From a Denied Roof Claim to a $16,667 Award
How PALCO overturned a “cosmetic damage” denial and secured a real recovery for the homeowner.
Below deductible · file closed · $0 paid
Over 20× the carrier’s figure
Wind & hail roof damage (May 2025)
Single-family home, Austin area (TX)
Carrier called the damage “cosmetic” and age-related, valued it at $821.75 — below the $2,810 deductible — and closed the file with $0 paid.
Loss set at $16,667.06 replacement cost ($14,518.12 ACV), plus $580.84 emergency services.
≈ $16,400 — a closed, $0 claim turned into a real recovery.
The Challenge
After a spring storm, the carrier hired an engineer who called the roof damage “cosmetic” and age-related — not storm-caused — and applied the policy’s cosmetic-marring and wear-and-tear exclusions. The covered damage was valued at just $821.75, below the homeowner’s $2,810 deductible, so nothing was paid and the file was closed.
How PALCO Helped
Rejected the “cosmetic / age-related” position and prepared a detailed, storm-based repair estimate of the true loss.
Invoked the policy’s appraisal provision — a binding dispute-resolution process — after the carrier closed the file.
Served as the homeowner’s appraiser, worked with the carrier’s appraiser, and selected a neutral umpire.
Drove the file to a binding award that established the damage the carrier had written off.
The Outcome
The binding award set the covered loss at $16,667.06 replacement cost ($14,518.12 ACV), plus $580.84 in emergency services — over 20 times the carrier’s figure. A claim denied and closed for $0 became a real, funded recovery.
Proven Results
PALCO’s 2025 appraisal outcomes, on average
$15,363
Average initial carrier offer
$44,385
Average final award
+$29,021
Average extra recovery per claim
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