Insurance Claims

A hail storm hits, and roofing companies come running to knock on doors.  We watch our local news outlets, and we know that we have a lot to prove in an industry with some scammers.  Good news for us, we stand by our work, we are locally owner, and we believe that we are one of the best roofing companies in the state of Colorado.

Filing an insurance claim on your home can be very stressful, and we recognize that firsthand.  We are here to help you get through this process, and we will do it the right way.

A common question that we get is, “Will you waive my deductible?”  We will not.  We stand by following the law, even if it means losing out to other companies who may turn a blind eye to Colorado Senate Bill 38.  We will work very closely with your insurance company upon determining that there is damage to repair.

An excerpt from a good article  to help you understand the confusion behind waiving deductibles:

“In Colorado, Senate Bill 38 states, “A roofing contractor that performs roofing work, the payment for which will be made from the proceeds on a property and casualty insurance policy issued … shall not advertise or promise to pay, waive, or rebate all or part of any insurance deductible applicable to the claim for payment for roofing work covered.” Again, this sounds very clear cut.

Having a contractor “pay,” “cover,” “handle,” “waive,” or “take care of” the deductible is viewed as both poor business practice and illegal. GAF supports those contractors who continue to encourage best industry practices in roofing.

Most respected roofers have experienced a scenario in which a homeowner had a competitive contractor propose to take care of all repairs without the homeowner having to pay out-of-pocket deductibles, but is it legal? Is it right? Where do you draw the line?

Just to be clear, the homeowner’s insurance policy between an insurance carrier and a homeowner is a contract signed by both parties outlining their responsibilities should an unforeseen event occur. In that contract, there is a section that explains what the homeowner is responsible for (deductible) and what the insurance carrier is responsible for (benefits, limits, and exclusions). It’s not just the insurance companies that have financial responsibility if something happens; the homeowner signed a contract stating their responsibilities as well.

First, is it legal or ethical for a contractor to waive a deductible? It’s all up for interpretation and discussion. Although, there is a significant difference between “legal” and “ethical.” Here are a few examples:

If a contractor knowingly misleads or inflates an estimate to cover the cost of the deductible, then that is considered insurance fraud. For example, if a homeowner had a deductible worth $1,000 and the damage is estimated at $10,000, $9,000 should come from insurance and $1,000 from the homeowner. Now let’s say a contractor knowingly inflates the damage to $11,000. The financial responsibility of the carrier increases to $10,000, and the contractor does the repair without the homeowner deductible. Knowingly misrepresenting an estimate to allow for an increase in carrier payouts is insurance fraud. There are significant criminal penalties for this type of fraud and hurts all parties involved. The carrier pays more immediately and has to increase rates at a quicker pace (the FBI states that the cost of insurance fraud is over $40 billion a year).  The insured could potentially be held liable for the fraud and the uncertain nature of the completed work.  The contractor will have obvious legal ramifications and the potential for brand destruction should they be caught. Finally, the insurance restoration industry as a whole will be affected by continuing to support a practice that is ethically wrong.

But what if the contractor gives a discount to a homeowner to do work that happens to be the same amount of a homeowner’s deductible? From the previous example, the contractor fixes the property by only using the $9,000 provided by the insurance carrier and not collecting the $1,000 from the homeowner. In that case, the actual amount supplied from the carrier will only be $9,000, as that is what was agreed upon in the homeowner’s policy. The other $1,000 is a “new customer discount” or an “advertising discount.”  In other words, a contractor is “paying” a homeowner $1,000 for their marketing. In that case, one could argue that the homeowner and contractor need to fill out a 1099 because income was made on the marketing services. This type of financial transaction could be considered tax fraud.

When you dive into the above scenario further, it is the insurance carrier’s responsibility to pay for the value of the damaged property minus the deductible. If the contractor can do the work for $9,000, then the insurance carrier theoretically should have paid $8,000 and the homeowner the remaining $1,000. This could also be considered insurance fraud by inflating the price of the initial estimate.”