How do I force my insurance company to pay a denied claim for damages to my home, that are covered under my current homeowner policy?

In the United States, we are forced to buy insurance for many things we value and work hard to acquire.  They include our homes, automobiles, health, businesses, and even our credentials as a professional.  We buy the insurance to protect us, and our families from unexpected losses of livelihood, medical bills, accidents and physical damage to our businesses or home structures.

Forcing the insurance companies we contract to cover the costs of damages to homes is a arduous process after a claim is denied. Often, insurance companies find a means of refusing to pay a claim that was previously outlined in a current policy, based on some arbitrary reason, and/or they raise rates or drop coverage due to a claim on a policy defeating the purpose of buying insurance in the first place.  Insurance policies are legal contracts, so knowing the law will be to your benefit when you file a loss claim.  Hiring an attorney who specializes in these cases is recommended for smooth claims processing and receiving best settlement amounts. Home insurance matters are complicated to the benefit of the insurance companies who hope that the person putting in the claim may give up their quest for payment, after they engage them in a trail of claims paperwork. Luckily, the Texas Department of Insurance created a Consumer Bill of Rights for homeowners and renters that outlines the basic knowledge you need. It’s in the Texas Administrative Code at: 28 Tex. Admin. Code § 5.9970(d). Your insurance company is required by law to send a copy of the Bill of Rights with your policy and upon renewal.

Under Texas law, a lender cannot require you to purchase insurance on your property in an amount that exceeds the replacement cost of the dwelling and its contents as a condition of financing a residential mortgage or providing other financing arrangements for the property, regardless of the amount of the mortgage or other financing arrangements. In determining the replacement cost of the dwelling, a lender cannot include the fair market value of the land on which a dwelling is located.

There is no requirement for Windstorm Insurance in Texas, but almost any mortgage company will require coverage as part of their terms. Even if you are building your own structure, from your own finances without use of a mortgage, it is a good idea to build any structure compliant to windstorm specifications.

What rights do I have regarding my rejected claim?

You have the right to sue, to report the insurance company to Texas Department of Insurance and the insurance company has the burden of proof regarding support for the denial of your claim.

What happens after a homeowner loss occurs?

Insurance companies should be sending licensed insurance adjusters to your property; however, sometimes the first responders sent to assess the damage are not qualified. It is important to ask the person who visits your property for a business card, and it should state a first and last name and all license numbers (they should be licensed with the state).

Write down the name and reason for all persons visiting your property as it pertains to restoring your home back to its pre-damage state.

Negotiating a settlement.

A property insurance claim is challenging, life-changing, and in some cases a devastating event for a homeowner.  As for the insurer, it is business as usual which gives them the advantage. An insurance claim is a business negotiation, and policyholders must approach the adjustment and settlement of their property insurance claim like any other business transaction regarding a high-ticket item.

A residential property claim involves restoring or replacing the property – both the structure and the personal property inside the dwelling – to pre-loss conditions within the limits of insurance purchased. Policyholders are faced with the tasks of investigating and documenting losses and learning the terms and conditions of insurance policies: the insurance coverages available, limitations on those coverages, deductibles, conditions precedent, and specific requirements necessary to make an insurance claim. It is wise to contact and work with an expert in the field to reach your best settlement possible and have your claim settled in an expedient manner.  You should seek professional services from the Will Peterson Agency in Cibolo, TX for information on how to process your homeowner’s claim, and to make sure you have the right coverage.

Will Peterson Agency

P.O Box 389

Cibolo, TX 78108

Phone: 210-WIL-WILL

www.wilwill.org

 

 

Sources:

https://www.twia.org/coverage-eligibility/

https://www.tdi.texas.gov/rules/bor-home-english.html