Claims Basics
This is the person or business that reports a loss and seeks payment under an insurance policy.
This section of a policy identifies events or circumstances that are not covered.
What are exclusions?
This tool is commonly used to create itemized property repair estimates using labor, materials, and pricing data.
What is Xactimate?
These images help document the condition of damaged property before repairs begin.
What are photographs?
I am the most common sloped-roof covering on residential homes. I consist of overlapping pieces with a granular surface that helps protect against weather and ultraviolet exposure.
What are asphalt shingles?
This document outlines the insured property, coverages, exclusions, and conditions.
What is the insurance policy?
This type of coverage generally pays for the cost to repair or replace damaged property without deducting depreciation, subject to policy limits and terms.
What is replacement cost coverage?
This term describes the reduction in an item's value due to age, wear, and condition.
What is depreciation?
What is a cause-of-loss or inspection report?
I cover the horizontal peak where two roof slopes meet. I am designed to protect this vulnerable area from water intrusion.
What are ridge caps?
This is the amount the policyholder generally pays out of pocket before covered losses are paid, subject to policy terms.
What is the deductible?
This valuation method subtracts depreciation from the replacement cost of damaged property.
What is actual cash value (ACV)?
A roof replacement estimate is $12,000, and the deductible is $2,000. Assuming the entire amount is covered and no other adjustments apply, this is the initial payment under an ACV settlement if depreciation is $3,000.
What is $7,000? ($12,000 − $3,000 − $2,000)
This professional may be hired to evaluate structural damage, roof conditions, or other specialized issues.
Who is an engineer or specialist?
I am a metal flashing installed along roof edges to help direct water away from the roof deck and into the gutter or away from the fascia.
What is drip edge?
This professional investigates property damage, evaluates coverage, and helps determine the amount of a covered loss.
Who is a property claims adjuster?
This policy provision may limit or exclude coverage for damage caused by flooding from rising surface water.
What is the flood exclusion or flood limitation?
This estimate compares the cost to repair damaged property with the cost to replace it.
This occurs when the observed damage does not appear consistent with the reported date or cause of loss.
What is a discrepancy that requires further investigation?
I am installed where two sloping roof planes meet and form an interior angle. I help channel water down the roof toward the eaves.
What is valley flashing?
This process involves reviewing the facts, policy language, and evidence to determine whether a loss is covered.
What is coverage determination?
This policy feature sets the maximum amount an insurer will pay for a covered loss or category of loss.
What is a policy limit or sublimit?
This is the amount potentially held back until covered repairs are completed and the policy's requirements for recovering depreciation are met.
What is recoverable depreciation?
These records may help establish when damage occurred, prior repairs, and the property's condition before the loss.
What are maintenance records, invoices, prior claim records, and other supporting documents?
I consist of small metal pieces woven into the shingle courses where a sloped roof meets a vertical wall, helping direct water away from the intersection.
What is step flashing?