What to Expect After Filing a Claim | Texas Insurance Claim Timeline
You are probably aware that filing a claim can be an overwhelming process. There is a lot of information to gather, and you may have questions about the entire process. For starters, how long should you wait for an insurance claim you filed? By taking some time to learn about what happens when you file a claim, it will not seem so daunting.
What Happens When You File A Claim?
Hail, high wind, fire, flood, burglary. These are just a few examples of unforeseen catastrophic loss events that may happen to your home or business. While no one enjoys the exhausting process of filing a claim with their insurance company, it is one of the necessary burdens we must endure to repair any damages suffered to our property and prevent any further damage from occurring.
Thankfully, the average policyholder will only file an insurance claim once every ten years. Unfortunately, the downside to that long gap between claims is that we often don’t know what to do or expect.
Example Insurance Claim Timeline
On top of that, the law could have changed since our last claim. So what are the most current and important deadlines that policyholders should know when filing a claim? This example scenario will run you through a timeline for insurance claims using the Texas Insurance Code to help you figure it out. Not from Texas? Contact our team for similar information regarding your state’s policies.
Your property, let’s say your home, sustains hail damage after a hailstorm. This hypothetical hailstorm occurred on March 26th, 2022. You call your insurance company on March 27th and successfully report and open a claim. Now what?
In Texas, the insurance company must do all of the following within 15 days after receiving notice of the claim:
- Acknowledge receipt of the claim
- Commence any investigation of the claim
- Request from you all items, statements, and forms that the insurance company reasonably believes, at that time, will be required from you
In our scenario, this means the insurance company must do all of the above by April 11th, 2022. Now, please keep in mind that the insurance company may make additional requests for information should those requests be deemed necessary during their investigation.
Contact a hail damage attorney in Houston today.
How long should I wait for an insurance claim?
Once the insurance company receives all requested items, statements, and forms from you, the insurance company must notify you in writing whether they will accept or reject the claim within 15 days. Please note: they must provide you with the written notice 15 days after providing them with all their requested items, NOT 15 days after they have asked for them. In our scenario, the insurance company successfully acknowledged, investigated, and requested all necessary items pertaining to the claim on April 11th, 2022. However, let’s say you provided them with the last requested document on April 15th. The insurance company must then accept or reject your claim in writing by April 30th unless one of the following occurs:
- If the insurance company has a reason to believe that the loss resulted from arson, the Texas Insurance Code extends the deadline to the 30th day after it receives all requested paperwork (in our scenario, May 15th)
- If the insurance company is unable to accept or reject the claim by the deadline (April 30th), it must at least notify you of the reasons that it needs additional time. The insurance company should then accept or reject the claim within 45 days of this notice (if the insurance company informs you on April 25th that they cannot accept or reject the claim, the Texas Insurance Code extends the deadline to June 9th, 2022)
What happens if your claim is rejected?
Should the insurance company decide to reject your claim, they must state their reasons for the rejection. At this point, it is recommended you seek advice from a public adjuster or an insurance claim law firm on how to proceed.
However, if the insurance company notifies you that they fully or partially accept your claim, it must render payment no later than the 5th day after the said notice. If we continue with our scenario without the listed exceptions, this means the insurance company should render payment to you by May 5th, 2022, unless the following applies:
- The full or partial payment of the claim is conditioned on you taking a (or some) requested action(s). The insurance company must then render payment no later than the 5th day after you have completed the requested action(s). For example, the insurance company accepts the claim on April 30th on the condition that you hire a roofer and provide them with the roofer’s contact information. If you give them this information on May 5th, they must render payment by May 10th.
A Brief Explanation
Had trouble following this timeline for insurance claims? We’ve included an easy-to-follow table below. Please note: that this informative post does not encompass all the possible exceptions or extensions that may apply to your claim. The scenario plays out a generic insurance claim timeline based on the Texas Insurance Code. To ensure you are following the deadlines most applicable to your claim, please consult with a public adjuster and/or insurance claim attorney.
|Loss event occurs
|March 26th, 2022
|You report your claim
|As soon as you believe a covered loss has occurred
|March 27th, 2022
|Insurance Company must: 1. Acknowledge Receipt of the Claim 2. Commence any investigation of the claim 3. Request all items, statements, and forms required from you
|Within 15 days after the insurance company received notice of your claim
|April 11th, 2022
|You provide the insurance company with all the documents it requested
|April 15th, 2022
|Insurance Company must accept or reject your claim via written notice
|Within 15 days after it has received all the requested paperwork from you
|April 30th, 2022
|Insurance Company must render payment to you after partially or fully accepting your claim
|Within 5 days after it accepts the claim OR within 5 days after any requested actions are taken by you. (Our scenario had no requested actions)
|May 5th, 2022
Finding the Right Insurance Dispute Lawyer Near You
at MMA Law Firm, our experienced insurance defense attorneys in Houston are well-versed in insurance dispute litigation and commercial property loss. Our team fully understands how these processes work and will do everything in our power to help you. We are experienced in Texas natural disasters, fire claims, theft claims, vandalism claims, and much more.
This blog published by MMA Law Firm is available for informational purposes only and is not intended to be legal advice on any subject matter. The content available on this website may not constitute the most up-to-date legal or other information.