California storms can be brutal. High winds and torrential rain punish our homes. After a storm passes, you might notice a brown stain spreading across your ceiling. You climb into the attic and see water dripping. It seems obvious: the storm caused a leak.
You file a claim. The insurance adjuster comes out, walks on the roof for ten minutes, and hands you a denial letter. “This isn’t storm damage,” they say. “Your roof is 20 years old. The shingles are worn out. This is a maintenance issue. We don’t cover wear and tear.”
This is the most common denial tactic in storm claims. The carrier admits it rained, and they admit your house is wet, but they refuse to pay because they blame the age of your roof rather than the severity of the storm. Fighting this denial requires proving that the storm was the “proximate cause” that turned an old roof into a leaking roof.
The “Storm-Created Opening” Requirement
To trigger coverage for interior water damage during a storm, most policies require a “storm-created opening.”
This means the wind must have damaged the exterior of the building (ripped off shingles, lifted flashing, broke a window) to let the rain in. If the rain simply soaked through old, porous shingles, that is indeed maintenance.
However, adjusters often ignore subtle wind damage on older roofs. They see a few missing granules and call it “wear.” We look closer. We look for:
- Lifted Tabs: Shingles that aren’t missing but were bent back by the wind, breaking the adhesive seal. This allows wind-driven rain to blow underneath.
- Creased Shingles: A horizontal line near the top of a shingle indicating it flapped in the wind. This is structural damage.
- Impact Marks: Evidence of tree branches or debris hitting the roof, creating micro-cracks.
If we can prove the wind broke the seal of the roof system—even on an old roof—the resulting water entry is covered.
The “Proximate Cause” Doctrine
California law generally follows the “Efficient Proximate Cause” doctrine. This legal concept states that if two causes combine to create a loss (e.g., an old roof + a massive storm), coverage exists if the covered peril (the storm) was the “predominant” cause.
We argue that the roof was performing its job perfectly fine before the storm. It wasn’t leaking yesterday. The storm happened, and now it is leaking. Therefore, the storm is the efficient proximate cause of the loss. The age of the roof is secondary.
While the insurance company might not owe you a brand new roof (they might only pay the depreciated value of the old shingles), they absolutely owe you for the resulting damage to the interior—the wet drywall, the insulation, and the paint.
Repair vs. Replacement of the Roof
Another battleground is the scope of the roof repair. If the wind tore off 20 shingles, the carrier wants to pay to patch those 20 shingles.
But if your roof is older, the shingles are likely brittle and faded. You cannot weave new shingles into old, brittle ones without breaking the surrounding shingles. Furthermore, the new shingles won’t match the color (a cosmetic issue).
We often argue that the roof is “non-repairable.” If the repair attempt will cause more damage, the carrier owes for a full roof replacement (or at least a full slope replacement) to make the homeowner whole.
The “Interior Only” Strategy
Sometimes, the roof is truly just old and wasn’t damaged by wind. In this case, you might lose the battle for the roof replacement. However, you can still win the battle for the interior.
Some policies have an endorsement for “Collapse” or “Hidden Decay” that might trigger coverage for the interior water damage even if the roof itself is excluded. We review your specific policy endorsements to find these avenues for coverage. We ensure that even if you have to pay for the new shingles yourself, the carrier pays the $10,000 bill to fix your living room ceiling and floors.
The National Association of Public Insurance Adjusters (NAPIA) notes that interpreting the “storm-created opening” clause is one of the most frequent areas of dispute in property claims, and having professional representation significantly increases the likelihood of overturning a denial.
Your California Experts for Storm Damage Claims
Did the storm break your roof, or was it just “old”? We know the difference, and we make sure the insurance company acknowledges it too.
Acuity Adjusters conducts forensic roof inspections to prove storm damage and secure your interior repairs. Visit our Storm Damage Claims page to challenge your denial, or Contact Us for a roof assessment.