How State Farm Evaluates Hail Damage Claims

A number of attorneys, public adjusters, and roofers have been asking me questions about State Farm claims practice related to hail damage claims.

Many insurers are not willing to fully explain to their customers how they instruct adjusters to handle claims—unlike the federal government, which published a manual regarding national flood insurance adjustments and invites the public to its claims certification training. As a result, it is often difficult to determine what criteria an insurer uses to determine what is covered and what is owed. This is one problem regarding State Farm hail damage claims.

Before I launch into that discussion, though, let’s go over the basics of hail damage and filing this type of claim. Then, I’ll move into what you should know as a State Farm policyholder.

Contents

How Do You Know if Your Property Has Hail Damage?

Hailstorms can wreak havoc on your property, leaving behind a trail of destruction that’s not always easy to spot. While large hailstones can cause obvious damage, smaller stones can also leave their mark. Here’s what to watch out for:

Roof: Hailstones can damage all types of roofs, but asphalt shingles are particularly susceptible. Look for dents, cracks, or missing granules (the small pebbles that cover the shingles). These can appear as dark spots or areas where the underlying asphalt is exposed.
Siding: Hail can dent, crack, or even pierce siding made of vinyl, aluminum, or wood. The damage may look like round bruises or pockmarks.
Windows: Large hailstones can shatter windows, while smaller stones may leave cracks or chips in the glass.
Cars: Dents and dings are the most common signs of hail damage on vehicles. Look for them on the hood, roof, trunk, and fenders.

It’s important to note that not all hail damage is immediately visible. Hidden damage can occur underneath siding or shingles, and leaks may not appear until after a heavy rain. If you suspect hail damage, it’s important to have your property inspected by a qualified professional as soon as possible.

How Do You File a Hail Damage Claim With State Farm?

If you think you have hail damage covered by your State Farm policy, it’s important to act quickly to file a claim. The earlier a claim is filed, the sooner an adjuster can assess the damage, and the repair process can begin. Here’s how to file your hail damage claim with State Farm:

Assess the Damage

Before filing a claim, take a safe walk around your property to visually inspect for possible hail damage.
Take photos or videos of any damage you find for your records.

How Does State Farm Evaluate Hail Damage?

Once you’ve filed your claim, you probably want some insight into when and how you’ll be compensated for your damages. But insurers are not always forthcoming about that process, and that’s where our experts in case law come in. By looking at past examples of bad faith claim handling from State Farm, we can learn a lot about how they assess hail damage.

First, a previous post on our blog discusses how a trial court order from a few years ago revealed important insights into State Farm’s operation guidelines when it comes to hail damage claims. Here’s what we learned:

Granular Loss

State Farm generally does not cover granular loss from normal wear-and-tear, as it doesn’t compromise the roof’s watertight integrity.
If hail causes excessive granular loss alongside other damage that affects the roof’s integrity, payment for granular loss may be considered.

Wind Damage

Covered wind damage to asphalt shingles typically includes shingles blown off or shingles bent, resulting in a fracture through the shingle material.
If wind breaks shingle seals, hand sealing may be necessary.

Unsealed Shingles

Claims adjusters should note any unsealed shingles.
Coverage may be provided when unsealing is caused by “accidental direct physical loss” (e.g., tearing or sealant residue on the underlying shingle).

Beyond State Farm Policy: Field Adjuster Knowledge

While our firm doesn’t have full knowledge of all of State Farm’s hail damage assessment process, we know from looking at previous lawsuits filed against State Farm that many of the problems which arise in filing claims with State Farm are less a matter of policy and more about issues stemming from the field adjustment process. Indeed, a successful State Farm hail damage claim is greatly impacted by the amount of knowledge that the field adjuster has about State Farm’s own policies. Let’s look at a case study to understand how that works.

In a previous post, Two Oklahoma Juries Find State Farm Acted in Bad Faith, we noted two State Farm hail damage cases where State Farm was found guilty of improperly handling hail damage claims. The jury heard testimony from a former State Farm adjuster about a program called “Hail Focus”. She claimed that this program significantly restricted her authority as an adjuster. Under “Hail Focus,” she was unable to independently approve roof replacements, mark suspected hail damage, or inform clients of coverage decisions without prior approval from her superiors. These restrictions were disputed by higher-level management who denied knowledge of the program.

