How far does an insurer have to go to match an undamaged area?

Sometimes disaster destroys everything in sight, but misfortune often causes damage here and there.

A pipe bursts, and water ruins a corner of your Brazilian cherry wood floor. A windstorm tears off half of the vinyl shingles on one side of the house. Or a fire burns a couple of kitchen cupboards. Home insurance generally covers partial losses such as these. But the extent to which the insurer must go to make everything look how you'd like is a thorny issue.

What happens, for instance, when the new siding contrasts with the older, weathered siding? Or you can't find replacement kitchen cupboards that precisely match the others?

"Most commonly, we see the question come up with roofs," says Ronald Reitz, president of Quality Claims Management Corp. in San Diego and a past president of the National Association of Public Insurance Adjusters (NAPIA).

Sometimes insurers propose replacing only the broken shingles. That's a problem if the end result is a roof that looks like a patchwork quilt, Reitz says.

The new part shouldn't stick out like a sore thumb, he says. The appearance should be uniform within the line of sight. Inside, that could mean replacing the entire floor of a room, even if only a portion needs repair, or repainting all the walls, even if only one was damaged.

Matching laws and making a case for full replacement

In some states, you have case law or state statutes on your side. In Florida, for example, if replaced items don't match in quality, color, or size, the insurance company must make "reasonable repairs or replacement of items in adjoining areas."

While not every state has such rules, some carriers have added non-matching language to policies and introduced endorsements, or insurance add-ons, to cover matching.

Matching coverage is a fairly low-price add-on to your home insurance that ensures that when you file a claim for your roof, siding or windows, the surrounding undamaged roof, siding or windows will, if needed, be replaced with materials that match.

American Family Insurance, for instance, offers the "Matching Undamaged Siding and Roof Coverage" endorsement, which covers up to $20,000 of the cost to update with new materials the undamaged siding or roofing if there's a mismatch when repairs are made. The endorsement costs $25 a year.

Even in states where insurance companies are required by law to make everything match, company adjusters often push for less-expensive patching and resist full replacement, according to United Policyholders, a San Francisco-based consumer advocacy group.

"It's not a slam dunk," Reitz says. "They balk, but when you press, they'll give in. The argument I generally make is it all matched before, so it should match now."

Reitz says there's less push-back from insurers about replacing an entire counter or floor than replacing a roof or all the siding.

Making the argument when filing an insurance claim

The issue of patching versus full replacement depends a lot on individual insurance company adjusters. Some are more flexible and willing to accommodate customers than others.

If you can't make any headway, consider going over the adjuster's head to a supervisor.

Still think the insurer is treating you unfairly? Contact your state's insurance department to file a complaint.

Another option is to hire a public insurance adjuster who works on your behalf through the claims process. Public insurance adjusters can charge a fee of up to 15% of the final settlement, according to the Insurance Information Institute, so you'd pay about $3,000 if your claim settlement is $20,000. But if they can get a better settlement than you could by filing a claim by yourself, it could be worth it.

FAQ

–Additional reporting by Prachi Singh

Sources

• Cincinnatus Insurance : What to know about matching coverage
• Performance Adjusting : What is matching coverage?
• Acuity: What-is-matching-siding-coverage
• Amfam : Siding coverage for home 
• Insurance Information Institute : What is a public adjuster?