Guide to Property Insurance Claim Denials in Frisco, Texas

Introduction: Why Frisco Homeowners Need a Focused Guide

Frisco, Texas is one of the fastest-growing cities in the United States, straddling Collin and Denton Counties just north of Dallas. With rapid development come newer roofs, expanding neighborhoods, and—unfortunately—an increased volume of property insurance claims stemming from North Texas weather. According to data frequently cited by the Texas Department of Insurance (TDI), the Dallas–Fort Worth metroplex consistently ranks among the state’s leaders in hail and windstorm losses. When an insurance carrier denies, delays, or underpays a claim, Frisco homeowners can feel powerless, especially if significant roof or interior water damage threatens family finances. This comprehensive, Texas-specific legal guide explains what constitutes a property insurance claim denial Frisco Texas residents might encounter, the common reasons insurers cite, and the rights and remedies available under state law. It aims to equip policyholders with the knowledge to push back against improper denials, pursue statutory penalties when warranted, and know when it is time to involve a qualified Texas attorney.

1. Understanding Your Rights as a Texas Policyholder

1.1 The Insurance Contract Is Legally Binding

Your homeowners or commercial property policy is a contract. Once you pay premiums, your insurer owes contractual duties, including prompt claim handling and payment of covered losses. In Texas, these obligations are reinforced by statute.

1.2 Key Statutory Protections

• Texas Insurance Code Chapter 542—commonly called the Prompt Payment of Claims Act—imposes strict deadlines on insurers to acknowledge, investigate, and pay or deny claims. If an insurer violates these deadlines, it may owe the policyholder interest (currently 10% per year) and reasonable attorney’s fees. Tex. Ins. Code §§ 542.055–.060.

• Texas Insurance Code Chapter 541 prohibits unfair or deceptive acts or practices, including misrepresenting policy provisions or failing to attempt in good faith to effect a prompt, fair, and equitable settlement once liability becomes reasonably clear.

• Texas Deceptive Trade Practices–Consumer Protection Act (DTPA), Tex. Bus. & Comm. Code § 17.46 allows consumers, including homeowners, to pursue remedies for false, misleading, or deceptive acts. Violations can lead to treble damages if the conduct was knowing or intentional.

1.3 Time Limits Matter

Under the general contract statute of limitations in Texas, a policyholder has four (4) years to file suit for breach of an insurance contract (Tex. Civ. Prac. & Rem. Code § 16.004). Many policies shorten that period to two years and one day. Always verify the policy’s suit-limitation clause and comply with Tex. Ins. Code § 554.005, which restricts an insurer from shortening the period to less than two years.

2. Common Reasons Insurers Deny Property Insurance Claims in Texas

While every claim is fact-specific, insurers in Texas most frequently cite the following grounds for denial:

Wear and Tear/Pre-Existing Damage Carriers often argue that roof or plumbing leaks pre-dated the most recent hailstorm or freeze. Texas courts, such as in Hibbs v. Allstate County Mutual, No. 05-18-00231-CV (Tex. App.—Dallas 2019), uphold denials if the insurer provides credible evidence the loss was not sudden and accidental. Named-Peril Limitations Policies may exclude flood, earth movement, or seepage. For example, most Texas homeowners policies exclude surface water; flood coverage must be purchased through the National Flood Insurance Program. Late Notice Chapter 542 requires insurers to act promptly after receiving notice. If homeowners delay reporting, the carrier may allege prejudice and deny. Still, Texas law places the burden on insurers to show they were prejudiced by untimely notice (see PAJ, Inc. v. Hanover Ins. Co., 243 S.W.3d 630, 634–35 (Tex. 2008)). Misrepresentation or Fraud Material misstatements in the application or during the claim can void coverage. Insurers must still prove intent to deceive if they seek to rescind. Tex. Ins. Code § 705.004(b). Policy Lapse for Non-Payment Texas law requires at least 10 days’ notice of cancellation for non-payment (Tex. Ins. Code § 551.105). If you never received the notice at your correct Frisco address, the denial may be contestable.

3. Texas Legal Protections & Key Regulations

3.1 Prompt Payment of Claims Act (Chapter 542)

An insurer must:

• Acknowledge the claim within 15 calendar days of receipt (Tex. Ins. Code § 542.055(a)(1)).

• Begin an investigation within 15 days (§ 542.055(a)(2)).

• Request all relevant items from the claimant within 15 days (§ 542.055(a)(3)).

• Accept or reject the claim within 15 business days after receiving all requested items (§ 542.056(a)).

• Pay accepted claims within 5 business days (§ 542.057).

Violations trigger mandatory interest (5% over the Texas judgment rate, currently 10% per year) plus attorney’s fees.

3.2 Unfair Claim Settlement Practices (Chapter 542A)

Passed in 2017 to address weather-related litigation, Chapter 542A sets pre-suit notice requirements. Homeowners must send a detailed notice at least 60 days before filing suit, specifying the amount owed and attorney’s fees. Insurers may accept liability for their adjuster’s acts, limiting direct claims against the adjuster.

