What does the appraisal clause in property insurance decide?
Amount questions, the core of appraisal
- Unit prices for materials and labor.
- Roof measurements, pitch and waste.
- Which line items are needed to complete the repair, like drip edge, starter, flashing and vents.
- Actual cash value and depreciation, when the policy asks for both figures.
Gray areas
Some disagreements sit between amount and coverage, and how they are handled depends on the policy wording and court decisions where you live. Common gray areas include whether a damaged slope can be repaired or must be replaced, whether matching requires more of the roof to be replaced, and how much of the damage came from the storm versus earlier wear. Appraisal panels often address scope, while insurers may reserve coverage objections.
Coverage questions, usually outside appraisal
- Whether the damage was caused by a covered peril at all.
- Whether an exclusion, like wear and tear or cosmetic damage, applies.
- Whether the claim was reported on time and the policy was in force.
Choosing the right tool
If the insurer agrees hail damaged the roof but pays for far less work than your roofer documented, appraisal can fit well. If the insurer says there is no storm damage, the dispute is about coverage, and a reinspection, an engineer's rebuttal, a complaint to the Commissioner or legal advice may be the better path. Unreasonable refusals to pay can raise bad faith questions. See appraisal on roof claims for the process itself.