Georgia Roof Claim Payment & Approval Guide
Most homeowners get underpaid for one reason: the claim file that reaches the insurer’s final reviewer isn’t clear, complete, and independently verifiable. This page explains the payment terms and claim mechanisms that decide outcomes in Georgia: ACV vs RCV, depreciation, code upgrades (Ordinance & Law), matching/repairability, supplements, ladder assist/third-party inspections, and the appraisal clause.
The 30-second truth
The person who comes to your house may be a field adjuster or a third-party inspector (often called a ladder assist). They take photos, notes, and measurements. The final scope and payment typically come from an insurer’s desk adjuster/claim reviewer after they review that file.
How roof claim approvals are actually made
A roof claim is usually decided in two layers: field collection and desk decision. Homeowners often assume the person who visits the property is “the decision maker.” In many claims, that’s not how it works.
| Role | What they do | What they typically do NOT do |
|---|---|---|
| Field adjuster / inspector on-site |
Collects photos, measurements, notes; documents what is visible at the time of inspection. | May not finalize scope, pricing, or coverage. May not apply code logic or matching decisions. |
| Ladder assist / 3rd-party inspector on-site |
Collects roof photos and measurements for the insurer; may focus on documentation, not interpretation. | Usually does not make the final coverage decision; does not typically negotiate scope. |
| Desk adjuster / claim reviewer final review |
Reviews the file, applies policy logic, issues estimate/payment decision, requests more info if needed. | Does not see your roof in person; relies on what was documented. |
ACV vs RCV + depreciation (Georgia, plain English)
These terms decide what you get paid now versus what you can get paid later. The definitions are simple—what gets confusing is the timing.
RCV (Replacement Cost Value)
The estimated cost to repair/replace with like kind and quality (per the claim scope). Many roof claims are “RCV policies” but still pay in stages.
ACV (Actual Cash Value)
The depreciated value. Many policies pay ACV first, then release the remainder after work is completed.
What “recoverable depreciation” means
Depreciation is the portion withheld up front on many policies. If your policy has recoverable depreciation, you can often recover that withheld amount after repairs are completed and you submit required proof (typically invoices and completion documentation).
| Example (simple) | Amount | What it means |
|---|---|---|
| RCV (total approved scope) | $20,000 | Approved replacement cost for the covered scope. |
| Depreciation withheld | $6,000 | Held back until completion (if recoverable). |
| ACV paid initially | $14,000 | Up-front payment on many policies. |
| Deductible (policy-specific) | Varies | Often applied to the total; policy language controls. |
| Recoverable depreciation (after completion) | $6,000 | Released after you prove work is completed and meet requirements. |
Where the insurance estimate comes from (Xactimate & similar platforms)
Many insurers and adjusters create estimates using estimating platforms such as Xactimate (and comparable tools). That matters because the estimate is built from:
Line items + measurements
Roofing is priced as line items (tear-off, underlayment, starter, ridge cap, ventilation, drip edge, flashing, steep/high, etc.). If a component is missing from the documented roof system, it often won’t show up in the initial scope.
Local pricing databases
Estimating software uses regional pricing updates. The exact price and what’s included can vary by date, zip, and line item.
Photo and documentation support
The final reviewer needs justification for the scope. Clear photos and measurements reduce “missing items” and help supplements get approved.
What helps you
A roof-system inventory (what’s installed), photos of accessories/edges/penetrations, and measurements that match the actual roof complexity.
What creates underpayment
A scope built from incomplete roof-system info: missing drip edge, missing vents, missing flashing steps, incorrect waste, wrong steep/high, or missing code-required items.
Ordinance & Law coverage (code upgrade coverage) — what it is and what triggers it
Ordinance & Law (often abbreviated O&L) is coverage that may apply when local building code requires upgrades as part of restoring the roof after a covered loss. It is not automatic in every policy, and it is not unlimited.
When code items become “real” in a claim
In practice, code items are easiest to justify when you have permit/AHJ requirements and documentation that shows the item is required to pass inspection. The final reviewer wants a clean chain: code requirement → scope item → documentation.
| Common code-related roof items | What to document | Why it matters |
|---|---|---|
| Deck attachment / re-nailing requirements | Photos of decking, fastening pattern, permit notes (if applicable) | Code-mandated steps can change labor and material requirements. |
| Ice & water / underlayment requirements (location-dependent) | Existing conditions + required protection areas per local code/permit guidance | Underlayment scope affects cost and compliance. |
| Ventilation / intake-exhaust balancing (system performance) | Photos of current ventilation, measurements, attic/soffit conditions | Improper ventilation can create inspection failures and performance issues. |
| Drip edge / edge metal requirements | Photos of existing edges; proof of absence; permit requirements | Common missing line item in underpaid scopes. |
Note: Code triggers and coverage depend on policy language and local enforcement. This page is educational, not legal advice.
Repairability & matching (when replacement is justified)
Many roof disputes aren’t about whether damage exists—they’re about whether the roof can be repaired versus replaced. “Repairability” is an evidence question, not an opinion contest.
What “matching” and “repairability” really mean
Repairable roof
A roof is more likely repairable when replacement shingles are available, a reasonable color/texture match exists, and the repair can be performed without breaking surrounding shingles or creating functional defects.
Not reasonably repairable
Repair becomes difficult when shingles are brittle, discontinued, unavailable in matching form, or when partial replacement creates performance issues, leaks, or obvious mismatch.
What to document for repairability disputes
- Product identification: manufacturer/style (when possible), photos of markings, measurements, and profile.
- Availability: evidence that matching materials are unavailable or discontinued (documentation matters).
- Brittleness / breakage: evidence that shingles break during reasonable repair attempts (photo/video where appropriate).
- System continuity: how components tie together (starter, ridge cap, valleys, flashings) and why partial work fails.
