What to Do When an Insurance Adjuster Denies Your Claim in Texas

Introduction

When you file an insurance claim, you expect help—not a denial. But in Texas, it’s not uncommon for an insurance adjuster to deny a claim, even when damages seem clear.

Whether you’re dealing with a denied homeowners, auto, or business insurance claim, a denial from the adjuster can feel like a dead end. The good news is that it’s not. This guide explains why insurance adjusters deny claims, what you can do about it, and how to protect your rights under Texas law.

Why Insurance Adjusters Deny Claims in Texas

Insurance adjusters work for the insurance company, not for you. Their job is to assess damage, investigate the claim, and determine what the insurer is obligated to pay—if anything.

Here are some common reasons they might deny your claim:

• Policy Exclusions: They say the type of damage isn’t covered by your policy.

• Pre-existing Damage: The adjuster believes the damage existed before the event.

• Insufficient Evidence: You didn’t provide enough documentation to support the claim.

• Lapsed Coverage: They claim your policy was inactive due to missed payments.

• Negligence Allegations: They accuse you of contributing to the loss.

Sometimes these reasons are valid—but other times they’re based on errors, biased investigations, or bad faith.

Understanding Your Rights as a Policyholder in Texas

Texas law gives consumers several protections when dealing with insurance companies and adjusters. The Texas Insurance Code requires insurers to handle claims promptly, fairly, and in good faith.

Here are key rights you have:

• Right to Timely Processing: The insurer must acknowledge your claim within 15 days.

• Right to Fair Investigation: They must investigate your claim thoroughly and fairly.

• Right to Know Why: If your claim is denied, the insurer must explain why in writing.

• Right to Appeal or Dispute: You have the right to challenge a denial you believe is wrong.

If an adjuster denies your claim without a valid reason, you may be entitled to compensation for the loss—and possibly additional damages for bad faith.

For more on your rights, visit the Texas Department of Insurance.

What to Do Immediately After a Denial in Texas

If an adjuster denies your claim, take the following steps right away:

• Request a Written Explanation: Get the denial in writing if you haven’t already. This should include the specific reasons and any supporting policy language.

• Review Your Insurance Policy: Look closely at what is and isn’t covered. Compare the denial letter with your policy.

• Gather Evidence: Photos, receipts, damage reports, contractor estimates, and any communications with your insurer can help support your case.

• Document Everything: Keep detailed notes of calls, emails, and any contact with the insurance company.

• Remain Calm and Professional: Don’t lash out or accuse the adjuster. Keep everything in writing and stay focused on facts.

How to Appeal a Denied Insurance Claim in Texas

You have the legal right to appeal a denied claim. Here’s how to build a strong appeal:

• Submit a Detailed Appeal Letter: Explain why the denial is wrong. Reference your policy and include any new documentation.

• Include All Supporting Evidence: Repair estimates, photos, and third-party evaluations strengthen your case.

• Follow Policy Procedures: Your policy may outline the exact process for submitting an appeal. Follow it carefully to avoid delays.

• Keep Copies of Everything: Always retain copies of your submission and any correspondence with the insurer.

When to Involve a Lawyer

Sometimes, appealing on your own isn’t enough. You should speak with a lawyer if:

• The insurance company refuses to reconsider your claim

• The damages are significant (e.g., home repairs, vehicle loss, major business interruption)

• You believe the adjuster acted in bad faith

You’re struggling to understand the policy language or appeal process

At Louis Law Group, we help Texans fight back against denied claims. Our experienced legal team can review your case, negotiate with the insurance company, and even take legal action if necessary. We don’t get paid unless we win.

How Louis Law Group Can Help

If your insurance adjuster denies your claim in Texas, you don’t have to fight alone. Louis Law Group has years of experience handling denied claims and helping policyholders recover what they’re owed.

We can:

• Analyze your denial letter and policy

• Help you prepare a detailed and persuasive appeal

• Negotiate directly with your insurance company

• Represent you in court if the insurer refuses to pay

We’ve helped hundreds of clients throughout Texas, and we’re ready to stand up for you too.

To learn more, visit our website and request a free consultation.

Frequently Asked Questions (FAQ)

Why do insurance adjusters deny claims in Texas?

Adjusters deny claims for reasons like policy exclusions, lack of documentation, or suspected fraud. Sometimes these denials are valid, but not always.

Can I appeal a claim denied by an adjuster?

Yes. You have the right to submit an appeal with supporting evidence. Always review your policy and denial letter before starting the process.

What is bad faith in insurance?

Bad faith occurs when an insurer unreasonably delays, denies, or undervalues a claim. You may have legal grounds to sue for damages if this happens.

How long does the appeal process take in Texas?

It varies by case, but insurers must generally respond within 15 business days of receiving your completed appeal.

Do I need an attorney to fight a denied insurance claim?

You don’t always need one—but having an experienced attorney can significantly increase your chances of a successful resolution.

Conclusion

A claim denial from an insurance adjuster can feel overwhelming—but it’s not the end of the road. By knowing your rights, gathering evidence, appealing properly, and seeking help when needed, you can challenge the denial and get the coverage you deserve.

Have you had your insurance claim denied by an adjuster in Texas and don’t know what to do next?

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.