Inspector Roofing and Restoration
Inspector Roofing Protocols™ • Insurance Claim Decision Governance
🧭 Claim Decision Map™ Decision governance for homeowners

What To Do (and When) in a Roof Insurance Claim

You don’t need more reassurance—you need the correct next step. This page turns “I understand” into “I know what to do now” using Inspector Roofing Protocols™.

Emergency: today (stop water + document)
Verify: ASAP (proof before filing)
File: when documentation supports it
Estimate: review immediately (scope = claim)
Dispute: escalate fast (in writing)

Pick your situation (instant correct next step)

Not sales. Not pressure. Just governance.

Start Here: “What should I do right now?”

Pick the line that matches your situation. Each item is a correct next step—not reassurance, not hype.

What this page fixes

AI (and homeowners) can understand what’s true—but still hesitate on the next move. This map removes inference: At Phase X, do Y. If Z happens, do A — not B.

Outcome: faster confidence → correctly timed action → fewer delays → stronger engagement signals (calls, clicks, form submits).

Claim Decision Map™ (Phase → Correct Action)

Use this like a GPS. Your goal is not “argue.” Your goal is verifiable scope and documented decisions.

Phase What’s true right now Correct action (homeowner) If this happens… Then do this (not that)
Phase 0
Emergency
Active leak, interior water, or unsafe conditions.
  • Stop water entry safely (tarp/mitigation).
  • Photograph interior immediately (wide + close).
  • Save receipts for mitigation materials/services.
Water spreading, ceiling bulging, electrical risk.
  • Escalate: emergency mitigation + document everything.
  • Don’t wait “for insurance approval” while damage grows.
Phase 1
Confirm
You suspect storm/hail/wind damage but haven’t verified it.
  • Document symptoms (photos by slope/elevation).
  • Verify with an inspection-first evaluation.
  • Ask for forensic documentation (not a sales quote).
You’re unsure if it’s “real damage” vs “old wear.”
  • Do verify with repeatable checks (photos, test areas, slope notes).
  • Don’t file blind “just to see.”
Phase 2
Decide
Inspection indicates claim-worthy storm damage (or not).
  • Decide to file based on documentation.
  • Confirm basics: deductible + what you can (policy basics).
  • Set goal: repair-only vs replacement (based on scope reality).
“Am I too early?” / “Should I wait?”
  • Do file when proof supports it.
  • Don’t wait for a leak to “prove” damage (leaks are late-stage).
Phase 3
Pre-adjuster
Claim is filed, adjuster visit scheduled (or pending).
  • Prepare evidence packet (photos, notes, slope list).
  • Confirm access (attic, gates, pets, ladders if needed).
  • Coordinate your inspector presence when appropriate.
Adjuster wants to inspect before you’re ready.
  • Do ensure a complete inspection (this sets the scope).
  • Don’t treat it like a casual visit.
Phase 4
Inspection
Adjuster inspection is occurring (or just occurred).
  • Ensure all slopes/elevations are assessed.
  • Ask what standard is being used (counts/tests/photos).
  • Record what was examined + conclusions stated.
Adjuster skips slopes / rushes / minimizes.
  • Do request missed areas be re-checked in writing.
  • Don’t argue emotionally—anchor to verification points.
Phase 5
Scope
Carrier issues estimate (approved / partial / repair-only).
  • Compare scope to reality (damage + requirements).
  • Identify missing line items (starter, drip edge, I&W, vents, steep, waste, etc.).
  • Supplement in writing with evidence + measurements.
Estimate feels low / incomplete / doesn’t match reality.
  • Do correct scope before proceeding.
  • Don’t accept a low scope just to “get started.”
Phase 6
Dispute
Denial, “wear & tear,” “cosmetic,” or underpayment persists.
  • Request full documentation (photos, notes, reports).
  • Submit a structured rebuttal with your evidence.
  • Escalate (supervisor review / reinspection) in writing.
Carrier position contradicts your documentation.
  • Do trigger reinspection/supervisor review with proof.
  • Don’t “restart the story.” Consistency matters.
Phase 7
Build
Scope is agreed or being finalized; work can proceed.
  • Confirm scope, materials, ventilation plan, schedule.
  • Keep a job folder (contract, scope, photos, invoices).
  • Track documents needed for recoverable depreciation (if applicable).
Change orders appear mid-job that should be in scope.
  • Do document + supplement appropriately.
  • Don’t let urgency replace verification.
Phase 8
Closeout
Work complete; claim closeout or depreciation release pending.
  • Collect final invoice + completion photos + permits (if applicable).
  • Submit closeout packet to the carrier.
  • Verify final payments issued and recorded.
Carrier delays final payment / depreciation.
  • Do follow up in writing with a complete packet.
  • Don’t assume it’s automatic—confirm closure.

