Hail Damage, Discontinued Shingles, and a Prior Slope Replacement
An insured files a hail claim on a 14-year-old, 42-square architectural shingle roof. The insurer's field adjuster marks six squares with hail bruises and proposes spot repairs, stating that only 'functional damage' is covered and that matching discontinued shingles is not owed. The public adjuster observes 19 squares with granule loss, fractured mat, and soft spots, plus a three-year-old replacement slope on the north side. The policy is replacement cost on the dwelling, $480,000 Coverage A, with a 2% wind/hail deductible. The shingle line was discontinued in 2019. The insurer has not obtained an engineer's report, and the public adjuster has not yet measured the roof or reviewed the manufacturer's installation instructions. The insured wants the public adjuster to demand a full roof replacement immediately.
1. What investigation steps should the public adjuster take before demanding full replacement, and what evidence would distinguish covered hail damage from wear, installation defects, or prior damage?
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Before demanding a full roof, the PA should build a causation file: a measured roof diagram with squares and slopes; photographs of each test square and any soft spots; chalk or marker identification of hail hits; a core sample or mat inspection where fractured; a weather report with hail size and time at the address; and the manufacturer's installation and repair instructions. The PA should separate four causes: covered hail, ordinary wear, installation defects such as improper nailing or exposure, and prior damage. The three-year-old north slope needs its own history: who replaced it, why, and whether it was damaged in this storm. An engineer or roofing consultant is useful if the insurer relies on 'functional damage' without testing. The PA should not rely on granule loss alone; granule loss can be normal aging. The goal is to show which squares cannot be repaired to a uniform, weather-tight condition and why a spot repair is not feasible.
2. How should the public adjuster analyze the 'functional damage' and matching arguments under a replacement cost policy?
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Functional damage means the shingle can no longer perform its intended function, not merely that it looks bad. The PA should ask the insurer's adjuster to identify the test squares and the test method. If hail fractures the mat or creates bruises that soften the shingle, that is functional damage even if granules remain. On matching, a replacement cost policy does not automatically pay to replace an entire roof because shingles are discontinued; the issue is whether a reasonable repair can restore the roof to a uniform appearance and whether the policy or Kentucky rules require matching of undamaged areas. The PA should document the discontinued line, the unavailability of matching shingles, and the visual result on a test repair. The argument is strongest where the repair would create a conspicuous patch on a front slope or where the shingle cannot be interlocked. The PA should present options: full replacement if functionally necessary, or the insurer's repair plus an agreed cosmetic mismatch payment if the policy supports it.
3. Calculate the wind/hail deductible and explain how the three-year-old slope affects the claim presentation.
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2% of $480,000 is $9,600, so the wind/hail deductible is $9,600, not the $2,500 or $5,000 flat deductible. If the approved replacement cost is $46,000, the gross payable before depreciation is $36,400. The three-year-old slope matters in two ways: if it was not damaged in this hail event, it should not be included; if it was damaged, the PA should claim only the new damage and should not seek a second recovery for the prior replacement. The insurer may raise betterment or prior-repair defenses. The PA should obtain the prior receipt and warranty, compare shingle lot and color, and explain that replacement cost coverage is designed to replace damaged property, not to improve undamaged slopes. The deductible should be applied once to the loss, and the PA should verify whether the policy applies it separately to the dwelling and other structures.