What to Do If Your Insurance Company Denies Your Claim in Texas

Introduction

Having your insurance claim denied can be frustrating and confusing. You’ve paid your premiums and expect coverage when you need it. If your insurance company denies your claim in Texas, you might feel powerless—but you do have options.

This article walks you through common reasons for denials, your legal rights, and how to respond effectively. Whether you’re dealing with a denied home, auto, or business insurance claim, knowing your next move is crucial.

Common Reasons Insurance Companies Deny Claims in Texas

Insurance companies may deny claims for many reasons, but not all are justified. Some of the most frequent causes include:

• Policy Exclusions: The insurer claims the loss isn’t covered due to specific exclusions.

• Lapsed Policies: If your premium wasn’t paid on time, they may argue your policy was inactive.

• Alleged Misrepresentation: The insurer accuses you of giving false or incomplete information.

• Delayed Reporting: You didn’t report the incident in time, violating policy terms.

• Lack of Documentation: They say you didn’t provide enough proof of the loss.

It’s important to understand why your claim was denied. The denial letter should include specific reasons and reference sections of your policy.

Understanding Your Rights Under Texas Insurance Law

In Texas, insurance companies must follow strict rules when handling claims. The Texas Insurance Code protects policyholders from unfair treatment.

Your rights include:

• Timely Response: Insurance companies must acknowledge your claim within 15 days of receiving it.

• Prompt Decision: After getting all necessary info, they must approve or deny your claim within 15 business days.

• Good Faith Practices: Insurers are required to act fairly and honestly. Delays, false information, or misrepresentation can be signs of bad faith.

If your insurer violates these rules, you can file a complaint with the Texas Department of Insurance (TDI) and may have grounds for legal action.

Immediate Steps to Take After a Denied Claim

If you’ve received a denial, here’s what to do:

• Review the Denial Letter: Understand the insurer’s reasoning and what part of your policy they reference.

• Check Your Policy: Read your policy carefully to verify if the denial is valid or disputable.

• Collect Evidence: Gather any photos, receipts, inspection reports, and communication with the insurer.

• Document Everything: Keep a written record of every interaction with the insurance company.

• Don’t Panic: Many claims are denied initially but can be reversed through appeals or legal steps.

How to Appeal a Denied Claim

If you believe the denial was wrong, follow these steps to appeal:

• Write an Appeal Letter: Clearly explain why you believe the denial was incorrect. Reference your policy language and attach evidence.

• Submit Supporting Documents: Include documentation like repair estimates, contractor reports, and before-and-after photos.

• Request a Reconsideration: Ask the insurer to take another look at your claim with the new evidence.

• Stay Organized: Track deadlines, submission dates, and all responses from the insurer.

If the insurer still refuses your appeal without a valid reason, it may be time to escalate the issue legally.

When to Contact an Attorney in Texas

An attorney can help you stand up to powerful insurance companies—especially if:

• The denial involves significant property damage or financial loss.

• You suspect the insurer acted in bad faith.

• You’ve exhausted your appeal options with no resolution.

• The policy language is too complex to understand on your own.

Legal help can mean the difference between a denied claim and a full payout.

How Louis Law Group Can Help

At Louis Law Group, we’ve helped countless Texas residents challenge unfair insurance claim denials. We understand the tactics insurers use to avoid paying what’s owed, and we fight aggressively to protect your rights.

Whether you’re dealing with a home, auto, health, or business insurance claim, we can:

• Review your denial and advise you on legal options

• Handle communication and negotiation with your insurer

• File a lawsuit if your rights have been violated

To learn more, visit Louis Law Group’s website and request a free case evaluation.

Frequently Asked Questions (FAQ)

Can my insurance company legally deny my claim in Texas?

Yes, but only for valid reasons outlined in your policy. If the denial is unfair or violates Texas law, you can appeal or take legal action.

How long do I have to file an appeal in Texas?

There’s no one-size-fits-all answer—it depends on your policy. Some policies set deadlines, so read your documents carefully or consult an attorney.

What if I miss the deadline to file a claim?

Missing deadlines can be used to justify a denial, but sometimes exceptions apply. An attorney can review your case to see if you still have options.

Should I file a complaint with the Texas Department of Insurance?

Yes, if you believe your insurer acted unfairly or violated state law. TDI may investigate and help pressure the insurer to do the right thing.

How do I know if I need an attorney?

If your claim is large, your appeal failed, or you suspect bad faith, consult an attorney. Many offer free consultations to review your case.

Conclusion

Being denied by your insurance company is not the end of the road. Texas law gives you rights—and ways to fight back. By understanding why your claim was denied, appealing with strong evidence, and seeking legal help when needed, you improve your chances of turning a denial into an approval.

Have you recently been denied an insurance claim and aren’t sure where to turn?

Contact Louis Law Group today for a free consultation. Call 833-657-4812 or submit a free case evaluation form to get started. Don’t wait—let us help you take the first step toward justice and financial recovery.