Recorded August 5, 2024, this policyholder webinar, How a TWIA Claim Works – Part 2, has information for TWIA policyholders who reported a claim for damage after a hurricane.
Covered topics include the TWIA claims process and details on possible claims decisions. This includes deductible questions and information, how to use your estimate as a tool and tips on how to best avoid delays in your claim, and the dispute process and deadlines for disagreements with claim decisions.
Frequently Asked Questions*
Deductible Questions
I received a check with the deductible & depreciation subtracted. Is the deductible taken from the payment I received from TWIA?
The deductible is subtracted from your payment. The cost of repairs will include the amount of your payment plus any depreciation plus your deductible.
You mentioned that your deductible was already taken out of the check you receive and that you must prove you paid the deductible to the contractor. Which is correct?
TWIA subtracts the deductible, and we also hold back (subtract) “depreciation” until repairs are made (on a replacement cost policy). In order to be paid the depreciation, we need proof that you paid the deductible to the contractors. You will need to save documentation on how you paid the deductible, like a canceled check, money order, financing agreement, etc.
My policy states a deductible of 2%. Is that 2% of the loss amount or 2% of the coverage amount?
The deductible is calculated from the maximum limit of coverage on your property, not on the loss amount. You can check your policy declarations page for the limit on your coverage. You and your agent determined your deductible when your TWIA policy application was submitted by your agent.
Is the deductible for the full claim or just the roof?
There is a deductible for the dwelling, which includes the roof and other parts attached to the home. A separate deductible applies to personal property if it is damaged.
If I have multiple contractors, do I pay deductibles for each, and how do I determine the deductible for each contractor?
You have a single deductible for a dwelling and a single deductible for personal property. It may be easier to pay the deductible to the contractor doing the largest amount of work; however, if you need to split it up just make sure to save a copy of the payment (check/money order/etc.) and submit those to TWIA.
What does “you may be eligible for $xxx for depreciation after paying a contractor for deductible” mean? Does this mean I ask for a second check for that amount?”
Yes, if you had recoverable depreciation subtracted from your claim payment. After the repairs are completed, you will be asked to submit documentation to TWIA showing the completed repairs and the payment of your deductible. These will be reviewed, and you may be eligible to receive your recoverable depreciation.
The roof has been damaged, and we need to replace it, but TWIA said the damage was below the deductible. Can my roofing contractor work with TWIA?
Please submit your contractor’s proposal for review. After we receive permission from you, we can discuss it with the contractor.
Coverage Questions
If we file a claim but don’t use the insurance, how will filing a claim affect our policy going forward? Does the premium go up even if we don’t use the insurance money?
Your TWIA premium will not increase because you filed a claim with TWIA.
When receiving our claim findings concerning estimate repairs, do they include “Loss of Income” as well?
It depends on your policy if you have commercial coverage and a Business Interruption endorsement. If you have a residential policy, there isn’t coverage for loss of income. Talk with your claim examiner for additional details.
How can we know if we have a replacement or ACV provision for damaged personal items such as furniture, art, bedding, etc.?
If your policy includes the 365 Endorsement, you have replacement cost coverage on personal property.
I have a flat top roof, originally tar paper and tar with gravel. The roofer says that no one does that anymore. They use a plastic covering for the flat-top roofs. Would that be covered? Or would it be an upgrade?
Changing from rolled roof material to a better material would be a code upgrade. If your original roof is not allowed by code, you would need to have the Increased Cost of Construction endorsement on your policy. If the roof is just not available anymore, that may be covered. It is best to speak with your claims examiner about your particular situation.
My roof needs replacement, and I have solar panels. My vendor sent me the cost to remove and reinstall the panels. I sent the estimate to the adjuster. Is this covered? Another question: Can I obtain a copy of the repair estimates?
If TWIA is replacing the roof, we would typically cover removing and resetting the panels. Every claim is unique and this should be discussed with your claims examiner. Yes, we will provide you with a copy of any estimates we prepare.
What if a home is not livable during repairs? Is the cost to temporarily relocate covered?