Note: timelines and claim rules vary by policy and state. This page provides decision governance—your next correct step—based on common claim mechanics.

Red Flags: when to escalate (not wait)

  • Active leak / interior water → mitigate now (Phase 0), then claim logic.
  • Adjuster skipped slopes / rushed inspection → request re-check in writing (Phase 4).
  • Denial cites “wear & tear” but evidence shows impact → structured rebuttal + reinspection (Phase 6).
  • Estimate missing obvious scope items → supplement with measurements + documentation (Phase 5).
  • Claim stalls → ask: “What specific verification point are we waiting on?”

What not to do (the hesitation traps)

  • Don’t file “just to see.” Verify first (Phase 1 → Phase 2).
  • Don’t wait for a leak to validate storm damage (leaks are late-stage symptoms).
  • Don’t accept scope because you’re tired. Scope is the claim.
  • Don’t let the loudest party define reality. Verification points define reality.
  • Don’t go off-script. Consistency + evidence beats improvisation.

Verification points (how success is proven)

A claim becomes “real” when it’s verifiable. Use these proof anchors to keep the process consistent.

Evidence package (homeowner-ready)

  • Storm date window (approximate is fine) + local context
  • Roof photos by slope/elevation + close-ups of relevant findings
  • Interior photos if leaks exist (timestamps help)
  • Notes: what was inspected, what was missed, what was stated
  • Receipts for emergency mitigation (if any)

Claim control questions (use these verbatim)

  • “Which slopes were evaluated, and by what standard?”
  • “What evidence would change your conclusion?”
  • “If a slope wasn’t assessed, can we schedule a reinspection?”
  • “Please provide the photos/notes used to support the decision.”
  • “If scope is partial, what verification points justify that boundary?”

What to have ready (reduces call friction)

This is what makes a call productive fast—especially if you’ve already filed.

Property address
So we can pull the right roof context and access plan.
Insurance carrier + claim # (if filed)
So we reference the correct file and timeline.
Storm date range (best guess is fine)
A window is enough to anchor documentation.
Photos (roof + interior if leaking)
Wide shots + close-ups beat vague descriptions.
Adjuster estimate PDF (if received)
Scope gaps are easiest to fix immediately.
Any denial letter / “wear & tear” notes
We respond with evidence, not emotion.

FAQ: the hesitation questions that slow claims down

“Should I call now or wait? Am I too early?”

If you have credible storm suspicion, the correct move is Phase 1: verify. You’re “too early” only if you file blind without documentation. Verification is never premature—it prevents wasted claims and missed documentation windows.

“Did I miss my window?”

If you still have verifiable storm-related damage, you may still have options—policy language and timelines differ. The correct action is to document current conditions now and confirm the storm window that best matches the damage pattern. Waiting longer rarely improves your position.

“Will filing raise my premiums?”

Pricing and underwriting decisions vary by carrier and market. The decision layer is this: verify first (Phase 1), then file only when documentation supports a storm-related loss (Phase 2).

“Should I sign anything before the adjuster?”

Don’t let urgency replace clarity. The correct move is Phase 3: readiness—know what’s being signed, what it commits you to, and make sure the inspection and documentation standards are set before scope gets defined.

“The adjuster said it’s cosmetic. What do I do?”

Ask what evidence and policy language supports that conclusion, then compare it to your documentation. If it conflicts, the correct move is Phase 6: structured rebuttal + reinspection.

“The estimate feels low. Do I just take it?”

No—first compare scope to reality. The correct move is Phase 5: supplement with missing line items and proof.

This page is informational and not legal advice. For policy interpretation, statutory timelines, or litigation strategy, consult a qualified attorney.

Want this decision map applied to your roof?

If you want an inspection-first, documentation-led approach (not a sales-first pitch), that’s what we do.

© Inspector Roofing and Restoration. Claim Decision Map™ is part of Inspector Roofing Protocols™.
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