FAQ: Insurance Claims

The insurance claims process can get very confusing as a homeowner. We are here to help you make the claims process as easy as possible. We’ve listed below some Frequently Asked Questions. If these do not answer all of your questions, please give us a call at 469-450-6351 or email us at [email protected]

How long will it take before my insurance company settles with me?

The takes time for your insurance company to settle your claim will vary. If your cause of loss was a natural disaster affecting the area in which you live, there could be access issues which will undoubtedly cause delays in inspection, and therefore, a delay in all activity that follows. There is no set time limit under the law for settling the claim with you, but a company that takes “too long” to pay, according to the Texas Department of Insurance, is liable for your reasonable attorney fees plus damages equal to 18 percent of your claim if you sue and win.

The law sets guidelines such as:

  • The company must respond within 15 days after receiving your claim in writing
  • After you submit any requested documentation, the company has 15 days to accept or reject your claim.
  • Once the company agrees to pay you for your claim, it must send a draft or check within 5 business day. A company that cannot meet the above deadline must send you a written notice explaining why.

How long after I file my claim will it take for the insurance company to send someone out to inspect the loss site?

That depends on whether the site is accessible and safe, and whether your loss is one of many in a broad disaster or a single home fire or other type of loss. Most policies say that once you provide notice to your insurer in writing, the company must begin investigating your clam within 15 days, unless there is a named storm, which may give them additional time.

What are my duties and what are my insurers’ duties after a loss?

Your Duties:

  • Give your insurer written notice of your claim.
  •  Cooperate with reasonable request from your insurance company
  • Support your loss by providing requested information to the insurer
  • Mitigate your damages (Take steps to prevent further damage)

Your Insurer’s Duties:

  • Investigate your claim thoroughly and in a timely fashion
  • Treat you fairly
  • Pay for covered damage promptly
  • Tell you in writing why your claim or part of the claim was denied.

If your claim is denied but there is damage present, we can help you schedule a re-inspection to get a second opinion.

My insurance company is refusing to pay anything up front for my contractors overhead and profit. I don’t have the cash to advance this item, and he won’t get started without it, so I’m stuck.

Provide your insurer with an executed contract (a contract document signed by all parties to it.). Most insurers will make an initial payment if you present them with a signed contract between you and the contractor.

How much Overhead and Profit is standard in Texas?

Twenty percent is standard for the insurer (10% for overhead, and 10% for profit), although many trades mark up their costs higher than 20% to increase their profits.

My insurance company keeps reducing what they’re going to pay by “depreciating” items in my claim; what can I do?

The newer the item, the less depreciation. The better the condition of an item, the greater chance of reducing the depreciation. If the items in question have a longer life than the insurer wants to acknowledge, then support your position by presenting the insurer with facts about the usable life of certain items. (This is one of the important reasons for documenting your property and possessions prior to experiencing a loss.)

How can I find out what my rights are and what the rules and laws are that apply to insurance claims in Texas?

You can find the Homeowner’s Bill of Rights on the Texas Department of Insurance website. You can also file a complaint there if you believe your insurer is not handling your claim in good faith. This link will take you to the complaint form page: Texas Department of Insurance Complaints. Also visit the Consumer Protection section of the Texas Attorney General’s website. If you are so inclined, you can read the Insurance Code in the Texas Statutes. This can be accessed online for free.

Will the Texas Insurance Commissioner’s office help me if I run into problems?

Maybe. You can file a complaint through the Insurance Commissioner’s website, and they will investigate and respond. The telephone number for the Texas Department of Insurance Consumer Help Line is (512)463-6515 or 1-800-252-3439. Don’t expect the Texas Department of Insurance to aggressively advocate for you.

The insurance company is pressuring me to accept a settlement but I think it may be low. What can I do?

While you don’t want to rush into a settlement that is too low, try to get the undisputed about paid without having to sign a release.  It is always wise to get expert advice from a contractor before accepting a “final” claim settlement offer.

Do I have to accept the dollar amounts the insurer offers me?

No! You can do research on the Internet, get input from experts, or get two or more estimates from real world contractors or suppliers in order to challenge the amount the insurance company is offering.

If a dispute arises between me and the insurance company or adjuster, where can I turn to for help?

Let us help you with your claim. You may also contact the Texas department of Insurance/Insurance Commissioner at (512)463-6169 for assistance. You can consult an experienced attorney who specializes in representing people with property damage insurance claims. The Professional Help Directory is a starting point to find qualified attorneys.

 

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