depreciation assumed something older; interior water photographed after the inspection; or a contractor's written scope identifying line items absent from the estimate, such as ridge vent footage, valley metal, drip edge or a second layer of tear-off.

The letter is short and it comes from you. State the claim number, the date of the inspection, the specific items you say are wrong, what you are attaching, and a request for a reinspection. Send it in a way that creates a record. Then note the date, because carriers are slower than the letter suggests and a polite follow-up on a stated date is more effective than three phone calls.

You send itContractor supplies the documents

A roofer can produce the measurement, the photographs and the scope, and can be on the roof for the reinspection as the contractor. Under RSMo 407.725(6) no roofing contractor may represent or negotiate the claim, so the letter goes out over your name and the conversation with the carrier is yours.

A roof stripped down to bare board decking, wide sawn planks running up to the ridge with gaps between them and one board split mid slope, with neighbouring houses and bare winter trees beyond
Board decking exposed on a Keys Roofing tear-off. Conditions that only become visible once the old covering is off are the most common honest basis for a supplement, and they are documented with photographs on the day rather than argued about afterwards.
Routes two, three and four

What exists after the reinspection

The appraisal clause
If your policy has one, it resolves amount, not coverage. Each side names an appraiser, the two name an umpire, and the process fixes the value of the loss. It cannot decide whether the loss is covered at all, and it is not free. Read the clause in your own policy before invoking it.
Missouri DCI complaint
Free, and it produces a written response. The Department of Commerce and Insurance takes consumer complaints about carriers at insurance.mo.gov and requires the company to respond. It is not a court and it will not order anybody to pay you, but a complaint puts the carrier's reasoning on the record in writing, which is useful whatever happens next.
RSMo chapter 325
A licensed public adjuster can act for you. The one trade licensed to argue the claim on your behalf, working under a written contract with a fee Missouri does not cap. Their page is here.
RSMo 375.420
Missouri's vexatious refusal statute. Where an insurer's refusal to pay was without reasonable cause or excuse, a court may add a penalty and attorney fees to the judgment. Whether that describes any particular claim is a question for a lawyer, and it is not a question a roofing contractor can answer.
RSMo 516.110(1) and 431.030
Ten years to sue, and the policy's one year clause is void here. The suit-against-us clause printed in most national forms is unenforceable in Missouri. The deadlines page sets out all six clocks.
The clock a denial starts

If you already signed a roofing contract, read this today

Where a residential roofing contract was contingent on insurance paying for the work, RSMo 407.725(3) gives you five business days to cancel it, and that clock runs from the insurer's written denial. Not from the phone call. Not from the day you signed. The contract has to carry a detachable cancellation notice, and any deposit has to be returned to you within ten business days of the cancellation.

Five business days is a week and it goes quickly while a household is absorbing bad news. If a denial letter has arrived and there is a contingent contract in a drawer, deal with the contract before you start arguing with the carrier. The claim will still be there next week. The cancellation right may not be.

Cancel in writing, keep a copy, and use the detachable notice if the contract has one. If it does not have one, that absence is itself worth noting, because the statute requires it.

A caution

What a denial is not

A denial is not proof that the carrier is dishonest, and treating every no as bad faith is the fastest way to spend money badly. Roofs age. Granule loss happens without hail. Blistering, thermal splitting, foot traffic and manufacturing variation all produce marks that look like impacts to a homeowner and do not to somebody who inspects roofs for a living. Sometimes the adjuster is right.

Equally, a denial is not the end of the process, it is a written position with a stated basis, and written positions with stated bases can be examined. The examination starts with the letter, the policy, the estimate and a measurement, and it goes better when it is done calmly and in writing than when it is done at volume.

Nothing on this page is legal advice. It is a description of routes that exist, written by a roofing contractor who watches homeowners take them.

The contractor, direct

Something new to put in the letter

A reinspection works when it arrives with new information. Keys Roofing measures the roof, photographs every slope and writes a priced scope, and you keep all of it and send whatever part of it you want to.

Keys does not write to your carrier for you, does not negotiate any part of a claim, and takes no share of any settlement. That line is drawn by RSMo 407.725 and it applies to every roofing contractor in Missouri.

Straight through to the office

Roofing, gutters and downspouts across greater St. Louis. No siding, no windows, no commercial work.

(314) 220-2333

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