Digging a little deeper for those asking questions and readers of this blog, I found the policyholder’s response to State Farm’s motion for partial summary judgment1 worthy of study and encourage others to read it in its entirety. It stated in part,

There is a disturbing amount of evidence in this case and across an entire segment of State Farm’s claims department that saving money by turning a blind eye to their own hail recognition training became an end in itself. The truth revealed through an honest and thorough investigation would have dictated that Plaintiff’s claim be paid. Clearly, however, State Farm was not interested in being a ‘good neighbor’ to its insureds.

As demonstrated above, State Farm engaged in bad faith claim handling by: (1) drastically reducing the amount of training provided to field adjusters and sending a field adjuster who had never felt hail damage to conduct an inspection for hail…(2) stripping field adjusters of their ability to authorize roof replacements due to hail damage because State Farm was ‘paying for too many roof claims’ …(3) instructing field adjusters not to use chalk to circle spots they thought might be hail damage..(4) requiring field adjusters to send pictures of the roofs via text or email so Draper could decide whether or not to pay, a method which ignores State Farm’s training materials and the expection [sic] of Section Manager Sharon Arnold that hail damage identification must include a tactile examination..(5) purposefully omitting consultations with Draper from the claim file…and (6) using the term ‘wear and tear’ (which is not a covered cause of damage) to describe ‘old hail damage’…No one can honestly say this is a reasonable way to conduct an investigation.

The brief notes that State Farm has training manuals, PowerPoints, and videos that were part of its training. The problem was that this training would have proven a covered hail damage claim, and the new adjuster never went through that extensive training.

(The partial deposition of the former State Farm adjuster is worthy of study as well.)

The point is that when dealing with State Farm in the field, one should politely try to determine the experience and training of the person handling the file. I would strongly suggest that the authority of that person to determine coverage and pay the claim be inquired about. It appears from the hail damage claims that State Farm is providing little authority to the field claims adjusters. Then a desk managing adjuster who never speaks with the policyholder or goes to the loss site makes the decisions on claims.

State Farm Hail Damage Claims: The Bottom Line

As we see in the documents above, despite State Farm’s policies, there may be times when a field adjuster is not fully aware of coverage details or provides an assessment you suspect is incorrect, even if you do not have that knowledge yourself. Fortunately, when problems do arise with your claims handling, there’s a few ways you can deal with them:

Document Everything: Keep detailed records of all communication with your adjuster. This includes dates, times, names, and summaries of your conversations. Note any apparent misunderstandings or policies the adjuster seems unaware of.
Try Mediation: Before resorting to legal steps, consider mediation. This involves working with a neutral mediator to reach a mutually agreeable solution. Mediation can be a faster and less expensive alternative to litigation. Your state or local bar association may offer resources for finding a qualified mediator.
File a Complaint: If you feel your claim is not being handled fairly, you can consider filing a formal complaint with your state’s Department of Insurance, which regulates insurance companies and investigates consumer complaints.
Consult an Attorney: If the above steps don’t lead to a satisfactory resolution, consulting with an attorney specializing in insurance disputes is the best way to protect your rights. They can assess your case, explain your legal options, and advocate on your behalf.

Insurance companies have an obligation to service the product they sell when claims are made. “Getting it right” can only be done by “doing it right.” My hope is that State Farm would take an honest look at what is happening in its claims operations. A lot of customers rely on it “getting it right.”

Need Help With Hail Damage Claims?

Are you fighting an insurance company that won’t pay out on hail damage claims? With over 39 years of practice and $2 billion in recovered claims, our team stands by your side to ensure you can face any insurance challenge with confidence.

Thought For The Day

A man must be big enough to admit his mistakes, smart enough to profit from them, and strong enough to correct them.

—John C. Maxwell

1 Bates v. State Farm Fire & Cas. Co., No 5:21-cv-00705 (W.D. Okla.).

How State Farm Evaluates Hail Damage Claims

How Do You Know if Your Property Has Hail Damage?

How Do You File a Hail Damage Claim With State Farm?