Supplement process (what it is, when it’s legitimate, and why it’s not “padding”)
A supplement is a documented update request to the insurer’s estimate when the original scope is missing legitimate items, when concealed conditions are discovered, or when measurements/pricing are corrected. In professional claim handling, supplements are normal—because the initial inspection is not always complete.
When supplements are legitimate
Legitimate supplement examples
- Hidden decking damage discovered after tear-off
- Missing roof components in the initial scope (edges, vents, flashings)
- Correcting steep/high charges when slope/access requires it
- Code-required items triggered by permit/AHJ requirements
- Measurement corrections (facets, ridges, valleys, waste)
Weak supplement requests
- Requests with no photos, measurements, or documentation
- “Because we always do it this way” with no justification
- Adding items unrelated to restoring the covered loss
- Guessing at hidden damage without evidence
How to make a supplement easy to approve
State the missing item clearly
Example: “Drip edge required by permit/AHJ. Not included in original scope.”
Attach proof
Photos, measurements, manufacturer documentation, permit notes—whatever makes the item verifiable.
Connect proof to scope line items
The reviewer should immediately see what line item changes and why.
Ladder assist / Seek Now / 3rd-party inspections (full explainer)
In Georgia, many insurers use third-party inspection services (often called ladder assist) to collect roof documentation. This can include companies like Seek Now and similar services. The purpose is usually to obtain photos, measurements, and a standardized file.
What a ladder assist typically does
- Measures the roof (facets, hips, ridges, valleys)
- Takes photos of slopes and conditions
- Submits a documentation package to the insurer
What a ladder assist typically does NOT do
- Make the final coverage decision
- Negotiate scope with you
- Guarantee code items, matching logic, or full system scope
How to protect yourself when a third party inspects
| Do | Why it helps |
|---|---|
| Ask what slopes/facets are being sampled and documented | Prevents “only one area documented” outcomes. |
| Make sure collateral evidence is photographed (vents, gutters, soft metals) | Corroboration strengthens causation and severity. |
| Keep it factual: dates, observed symptoms, where leaks/stains appeared | Factual statements reduce coverage disputes. |
| Document your own photos before/after (wide, medium, close-up with scale) | Creates redundancy if the inspection file is incomplete. |
Appraisal clause (when to use it, when not to)
Appraisal is a policy mechanism used to resolve disputes about the amount of loss (scope/price), typically after coverage for the loss is acknowledged but the parties disagree on how much should be paid.
Appraisal is commonly used when…
- There is agreement a covered loss occurred
- The disagreement is about scope or pricing
- Documentation exists but valuation differs
Appraisal is usually NOT ideal when…
- The insurer denies coverage entirely (coverage dispute)
- The dispute is primarily about policy interpretation
- The documentation is incomplete (verification gaps)
This section is educational and not legal advice. Policy language and claim facts control.
What to document so a desk reviewer can verify your claim
The fastest way to improve claim outcomes is to build documentation that is organized, labeled, and repeatable.
Exterior documentation (minimum)
- All elevations (wide photos)
- Each roof slope/facet (wide + medium)
- Test areas per slope (close-ups with scale)
- Edges: eaves/rakes/drip edge conditions
- Penetrations: vents, pipe boots, flashing
- Soft metals: gutters, caps, vents (hail corroboration)
- Tree impacts (wide + close if present)
Interior documentation (facts only)
- Ceiling stains or bubbling paint (wide + close)
- Attic photos: wet decking, insulation, moisture
- Room location photo (for orientation)
- Notes: “Observed after storm on [date]”
- Mitigation documentation (tarp, buckets)
Example: GA_2026-01_STORM_REAR-RIGHT_SLOPE_TESTAREA-2_CLOSE_SCALE.jpg
Want a claim file built to survive desk review?
If your claim is confusing or underpaid, you don’t need louder opinions—you need documentation that is independently verifiable, tied to scope logic, and organized for third-party review.
Carrier-neutral education. Coverage depends on policy language and claim facts.
Quick answers (AEO-friendly)
Who makes the final decision if a ladder assist or third party inspected my roof?
Usually the insurer (often a desk adjuster/claim reviewer) makes the final decision after reviewing the third-party file. The on-site person typically collects photos/measurements; the insurer reviews the documentation and issues the estimate and payment decision.
Why did I only receive a partial payment at first?
On many policies, the first payment is ACV (depreciated value). The withheld amount is often recoverable depreciation released after repairs are completed and proof is submitted—if your policy allows it.
What is the fastest way a roof claim gets underpaid?
A file that is not independently verifiable: unclear slope orientation, missing test areas, no scale in photos, missing collateral evidence, and a scope that doesn’t match the roof system or code/permitting requirements.
Are supplements legitimate or “padding”?
Supplements are legitimate when they are supported by documentation—missing items, concealed conditions, measurement corrections, or code-required items. Weak supplements are those with no photos/measurements or unrelated additions.
When should appraisal be considered?
Appraisal is typically considered when coverage is acknowledged but the dispute is about the amount of loss (scope/price). It is usually not the right tool for full denials or coverage/policy interpretation disputes.
Primary references used for this explainer
This page is carrier-neutral and educational. Exact coverage depends on your policy language, endorsements, and claim facts. For deeper verification, review these primary references:
- Insurance Information Institute (III): background on replacement cost vs actual cash value and depreciation concepts.
- NAIC consumer resources: general claim process expectations and consumer guidance (state-specific details vary).
- Xactware / Verisk documentation: estimating platform context (how line items and pricing are structured in common workflows).
- International Code Council (ICC): building code framework (local adoption/enforcement varies by AHJ).
- Your policy declarations + endorsements: especially Ordinance & Law, roof surfacing schedules, deductibles, and depreciation language.