Hail Damage Vs Pre-Existing Wear. How Insurance Companies Decide What to Cover
After a hailstorm, homeowners often notice marks on their roof, siding, or exterior surfaces and assume the damage will be covered by insurance. But you must know that hail-related claims are some of the most frequently questioned and denied claims in residential insurance. The reason is not that hail damages are not entitled to claims, but that insurance coverage depends on cause, and not appearance.
In this blog, you will read from an engineering standpoint, how insurers evaluate hail damage, and why wear and tear is usually cited. Not just that, you will also get to know about how forensic structural inspections help establish the facts when coverage decisions are challenged.
Insurance companies do not simply decide whether the damage is due to existing wear and tear or caused by the hailstorm. They look for whether damage can be tied to a specific hail event or events like whether the damage developed gradually with time. This difference between hail damage vs. pre-existing wear is where most insurance claims become disputed.
Why Hail Damage Claims Are Often Challenged
Hailstorms can affect large geographic areas, but not every home gets affected by hail in the same way. Roof age, material condition, slope, orientation, and construction details, along with several other attributes, all influence how a structure reacts to hail storm impact. Because of this variability, insurers cannot assume that all observed damage was caused by a single storm.
From an insurance provider’s perspective, covering long-term deterioration under a storm claim would shift routine maintenance responsibility to the policy. This becomes the major reason why adjusters focus heavily on determining whether damage reflects sudden impact or gradual degradation.
This is also why homeowners dealing with home insurance structural damage claims often feel frustrated. Because what looks like storm damage to the homeowner may appear consistent with aging or wear to the insurance company.
Solution to this problem? Always go for Forensic Structural Inspection and call the best structural engineers, rather than home inspectors. Read how the professional capabilities of a structural engineer are different from those of a home inspector.
How Insurance Adjusters Evaluate Hail Damage in Virginia
Insurance adjusters are trained to evaluate damage patterns in relation to reported storm events. During any hail storm damage inspection, they do not only look at the damaged area itself. They also consider how damage is spread across the structure of your home and whether it matches with the known storm behavior.
For example –
Hail damage tends to be localized and irregular. When damage is uniform on all surfaces that are normally exposed to potential damage, it tends to be viewed in terms of long-term weathering and not an occurrence that took place suddenly. Adjusters may end up comparing affected areas to shaded surfaces on the structure.
This process is known as adjuster evaluation, and it is heavily influenced by policy definitions and claim guidelines. Adjusters do not perform structural failure analysis, rather they classify damage based on observable indicators and policy language.
Granule Loss vs. Impact Damage: One of the Most Common Disputes
As any hail claim adjuster knows, one of the most contentious issues arising from the receipt of a hail claim notice has to do with asphalt shingle roofs. Shingles naturally lose granules over time due to exposure to the sun, temperature fluctuations, and rain. This process is slow, and generally speaking, is uniform in nature.
When hail hits a shingle, it impacts the material, displacing the granules concentrated over a small area and possibly breaking the layer beneath.
Claims are usually denied when apparent granule deterioration seems representative of the consensual age-related pattern of granule loss and lacks discrete points of impact. Without technical evaluation by an experienced forensic structural engineer, it may be hard to dispute on the part of the homeowner.
Why “Wear and Tear” Is Commonly Cited in Denials
“Wear and tear” is one of the most frequently used justifications for denying hail claims. From an insurance standpoint, wear refers to deterioration that occurs over time due to regular exposure and use, not from a sudden, accidental event.
Materials that have become brittle, connectors that have corroded, or roofing systems that are near the end of their service life may show damage during a storm, but that does not automatically mean the storm caused the damage.
Where Forensic Structural Engineers Add Critical Clarity
Where there may be a difference of opinion with respect to causation, an independent assessment by a forensic structural engineer is carried out. It involves a stamped report by the state, which focuses more on engineering evidence rather than an interpretation of state policies.
In contrast to insurance adjusters, structural engineers review how materials and structural systems react to forces. They determine if the damages are consistent with impact, if materials indicate the same and the structure of your home also showed similar signs of impact.
How Engineers Distinguish Hail Damage From Pre-Existing Conditions
A forensic structural inspection done by a professional structural engineer covers more than just surface observations. Structural engineers have years of experience and they study impact patterns across multiple elevations, examine whether damage aligns with storm direction and intensity, and assess if the structure shows signs of sudden load redistribution.
Existing wear typically presents as gradual, predictable deterioration that affects materials evenly.The changes are uniform. The damage caused by a storm usually entails sudden variation in the change, which has a directional nature.
This way, Engineers assess the differences to conclude if the damages are caused by hail or if the damages occurred separately from the hail storm.
The Importance of Early and Accurate Damage Documentation
One of the biggest challenges faced by homeowners in disputed claims is inadequate documentation of the impact of hailstorms. Photos taken long after a storm, usually after temporary repairs or cleanup, fail to capture the original condition of the damage and leaves a space for confusion for the insurers to assess the actual damage caused by the storm.
From an engineering standpoint, damage documentation should establish not only what was damaged, but how and where it occurred. Engineers rely on detailed photographs, measurements, and location mapping to analyse the structure failure of a place.
Without proper documentation, even valid hail damage claims can become a challenging task for homeowners.
Why Structural Proof for Claims Requires Engineering Analysis
Photos of the damage caused by hailstorms are not enough as they do not establish any cause and effect relation. Structural proof requires analysis of how hailstorm damage affects load paths, connections, and material behavior.
Professional Structural Engineers evaluate whether framing members of the home shifted, whether the connectors deformed under impact, and whether damage altered the overall structural performance of the home.
When homeowners have this type of structural proof for claims, it provides the technical foundation which insurers rely on when reassessing disputed cases of hailstorm damage claims.
Why Claims Can Be Denied Even After Severe Hailstorms
Even when a hailstorm event is well documented, insurance claims may still be denied by insurers in case the damage patterns do not align with expected impact behavior or if materials show signs of long-term degradation.
In these situations, homeowners usually ask this question to us about whether accepting the insurer’s decision is the only option or whether additional technical evidence provided by structural engineers after a proper analysis could change the outcome.
Our answer – Forensic engineering evaluations are necessary.
When a Forensic Structural Inspection Is Warranted
A forensic inspection should be considered when the cost of repair is significant after a hailstorm, when coverage is disputed, or when the cause of damage is unclear. Forensic Structural Engineering analysis helps eliminate any confusions and helps homeowners have a solid care for claiming insurance for the damages caused.
Conclusion - Forensic Structural Engineers Are a Must to Call After a Hailstorm
Insurance companies do not decide coverage based on appearance of the damage alone. They decide based on what caused the damage. Understanding the difference between hail impact and pre-existing wear is essential when navigating a hail damage insurance claim.
Forensic structural inspections conducted by professional and experienced structural engineers provide evidence-based conclusions grounded in engineering science. When claims are questioned or denied, this level of professional analysis often makes the difference between uncertainty and clarity.
At A Step in Time Structural Engineering, forensic evaluations are performed by licensed Professional Engineers with experience in storm damage analysis and insurance claim support. We complete the assessment covering all the aspects including event mapping, linking damages caused to the event of hailstorm, and finally offer a state-stamped report to homeowners for filing the insurance claim with solid evidence.
Call (848) 467-7328 now to book a professional forensic structural assessment or visit our website for more details.
