The hidden maze behind home insurance claims

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Published Date 1/10/2025

In light of the devastating fires happening in the Los Angeles area, this might be a good time to hear stories of how one homeowner made decisions in filing her insurance claims. In this case, the damage was minor compared to losing an entire structure to flames. But the process is good to know just in case.

Back in April, a big storm blew through Realtor.com’s Julie Taylor’s Missouri neighborhood, with golf ball–sized hail pounding her home with fierce intensity. A little later, she was sitting on her couch when she felt something wet hit her shoulder. She looked up, to find water was gushing from the ceiling.

“My husband and I frantically grabbed some plastic buckets to try to catch as much water as we could, and then we called a neighbor who worked in insurance to get his advice on what to do,” says Taylor. “Although this is the fourth home we have owned, it’s the first time we’ve ever considered filing an insurance claim—so we weren’t entirely sure what our next steps should be.

Taylor reports on what she discovered along the way. First off, the couple knew they should place a tarp on the roof to prevent more water from coming in. But they also found that there was to be an important step that needs to be taken before that happens. “The first step when experiencing damage to your roof or home is to document damages with a camera or phone before making any temporary repairs,” says Insurify data expert Cassie Sheets, data journalist at Insurify. Images can speed up the claims process and ensure an accurate claim payout. It’s only after that documentation that it’s time to make temporary repairs to prevent further damage. She also advises you to save the receipts from what you spend on emergency repairs to get reimbursed later in the claims process.

Now it’s time to get a professional opinion on the state of your house—particularly when it comes to the roof. Taylor turned to local roofing expert Niki O’Brien: “We recommend that homeowners have their roofs inspected anytime they experience a severe weather incident.” She adds that most reputable roofing companies will provide this inspection at no cost—and even the most minor damage to your roof can result in significant restoration expenses. According to O’Brien, a professional roofing company will be able to tell you if you should file a claim or not, and how much damage your roof sustained, if any.

In Taylor’s case, their insurance-savvy neighbor volunteered to inspect their roof. “Our neighbor said our damage was fairly major and advised us to call our insurance agent right away,” says Taylor. “My husband and I weren’t 100% certain we should file a claim with our insurance company, since we have a $4,000 deductible.” They were to find, however, that on average a single hail damage claim costs between $15,000 and $20,000, which made the decision a no-brainer.

Once on the phone with their insurance agent Taylor and her husband provided a detailed account of their roof damages. They then uploaded all the pictures they’d taken into the company’s claims portal. The agent said he would send someone out to tarp the roof immediately and would also schedule an adjuster to come out. The inspector showed up a few days later and immediately climbed on the roof to evaluate the damage and estimate repair costs.

The couple invited three roofers to offer estimates for replacing the roof and uploaded all three estimates into the insurance company’s portal. “This was a fairly straightforward process, and we were able to complete this task in a matter of days,” says Taylor.

The adjuster then sent his report, listing how much the insurance company was willing to pay for the damages. “In our case, that dollar amount looked fair, and we got a check for half of the claim, minus our deductible, just a few days later,” recalls Taylor. “We’d been warned that the insurance company would hold back half of the funds until the work was at least 50% completed, so that part wasn’t a total surprise.”

But when the couple went to deposit the check at the bank, the teller pointed out that the check was made out to the mortgage company, along with her and her husband, making it necessary to get the mortgage company to endorse the check before they would have access to the funds.

Yet another snag: The insurance company had made the check out to their previous mortgage company, which had sold the loan a few months prior. So the payout check had to be reissued altogether, which took several days.

Despite the hoops the couple jumped through, they tried to remain calm and patient. “About a week later, I still hadn’t received a check, so I checked in—and the mortgage company rep said they’d never gotten the forms I’d uploaded, so I had to upload them all over again.” Ugh. At this point, all the work was on hold until the check arrived. A few weeks later they got the funds and construction could begin at last.

The roofing team ended up having to cut a large portion out of the old roof, which created a temporary hole in the ceiling, causing debris to rain down on the couples’ beige carpet. “The insurance company had given us funds to get our carpets cleaned, which we vowed to do as soon as the roof was complete,” says Taylor.

The second check arrived, and the same process of mortgage company endorsement ensued. But this time, the mortgage company said they would release only a certain amount of funds, and would then give them the remainder of the funds in increments after they inspected the property.

Huh? “Lenders often hold back part of the insurance claim payout to ensure that the repairs are done correctly and that the homeowner does not simply pocket the money without completing the necessary work,” says J.D. Koontz, a banking expert from Rock Hill, SC.

Once the roof was done, Taylor had a video call with her mortgage company’s inspector and was asked to upload even more photos. Finally, the project was finished to her satisfaction, the mortgage company released the rest of the funds and they got a check about a week or so later.

“At that point, we were able to pay our roofer in full, which was certainly a load off our minds,” recalls Taylor. On to carpet cleaning. Another hitch. The stubborn stains remained. So Taylor called the toll-free number on the assessor’s report, and an insurance representative told her he’d reopen the claim so she could upload more pictures.

As of the writing of her article for Realtor, Taylor says she was still waiting for the verdict on that with fingers crossed.

As the climate continues to change, experts predict we’ll have more natural disasters in the years to come. So now is the time to find out what kind of homeowners insurance policy you have and adjust it if necessary ahead of time, potentially saving you tons of trouble (and money) down the road.

“Make sure you have enough coverage, and look into flood and earthquake policies—since they’re not usually covered by regular homeowners insurance,” says Taylor, who says the entire process has taken about six months from start to finish. She has learned a lot along the way. One thing that remains uncertain, however? Will her rates go up? Probably, according to Sheets. “Any claim you make, including a hail damage claim, will likely increase your home insurance premium, usually upon policy renewal,” she says.

Realtor, TBWS

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