Last reviewed October 31, 2026.
The morning after a nor’easter, there are shingles in the hedge and a brown ring on the bedroom ceiling. The call to the insurance company is the easy part. What the insurer owes you, how fast, and what a roofer at the door is allowed to promise are all set by New York rules.
Deadlines New York sets for insurers
New York’s claim settlement regulation, 11 NYCRR Part 216, puts the insurer on a clock:
| Step | Deadline in the regulation |
|---|---|
| Acknowledge your claim | 15 business days after notice (216.4) |
| Accept or reject in writing | 15 business days after it receives a properly executed proof of loss and the items it requested (216.6) |
| If it needs more time | Say so, with reasons, inside those 15 business days, then send a letter every 90 days while the claim is open (216.6) |
| Pay an agreed settlement | Within 5 business days of receiving the agreement (216.6) |
The clock on a decision starts when the insurer has everything it asked for, so answer document requests quickly and keep copies. If the deadlines slip, the Department of Financial Services takes complaints against insurers and adjusters.
Wear and tear or storm damage
Wear and tear sits on the Department of Financial Services list of standard homeowners exclusions, next to flood and earth movement. A roof that leaks because it is old is a maintenance problem. A roof that loses shingles in a windstorm can be a claim, even if the roof is old.
The department’s consumer guide also warns that several small claims in a short span can mark you as a higher risk with some carriers and lead to a nonrenewal, and suggests paying for minor damage yourself. Compare the repair estimate with your deductible before you file.
Roof age, depreciation and the 80 percent rule
Two things decide how much an older roof brings. One is the basis of payment, replacement cost or actual cash value. The other is whether the house is insured for at least 80 percent of its replacement cost.
The department’s guide works through its own example. Two 15-year-old frame houses each have a replacement cost of $100,000, and a windstorm destroys both roofs, each costing $5,000 to repair. The owner insured for $80,000 is paid the full $5,000, less the deductible. The owner insured for only $50,000 gets the greater of the roof’s actual cash value or a proportional share. With a 25-year expected life, the department figures that roof’s actual cash value at $2,000, and the proportional share at $3,125, so that owner collects $3,125. Check your coverage amount against today’s rebuilding costs before a storm, not after.
Hurricane and windstorm deductibles
According to the Department of Financial Services, many insurers require a hurricane deductible for homes in Nassau and Suffolk counties. It is commonly 1 to 5 percent of the dwelling’s value or the amount of insurance on it, and insurers must print it as a dollar amount on the declarations page. In the department’s example, a home insured for $150,000 with a 5 percent hurricane deductible pays the first $7,500 of a hurricane loss.
Under Insurance Law Section 3445 and Regulation 159 as amended effective February 2, 2026, which the Department of Financial Services summarizes on its basic coverage page, a hurricane deductible applies only when the hurricane makes landfall in New York, and only to wind damage from 12 hours before landfall until 12 hours after the last hurricane watch or warning for the state is cancelled. The law lets insurers apply the change at a policy’s renewal. A separate windstorm deductible, which some policies carry, applies to any windstorm loss and also commonly runs 1 to 5 percent.
Proving the loss
The department’s guide says plainly that it is up to you to prove your loss. Tell the insurer or agent by phone, then follow up in writing and keep copies. Protect the house from further damage, keep receipts for temporary fixes, and wait for the insurer’s inspection before making permanent repairs. You can get your own contractor’s estimate to compare with the adjuster’s. If the adjuster says something is not covered, ask to see the policy language. If the two estimates differ, the department suggests going through them line by line with the adjuster and the contractor together, then getting a second independent estimate. Our emergency roof repair page covers the first hour after the damage.
Roofers and your deductible
A 2019 law added General Business Law Section 771-b, which sets rules for roofing contractors. A roofer may not advertise or promise to pay or rebate any part of your deductible, and the law counts allowances and discounts as a rebate. It also requires a written contract that names the contractor’s insurer, coverage and limits, and bars the roofer from requiring a deposit. A roofer may not report, adjust or negotiate a claim on your behalf. If the job is to be paid under your policy, you can cancel the contract until midnight of the third business day after the insurer tells you in writing that all or part of the claim is not covered, unless you waived that right in writing for emergency work you asked for.
Billing an insurer the full price while charging you less is a separate risk. The state’s insurance lawyers, in a 2007 opinion about auto repair shops, said that can amount to insurance fraud if the insurer does not know. For crews knocking on doors after a storm, see the storm chaser advice on our emergency roof repair page.
Public adjusters and appraisal
A public adjuster works for you, not the insurer, and must be licensed by the Department of Financial Services. By regulation, the fee cannot exceed 12.5 percent of the recovery, counted only on money the insurer pays after you hire the adjuster, and it can reach 20 percent on a supplemental claim only if the total stays within 12.5 percent of the full payment. The department adds that you can back out without penalty up to midnight on the third business day after you sign, that adjusters may not solicit between 6 p.m. and 8 a.m., and that you owe the agreed fee whatever the outcome.
When the dispute is about the amount, every New York homeowners policy has an appraisal clause. You and the insurer each pick an appraiser, the two choose an umpire, and the umpire settles what they cannot agree on, with both sides sharing the cost. Appraisal cannot resolve an argument over what caused the damage.
