Ask for the denial in writing, with the policy clause it rests on. Then hold it up against your own inspection report and ask the insurer to look again.
A fight over how much the damage costs can go to appraisal under your policy. A fight over whether the damage is covered goes to the South Dakota Division of Insurance or a lawyer. This is general information, not legal advice.
Why do insurers deny roof claims?
Wear and tear is the reason given most often for hail roof denials, according to policyholder lawyers and claim consultants. The rest of the list is short.
| Reason given | What the insurer means | What to check |
|---|---|---|
| Wear and tear | The shingles were old and failing before the storm | Your inspection photos, the roof’s age, the storm date |
| Cosmetic damage | Hail marked the roof but it still keeps water out | Whether your policy has a cosmetic exclusion, and what it covers |
| Late notice | You reported after the policy’s deadline | The notice clause in your policy and the date you first called |
| Pre-existing damage | The damage came from an earlier storm | Dated photos or an older inspection report |
| No storm damage found | The adjuster saw nothing that hail or wind did | Whether your roofer found damage the adjuster missed |
Small hail lands right on the wear and tear line. Here is what years of small hail do to shingles.
Cosmetic exclusions can reach metal too. Western National’s 2024 South Dakota homeowner changes made its cosmetic roof exclusion cover all metal parts of a roof. In July 2026 the federal appeals court that covers South Dakota held, in a Minnesota school case, that a dented metal roof that can no longer carry the same snow or wind load is more than cosmetic.
What should a roof claim denial letter say?
Why the claim was turned down, and which part of the policy or the law backs that up. South Dakota’s unfair claims law, SDCL 58-33-67, lists failing to promptly give a reasonable explanation for a denial or a low offer as an unfair practice.
The same law lists failing to act on claim communications within 30 days.
If you only got a phone call, write to the adjuster and ask for the reason and the policy wording. From then on, keep copies of every letter and email, and note the name, date and time of each call.
One more right kicks in now. If you signed a storm damage roofing contract, you can cancel it within 72 hours of learning the claim was denied in whole or in part. Here is how that 72-hour rule works.
Can I ask the insurer to inspect my roof again?
Yes, and bring your own evidence. Get a roof inspection with dated photos and a written report.
Write to the adjuster asking for a second look, attach the report, and ask to be home for it. Your roofer can be there too and point to each hit.
Aim the new evidence at the reason in the letter. If they said wear and tear, show the storm date and fresh marks. If they said late notice, show the date you first called.
What is the appraisal clause in a homeowners policy?
A way to settle a dispute over the amount of the loss without going to court. Check your policy’s conditions section for it. Wording differs by insurer, but a standard clause works like this:
- Either you or the insurer demands appraisal in writing.
- Each side picks a competent, independent appraiser.
- The two appraisers pick an umpire. If they cannot agree, a court can name one.
- Any two of the three agree on the amount, and that sets it.
You pay your own appraiser. The umpire’s fee and other appraisal costs are split.
Appraisal sets how much. It does not decide whether the damage is covered, so a flat denial for wear and tear or late notice needs one of the routes below.
How do I file a complaint with the South Dakota Division of Insurance?
Online, by mail, fax, email or phone. The Division asks you to raise it with the insurer first, then file if that fails.
- Online: the complaint form at dlr.sd.gov/insurance.
- Mail: Division of Insurance, 124 South Euclid Avenue, 2nd Floor, Pierre, SD 57501.
- Phone: 605-773-3563 (TTY 711).
- Fax: 605-773-5369.
- Email: sdcomplaints@state.sd.us, with the printable form.
The form asks for your policy number, claim number and date of loss, what happened, the outcome you want, and whether you have a lawyer. Attach the denial letter, your inspection report and photos.
Know its limits. A policyholder law firm says the Division asks the insurer for a written answer within 20 days, but cannot act as your lawyer, decide the facts of your claim or order the insurer to pay. We could not confirm the 20 days on the Division’s own site.
Can I sue my insurer for an unfair roof claim denial in South Dakota?
Not under the unfair claims law itself. SDCL 58-33-69 says it gives no private right to sue, so the Division enforces it, and only after it gives the insurer notice and the insurer fails to fix the problem.
You can still sue on the policy. That is a contract claim, and SDCL 15-2-13 gives six years.
South Dakota adds a lever. Under SDCL 58-12-3, if an insurer refuses to pay the full loss and the refusal was vexatious or without reasonable cause, the court must award the homeowner who wins a reasonable attorney’s fee. There is no fee if the insurer offered money before the suit and you won no more than that offer.
When should I talk to a lawyer about a denied roof claim?
When the insurer says the damage is not covered at all and the roof is worth more than a lawyer’s fee. Also when the insurer stops answering, when appraisal stalls, or when a deadline in the policy is close.
The State Bar of South Dakota runs a lawyer referral service at findalawyerinsd.com and 800-952-2333. Ask for someone who handles insurance disputes, and ask about fees on the first call.
Before the next storm, read how to decide whether a roof claim is worth filing.
Questions about denied roof claims
Can I appeal a denied roof claim?
Yes. Ask for the reason in writing, send the insurer your own inspection report and photos, and ask for a re-inspection. If the dispute is over the amount, your policy’s appraisal clause may apply.
What is cosmetic hail damage?
Dents, marks or pitting that change how the roof looks but not how well it keeps water out. Some policies exclude it, so check yours for a cosmetic damage exclusion.
Does the South Dakota Division of Insurance make insurers pay claims?
No. It can ask the insurer to explain and act on unfair practices, but it cannot order payment on your claim or act as your lawyer.
How long does an insurer have to respond to a claim in South Dakota?
SDCL 58-33-67 lists failing to act on claim communications within 30 days as an unfair claim practice.
Who pays for a roof appraisal?
Under a standard clause, each side pays its own appraiser and the two split the umpire’s fee and other costs. Check your own policy’s wording.
Get a quote
Tell us about the job, with a copy of the denial letter if you have one, and a local roofing contractor will call, text or email to set up a visit. The quote is free.