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Understanding an Insurer’s Duty to Investigate in Homeowner Property Damage Claims

You’re relying on your insurance company to help you pick up the pieces after major damage to your house. Although you’ve held up your end of the bargain, your insurer keeps drawing out the process, forcing you to wait to rebuild or move back into your home. Attorney Bill Voss explains an insurer’s duty to perform prompt investigation of each claim and what homeowners should do if there are delays in the process.

Insurer’s Responsibility to Respond Quickly to a Claim

As a homeowner, you have certain rights when making an insurance claim for property damage. While some of these rights exist the minute you take out the policy, others are triggered once you give your insurer written notice of your claim.

Under the Texas Insurance Code, insurers are required to:

  • Respond to your submission of claim within 15 days after receiving your claim in writing
  • Begin investigating your claim within 15 days
  • Accept or reject your claim within 15 days after you have submitted any requested documentation
  • Send a check or bank draft for payment within five business days of approval of the claim, OR send you written notice of why the company that cannot meet the five-day deadline
  • Tell you in writing why some or all of your claim was denied

How Insurers Can Defend Against Bad Faith Claims Based on Delays

Delays in claims are most common during the insurance company’s investigation of a claim. In some cases, companies can decide whether to approve or deny claims based Magnifying Glass Under a Magnifying Glasssolely on photographic evidence; in others, the company may send one of its adjusters to the scene. It’s not uncommon for insurers to stall claims by making requests from policyholders that have nothing to do with the payment of the claim. While you’re required to cooperate with reasonable requests, you have the right to refuse to provide unrelated information (such as your federal income tax records). In fact, bogus requests for information during the adjustment process is a common basis for insurance bad faith claims.

It’s worth noting that there may be some legitimate reasons for a delay in claim evaluation, such as:

  • Extensions. There are some exceptions to the state-mandated deadlines above. For example, an insurer may take up to 45 days to make a decision if it sends a written notice to you explaining the delay. The company may also be granted a 30-day extension if there is cause to suspect the damage was caused by arson.
  • Natural disasters. The Texas Department of Insurance has the ability to grant companies an extra 15 days to investigate claims, and up to 20 days to pay approved claims, after a major natural disaster. Disasters can include named storms as well as flash floods or wildfires.
  • Dispute over cause. The cause of your losses may be obvious to you, but an inspection of the property could reveal hidden perils. Insurers don’t have to pay for certain causes of loss that aren’t listed on the policy—which makes them more likely to claim that the loss was tied to one of the exemptions. Since it’s the policyholder’s burden to prove the cause of loss, it’s important to have a property damage attorney on your side to help determine the cause.
  • Limited access. An insurer may have trouble investigating the damage because an adjuster cannot safely reach the property to perform an inspection.
  • Homeowner response delays. You’re required to respond to any reasonable requests for information from your insurance company. Taking a long time to value or document each loss can slow down the processing of your claim. However, you shouldn’t be unfairly rushed into giving inaccurate values for your belongings.

If your insurer is guilty of bad faith, you could collect an amount over and above your property damage policy limit. Simply fill out our contact form today to have the experienced bad faith attorneys at Voss Law Firm answer your questions, or start reading your copy of our free book, Your Essential Guide to Residential Claims.

 

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The Voss Law Firm, P.C. represents clients on a local, national and international basis. We proudly serve companies and individuals along the Gulf Coast and around the globe on a contingency fee basis. Our law firm collects nothing unless we recover on our client's behalf.

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