Ch 5 · Common Loss Types
Module 5.2
Wind Loss Playbook
Roof deductibles. Hurricane vs named storm. Causation fights.
12 min read
What you'll learn
Hurricane vs named storm. Roof deductibles. Wind-vs-flood causation. The reform-era roof rules. Carrier playbook to expect.
5.2.1 Wind claim categories
| Category | Trigger | Typical $ |
|---|---|---|
| Hurricane | Named storm, hurricane status | $25K-$5M+ |
| Tropical storm / named storm | Named, not hurricane | $10K-$1M |
| Wind alone (non-named) | Severe thunderstorm, microburst | $5K-$200K |
| Tornado | Local rotation event | $50K-$2M |
| Hailstorm | Wind-driven hail | $10K-$300K |
Each category triggers different deductibles + reform rules. Identify category at intake.
5.2.2 The deductible gauntlet
Hurricane deductible
Triggered by declared hurricane. Typically 2-10% of dwelling Coverage A. On $400K dwelling at 5% = $20K out of pocket.
Named storm deductible
Triggered by named tropical system. Often same or slightly less than hurricane. Some policies treat tropical storm + hurricane same.
All-other-perils (AOP) deductible
For non-named wind events (regular thunderstorm). Typically $1K-$2,500.
Once-per-year rule
Florida statute: once a hurricane deductible is met in a year, subsequent named-storm losses use AOP. Critical — saves tens of thousands.
Strategy: Verify which deductible applies at first notice. Don't assume.
5.2.3 The roof claim — reform-era reality
Florida roof claim rules changed materially in 2022-2023. Outdated info still circulating.
Current rules (post-SB 2A + reforms)
- Replacement cost for roofs less than 25% damaged = repair, not full replacement
- Matching statute (§ 626.9744) narrowed for roofs — replacement of damaged tiles only, not full slope
- ACV-only roof endorsement widely available — caps roof recovery at depreciated value
- Roofer disclosures + AOB ban changed contractor relationships
- 1-year notice applies to roof claims
- 18-month supplemental applies to hidden roof damage discovered later
Strategy
- Determine if 25% threshold met → triggers full replacement
- Check ACV vs RCV roof endorsement
- Document slope-by-slope damage
- Use IICRC + roofing standards (manufacturer specs, NRCA, ASTM)
5.2.4 Wind-vs-flood causation fight
The problem
Hurricane causes both wind + flood damage. Wind = covered by HO. Flood = covered by NFIP only.
Carrier strategy
Attribute as much as possible to flood → not their problem. Send their cause-and-origin expert.
Counter strategy
- Wind first, water second — typical sequence
- Anti-concurrent causation language — read policy carefully
- Independent meteorologist + engineer report
- Roof damage = wind, not flood
- Above-flood-line damage = wind
- Document elevation of damage — water marks indicate flood line
Documentation
- Water lines on walls
- Wind-thrown debris angles
- Pre-storm + post-storm Google Maps comparison
- Witness statements (neighbors, news footage)
5.2.5 The wind claim workflow
Day 1-3: Mitigation + safety
- Tarp the roof immediately
- Board windows
- Document damage before tarping
- Save receipts
- Photo + video full property
Day 1-14: Documentation
- Notice carrier in writing
- Aerial drone photos if possible
- Slope-by-slope roof documentation
- Interior water intrusion photos
- Tree fall, fence, exterior damage
- Wind debris collection
Day 14-30: Initial inspection
- Carrier sends adjuster (often a CAT adjuster post-hurricane)
- Their roofer + engineer may inspect
- Your roofer + engineer + contractor present
- Independent estimate prepared
Day 30-60: Causation + scope fight
- Carrier issues estimate (often heavily depreciated, often "wind-only" excluding mixed damage)
- Your independent estimate w/ wind causation supported
- Engineer report on causation
- Specific rebuttal
Day 60+: Negotiation / escalation
- Reinspection
- Mediation
- Appraisal
- Litigation + § 86.121 declaratory if denied
5.2.6 Common scope items missed
| Item | Often missed |
|---|---|
| Soft metals (vents, flashing) | Replaced individually = matching disputes |
| Underlayment | Hidden under shingles |
| Decking | Under shingle / underlayment |
| Insulation in attic if water intrusion | Hidden damage |
| Drywall on interior ceilings | Water damage from roof |
| Code upgrades for roof rebuild | Often $5-15K |
| Detached structures (sheds, fences) | Coverage B |
| Trees + landscaping | Sub-limit traps |
| Pool cage | Sub-limit + matching |
| HVAC roof equipment | Often missed |
| Solar panels | Coverage clause |
| ALE during reconstruction | Often substantial for hurricane |
5.2.7 Engineering reports — when essential
Required for:
- Causation disputes (wind vs flood, wind vs settlement)
- Code-required rebuild scope
- Structural integrity questions
- Roof slope analysis
- Wind-uplift calculations
Cost
$1K-$5K typical. Worth it for any disputed claim $50K+.
Use
- Submit early to set causation narrative
- Cite in negotiation rebuttal
- Carry to mediation / appraisal
- Foundation for litigation
5.2.8 Carrier tactics + counters
| Carrier tactic | Counter |
|---|---|
| "Damage is wear, not wind" | Engineer + photos pre-storm |
| "Damage from prior storm" | First notice, no prior claim |
| "Water = flood, not us" | Wind-first sequence + anti-concurrent |
| "25% threshold not met" | Slope-by-slope analysis |
| "Repair, not replace" | Matching statute + manufacturer specs |
| "ACV only" | RCV per endorsement reading |
| "Code upgrade not covered" | O&L coverage clause |
| "Hurricane deductible applies again" | Once-per-year rule |
5.2.9 The CAT adjuster reality
Post-hurricane, carriers deploy:
- CAT adjusters — out-of-state, paid by claim, time-pressured
- High volume — 100+ claims per adjuster
- Quick scopes — 30 min per inspection
- Limited expertise — may be new to FL pricing
Strategy
- Slow them down — multi-hour walk-through
- Provide your scope + photos in advance
- Independent expert + contractor present
- Don't rush settlement
- Reinspection if needed
5.2.10 Action steps
- Day 1: Tarp + mitigation. Document first.
- Day 1-7: Aerial + slope-by-slope photos.
- Day 7-14: Engineer for causation if disputed.
- Day 14-30: Independent estimate w/ full scope.
- Day 30-60: Push back on lowball + missed scope.
- Day 60+: Reinspection / mediation / appraisal.
- Once-per-year deductible — verify if applies.
- Wind-first narrative supported by engineer + meteorologist.
Next module: 5.3 Fire Loss Playbook.
Educational. Not legal advice. Specific wind/hurricane claim handling consults licensed FL professionals.