Three Policy Terms That Can Change What a Hail Claim Pays

Before You Read: How to Use This Hail Policy Guide

This guide explains how these terms commonly work so you know what to look for. For the claim process itself, see how homeowners insurance handles roof damage claims. This guide isn't legal or insurance advice, and Timberwolf doesn't interpret policies, act as an adjuster, or negotiate claims. Your policy controls. Every example below is hypothetical: whether any of it applies to you depends on what your policy says.

1. Cosmetic Damage Exclusions

A cosmetic damage exclusion (sometimes called a "cosmetic loss" or "marring" endorsement) can let the insurer decline wind or hail damage that changes how part of the home looks without affecting how it works. Insurance Journal notes that standard-form endorsements define cosmetic damage as marring, pitting or other superficial damage that doesn't affect the roof's function as a weather barrier. According to Insurance.com, these exclusions can apply to roofing, windows, doors and exterior walls, and some apply only to the roof.

For walls specifically, see hail damage to stucco and insurance.

Where it tends to matter: metal roofs. Hail can dent a metal panel without puncturing it. If a policy has a cosmetic exclusion, dents that don't affect function may not be covered.

What is generally still covered: damage that affects function. Insurance.com gives leaks and structural damage as examples. Where the line falls on a particular roof is decided by the insurer under the policy wording, and it's often the point of disagreement.

What to look for:

• The words "cosmetic," "marring" or "appearance" in your policy or endorsements.
• If you have a metal roof and find that language, ask your agent what the endorsement covers and whether other options exist.
• After a hailstorm, photograph dents closely, including any spots where the finish has cracked or come off. Documentation helps whoever decides the claim see the actual condition.

Our metal roofing guide covers how metal performs in hail.

2. Separate and Percentage Wind/Hail Deductibles

The New Mexico Office of Superintendent of Insurance advises checking whether wind or hail damage is excluded or covered by a separate deductible. Some policies set that separate deductible as a percentage of dwelling coverage rather than a flat dollar amount.

How the math works, if your policy has one. A hypothetical example: a home with $400,000 in dwelling coverage and a 1% wind/hail deductible would carry a $4,000 deductible for a hail claim. At 2%, the same home's deductible would be $8,000. Your own numbers depend on your dwelling coverage and the percentage on your declarations page.

Why it matters. If a policy has a high wind/hail deductible, a smaller hail claim may pay little or nothing after the deductible. Whether to file, and how a claim might affect your premium, are questions for your agent. Our article on whether a roof claim raises your insurance covers that side.

What to look for:

• The deductible section of your declarations page. If wind/hail is listed separately, note whether it's a dollar amount or a percentage.
• If it's a percentage, multiply it by your dwelling coverage so you know the number before a storm.
• If the figure surprises you, ask your agent what other deductible options cost.

3. ACV Roof Endorsements and Roof Payment Schedules

Many homeowners policies settle covered roof damage at replacement cost, often paying the depreciated amount first and the rest after the work is completed. Our ACV vs. RCV guide explains that process. Two kinds of endorsements can change it for the roof specifically:

ACV roof endorsement. If a policy has one, covered roof damage is paid at actual cash value, meaning replacement cost minus depreciation. Rough Notes describes carriers adding this kind of endorsement, often when a roof's age doesn't qualify for replacement cost, and notes that some versions stay on the policy after the roof is replaced unless they are removed.

Roof payment schedule. Some policies use a table that sets the roof payout as a percentage of replacement cost based on the roof's age and material. Rough Notes describes carrier tables running from a new roof to 30 years or older, with separate columns for asphalt, metal, tile and other materials. The percentages differ by carrier.

What to look for:

• "Actual cash value," "roof surfacing" or "payment schedule" in your policy or endorsements.
• The roof installation year your insurer has on file. Rough Notes notes that some carriers apply the schedule using the year on record, so it's worth confirming it's correct.
• If you don't know your roof's age, a past permit or a roofer's inspection can help. A Free Roof Report includes our assessment of the roof's condition, with photos.

If you're weighing impact-resistant shingles, ask your agent whether your carrier offers any premium credit for them. Our impact-resistant shingles guide covers the product side.

A Hypothetical: Same Storm, Two Policies

Made-up numbers, for illustration only. Actual results depend entirely on your policy, the adjuster's findings and your insurer's decision.

Suppose a home with $350,000 in dwelling coverage has a 12-year-old shingle roof, and hail damage is found to be covered. Suppose a replacement estimate of $16,000.

• If that policy has a 2% wind/hail deductible ($7,000) and an ACV roof endorsement, and if the insurer applied 50% depreciation for age, the ACV would be $8,000. Minus the $7,000 deductible, the payment would be $1,000.
• If instead the policy had a $1,000 flat deductible and replacement-cost coverage for the roof, the total could be up to $15,000, typically paid in parts as described in our ACV vs. RCV guide.

The roof and the storm are identical in both cases. The difference is policy terms, which is why it's worth reading yours before monsoon season.

What a Roofer Can and Can't Do

New Mexico law (NMSA 1978, § 59A-13-13) doesn't allow a contractor or roofing contractor to act as an adjuster, or advertise adjusting services, on property it has worked on or may work on. Here's how that plays out with us:

• What we do: inspect the roof, document what we find with photos and measurements, and give you a written estimate for the repair or replacement. If you ask, we can meet the adjuster and walk the roof with them, pointing out what we documented.
• What we don't do: interpret your policy, negotiate your settlement, or act as your public adjuster. Coverage and payment are between you and your insurer. What we give you is the evidence.

If you have questions about how your insurer is handling a claim, the Office of Superintendent of Insurance can help with complaints against insurers, agents and adjusters, and its claim line is 855-427-5674. Our guide on what to do when a claim is denied or underpaid covers your options.