Rules for Insurance Claims in Texas
Filing Deadlines
In Texas, insurance claims have specific time constraints. You must file a property claim promptly after damage occurs, though Texas law doesn't specify an exact deadline. However, most policies require notification "as soon as reasonably possible." For weather-related claims, you typically have one year from the date of damage to file a lawsuit against your insurer if a dispute arises. This deadline can be extended in certain circumstances, but prompt action is always recommended.
The Prompt Payment Act
Texas has a Prompt Payment of Claims Act, which establishes strict timelines for insurers. Once you file a claim, insurance companies must acknowledge receipt within 15 days. They must then accept or reject your claim within 15 business days (or 30 days in complex cases) after receiving all necessary documentation. If they approve your claim, payment must be issued within five business days.
The Right to Independent Appraisal
Most Texas insurance policies include an appraisal clause. If you disagree with the insurer's damage assessment, you can invoke this clause to obtain an independent evaluation. Both you and the insurance company select appraisers, who then choose a neutral umpire. The decision reached through this process is binding on the amount of loss, though it doesn't address coverage issues.
Bad Faith Insurance Practices
Texas law protects consumers against "bad faith" insurance practices. Insurers must conduct reasonable investigations, cannot misrepresent policy provisions, and must attempt to settle claims promptly and fairly. If an insurer violates these obligations, you may be entitled to additional damages beyond your claim amount, including penalty interest, attorney fees, and potentially punitive damages.
Roof Claims Special Provisions
Texas has implemented specific rules for roof claims related to weather events. Since 2021, contractors cannot offer to waive or absorb insurance deductibles, which is now illegal. Additionally, policyholders must pay their full deductible for roof replacements.
Disclosure Requirements
Insurers in Texas must provide clear explanations of coverage, exclusions, and the claims process. Your policy should outline specific procedures for filing claims and appealing denials. Insurers must also provide a written explanation when denying a claim or offering a settlement less than what was claimed.
Mediation and Complaint Options
Before pursuing litigation, Texas encourages alternative dispute resolution. The Texas Department of Insurance offers a complaint process and mediation services to help resolve disagreements between policyholders and insurance companies without costly litigation.