When Your Insurer Blames Wear and Tear

A severe storm passes through the neighborhood. Afterward, a homeowner notices missing shingles and water stains on the ceiling. A roofing contractor inspects the property and recommends replacing the roof.

The homeowner submits an insurance claim, and the insurer sends an adjuster to inspect the damage. But several weeks later, the insurer denies the claim, concluding that the roof's condition resulted from its 20-year age, deterioration, and ordinary wear and tear rather than the storm.

Does that mean the insurance company can refuse to pay? Not necessarily. An older roof may have existing problems, but its age alone does not establish what caused the damage being claimed.

A Roof’s Age Doesn’t Explain What Damaged It

Under Illinois law, the policyholder generally has to show that the loss falls within the policy’s coverage. The insurer then has to prove that an exclusion, such as wear and tear, applies. A denial letter that relies on the roof’s age alone, without explaining why the specific damage isn’t related to the storm, may not carry that burden.

A denial that rests on the roof’s age is an opening position, not a finding. The useful question is whether the insurer actually explained why the specific damage, in the specific places it appeared, came from deterioration and not from the storm. When that explanation is missing, the strongest response is usually better evidence, presented while the deadline still allows time to use it.

That said, property insurance generally doesn’t cover gradual deterioration or the cost of maintaining an aging roof. But an old roof can still be torn up by wind or bruised by hail. Coverage depends on what caused the damage being claimed, not on the age of the roof.

When the Storm and the Wear Both Played a Part

Many roof claims involve both storm damage and wear. Worn shingles may have lifted more easily in a wind that a newer roof would have handled without damage.

In these cases, how the policy treats losses with more than one cause matters a great deal. Some policies contain language stating that an excluded cause defeats coverage even when a covered cause also contributed. Others are silent, which leaves more room to argue that the storm was the cause that mattered. The specific wording, and how courts have read it, can determine the outcome.

The evidence usually decides these disputes. Hail strikes on gutters, vents, and other metal surfaces, along with creased or missing shingles on the sides facing the wind, point toward the storm. Weather data for the property’s address, photographs taken before the storm, maintenance records, and an independent engineer’s report can separate new damage from old.

Spot Repair or a New Roof?

Even after an insurer accepts that the storm caused some damage, it may offer to replace only the damaged shingles. The roofer, on the other hand, may say a 20-year-old roof can’t be patched with new shingles that match.

Illinois has no statute or regulation that expressly requires insurers to pay for matching materials. The answer usually comes from the policy language. In a 2019 decision, a federal appeals court applying Illinois law ruled that an insurer had to pay to replace undamaged siding so it would match the damaged sections, because the policy’s wording was ambiguous. That decision doesn’t bind Illinois state courts, but it is frequently cited in these disputes.

Building codes can raise a separate issue. If a repair triggers code requirements, such as removing old layers of roofing, the extra cost may be covered only if the policy includes ordinance or law coverage. Many owners don’t know whether theirs does.

Coverage and Payment Are Two Different Fights

An owner can win the coverage argument and still receive far less than the cost of a new roof. A replacement cost policy usually pays the depreciated value first and the remainder after the work is completed. An actual cash value policy subtracts depreciation permanently, and on a 20-year-old roof that deduction can be large. Some policies use a roof payment schedule that reduces payment based on the roof’s age. Many policies also carry a separate wind and hail deductible set as a percentage of the building’s insured value, not a fixed dollar amount.

Before contesting the payment, an owner needs to know which issue is actually in dispute: whether the loss is covered at all, how much repair is needed, depreciation, or the deductible. Each one calls for different evidence.

Responding to a Denial Based on Wear and Tear

The insurer’s written explanation is the starting point, and it can be compared with the policy provisions the insurer relies on. Photographs of the damage, repair estimates, contractor findings, and information about the storm all help preserve the record.

If the cause of damage is genuinely disputed, an independent roofing or engineering assessment may help determine whether the insurer's conclusion is supported by the physical evidence.

It also matters whether the insurer inspected all affected areas and distinguished preexisting deterioration from damage attributable to the recent storm. Documenting any temporary repairs and checking the policy’s deadlines before seeking reconsideration or taking legal action helps protect the claim.

Not every denial is improper. But if there is credible evidence that a recent storm caused distinct physical damage, a denial based largely on the age of the roof warrants further review.

This article provides general information and does not constitute legal advice. For guidance concerning a specific matter, see our insurance recovery services. Coverage depends on the policy wording, the facts, and applicable law. To discuss potential representation, request a consultation. Submitting an inquiry does not establish an attorney-client relationship.