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

Introduction

It’s frustrating to pay insurance premiums for years—only to have your claim denied when you finally need help. If your insurance company denies a claim in Texas, don’t panic. You still have options, and in many cases, you may be able to overturn the decision.

This guide breaks down why claims get denied, what Texas law says about it, and what steps you can take to fight back and protect your rights.

Why Insurance Companies Deny Claims in Texas

Insurance companies can deny claims for a number of reasons. Sometimes it’s a valid issue. But other times, denials are based on vague interpretations, missing documents, or even bad faith practices.

Common reasons include:

Alleged Policy Exclusions

The insurer says your damage isn’t covered by your policy.

Missed Deadlines

They claim you didn’t report the damage or file paperwork on time.

Negligence or Fraud Allegations

They say the loss was caused by your actions or accuse you of misrepresentation.

Insufficient Evidence

The company claims you didn’t provide enough documentation or proof.

It’s important to read the denial letter carefully. It should explain the specific reason your claim was denied and reference the part of your policy that applies.

Your Rights Under Texas Insurance Law

In Texas, insurance companies are required to follow the law when handling claims. The Texas Insurance Code offers protection for policyholders, especially when insurers act unfairly.

Key rights you have include:

Timely Communication

Insurers must respond to your claim within set time limits. Usually, they must accept or deny a claim within 15 business days after getting all necessary documents.

Fair Investigation

The insurance company must thoroughly investigate your claim before making a decision.

Prohibition Against Bad Faith

Under Chapter 541 of the Texas Insurance Code, insurers cannot lie, delay payments unfairly, or misrepresent policy coverage.

If they break these rules, you may have grounds for a complaint—or even a lawsuit.

Steps to Take If Your Claim Is Denied in Texas

If your claim is denied, here are the key steps to follow:

Request a Written Denial

Make sure the insurer puts the denial in writing and explains the reasons.

Review Your Policy Carefully

Compare the denial reasons with your policy language. Sometimes insurers misinterpret the coverage.

Gather Supporting Evidence

Collect all relevant photos, receipts, estimates, and correspondence.

Respond Promptly

Don’t wait too long. Your policy may have deadlines for disputes or appeals.

Keep Records

Document all communications with your insurance company.

These steps can help you build a strong case if you need to appeal the denial or take further legal action.

How to Appeal a Denied Insurance Claim in Texas

Appealing a denied insurance claim in Texas involves several steps:

Write a Detailed Appeal Letter

Your letter should clearly explain why the denial is incorrect. Include evidence and policy references.

Send Supporting Documentation

Add receipts, expert reports, and photos that back up your claim.

Request a Re-Evaluation

Politely ask the insurer to re-review your case and explain how their denial may be based on incomplete or inaccurate information.

Follow Up in Writing

Keep everything documented. If the insurer still refuses to change its decision, you may need to take legal action.

You also have the option to file a complaint with the Texas Department of Insurance (TDI) if you believe the insurer acted unfairly.

When to Involve an Attorney

You don’t always need an attorney to resolve a denied claim, but legal help can make a big difference—especially if:

• The denial involves a large amount of money

• You believe the insurer acted in bad faith

• You’ve already tried to appeal with no success

• You’re confused by the policy language or legal terms

An experienced insurance attorney can review your claim, communicate with the insurer on your behalf, and take legal action if necessary.

How Louis Law Group Can Help

At Louis Law Group, we help Texas policyholders fight denied insurance claims every day. We know the tactics insurers use to avoid paying valid claims, and we work hard to protect our clients’ rights.

Our firm can:

• Review your denial and policy in detail

• Help you file an effective appeal

• Take legal action if the insurer is acting in bad faith

We’ve helped homeowners, car owners, and business owners across Texas recover money they were owed—and we can help you too.

Visit Louis Law Group to learn more about our insurance dispute services.

Frequently Asked Questions (FAQ)

Can an insurance company deny a claim in Texas?

Yes, but they must have a valid reason. Denials based on vague, incorrect, or deceptive grounds may be challenged under Texas law.

What should I do if my claim is denied?

Request a written denial, review your policy, gather documentation, and file an appeal. If needed, consult an attorney for legal help.

How long does an insurer have to respond to a claim in Texas?

Typically, they must respond within 15 business days after receiving all required documentation.

Can I sue an insurance company for denying a claim in Texas?

Yes. If the insurer acted in bad faith or violated Texas law, you can file a lawsuit to recover damages and penalties.

Is it worth hiring an attorney for a denied claim?

Yes, especially for high-value claims or if the insurer is being difficult. Legal support can improve your odds of success and protect your rights.

Conclusion

A denied insurance claim in Texas doesn’t mean your case is over. You still have rights—and the law is on your side. Whether the denial was due to an alleged policy exclusion or an unfair investigation, you can fight back with the right approach.

Start by reviewing your policy, gathering evidence, and considering legal support. The sooner you act, the better your chances of a successful resolution.

Have you received a claim denial letter and aren’t sure 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.