The Cedar-Shake Claim That Grew $31 k Between Desk and Field
Anonymized from a Midwest hail/wind claim, closed last year. Policy: HO-3, RCV, $2,500 deductible. Peril: severe thunderstorm, 1.5" hail, 58 mph gusts. The carrier assigned a desk review first, then dispatched a field IA when the contractor's estimate came in $28 k above the initial payment.
What the desk review scoped
- Partial shake replacement, rear slope only: $4,100
- Ridge cap repair (12 LF): $480
- Chimney caulk / minor repoint: $620
- O&P: $800
- Total: $6,000 ACV (after depreciation)
The desk adjuster worked from six submitted photos — all taken from the ground, all of the rear slope. Reasonable process. Insufficient evidence.
What the field inspection found
- Full rear slope replacement (shakes end-of-life, storm-accelerated): $11,200
- Left slope — full replacement (cupping and splitting visible on approach, not captured in submitted photos): $9,800
- Ridge and hip cap — full perimeter (displacement confirmed by touch; not just 12 LF): $3,100
- Chimney flashing tear-off and reinstall (step and counter-flashing, not just caulk): $4,200
- Chimney crown rebuild and tuckpointing: $3,600
- Cupola vent trim and louver replacement: $1,400
- Attic moisture inspection, drying, and treatment (discovered during interior): $3,800
- O&P: $3,300
- Total RCV: $40,400
The delta: $34,400 RCV / $28,600 net after deductible and initial payment
Every line item above was supportable from the original photo set — if the photos had been taken from the roof, not the ground, and if a second set captured the chimney flashing plane and the left slope. The submitted photos were not fraudulent; they were just incomplete.
What an AI-assisted review caught in the desk phase
Running the original six photos through an image-intelligence pass flagged the chimney flashing lift (visible at the edge of frame in photo 3), the hip ridge displacement (photo 5, background), and the left-slope curl (reflected in photo 2's shadow line). None of those flags made it into the first scope. The flags alone would not have closed the gap — but they would have prompted a targeted field request two weeks earlier and saved one full reinspection cycle.
The lesson
Cedar shake is a material where pre-loss condition, storm-date condition, and post-loss deterioration are genuinely hard to separate. That ambiguity is a workflow problem before it's a coverage problem. Get better photos earlier, and the ambiguity shrinks.