With the Additional Living Expense endorsement, those expenses are covered provided your home is unlivable due to the damage. Please discuss this with your claim examiner.
We had a wood floor that was saturated with water during the storm. I pulled it up and replaced a section of the floor myself. Is that recoverable? I don’t have an invoice for my work.
You should make sure you have submitted this information to your claim examiner. If we know the type of material and the measurements, we may be able to calculate the cost.
Are certain landmark lifetime shingles covered or qualified by the roof replacement policy?
We estimate roof shingles based on what was in place at the time of loss. You can replace shingles of comparable pricing if they meet the TDI Windstorm Certification requirements for shingles. If the shingles are of a higher quality than you had before, we would pay the recoverable depreciation available but not an additional amount for material upgrades.
Will you be reimbursed for all out-of-pocket expenses if you submit your receipts?
No. For us to cover your out-of-pocket expenses, they must be tied to the covered damages on your claim.
Do I submit a contractor estimate first to TWIA for approval before starting the roof replacement?
Please submit the contractor’s estimate for review by a TWIA claims examiner prior to starting the repairs.
What happens if we are hit by another hurricane before repairs are made? Will TWIA cover the additional damages?
It depends on many variables. The length of time between storms and the scope of repairs must be considered.
Can you discuss damage to personal property and how TWIA works for Condo units? We have a personal TWIA policy, but so does the HOA.
Condo claims are a little more complex. We first look at the HOA policy and determine what is covered under that policy for items attached to the unit. Then, if something isn’t covered under the HOA policy, we would look to see if we can cover it under your Unit owner policy.
My roof was installed just before roof vents were required. Two contractors have stated the TWIA estimate is low because it does not factor this in as a requirement to come up to code and be certified. Is this cost recoverable?
It is not uncommon for the contractor’s proposal to be greater in scope and pricing as the contractor will include all items necessary for the repairs to be performed to satisfy certification versus only including what is necessary to repair your damage to get you back to what it was before the storm If your policy includes the Increased Cost of Construction endorsement, then these additional costs may be accepted under your coverage.
How do we obtain a copy of our policy? Is there a portal or something where we can see our account details?
Yes, there is—the Policyholder Portal at twia.org/login. You must register for it using the email we have on file for you. If you can’t complete registration online, please call our Policy Services team at (800) 979-6443 , and they can help you register. Also, you can always get a copy of your policy from your agent.
Where can I find my estimate for damages in the portal?
The estimate is in the “Document” section. Your claims examiner can also send a copy by mail or email.
Claims Process Questions
How may I get a copy of the initial appraisal report by the adjuster who came to my home?
A copy of the estimate written by the field adjuster should be sent out by email or mail as part of the claim determination letter. You can also log into the Policyholder Portal, and a copy will be there.
Who is my point of contact for all things claim-related through this process?
Your claims examiner or claims examiner team should be your point of contact and capable of addressing any concerns or questions
How long do I have to get repairs completed & submit for recoverable depreciation?
You have 545 days from the date of our claim determination to complete the repairs and request depreciation.
How is the depreciation requested and claimed?
Depreciation is considered for release, or payment, with proof of the completed repairs, a final invoice from your contractor, and proof that you have paid your deductible.
What if I showed the adjuster damages and it wasn’t on the claim?
You can send in additional information for TWIA to consider. If you showed the adjuster and it is not included in an estimate or explained otherwise, you should document the issues and submit them to TWIA in writing via an email or in the Policyholder Portal.
When the adjuster came out, I had some buckling. Two weeks later, the buckling is much worse. Should I send those pictures to the adjuster for consideration?
Please send those pictures to TWIA at claims@twia.org with your claim number in the subject line or submit them in the Policyholder Portal.
The Portal states that a check has been issued for my claim, but there is no explanation of benefits document uploaded to the documents section. The check was written on August 1st. How soon will I see it?
A letter with an estimate of damages is sent separately from the claim check. This letter is usually mailed in 5-7 days and may arrive a few days apart from the check.
