The Situation
A 120-unit assisted living and memory care community in the Front Range. A spring hailstorm went through the area. Two weeks later, leaks showed up over the memory care wing.
The Problem
The carrier’s adjuster said most of the roof damage was age-related deterioration. They covered one roof section at actual cash value and offered $61,400. The contractor’s estimate to replace the full roof was $412,000. That left the operator to pay roughly $350,000 out of pocket, with residents living under a compromised roof.
What We Did
We treated it as an evidence fight instead of a negotiation. We collected the community’s roof maintenance logs and a third-party roof inspection from 18 months earlier that found no material defects. We added NOAA storm data that put hail of 1.75 inches within a mile of the property on the date of loss. We hired an independent engineer, who documented fractured shingle mats consistent with hail impact on every slope, not just the one the adjuster accepted. Then we checked the policy’s valuation clause. The policy was written on a replacement cost basis, and the operator had not received written notice of any roof-specific ACV endorsement. We put all of this in one package and asked for a re-inspection with the engineer present.
The Outcome
The carrier reversed its position on the scope of damage and paid for a full roof replacement at replacement cost. Final settlement: $398,600, less the $25,000 deductible. That is $312,200 more than the first offer.
Why It Matters
A first offer is the start of the conversation, and it is not a finding of fact.
Most brokers would have sent along the adjuster’s number.
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