“Wear and Tear,” “Old Damage,” “Preexisting”: An Insurance Lawyer and Former Adjuster Explains How Carriers Evaluate Storm Claims
After a hailstorm or windstorm, you file a claim. The adjuster inspects your property. Then the letter arrives:
- The roof shows wear and tear.
- The damage is old.
- The condition is preexisting.
- The policy does not cover it.
I know those explanations well.
Today, I am a Texas insurance lawyer representing homeowners and property owners in insurance disputes. Before becoming an attorney, I spent more than a decade handling and managing claims on the insurance side, including as a licensed Executive General Adjuster. Over those years, I personally performed or reviewed thousands of property inspections across Texas.
Along with cosmetic damage, wear and tear, deterioration, and preexisting damage were among the issues I encountered regularly when evaluating storm claims.
I have stood on the other side of these decisions. I know what adjusters look for when deciding whether roof damage came from the storm you reported or was already there.
Here is what homeowners should understand when an insurance company says the damage is old, preexisting, or simply the result of wear and tear.
Before you read: The information below is general. Every insurance policy and claim is different. Policies contain different forms, exclusions, limitations, deductibles, and endorsements, and coverage depends on both the policy language and the particular facts of the loss. The only way to determine how coverage applies to a particular claim is to review the actual policy and evidence.
Why Do Insurance Companies Care Whether Damage Is Old?
Property insurance is generally intended to cover specified losses occurring during the policy period, subject to the policy’s terms, exclusions, and limitations.
It is not typically intended to function as a maintenance contract for ordinary aging or deterioration.
That is why policies commonly contain exclusions or limitations involving conditions such as:
- Wear and tear
- Deterioration
- Rot
- Corrosion
- Repeated seepage or leakage
- Defective construction or maintenance
- Other long-term or excluded conditions
The exact wording varies from policy to policy.
After a storm, the important question may therefore become:
Did the reported storm cause new covered damage, or is the observed condition attributable to age, deterioration, a prior event, or another excluded cause?
Sometimes the answer is straightforward.
Sometimes it is not.
An Old Roof Can Still Sustain New Storm Damage
This is an important distinction.
A roof does not have to be new to sustain hail or wind damage. A ten-, fifteen-, or twenty-year-old roof may already have age-related conditions and still suffer new damage during a later storm.
That means two things can potentially exist at the same time:
- Preexisting wear or deterioration
- New damage associated with the reported event
The existence of the first does not automatically answer whether the second occurred.
But when both are present, proving what the storm actually caused can become more complicated. Herrera PLLC addresses similar disputes involving denied wind, hail, and roof damage claims.
What Does Wear and Tear Look Like?
When adjusters inspect roofs, they may look for conditions they believe indicate age, deterioration, or long-term exposure rather than a recent storm event.
Depending on the roofing material, those observations may include:
- Generalized granule loss
- Cracking
- Curling
- Blistering
- Oxidation
- Corrosion
- Deteriorated sealant
- Long-term staining
- Weathering
- Prior repairs
- Mechanical damage
- Other conditions associated with aging or maintenance
But physical indicators should be evaluated in context.
A particular condition may support an opinion about age or causation, but it does not necessarily establish the exact date a condition occurred or eliminate the possibility of additional storm damage.
That is why the full pattern of damage and the available history matter.
How Do Adjusters Try to Determine Whether Damage Is New or Old?
When I inspected storm claims, the entire property mattered.
An adjuster may consider:
- The appearance and condition of the roof
- Whether similar conditions exist across all slopes
- Whether the reported damage appears concentrated on slopes exposed to the storm
- Collateral damage to gutters, vents, siding, screens, HVAC equipment, fencing, or other exterior components
- Weather information
- Prior claim history
- Prior photographs
- Repair records
- The age of the roof
- Whether patches or prior repairs are visible
- Statements from the homeowner, contractor, or other witnesses
No single item necessarily answers the question.
The objective is to determine whether the overall evidence is consistent with the reported event.
Prior Claims Can Become Important
One issue homeowners sometimes overlook is prior insurance claims.
