Roof insurance claim refused: why, and what to do next

Insurers decline roof claims at a higher rate than almost any other household claim, and the wording of the refusal is usually identical: the damage is due to wear, tear and gradual deterioration, which is excluded under your policy. That sentence is doing a lot of work, and it is challengeable.

The four reasons claims get refused

• Wear and tear. The adjuster has decided the roof failed because of age rather than the event. The most common outcome on any roof over about 25 years old.
• No storm in the data. You reported storm damage, the weather station recorded 30mph gusts, and the claim falls at the first test. See what counts as a storm.
• Lack of maintenance. Blocked gutters, heavy moss, a valley full of debris. Insurers photograph these on the site visit.
• A policy exclusion. Flat roofs over a certain age, undeclared flat roof area, storm damage to gates and fences, lead theft after a first claim. Read the schedule, not the brochure.

Read the refusal letter properly

Three things in that letter decide what you do next.

1. The exact clause relied on. "Wear and tear" is a judgement you can contest with evidence. A specific exclusion, such as flat roofs over 15 years old, is a contractual fact you probably cannot.
2. Whether it is a final response. Those words matter: they start the six month clock for the Ombudsman.
3. What evidence they used. Ask for the loss adjuster's report and the weather data they relied on. You are entitled to see the basis of the decision.

The evidence that overturns refusals

Arguing does nothing. Documents do. In order of weight:

• An independent roof report, £250 to £600. Written by a roofer who is not quoting for the work, describing the condition of the covering, the fixings, the failure pattern and whether it is consistent with the weather on the date. This is the single most effective document you can produce. Our roof inspection guide explains what a proper report contains.
• Weather station data. Gust speeds and rainfall for your postcode on the date, printed with the source.
• Before photographs. Any picture of the house from the last few years showing an intact roof. Estate agent photos, a neighbour's, a delivery app snapshot.
• Maintenance records. Gutter clearing invoices, a previous inspection, receipts for repairs. They demolish the lack of maintenance argument.
• The failure pattern. Damage on one slope facing the wind reads as storm. Damage scattered evenly across the whole roof reads as age. Say which yours is, and show it.

Send it all in one written complaint, state clearly that you are complaining rather than querying, and give them eight weeks.

The Financial Ombudsman route

If the insurer does not budge, the Financial Ombudsman Service reviews the case free of charge. Points worth knowing:

• You must complain to the insurer first and either receive a final response or wait eight weeks.
• You then have six months from that final response to refer it.
• The Ombudsman decides on what is fair and reasonable, not only on strict policy wording, which is why marginal wear and tear cases are worth referring.
• Their decision binds the insurer if you accept it. It costs you nothing either way.

Loss assessors: worth it or not?

A loss assessor works for you, unlike the loss adjuster, who works for the insurer. They typically charge around 10 per cent of the settlement, sometimes more on small claims. On a £15,000 fire or storm claim with a complicated scope, a good assessor usually earns their fee. On a £1,500 tile claim they rarely do, and the same money spent on an independent report and your own persistence goes further.

When to stop and pay for it

If the roof genuinely is at the end of its life, the refusal is correct and time spent fighting it is time the water is still coming in. At that point the question changes from who pays to what it costs. Our repair costs and replacement costs give the fair 2026 ranges, and a free quote comparison tells you the real local number.