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, a hurricane may cause both wind damage (typically covered) and flooding (typically excluded), and the insurer may argue that because both causes contributed, no coverage applies. This doctrine has become a significant obstacle for Houston policyholders after hurricanes and severe storms where wind and water damage overlap. Understanding how concurrent causation works, and your rights under Texas law, can make a significant difference in your claim’s outcome.
If your home insurance claim has been denied 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. Wind damage to your roof may be covered, but flood damage generally is not. Homeowners insurance in Texas usually excludes earthquakes, floods, landslides, sinkholes, or sewer backups unless the policyholder purchases separate coverage. When an insurer cannot cleanly separate covered damage from excluded damage, it may invoke concurrent causation to deny the entire claim.
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 flood as a contributing factor can allow denial under the ACC clause.
💡 Pro Tip: Review your homeowners policy for an anti-concurrent-causation clause before a storm hits. Knowing whether your policy contains this language helps you anticipate the insurer’s response and what documentation you’ll need.
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 requiring demolition and rebuilding, because both wind and flood contributed to the city’s "substantially damaged" determination. The Texas Supreme Court analyzed the ACC clause and held that the anti-concurrent-causation clause barred coverage for those ordinance-compliance expenses because flood damage directly or indirectly contributed.
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 ruling marked the first time the Texas Supreme Court directly enforced an ACC clause, giving insurers a powerful tool for denying mixed-cause claims.
💡 Pro Tip: If your insurer cites concurrent causation in a denial, request the specific policy language they’re relying on. You’re 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. After JAW The Pointe, insurers have a court-endorsed framework for denying claims where both covered and excluded causes contributed. This makes gathering independent evidence separating wind damage from flood damage critical immediately after a storm.
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 denial should identify specific policy provisions relied on.
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 requirements may result in 18% annual interest 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) |
đź’ˇ Pro Tip: Document every communication with your insurer in writing. If they miss a Chapter 542 deadline, that delay may give rise to additional claims and 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, penalty interest for delayed payments uses the post-judgment interest rate rather than the 18% rate under Chapter 542, typically resulting 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 required pre-suit notice under § 542A.003 can result in lawsuit abatement and limited attorney’s fees recovery.
Taking the right steps immediately after a denial can 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 potentially actionable. Not every concurrent causation denial is legally sound, particularly if the insurer failed to conduct a thorough investigation.
đź’ˇ Pro Tip: The statute of limitations for suing an insurance company in Texas is generally two years, and many policies contain contractual limitations that may impose separate deadlines. Do not wait until the deadline is near to seek legal counsel.
An attorney with extensive experience in Texas insurance disputes can evaluate whether your insurer properly applied the concurrent causation doctrine. In many cases, insurers rely on ACC clauses broadly without adequately investigating whether the excluded cause actually contributed to specific damage. A thorough legal review may reveal the denial lacks factual or contractual support.
A property damage claim Houston attorney can also ensure your insurer complied with all Chapter 542 deadlines and documentation requirements. Violations can create additional liability, including interest and attorney’s fees, providing leverage in negotiations or litigation.
Concurrent causation occurs when two or more 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, and an attorney can evaluate whether the clause was properly applied.
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 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 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 Texas insurance dispute attorney who can review your policy language, the insurer’s investigation, and 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 written explanations for every denial, you have 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, Fitts Law Firm, PLLC can help you understand your options. Call 713-871-1670 or contact us today to get started.
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