If the property had a previous hail, wind, or water claim, the carrier may investigate what was claimed previously and whether the repairs were completed.
That can create an important evidentiary issue.
Suppose a roof was damaged in an earlier hailstorm and the insurance company paid for repairs.
If the roof was never repaired and another hailstorm occurs years later, distinguishing between the two events can become difficult.
On the other hand, if the homeowner can show that the earlier damage was repaired, that evidence may become extremely important.
Useful documentation can include:
- Contractor invoices
- Receipts
- Photographs
- Proof of payment
- Warranties
- Permits
- Prior estimates
- Prior carrier photographs
- Other records showing what work was completed
Preserve those records.
What If You Bought the Home After the Alleged Prior Damage?
This can also happen.
You purchase a home, a storm occurs, and the insurance company later says some of the damage predates your ownership or policy.
You may not know the complete history.
In that situation, potentially useful evidence can include:
- Pre-purchase inspection reports
- Seller disclosures
- Listing photographs
- Real-estate photographs
- Prior roof inspections
- Contractor records
- Permit records
- Prior claim information, when available
- Photographs from before the reported storm
The goal is to establish the condition of the property before and after the event as accurately as possible.
What If the Carrier Says the Damage Is From a Prior Storm?
Weather history can become important.
Texas properties may experience multiple hailstorms or wind events over several years.
If the insurance company says the observed damage came from a prior storm rather than the date you reported, ask what evidence supports that conclusion.
Relevant evidence may include:
- Historical weather reports
- Prior claim files
- Earlier photographs
- Inspection reports
- Repair invoices
- Roof age
- Damage patterns
- Expert opinions
Physical appearance may provide information relevant to causation or age, but it should not automatically be treated as definitive proof of the exact date damage occurred.
The Policy Language Still Controls
Even when there is a legitimate factual question about the age or cause of damage, the insurance policy remains central.
The carrier should identify the policy language supporting its coverage decision. The Texas Department of Insurance homeowners insurance guide provides additional information about policy coverage and exclusions.
If the denial relies on wear and tear, deterioration, faulty maintenance, prior damage, or another exclusion, read the actual provision.
Do not rely only on a summary in the denial letter. The Texas Department of Insurance explains common reasons for homeowners insurance claim denials and options for asking the insurer to review its decision.
As an insurance lawyer and former insurance adjuster, this is where I see an important distinction.
Determining what physically caused damage is a factual and sometimes technical question. Determining how the insurance policy applies to those facts is a coverage and legal question.
Both matter.
What If There Are Multiple Causes of Damage?
Texas insurance disputes can become more complicated when covered and excluded causes or damages are alleged to exist together.
Depending on the policy language and circumstances, an insured may need to present evidence establishing what portion of the claimed loss is attributable to a covered event rather than an excluded or preexisting condition.
This is sometimes discussed in Texas insurance litigation in connection with concurrent or multiple causes of loss.
The exact legal analysis is highly dependent on the policy language, the type of claim, and the evidence.
It should not simply be assumed that the existence of any wear and tear eliminates coverage for everything else.
From a practical standpoint, however, one lesson is clear:
If the carrier says part of your roof was already damaged and part was affected by a new storm, evidence separating those conditions can become extremely important.
And the earlier that evidence is preserved, the better.
How Can You Challenge a Wear-and-Tear or Preexisting-Damage Denial?
Start with the evidence.
1. Read the Denial Letter Carefully
Identify exactly what the carrier says.
Is it claiming:
- No storm damage occurred?
- All observed conditions are wear and tear?
- Damage predates the policy period?
- A prior claim caused the damage?
- The roof was already deteriorated?
- Another exclusion applies?
Those are different positions and may require different evidence.
2. Get the Complete Policy
Review the policy forms and endorsements in effect on the date of loss.
Identify the specific exclusion or limitation the carrier relies upon.
3. Preserve Before-and-After Evidence
Photographs from before the storm can be extremely useful.
