Ordinance and Law Not Being Applied

My company is going to be doing a full roof replacement on two buildings of a condo association, which were originally approved for only a repair because the adjuster wanted to use the line of sight crap, so I instructed the president of the HOA to file a complaint with the Ohio Department of insurance, and to make a long story short they cited with me and the policyholder. I guess now the adjusters little pissed off because he didn’t get it his way so he’s making everything very hard in regards to this ventilation, code upgrade issue.

In all the years that I’ve been in the roofing business, I’ve never had an insurance adjuster, or an insurance company not pay for ventilation to be brought up the code if the insured has ordinance and law and their policy. I have an adjuster from Travelers who is refusing to pay for ventilation on these two buildings to be brought up code per Ohio building code requirements, and follow the states guidelines in regards to having to abide by the shingle manufacturer’s instructions.

He stated, and I quote,"as the attic was not damaged in the loss, and the ventilation is to ventilate the attic, I can’t consider it under the code upgrade coverage in the policy. Not only that, but an attic is not part of the roof. " I sent him the Ohio Building Code Requirement in regards to ventilation, I sent him the Residential Building Code which REQUIRES that materials be installed per manufacturer’s installation requirements. I still cannot get him nor his supervisor to reason with me on this. If anybody has anything good that I can say to this man to put him in his place once and for all please let me know! Thanks guys.

Well that depends on the outcome you expect?

If it’s your ego making the statement, consider calling him incompetent and of questionable intellect. Someone who wields position power recklessly and is an obstructionist with a fraction of your experience! Throw in the word “prick” here and there just to nail down your point.

Now if it’s your intelligent brain saying something, you’ll need to quiet your ego and craft something that might move you forward because it seems you’re at an impasse. Yup, sort of like putting out your hand when you feel like punching someone in the face.

The issue is not you being correct, it’s that he may be “wrong and strong”. The result of living in a world where facts matter less than feelings. Until you acknowledge you’ve bruised his ego, you simply won’t get anywhere because he has the power.

It’s really messed up but it also sounds like what you’re dealing with.

This is why alcohol was invented.

Are you in a jurisdiction which requires a building permit? You may be able to get the local building code enforcement arm to write a letter or written requirement that the work be performed in that manner. By law they must comply. If they still refuse then it is time for a lawyer to get involved.

Your best bet might be to do some digging and find an email or phone number to whoever is above their heads and call and plead your case that you just want to move forward with the job but you can’t unless all laws are complied with and you are at an impasse and don’t know what to do. (Never mention lawyer).

As a roofer myself AND as an adjuster in training, I see both sides of this. Couple questions though:

  1. Have you seen the policy and do you know for a fact the policy has L&O coverage? If so, is it enough to cover the ventilation?

  2. Have you gotten it paid for on other jobs by other adjusters? If so, then it’s just this adjuster, and yes you pissed him off so dealing with him will get you no where. Have the homeowner contact their insurance and deal with it (assuming their policy includes coverage).

In the future, demanding coverage from an adjuster is a bad way to approach it. Might I suggest asking if he would please include it as PWI (like drip edge) assuming L&O coverage exists, which is something you want to verify with the homeowner before you ask the adjuster.

Best of luck

Afaik in the state of ohio insurance must pay to replace the roof up to the current codes if it needs replaced due to damage. At least with commercial insurance, not sure about homeowners.

I had a similar issue with the ordinance and laws portion of an insurance claim.
I didn’t make anyone mad as you may have, however when a particular upgrade was asked about as a compliance update I was informed that the laws and ordinance coverage wouldn’t apply (although the policy provided coverage) because the residence was located within a jurisdiction that didn’t conduct enforcement inspections.

Hope you got your law of ordinance items covered. Travelers is notorious for doing “their own thing” even when they’re wrong.

That’s where your customer/their policy holder got shafted. Law of ordinance should be paid whether local municipality enforces the state requires code items or not. That’s like saying we only pay when there’s accountability. If there isn’t then we won’t pay it. It’s a state code. It should be installed accordingly and paid for by policies that include law of ordinance/code coverage. Period. To my knowledge there’s nothing in any insurance policy that says “we’ll pay to get it to current code… unless no ones checking, then we won’t.” But you catch more flies with honey. And it usually comes down to that since they write the check.

Hey if your in Florida Look me up and we put da spanking on that bad insurance company.

I agree with what your saying, however I’ve since heard this from another insurance company that basically give the same response.
Where I’m located we’re limited on what we can discuss or request whenever we’re dealing with an insurance company so it’s difficult to get much unless the policy holder is willing to stand up and ask questions when they are turned away from having something paid for that’s clearly covered.