When a Houston homeowner files a property damage claim after a major storm, the insurer may point to “concurrent causation” as a reason to deny all or part of the payout. Concurrent causation arises when two or more events contribute to a single loss, and at least one falls under a policy exclusion. For example, if a hurricane causes both wind damage, which is typically covered, and flooding, which is usually excluded, the insurer might argue that no coverage applies because both causes contributed. This doctrine frequently becomes a major obstacle for Houston policyholders after severe storms where wind and water damage overlap. Understanding how this works—and when to consult a home insurance denial attorney—can make a significant difference in your claim’s outcome.
If your claim was unfairly rejected and you need guidance, Fitts Law Firm, PLLC is ready to help. Call 713-871-1670 or reach out online to discuss your situation.
Concurrent causation is a legal concept that applies when multiple causes produce a single, inseparable loss. In a typical Houston scenario, a severe storm brings both high winds and flooding. While wind damage to your roof is usually covered, flood damage generally is not. Standard homeowners insurance in Texas excludes floods, earthquakes, landslides, and sewer backups unless the policyholder purchases separate coverage. When an insurance company cannot cleanly separate the covered damage from the excluded damage, they often invoke concurrent causation to deny the entire claim, which is when a property damage denial lawyer can step in.
The key mechanism insurers use is an “anti-concurrent-causation clause,” or ACC clause. This provision states the insurer will not cover damages caused “directly or indirectly” by an excluded event, regardless of any other cause that contributes concurrently or in sequence. In practice, even if wind caused significant covered damage, the mere presence of floodwater as a contributing factor can trigger a denial under this ACC clause.
💡 Pro Tip: Review your homeowners policy for an anti-concurrent-causation clause before a storm hits. Knowing whether your policy contains this specific language helps you anticipate the insurance company’s response and prepare the right documentation.
The leading Texas case is JAW The Pointe v. Lexington Insurance Co., which the Texas Supreme Court decided in a way that strongly favors insurers. A coastal Galveston apartment complex suffered damage from both wind (covered) and flood (excluded) during Hurricane Ike. The insurer paid the wind damage claim but denied coverage for ordinance-compliance costs that required demolition and rebuilding, arguing that both wind and flood contributed to the city’s “substantially damaged” determination. The Texas Supreme Court analyzed the ACC clause and held that it barred coverage for those expenses because flood damage directly or indirectly contributed to the loss.
The policyholder argued wind damage alone was a “separate and independent” cause sufficient to trigger the ordinance, and that common law concurrent-causation doctrine should override the policy’s ACC clause, but the court disagreed. The court held that contract language controls and the ACC clause applied by its terms. This landmark ruling marked the first time the Texas Supreme Court directly enforced an ACC clause, giving insurance companies a powerful tool to deny mixed-cause claims.
💡 Pro Tip: If your insurer cites concurrent causation in a denial, request the specific policy language they are relying on in writing. You are entitled to know exactly which clause applies and how it relates to your loss.
Houston’s geography and climate make concurrent causation disputes particularly common. Hurricanes, tropical storms, and severe weather regularly produce overlapping wind and flood damage. Following the JAW The Pointe decision, insurers now have a court-endorsed framework for denying claims where both covered and excluded causes contributed. This makes gathering independent evidence to separate wind damage from flood damage absolutely critical immediately after a storm, a process a Houston insurance dispute lawyer can help facilitate.
Texas law provides important protections for policyholders, even when an insurer invokes concurrent causation. If an insurance company denies your claim in whole or part, it must provide written reasons under 28 Texas Administrative Code § 21.203 and Texas Insurance Code § 542.056. This formal denial must clearly identify the specific policy provisions the insurer relied upon.
Texas Insurance Code Chapter 542, the Prompt Payment of Claims Act, sets strict timelines for insurers. Insurers must acknowledge claims within 15 days, accept or reject claims within 15 business days of receiving required documentation, and pay accepted claims within 5 business days. Violating these prompt payment requirements may result in an 18% annual interest penalty on the claim amount, plus reasonable attorney’s fees. These deadlines are extended by 15 additional calendar days for weather-related catastrophes.
| Requirement | Deadline | Statute |
|---|---|---|
| Acknowledge the claim | 15 days | § 542.055 |
| Accept or reject the claim | 15 business days after receiving proof of loss | § 542.056 |
| Pay accepted claim | 5 business days after acceptance | § 542.057 |
| Penalty for violation | 18% annual interest + attorney’s fees | § 542.060(a) |
💡 Pro Tip: Document every communication with your insurance adjuster in writing. If they miss a Chapter 542 deadline, that delay may give rise to additional claims and financial penalties in your favor.
