Texas Homeowners Insurance Lawyer

Why Might a Homeowners Insurance Claim Be Denied?

Homeowners insurance claims can be rejected for several reasons, and it's important to be aware of possible sticking points to ensure a smoother claims process.

Here are some common issues insurance companies may cite when denying a claim in Texas:

• Policy exclusions: The damage falls under a specific exclusion in your policy.
• Late reporting: You failed to report the damage within the required timeframe.
• Insufficient documentation: You didn't provide adequate evidence of the damage or loss.
• Premium payment issues: Your policy has lapsed due to nonpayment of premiums.
• Pre-existing damage: The insurer claims that the damage existed before your policy took effect.
• Wear and tear: The damage is attributed to normal wear and tear rather than a covered peril.
• Improper maintenance: The insurer argues that lack of proper maintenance contributed to the damage.
• Error or misrepresentation: You provided incorrect information on your insurance application.
• Insufficient coverage: Your policy limits are lower than the cost of repairs.
• Suspicion of fraud: Your insurer has reason to suspect fraudulent activity.
• Bad faith denials: Insurers may deliberately delay claims, deny valid coverage, make lowball offers, or falsely allege fraud to avoid paying legitimate homeowner claims.

If your insurer has unfairly denied your claim, a qualified Texas home insurance attorney can challenge their decision. Your lawyer will investigate your case, advocate for your rights, and take legal action if needed to secure the benefits your policy promises.

Texas Laws Protecting Homeowners with Insurance Claims

Texas has established strong legal frameworks governing how insurance companies handle home insurance claims. These laws set strict guidelines regarding insurer forms and decisions, prohibit unfair settlement practices, and impose meaningful penalties when companies fail to uphold their obligations to policyholders.

Homeowners Insurance Policy Exclusions in Texas

Texas’s Insurance Code specifies standard policy exclusions, including flood damage, earthquakes, mold, wear and tear, intentional damage, high-risk activities, war hazards, and government actions.

Prompt Payment of Claims Act

In Texas, insurance companies must adhere to the Prompt Payment of Claims Act, which establishes specific timelines for processing insurance claims. Under this law, insurers must:

• Acknowledge receipt of a claim within 15 days.
• Begin investigating the claim within 15 days.
• Accept or deny a claim within 15 days after receiving all necessary information.
• Pay accepted claims within five business days.

If an insurance provider fails to meet these deadlines without reasonable cause, it may face penalties, including interest on the claim amount and attorney's fees.

Unfair Claims Settlement Practices

Texas Insurance Code Chapter 541 prohibits unfair claims practices, such as misrepresenting policy provisions, failing to promptly investigate claims, or refusing to pay claims without conducting a reasonable investigation.

The state’s Deceptive Trade Practices Act (DTPA) supplements these protections by providing various remedies, including potential triple damages when insurers engage in deception.

Notification Provisions

Chapter 542A of the Insurance Code outlines specific procedures for notifying insurers of claims, including required pre-suit notice for weather-related damage. These procedures provide standardized guidelines regarding how claimants should communicate with their insurers.

Bad Faith Insurance Practices

When insurers unreasonably deny or delay legitimate claims, Texas law allows homeowners to pursue bad faith remedies beyond their policy limits. This possibility serves to ensure that companies fulfill their obligations. However, it takes a knowledgeable home insurance attorney to effectively challenge insurer tactics that circumvent these requirements.

How Omar Ochoa Law Firm Can Help You

If you believe your claim for homeowners insurance benefits has been wrongfully denied or delayed, our skilled attorneys can take legal action to protect your rights and obtain payment from your provider.

We can assist you in several key ways, including:

• Claim review: We'll start by thoroughly reviewing the denied claim to identify the reasons for the denial.
• Documentation and evidence: We'll work with you to gather evidence that supports your claim, such as home damage photos and repair estimates.
• Negotiation: Our attorneys are adept at negotiating with insurance companies. They’ll seek a prompt and just settlement on your behalf.
• Seeking full compensation: Our goal is to pursue every dollar the insurance company owes you for your home damage.

Dealing with a denied homeowners insurance claim during an already challenging time can be extremely stressful. We'll manage the legal aspects of your claim so you can focus on other areas of your life.