I would like to ask your opinion regarding the policy language addressing the Loss Settlement provisions requirement for the repairs to be performed with "like kind and quality" materials.

I am in disagreement with the insurance adjuster who argues that the policy does not guarantee/require matching of roofing and siding materials. He is denying the coverage for the obsolete replacement materials based on:

D. Loss Settlement

Paragraph 3.

"The 'repair' is intended to return the damaged property to a pre-loss condition without regard to cosmetic appearance. Materials used to make 'repair' may vary in color, shading, dimensions, pattern, and composition"

I am not in agreement with his determination as the policy includes the additional endorsements changing the policy. Endorsement used by the adjuster is listed on page number 58 of 64 CONDITIONS APPLICABLE TO WINDSTORM OR HAIL LOSS TO EXTERIOR OR ROOF SURFACING, but further on page 59 of 64, we find an additional endorsement SPECIFIED ADDITIONAL AMOUNT OF INSURANCE FOR COVERAGE A – DWELLING is in effect:

"2. Section I – Condition D. Loss Settlement

a. The replacement cost of that part of the building damaged with material of like kind and quality and for like use…"

I believe that since the additional coverage is granted by later endorsement, the endorsement quoted by the adjuster is tramped by added endorsement allowing for the "like kind and quality". Your opinion is kindly requested.

Illinois Subscriber

The issue with your question is what's the cause of loss? If the cause of loss is hail or windstorm, then the adjuster is correct because the HA 80 67 applies when the cause of loss is windstorm or hail. The HO 04 20 is for increased Coverage A limits; as long as the insured has allowed the carrier to adjust the coverage amount over time if at the time of loss the damage is more than the existing Coverage A amount, then Coverage A will be increased by the scheduled amount which in this instance is 50%. Otherwise, the standard policy provisions apply, which for Coverages A and B are replacement cost. Matching is one of the big issues in insurance – courts have fallen on both sides of the issue, with some maintaining that if the damaged property cannot be matched, for example, a roof, that the entire roof should be replaced while others find that simply repairing the damage as closely as possible is enough. FC&S has long held with the former opinion, that in order to restore the insured to his preloss condition, which was matching property, the entire property should be replaced if matching roofing/siding etc. cannot be obtained. If you can provide us with details as to the cause of loss we can be of more help. You may find the following helpful: