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I once represented a family upon whose house a large tree branch had fallen. A significant portion – but not all – of the roof shingles were damaged and due to be replaced by my client’s homeowner’s policy. The roof was 10 years old and composed of green architectural shingles that were no longer available. The family came to me because their insurance company refused to replace the whole roof, denying coverage for the replacement of otherwise undamaged shingles because of the difference in color. To the company’s point, the old shingles were not physically damaged. To my client’s point, half of the roof on the front slope did not match the shingles on another slope or the garage, both of which were visible from the street. The family believed that the mismatched shingles were unattractive.

On my inquiry, the company responded that there was no coverage for “indirect” damages. The policy only covers direct damage to covered property. The cosmetic damage undermined the home’s aesthetic appeal and perhaps fair market value, but those were not perils insured against by the policy. I told my client that I would see if I could find something in the policy that might offset the cost, though I was not optimistic. As I thumbed through the policy, I found this:

 Loss to a Pair or Set

If there is a covered loss to a pair or set, we may:

a) repair or replace any part of the pair or set to restore it to its actual cash value before the loss; or

     b)  pay the difference between the actual cash value of the pair or set before and after the loss. 

I had always thought about this provision, which appears verbatim in many homeowners policies, as providing coverage for losses to like pairs of vases or sets of silverware. But nothing in the policy suggests such a restriction. Instead, this provision spoke directly to my client’s situation. The family home had lost part of a set of matching shingles and that loss was covered.

While I could tell that the adjuster viewed my interpretation as a perversion of the policy terms, there was simply no arguing with it. Further, I pointed out that my clients were not receiving the Replacement Cost Value of the loss to the set, but rather the Actual Cash Value, which takes into account depreciation. It seemed to me that the pair or set provision provided balance to the policy’s harsher but fatter replacement cost coverage. But be aware that not all insurance policies contain the same language regarding a coverage for a matching pair or set.

Insurance policies are verbose, conflicting, confusing and complex. Make sure that you retain a qualified insurance claims attorney to evaluate your loss.