1. Gradual Leaks & Ongoing Seepage

State Farm generally covers only unexpected water incidents, such as a burst pipe, without any signs of long-term or gradual leaks. If the damage results from slow drips or ongoing leaks, insurers often deny coverage, claiming it falls under maintenance issues rather than a covered risk.

2. Wear, Tear & Maintenance Neglect

Most standard insurance policies, including those from State Farm, typically do not cover damage caused by age-related wear and tear, such as corroded pipes or malfunctioning appliances. When State Farm evaluates a claim and determines it to be a maintenance issue, they often deny it, even if a sudden incident triggered the damage. This means that if the loss is linked to ongoing maintenance problems, policyholders may have their claims denied, regardless of whether an unexpected event caused the situation.

3. Policy Exclusions or Missing Endorsements

Many policies exclude coverage for:

• Flood and subsurface/groundwater
• Sewer or drain backups (unless specifically endorsed)
• Microbial contamination or mold (unless specifically endorsed)

4. Delay in Reporting or Poor Documentation

Delayed reporting or a lack of adequate evidence (such as photographs, contractor documentation, or mitigation records) gives insurers a legal basis to reject or reduce claims. Additionally, homeowners are obligated to take steps to minimize damage, like hiring plumbers or water extraction services, to ensure coverage eligibility.

5. Misclassification of Cause or Alleged Pre-Existing Damage

Insurers may assert that the damage existed before the policy began or mischaracterize the source. Some cases feature State Farm-appointed experts concluding damage was pre-existing, contradicting homeowner evidence. Courts have found such tactics problematic when policyholders present timely evidence.

What the Lawsuit Alleges

According to the complaint, plaintiffs sustained roof damage from hail between March and June 2025. Many also reported subsequent interior issues like ceiling stains and drywall damage due to delayed repairs. Despite being fully insured under what they believed were comprehensive homeowners policies, their claims were denied with little explanation.

The complaint further states that State Farm’s insurance adjusters and agents misrepresented policy coverage, specifically, that hail damage would be included. These homeowners, some of whom have been with State Farm for over two decades, now find themselves paying out of pocket for roofing and structural repairs they expected would be covered.

Damages in the complaint are estimated between $18,000 and $20,000 per property. In addition to roof damage, many of the homes sustained water damage to personal belongings, insulation, and even HVAC system components.

Real Estate Meets Reality

Paul Epperley, president of the Greater Fort Worth Association of Realtors, told the Star-Telegram that many buyers are caught off guard when they see their projected insurance premiums. “I do feel like there are people that just either drop out or they drop down,” he said, referring to prospective buyers walking away altogether due to rising insurance costs.

Why Are So Many Claims Getting Denied?

Experts attribute this alarming surge to several key factors:

Rising Deductibles

Insurers have steadily increased deductibles, often pushing the out-of-pocket cost so high that minor claims simply go unpaid. In coastal Texas, wind damage deductibles of 2–3% of home value are now common—translating to nearly $9,000 on a $300,000 home .

Narrower Coverages

More policies are excluding specific perils like wind or hail—reducing insurer liability, but leaving homeowners exposed

Homeowner Inaction

Many homeowners don’t dispute claim denials due to time, complexity, or lack of resources.

Industry responses often point to high deductibles or policy grouping—such as associating renter claims with homeowners—in explaining these statistics

Why Premiums Are Surging

Climate Change

Unpredictable and more frequent climate disasters are driving up insurance rates. The rising number of claims from recent wildfires, storms, floods, and tornadoes is forcing insurers to increase costs.

Rising Inflation

Inflation has raised the cost of building materials and labor, making it more expensive to repair or rebuild homes.The escalating costs of building materials and labor due to inflation have significantly increased the expense of repairing or rebuilding homes.

Storm and Flood Damage in the Midwest

According to Insurify,  Homeowners nationwide should anticipate increased insurance expenses as insurers modify their pricing to account for escalating risks, with the Midwest potentially experiencing some of the most substantial premium hikes.