Effective September 1, 2017, SB 10 (also known as HB 1774) changed several rules for weather-related property claims in Texas. For claims subject to Chapter 542A, the penalty interest for delayed payments now uses a post-judgment interest rate rather than the flat 18% rate under Chapter 542, which typically results in a lower rate. Additionally, policyholders must give insurers at least 61 days of pre-suit notice listing all damages before filing a lawsuit. Failing to provide this required pre-suit notice under § 542A.003 can result in a lawsuit abatement and severely limit your ability to recover attorney’s fees.
Taking the right steps immediately after a coverage denial can significantly strengthen your position. Here is what Houston homeowners should consider:
Understanding common reasons Houston home insurance claims get denied can help you recognize whether your insurer’s position is legitimate or if they are acting in bad faith. Not every concurrent causation denial is legally sound, particularly if the insurance adjuster failed to conduct a thorough, independent investigation of the damage.
💡 Pro Tip: The statute of limitations for suing an insurance company in Texas is generally two years, but many policies contain contractual limitations that may impose separate, shorter deadlines. Do not wait until the deadline is near to seek legal counsel.
A dedicated concurrent causation insurance attorney can evaluate whether your insurer properly applied this complex doctrine to your specific loss. In many cases, insurers rely on ACC clauses too broadly, denying claims without adequately investigating whether the excluded cause actually contributed to the specific property damage. A thorough legal review may reveal the denial lacks factual or contractual support.
An experienced insurance claim lawyer Houston residents trust can also ensure your provider complied with all Chapter 542 deadlines and documentation requirements. Any statutory violations can create additional liability for the insurer, including interest and attorney’s fees, which provides crucial leverage during settlement negotiations or litigation.
Concurrent causation occurs when two or more distinct causes contribute to a single property loss, and at least one cause is excluded under the policy. In Houston, this most commonly involves wind (covered) and flood (excluded) damage from the same storm. If the policy contains an anti-concurrent-causation clause, the insurer may deny coverage for the entire loss.
In many cases, yes, depending on your policy language. Under JAW The Pointe v. Lexington, the Texas Supreme Court held that when covered and excluded causes both contributed to a loss, the anti-concurrent-causation clause can bar coverage. However, specific policy language and claim facts matter greatly, and a property damage denial lawyer can evaluate whether the clause was properly applied to your situation.
Under Texas Insurance Code Chapter 542, your insurer must acknowledge your claim within 15 days, accept or reject it within 15 business days of receiving all required documentation, and pay accepted claims within 5 business days. These deadlines are extended by 15 additional calendar days for weather-related catastrophes. Violations can result in 18% annual interest and attorney’s fees, though weather-related property claims subject to Chapter 542A may use a different, typically lower, interest rate.
The time to file suit depends on the claim type and your specific policy terms. Statutory bad faith claims generally have a two-year limitations period, and many homeowners policies contain contractual suit-limitation provisions that may impose separate deadlines for breach of contract claims. Courts interpret these deadlines strictly, so it is crucial to act promptly.
Request the written denial with specific reasons as required by law. Obtain an independent damage assessment to separate covered from excluded damage. Document all communications with your insurer. Then consult with a Houston insurance dispute lawyer who can review your policy language, evaluate the insurer’s investigation, and determine whether the denial complied with Texas law.
Concurrent causation denials can feel overwhelming, but Texas law provides meaningful protections for policyholders. From strict insurer deadlines under the Prompt Payment of Claims Act to the right to receive detailed written explanations for every denial, you have legal tools to challenge an unfair decision. The key is acting quickly, preserving evidence, and understanding the specific policy language your insurer relies on.
If you are facing a Houston home insurance denial and need answers, the team at Fitts Law Firm, PLLC can help you understand your legal options. Call 713-871-1670 or contact us today to get started.
Why Your Insurance Check Is Smaller Than the Estimate Key Takeaways: Recoverable depreciation is the…
Why Houston Insurers Point to "Workmanship" When Denying Storm and Water Damage Claims Key Takeaways:…
When an Empty House Turns Into a Denied Claim Key Takeaways: The vacancy exclusion is…
Understanding the Coverage That Pays for Somewhere Else to Live Key Takeaways: Coverage D, or…
What Every Houston Policyholder Should Know Before Signing With a Public Adjuster Key Takeaways: Texas…
The Storm Clause Houston Homeowners Often Overlook Until It Matters Key Takeaways: A named storm…