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ClaimsTruth Analysis · SAMPLE-U

Claim Analysis Report

Structured analysis based on submitted documents and policy terms.

The carrier applied 30% depreciation to roof materials but the policy limits depreciation to 10%. This is one of the most common underpayment tactics.

Section 01

Claim Overview

Claim Type

Homeowners (Roof Damage)

Status

Approved but Underpaid

Documents

3

Report Date

2026-04-07T18:43:55.959Z

Documents Submitted

Homeowners_Policy_2023.pdfpolicy
Contractor_Estimate_Roof.pdfestimate
Adjuster_Estimate_Roof.pdfcorrespondence

Section 02

Policy Coverage Summary

Policy Type

HO-3 Standard Homeowners

Dwelling Coverage (Coverage A)covered

Coverage for structural damage to the home

Roof Coveragecovered

Roof replacement or repair, subject to depreciation limits

Depreciation Schedulecovered

Materials: 10% per year (max 50%), Labor: 5% per year (max 25%)

Analysis

The policy covers roof damage but applies depreciation. The approved payment is significantly below the contractor estimate due to excessive depreciation applied by the adjuster.

Section 03

Claim Outcome Analysis

This claim was approved but the payment is likely insufficient. The carrier applied depreciation rates that exceed policy limits, resulting in an underpayment of approximately $8,200.

Documented Financial Values

Claimed

$24,700

Approved

$19,700

Difference

$5,000

ItemSubmittedApprovedDifference
Material Cost (Shingles)$18,500 (3-tab asphalt shingles, labor included)$14,800 (30% depreciation applied)-$3,700 (excessive depreciation)
Labor Cost$6,200 (roof installation, removal, disposal)$4,900 (15% depreciation applied)-$1,300 (labor not depreciated per policy)
Total Shortfall$24,700 (full replacement cost)$19,700 (actual approval)-$5,000 underpayment

Section 04

Gaps & Inconsistencies

Depreciation Rate Exceeds Policy Limithigh

The carrier applied 30% depreciation to materials, but the policy limits material depreciation to 10% per year. At 5 years, the limit is 50%, not 30%. This is a policy violation.

Labor Depreciated Incorrectlyhigh

Labor costs should not be depreciated at the same rate as materials. The policy clearly separates labor depreciation (5% max) from material depreciation (10% max).

Section 05

Red Flags

Non-Standard Depreciation Schedule Appliedhigh

The adjuster used a depreciation rate that does not match your policy schedule. This is one of the most common reasons for underpayment.

Recommended Action

This is frequently cited as a basis for disputes. Verify the depreciation schedule matches your policy and that non-depreciable items (labor, materials) were not depreciated. Request an itemized breakdown of depreciation calculations.

Section 06

What Should Happen Next

1

Request Itemized Depreciation Schedule

Demand a detailed breakdown showing the depreciation calculation for each line item. Compare it directly to your policy depreciation schedule.

2

Obtain Contractor Estimate for Comparison

Ensure your contractor estimate matches standard regional pricing. Get 2-3 competitive quotes to establish fair market value.

3

Calculate Underpayment

Using your policy depreciation schedule, calculate what the approved amount should be. Document the difference.

4

Submit Formal Demand for Additional Payment

Submit written demand with your depreciation calculations and supporting estimates. Request payment within 14 days.

Section 07

Escalation Options

Request Appraisal

If the carrier denies your demand, you have the right to invoke the appraisal clause. An independent appraiser will determine the value and depreciation.

When to consider: Within 30 days of denied demand

File Complaint with Department of Insurance

File a complaint citing the specific depreciation violation. Provide your policy language and the adjuster calculations.

When to consider: If appraisal is refused or disputed

Legal Action

An underpayment of this magnitude may justify legal action. Consult an attorney regarding breach of contract or bad faith.

When to consider: If escalation does not resolve within 60 days

Section 08

Not Verified - Limitations & Unknowns

This analysis is limited by the documents provided. The following items could not be verified and represent gaps in the current understanding:

Missing

Adjuster Work Papers

The adjuster original notes, photographs, and calculations are not typically provided but are critical to verify their depreciation basis.

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This report is generated from structured templates based on standard insurance policy language, industry practices, and interpretive guidance. It does not constitute legal advice. Specific policy terms, state regulations, and individual circumstances may affect applicability. Consult a licensed professional for advice specific to your situation.

ClaimsTruth · Report SAMPLE-U · 2026-04-07T18:43:55.959Z

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