How to protect yourself

You can’t control the insurance industry or stop climate change, but you can take steps to lower your home insurance costs.

Each year, compare quotes from various insurance providers to secure the best rates. Enhancing your home’s weather resistance, such as by upgrading your roof or wiring, can not only help minimize damage but may also make you eligible for discounts.

Shopping around is key—but be prepared, it can take time to call around for quotes.Consider increasing your deductible and refraining from filing minor claims, as these actions can lead to lower premiums. Relocating to a lower-risk area might also be beneficial, given that residents in high-risk zones face insurance costs approximately 82% higher.

What’s inside:

• A clear breakdown of what’s actually covered in most home insurance policies
  
• Common things that aren’t covered (but often assumed they are)
• Extra coverage options—like flood or earthquake insurance—that may be worth adding
  
• Why reviewing your policy details before something goes wrong is so important
  

Whether you’re dealing with storm damage or just trying to protect your property, this article is packed with practical tips and simple explanations to help you feel confident about your coverage. 

Check out the full article here: https://roofingmagazine.com/do-you-know-what-your-policy-covers/

Allegations of a Coordinated Industry Pullout

According to one of the lawsuits, insurers engaged in an “illegal scheme” by simultaneously withdrawing or halting new business in fire-prone areas beginning in early 2023. The lawsuit, filed on behalf of homeowners who lost their homes in the devastating January wildfires, claims this coordinated retreat violated California antitrust and unfair competition laws. The wildfires destroyed nearly 17,000 structures and resulted in at least 30 fatalities, leaving survivors struggling to rebuild with insufficient coverage.

The second lawsuit seeks broader damages for any policyholder forced onto the FAIR Plan after January 2023. The FAIR Plan caps residential coverage at $3 million, which for many homeowners falls far short of the cost to replace or rebuild homes in California’s inflated real estate market.

“By colluding to push plaintiffs and so many like them to the FAIR Plan, the defendants have reaped the benefits of high premiums while depriving homeowners of the full coverage they were ready, willing, and able to purchase,” said attorney Michael J. Bidart, representing the homeowners (KCRA News).

The Shifting Landscape of Roof Coverage

One of the biggest changes Minnesota homeowners are now facing? A dramatic shift in how insurers handle hail damage and roof claims.

“Hail losses, specifically as it relates to roofs, are some of the biggest cost drivers right now,” said Aaron Cocking, an insurance industry lobbyist. To recoup losses, insurance companies are increasingly prorating roof claims—meaning the amount they’ll pay depends on the age of your roof—and applying separate deductibles based on damage type, rather than using a single, standard deductible.

This practice mirrors what we reported in Texas, where we covered how increasingly complex policy language and selective coverage limitations are leading to widespread confusion—and in some cases, outright denial of valid claims.

Homeowners Are Often Unaware Until It’s Too Late

“Many homeowners think, ‘I’ve got home insurance—I’m covered,'” said Cocking, “but they don’t actually read into it.”

This is a dangerous assumption, and one that’s exploited all too often. As noted in our recent coverage of the Texas insurance crisis, more and more policyholders are learning—after damage occurs—that their policies exclude or drastically underpay storm-related repairs.

Dan Walrach, a Minnesota-based contractor, echoed this concern. “Read your policy,” he advised. “If you don’t know how to read your policy, find someone to help you read it.”

Understanding Why Insurance Claims Are Denied

While the Weiss report paints a concerning picture, insurance companies argue that the numbers are more nuanced than they appear. Many of the denied claims cited in the report were closed without payouts because:

• Damages Did Not Exceed the Deductible: Claims were below the policy’s threshold for coverage.

• Policy Exclusions: The reported damage was not covered under the specific policy.

Despite these explanations, the end result for policyholders remains the same—no financial assistance to repair or rebuild after damage.