Insurance companies need to be held accountable when they deny a ligitimate insurance claim. Keep in mind that insurance companies will make every effort to cut corners.  If they deny your insurance claim you’ll need an experienced attorney to fight on your side.

My Insurance Claim Was Denied!

If this happened to you then keep in mind insurance companies deny claims often. For example, hail and wind damage is extremely common in Texas but insurers will often attempt to deny the legitimate claims that result, just to see if they can get away with it.  Insurance companies use a number of tactics to deny claims to help improve their bottom line.  Most commonly, insurance claims are denied due to:

  • Improper home construction by the builder
  • Defective products used in construction
  • Pre-existing damage
  • Roofing or building materials extended beyond their useful life
  • Failure to report a claim in time
  • Many other reasons

Insurance companies often deny insurance claims that absolutely should be covered.

This is wrong!

They may be operating in bad faith under Texas law.  Denying a valid claim is a breach of contract by the insurer.  Insurance companies are required to pay claims promptly or they are in violation of the Texas Prompt Pay Laws, covered in the Texas Insurance Code.  If your insurance company has denied your claim and refuses to pay you MUST contact a denied insurance claim lawyer immediately to evaluate your claim and contract before your time runs out.

What Should I Do If My Claim Has Been Denied?

  1. Document all of your communication with your insurance company, adjuster, and agent IN WRITING. Avoid phone calls and conversations that cannot be recorded.  Documentation will be useful in building your case.
  2. Request the insurance company send a representative for a second assessment of the damage. If you already have a contractor or roofers helping you assess the damages independently, try to have them on site when the insurance company inspector arrives.
  3. If they still deny your claim, consult a lawyer. An experienced insurance lawyer will assess your legal right to action under Texas law.

Is My Only Recourse Going Through The Appraisal Process?

No.  Insurance companies will often tell policyholders that their only remedy for a denied or underpaid insurance claim is to get an appraisal.

This is just not true.

Appraisal is intended for situations where the insurance company and a policyholder cannot agree as to the value of a covered loss, not for when there is a complete denial of a claim. A good example of a situation appropriate for appraisal would be if the only issue affecting your claim is a disagreement as to the specific value of something (such as a roof).

If an insurance company has denied your claim completely they are taking the position that you have not suffered a loss covered by your policy and therefore they do not need to pay.  This is a disagreement about overall coverage, not about specific value.  An appraisal will not solve this issue.

Failure to pay a valid claim is a breach of contract; you will need a lawyer to protect your rights and secure the compensation you deserve.

The Insurance Company Sent An Engineer Who Said I Didn’t Experience A Loss, Do I Still Have Rights?

Yes.  Insurance companies regularly retain engineers to assess damages for property insurance claims.  What they try to keep hidden is that they routinely hire the same engineers over and over again.  These engineers often complete half-hearted inspections, padding their report with the same attachments they use for every assessment to make the report appear thorough.  Almost all of their reports look the same, sometimes using the same exact language simply copied over from another report.  This destroys their credibility.

If the engineer wrongfully denies you suffered property damage you should hire your own engineer to make an independent assessment.  An unbiased engineer – one not making 90% of their income from the insurance company – will likely have a very different opinion about your loss and the insurance company’s obligation to you.

If you have filed an insurance claim but it was unfairly denied, we want to fight to make it right.  Contact the Fitts Law Firm today for your free denied insurance claim consultation.  We will review your claim and explain all the options available to you under Texas law.

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