Hail damage on a shingle roof: cosmetic, or covered?

The adjuster who inspects your roof is hired and paid by the insurance company.

They stand in the driveway, look up at the slope, and ask a question you have no reason to know the answer to: this looks like wear and tear to me — which of these marks is hail?

That question is the whole claim. Knowing which mark is hail, documenting it, and defending it when the answer is challenged is what a licensed public adjuster does.

Two things worth knowing before you call. Your deductible is yours to pay on any claim, whether or not you have help with it. And the fee for that help is set in writing before any work begins.

Being told the hail damage is only cosmetic is not the same as being told it is excluded. Some Illinois property policies carry a cosmetic damage exclusion or endorsement and many do not, and whether yours does is a fact about your document rather than a general rule about hail.

Check the declarations page first

Cosmetic damage exclusions usually appear as a named endorsement, often specific to roof surfacing and often tied to metal roofs in particular. If no such endorsement is attached, the characterisation carries much less weight than it sounds like it does.

Ask for the full policy including endorsements, not the summary. The exclusion, if it exists, will be in the endorsement pages rather than in the base form.

Appearance is not function

Where such an exclusion does exist, it addresses appearance. Hail that compromises how the covering performs — fracturing the mat, breaking the seal between courses, driving granule loss that shortens the life of the roof — is a different matter from hail that merely marks it.

That distinction is the whole argument on a cosmetic-exclusion claim, and it is made with close inspection and documentation rather than with a general position taken from the ground.

Newer roofs attract this more than older ones

On a newer covering the wear argument is unavailable, so the cosmetic characterisation is the one that tends to arrive instead. A new roof is not a more hail-resistant roof, and impact marks on soft metals show up the same regardless of the covering's age.

Your claim clock

Illinois sets no statutory deadline for filing. The limit is your policy's suit limitation clause, commonly about one year from the date of loss, and your policy's terms control. Under 215 ILCS 5/143.1 that period is suspended between your proof of loss and a formal denial.

Common questions

How do I know whether my policy has a cosmetic exclusion?

Ask your agent or carrier for the complete policy including all endorsements, and look for a named cosmetic damage endorsement. It will not usually appear in the base policy form or on a one-page summary.

The adjuster called it cosmetic. Is that a denial?

Not by itself. It is a characterisation of the damage, and it only has the force of an exclusion if your policy actually contains one. Check the endorsements before accepting the conclusion that follows from it.

My roof is metal. Does that change things?

Often, yes. Cosmetic damage endorsements are most commonly written for metal roofing, where denting is visible and the panel may still shed water. Whether your specific policy carries one is still a question about your endorsements.

How long do I have to dispute it?

Your policy's suit limitation clause sets the limit, commonly about a year from the date of loss. Illinois adds no statutory deadline. A proof of loss suspends the period under 215 ILCS 5/143.1 until the carrier denies.

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Sources: Where these statements come from