Sources may include:
- Real-estate listings
- Inspection reports
- Contractor photographs
- Prior claim photographs
- Google or aerial imagery where appropriate
- Personal photographs
- Maintenance records
4. Preserve Repair Records
If prior damage was repaired, preserve the evidence.
Invoices, photographs, receipts, warranties, and proof of payment can help establish what work was completed.
5. Look at the Entire Property
Collateral damage can provide context.
Damage to gutters, vents, screens, siding, HVAC equipment, fencing, and other exterior components may help establish what occurred during the storm.
Again, collateral damage does not automatically prove functional roof damage.
But it can be part of the overall evidence.
6. Consider an Independent Inspection
If the carrier’s causation determination is disputed, a qualified roofing professional, engineer, or other appropriate expert may be able to evaluate the condition and provide an independent opinion.
An independent inspection may also help document the issues involved in underpaid wind, hail, and roof damage claims.
7. Consider Legal Review
If the dispute involves substantial damage, competing causation theories, policy exclusions, or a significant amount of money, an insurance lawyer can evaluate the coverage issues separately from the repair issues.
What If Your Roof Really Does Have Wear and Tear?
Be realistic.
Not every roof condition is storm damage.
Sometimes a roof is simply old.
Sometimes deterioration, maintenance issues, or prior damage explain some or all of what is observed.
An independent contractor or expert may agree with the insurance company on certain conditions.
That does not mean the investigation was pointless.
The goal is not to turn every denial into a lawsuit.
The goal is to determine what the evidence actually supports.
If the roof has both long-term wear and legitimate new storm damage, those conditions should be evaluated separately where possible.
Talk to an Insurance Lawyer and Former Insurance Adjuster About Your Roof Claim
My perspective on storm claims comes from both sides of the insurance process.
Before becoming an insurance lawyer, I spent more than a decade handling and managing insurance claims, including as a licensed Executive General Adjuster.
I inspected properties, reviewed storm damage, evaluated prior conditions and repair histories, and worked with the types of evidence carriers use to make claim decisions.
Today, I use that experience to represent Texas homeowners and property owners in insurance disputes.
If your insurance company says your roof damage is “wear and tear,” “old damage,” deterioration, or preexisting, the denial letter does not necessarily tell the entire story.
The policy, storm evidence, condition of the property, prior repairs, photographs, inspections, and other evidence may all matter.
Herrera PLLC represents homeowners and property owners in Houston and throughout Texas, in English and Spanish.
Call (832) 891-3210 for a free consultation with an insurance lawyer and former insurance adjuster.
Hablamos español.
Herrera PLLC
2339 Commerce Street, #172
Houston, Texas 77002
Phone: 832-891-3210
Email: jherrera@jh-lawpllc.com
Related Reading
- Hail Claim Denied as “Cosmetic Damage”?
- The Insurance Company Is Sending an Engineer. What Should You Know?
- I Filed a Homeowners Insurance Claim. What Happens Next?
Frequently Asked Questions
An insurance company may consider the roof’s age and condition when determining what caused the observed damage. But age alone does not necessarily establish that a later storm caused no new damage. Coverage depends on the policy language and evidence regarding the particular loss.
Homeowners policies commonly exclude or limit ordinary wear, deterioration, and similar long-term conditions. The exact policy language controls. A separate question may arise when an older or worn roof also sustains new damage from a covered event.
Adjusters may consider the appearance and pattern of damage, weather history, prior claims, prior photographs, repairs, collateral damage, roof age, and other available evidence. Physical characteristics can provide context but may not definitively establish the exact date particular damage occurred.
The carrier may investigate what damage was previously claimed and whether repairs were completed. Invoices, photographs, receipts, warranties, and other proof of repair can be important.
An insurer may conclude that a condition resulted from aging, deterioration, or another excluded cause rather than hail. But that characterization should be supported by the policy language and evidence. When there is a legitimate dispute about causation, additional documentation or expert evaluation may be appropriate.
The existence of prior wear does not necessarily establish that a later storm caused no additional damage. When preexisting conditions and alleged new storm damage exist together, determining what the covered event actually caused can become a central issue in the claim.
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