Payment Questions
When the check is issued, will the check be given to us, or must it be issued to contractors?
The claim payment check will always be payable to you (the named insured) and your lienholder (mortgage company, etc.),if applicable. The contractor is not a named insured under your policy.
Why is the mortgage company name written on the TWIA check?
TWIA is required to include the mortgage company as required by the policy contract. You can reach out to the mortgage company for details on getting them to release the money to you so you can make repairs.
How do I cash the payment check since my name and my mortgage company are both on the check?
Because both you and the mortgage company (lienholder) are listed as having an interest in the property on the policy, claim payment checks may be written to both parties. Contact your mortgage company to find out how to endorse and process your claim payment check, as different mortgage companies have varying procedures.
How do you have the lienholder endorse the check for deposit?
You will need to contact your lienholder directly.
If the repair is less than the check that insurance gives us, will any difference be sent back to the TWIA?
No. We have paid the amount for the cost of repairs that is owed under your policy.
If I find a contractor or do the work myself and it is less than the estimate, do I return the difference, if any?
If you do not spend more than the actual cash value of your loss, which we have sent you, you do not need to request any additional payments or submit documentation to us. Make sure you have obtained any required TDI windstorm certifications for the repairs.
Contractor Questions
My property’s roof was damaged. My son is a jack of all trades. Can I hire him to do repairs, or does it have to be a professional business?
The decision of who completes your repairs is your choice. Roofs need to be windstorm certified when certain damages/repairs occur, like a full replacement or repairs over 100 square feet. Additional TDI windstorm certification details can be found on the TDI website.
Does the contractor have to honor the estimate you provided for the work? What if they try to charge us much more than what you estimated for the repair?
They do not have to honor our estimate if they feel the repairs cost more. If they disagree with our estimate, it would be helpful to us to understand why. Having them review the estimate and explain why and where the differences are can help us review your claim and potential payments. You may also find several contractors bid thejob differently. Submitting information to your claim examiner is the first step to getting it right
Any recommendations on roofers?
TWIA does not have preferred contractors.
Certification Questions
Can you explain the windstorm certification process?
TWIA has an excellent source of information at https://www.twia.org/windstorm-certification. That site also contains the TDI windstorm certification website for additional details.
Is the homeowner responsible for contacting TDI about coming out to inspect the roof before, during, and after the roof replacement?
For the WPI8 from the TDI windstorm certification program, you must schedule with their inspectors to have the roof inspected and certified. The earlier you contact them during the process, the better. They cannot certify work that has already been completed.
I had shingles blown off. Should I just replace them? Do I also need a certificate of compliance?
If you submitted a claim, the adjuster would provide a scope of repairs necessary. Depending on the scope of repairs, a certification may be necessary. Typically, if spot repairs are required, the repairs do not need TDI windstorm certification.
Do I set a TDI inspection to be done after the roof is fixed and who incurs the cost?
The TDI windstorm inspection must happen BEFORE the repairs are completed. TDI offers this WPI8 windstorm certification for free. Your examiner will be able to provide more detailed information regarding the certification. Visit the TDI windstorm certification website for additional details and scheduling.
Do new replacement windows need certification?
If the full window is being replaced, including the window frame, yes, they need windstorm certification.
Dispute Questions
If we have a dispute about our claim, should we get our roof fixed while we are in the dispute, or should we wait until the dispute is resolved?
If you dispute our claim assessment and disposition, I encourage you to discuss it with your claims examiner as soon as possible. Please submit written documentation of your dispute and the estimate and photos from your contractor. Making permanent repairs before the dispute is resolved is not recommended as it may be deemed that a second inspection by an expert is needed.
What is the deadline to let TWIA know I disagree with the amount of damage accepted and provide additional proof?
Actual cash value disputes must be initiated within 60 days of our claim disposition. Replacement Cost policies have additional time to initiate the dispute process. You are encouraged to present your concerns as soon as possible.
*This is intended for educational purposes only and does not supersede your policy contract. Every claim is evaluated on its own merits and it is possible your particular claim could be handled differently.