3.3 Texas Administrative Code, Title 28, Part 1

Rules promulgated by TDI require insurance companies to maintain fair claim settlement procedures and proper complaint handling (28 Tex. Admin. Code § 5.72-1 et seq.). Failure to follow these rules can support a statutory bad-faith claim.

3.4 Attorney Licensing in Texas

Only attorneys licensed by the State Bar of Texas may provide legal advice, file lawsuits on behalf of insureds, or negotiate settlements for a fee. Public insurance adjusters are limited to adjusting activities and cannot practice law or take contingency fees tied to litigation.

4. Steps to Take After a Claim Denial in Texas

4.1 Review the Denial Letter Carefully

Texas law requires the insurer’s written denial to state specific policy grounds. Compare the cited provisions with your policy declarations and endorsements. Pay attention to:

• Exact exclusion or limitation relied upon

• Dates of loss vs. policy effective dates

• Deadline to request an internal appeal or reassessment

4.2 Gather Evidence

Document everything promptly:

• Photographs or videos of storm damage (roof shingles, interior water stains, damaged personal property)

• Weather reports from the National Weather Service confirming hail or wind events in Frisco on the date of loss

• Repair estimates from licensed Texas contractors

• Communication logs with the insurer or adjuster (names, dates, content of calls/emails)

4.3 Request a Re-Inspection

Under most policies, you can request a second inspection. Provide your evidence to the reinspecting adjuster, emphasizing facts that contradict the original denial, such as fresh granule loss or lifted shingles indicative of recent hail impact.

4.4 Invoke Appraisal (If Available)

The Texas standard HO-B policy includes an appraisal clause allowing either party to dispute the amount of loss. Each side selects an appraiser, and the two appraisers pick an umpire. The panel sets the loss value, which is binding absent fraud. Note: appraisal determines amount of loss, not coverage; if coverage is denied, appraisal may be unavailable or unhelpful.

4.5 File a Complaint with the Texas Department of Insurance

TDI offers a consumer complaint process. Complete the online form, attach your denial letter, and include claim notes. TDI forwards the complaint to the insurer and requires a written response within 15 days (TDI Complaint Portal). While TDI cannot order payment, its inquiry often prompts insurers to reevaluate claims and comply with statutory deadlines.

4.6 Send Statutory Notice Under Chapter 542A

If the carrier still refuses to pay, prepare a 60-day notice under Tex. Ins. Code § 542A.003. The letter must state:

• Specific acts or omissions giving rise to the claim

• Amount owed on the claim

• Reasonable and necessary attorney’s fees (if represented)

Send via certified mail, return receipt requested, to preserve proof of delivery.

5. When to Seek Legal Help

5.1 Signs You Need a Texas Attorney

• Complex coverage disputes (e.g., anti-concurrent cause clauses, mold exclusions)

• Substantial underpayment relative to contractor estimates

• Bad-faith indicators—unreasonable delay, shifting explanations, or selective use of engineering reports

• Statute of limitations approaching or policy suit-limit nearing

5.2 Contingency-Fee Representation

Many property insurance lawyers in Texas, including firms servicing Frisco, work on contingency, meaning no fee unless money is recovered. Under Chapter 542, reasonable attorney’s fees may be recoverable if the insurer is found liable.

5.3 Litigation or Alternative Dispute Resolution

Once statutory pre-suit notice is satisfied, a lawsuit can be filed in Collin or Denton County district court, depending on property location. Some policies require pre-suit mediation or arbitration; confirm whether such clauses comply with Texas law and federal arbitration standards.

6. Local Resources & Next Steps for Frisco Residents

6.1 City and County Permitting Records

Obtain roof permits or inspection reports from the Frisco Building Inspection Department to show the roof’s age or prior code-compliant repairs—useful when combating a wear-and-tear denial.

6.2 Hail and Wind Data

The Insurance Institute for Business & Home Safety and Insurance Council of Texas track hail events in North Texas, supporting claims that a particular storm caused damage. Include hail swath maps when sending demand letters.

6.3 Texas Windstorm Insurance Association (TWIA)

Although TWIA primarily covers coastal counties, policyholders migrating from coastal properties to Frisco often carry misconceptions about windstorm coverage. Ensure your standard homeowners policy includes adequate wind/hail limits.

6.4 TDI Help Line

Call 800-252-3439 for general insurance questions. TDI staff cannot give legal advice but can clarify regulatory deadlines and insurer obligations.

Conclusion

A property insurance claim denial can devastate a household’s finances, but Texas law offers robust protections. By understanding statutory rights, gathering solid evidence, and acting within deadlines, Frisco homeowners can often overturn denials or secure fair settlements. When insurers refuse to honor their contractual and statutory duties, courts in Collin and Denton Counties provide a forum for justice, and the Texas Insurance Code adds leverage through interest penalties and attorney’s fee awards.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Every claim is unique. Consult a licensed Texas attorney for advice regarding your specific situation.

If your property insurance claim was denied, call Louis Law Group at 833-657-4812 for a free case evaluation and policy review.