When Hail Damage Is Not Cosmetic | Property Insurance Coverage Law Blog

What happened

Cosmetic loss or damage means damage that only alters the physical appearance of the metal roof covering but does not result in damage that allows the penetration of water through the roof covering or does not result in the failure of the roof covering to perform its intended function, to keep out elements over an extended period of time. The desk adjuster removed it, noting that the valley metals were “only cosmetically damaged.” The opposition also raised questions about the insurer’s reconsideration, its refusal to reinspect, and how quickly the supervisory review occurred. The court ruled that the exclusion applied to roof coverings that are metal and was not limited to buildings having what we commonly call a “metal roof.” That ruling is important, but it is not the most important lesson from the case.

Key details

• The desk adjuster removed it, noting that the valley metals were “only cosmetically damaged.” The opposition also raised questions about the insurer’s reconsideration, its refusal to reinspect, and how quickly the supervisory review occurred.
• The court ruled that the exclusion applied to roof coverings that are metal and was not limited to buildings having what we commonly call a “metal roof.” That ruling is important, but it is not the most important lesson from the case.
• After all, if hail merely makes a piece of metal a little less pretty while everything still works perfectly, many policyholders might understand why an insurer would want to limit that exposure.

Why it matters to restoration

This belongs on an operator’s radar because insurance behavior sets the rules for documentation, scope disputes, cash flow and customer expectations. If the article points to a carrier, court or coverage trend, the practical question is what proof your next file needs before the argument starts.

What to check next

Check whether your estimates, photos, notes and customer updates would survive the same dispute described in the article.

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