Teardown: The Church Tarp That Closed a Claim — Then Reopened It
The Setup
Mid-size regional carrier. Wind and hail event hits a historic church — rendered masonry exterior, terracotta tile roofs, a bell tower. First responders tarp the rear roof section within 48 hours. The insured submits photos. A desk adjuster builds a scope from the photo set: tarp TPM costs, tile replacement on the rear section, ridge repair. File closes at $68,000.
Fourteen months later a public adjuster files a supplement. The reopened scope comes in at $258,000. The carrier disputes. An umpire splits it. Net additional paid: roughly $190,000 over what the first desk review captured.
What the Photos Showed — and What the Scope Missed
The tarp was treated as the answer, not a question. The rear roof section had a large emergency tarp draped over it. The desk scope captured TPM and assumed the damage footprint ended at the tarp perimeter. Nobody ordered removal and inspection photos before closing the roof scope. When a contractor finally pulled the tarp, they found partial rafter failure over a 40-square-foot section — decking gone, not just tiles.
The bell tower was logged as 'existing temporary structure.' The adjuster noted the makeshift timber bell tower but coded it as a pre-existing condition — no additional inquiry. It wasn't. Engineering records obtained during the supplement process confirmed the original masonry bell tower had partially collapsed in the storm. Demolition of the remnant, structural engineering fees, and code-compliant reconstruction added $74,000 to the scope alone. Ordinance-or-law coverage applied; the original scope didn't trigger it.
The flashing junction at the tarp edge was never scoped. Where the tarp met the temporary tower structure, flashing had failed or was never reinstalled after the emergency response. Water tracked into the wall cavity for over a year. By the time it was discovered, the interior plaster on the apse wall required full hack-off and a mold protocol. That was $18,000 of scope that was actively being created while the file sat closed.
The rendered cornice was called cosmetic. Spalled render on the decorative cornice got a one-line note: 'minor cosmetic render damage.' Render on historic masonry is not cosmetic. It's a weather barrier. Once moisture gets behind render, it cycles through freeze-thaw or wet-dry, widening the breach. The repair required a specialist renderer, lime-based mix to match the original, and full cornice scaffold access. $11,000 line item, not in the original scope.
The $ Delta
- Original scope: $68,000
- Reopened + umpired: ~$258,000
- Net gap: ~$190,000
- Primary drivers: structural scope under the tarp ($52k), bell tower collapse + O&L ($74k), water-ingress mold from the flashing failure ($18k), cornice specialist repair ($11k), balance in adjustments and fees
What a Systematic Photo Review Would Have Caught
Three questions — asked on day one — would have changed this file entirely.
- What is under the tarp? Never scope around a tarp. Require removal and inspection before closing the roof line item.
- Is that tower original or temporary? A quick query to the insured or a title/permit search takes twenty minutes. The answer here would have immediately triggered an engineering referral and an O&L coverage analysis.
- Where does water go if the flashing at the tarp edge fails? Trace the water path on every tarp-related claim. The tarp is a temporary fix, not a permanent seal.
An AI photo review flagged all three questions in the initial photo set — flagging the bell tower as 'structural anomaly requiring verification,' the tarp junction as an 'active ingress risk,' and the cornice spalling as 'render failure, not cosmetic.' The desk adjuster's workflow didn't surface those flags before closing. That's not an AI problem. That's a workflow problem.