What a second look is worth

The Ledger

First offer, then the file

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Omitted scope

The largest single category. Detach-and-reset, tear-off, waste, code items, continuous-run flooring, and the general contractor’s overhead and profit on a multi-trade job. None of it is controversial and all of it is regularly absent, because an estimate is only as complete as the inspection behind it.

Mischaracterized cause of loss

A sudden discharge written up as gradual seepage. A wind loss written up as wear. A Category 3 backup written up as clean water. The characterization made in week one determines every number afterward, which is why reversing it moves so much money.

Coverages nobody claimed

Ordinance and law, additional living expense, business income, contents, debris removal, and recoverable depreciation. These are limits you already paid for, sitting unused because no one identified them and put them in writing.

A credible path to appraisal

When the dispute is amount rather than coverage, being genuinely prepared to invoke appraisal changes the negotiation before it is invoked. Two of the files above settled after the demand was made and before a panel ever convened.

Repairability assumed, never tested

A spot repair gets written because a spot repair is cheaper, not because the assembly can actually be repaired. Discontinued shingles, brittle tab seals, mortared masonry, and continuous-run flooring frequently cannot be patched to a reasonable match — which is a replacement question, and it has to be documented on the roof rather than argued on the phone.

Depreciation withheld and forgotten

On a replacement-cost policy the holdback is yours once the work is done, but it is only released if someone documents completion and asks for it in writing. Add an actual-cash-value roof endorsement to that and the depreciation stops being recoverable at all — a limitation worth reading in the declarations before the loss, not after.

How To Read These

No two claims settle alike

Past recoveries describe those files, not yours. Policy language, deductible, documentation, and the age of the loss all move the number.