Property Insurance Claim Denial Guide – Arlington, Texas

Introduction: Why Arlington Homeowners Need a Local Guide

Arlington, Texas sits in the heart of the “hail alley” that stretches across North Texas. Tarrant County routinely records severe thunderstorms bringing high winds, hailstones larger than golf balls, and occasional tornado touchdowns. According to the National Oceanic and Atmospheric Administration (NOAA), North Texas averaged more than 160 hail events per year between 2018 and 2022. Many Arlington homeowners therefore carry robust property insurance policies to protect against roof, siding, and interior water damage. Yet even with coverage, insurers sometimes deny or underpay claims. If you have searched “property insurance claim denial Arlington Texas,” you likely already received a denial letter, an unexplained delay, or a settlement offer that would not cover repairs. This guide explains the Texas-specific legal framework, the deadlines that matter, and the practical steps Arlington residents can take to pursue the benefits they paid for.

Every fact in this article comes from authoritative sources such as the Texas Insurance Code, the Texas Administrative Code, the Texas Department of Insurance (TDI), and published opinions from Texas courts. While we present a homeowner-friendly perspective, the information remains strictly factual and neutral to comply with professional ethics rules for Texas attorneys.

Understanding Your Rights in Texas

Your Insurance Contract Is Governed by Texas Law

Your homeowners or commercial property policy is a contract. Under Texas law, contracts for insurance are interpreted according to general contract principles and specific insurance statutes. If the insurer fails to pay a covered claim, you may have causes of action for:

• Breach of contract (Texas Civil Practice & Remedies Code §16.004 provides a four-year statute of limitations).

• Unfair claim settlement practices under Texas Insurance Code Chapter 541.

• Prompt Payment of Claims violations under Texas Insurance Code Chapter 542 (often called the Prompt Payment of Claims Act).

Prompt Payment Deadlines Under Chapter 542

Chapter 542 sets strict timelines:

• Within 15 business days after receiving your written notice of loss, the insurer must acknowledge receipt, begin an investigation, and request any additional information.

• After receiving all requested information, the insurer usually has 15 additional business days (or up to 45 in certain situations) to accept or deny the claim in writing. The letter must give the reasons for any denial.

• If the insurer accepts the claim, it must pay within five business days.

Failure to meet these deadlines can make the carrier liable for statutory interest (currently 5% per year above the judgment rate) and attorney’s fees. Arlington homeowners can leverage these penalties to push for timely payment.

The Texas Homeowner Bill of Rights

The Texas Department of Insurance publishes a “Homeowners Insurance Consumer Bill of Rights.” Key provisions include:

• The right to receive a written explanation of any claim denial.

• The right to fair treatment and to sue the insurer if it engages in unfair practices.

• The right to request all claim-related documents the insurer relied upon to deny or underpay.

You can download the full document from the TDI website or request a printed copy.

Common Reasons Property Insurance Companies Deny Claims in Texas

Insurance companies rely on multiple justifications when refusing to pay. Arlington policyholders frequently see the following reasons:

• Wear and Tear or Age-Related Deterioration – Texas courts (e.g., Lyons v. Millers Gen. Ins. Co., 866 S.W.2d 597 (Tex. 1993)) uphold exclusions for ordinary wear. Carriers sometimes misclassify hail damage as pre-existing deterioration.

• Late Notice – Most policies require “prompt” notice. Although Chapter 542 sets deadlines for insurers, the policy’s notice requirement still applies. Texas appellate courts evaluate whether late notice prejudiced the carrier.

• Improper Maintenance – Claims for interior water damage may be denied if leaks allegedly resulted from neglected roof repairs. Texas courts place the burden on the insurer to prove the exclusion.

• Cosmetic Damage Exclusions – Some policies sold in hail-prone areas exclude dented metal surfaces unless functional impairment occurs. Read the endorsements carefully.

• Disputed Causation – Adjusters may assert wind did not create the opening that allowed water entry, or that previous storms caused the damage outside the policy period.

Understanding the specific policy language and Texas case law that interprets that language is critical when contesting these reasons.

Texas Legal Protections & Regulations

Texas Insurance Code Chapter 541: Unfair Settlement Practices

Chapter 541 prohibits carriers from:

• Misrepresenting a material policy provision.

• Failing to attempt in good faith to effectuate a prompt, fair settlement.

• Denying a claim without conducting a reasonable investigation.

If the insurer knowingly violates Chapter 541, the court may award up to treble damages under §541.152.

Texas Administrative Code, Title 28, §21.203

The Texas Department of Insurance further defines unfair claim practices in the Administrative Code, including requiring policyholders to submit unnecessary paperwork or delaying a decision without reasonable grounds.

Statute of Limitations Checklist

• Breach of Contract: 4 years (Tex. Civ. Prac. & Rem. Code §16.004).

• Chapter 541: 2 years from the date the unfair act occurred or was discovered (Insurance Code §541.162).

• Chapter 542 Prompt Payment: 2 years and 1 day from the date the insurer denies the claim (Insurance Code §542.060).

Missing a limitations deadline can bar recovery, so calendar these dates as soon as a denial arrives.

Steps to Take After a Denial in Texas

1. Review the Denial Letter and Policy

Texas law requires a written denial stating reasons. Compare the cited exclusions with your policy declarations and endorsements. Note any ambiguous language—Texas follows the rule that ambiguities in insurance contracts are construed in favor of the insured.

2. Gather Evidence

• Date-stamped photographs or videos of the damage.

• Independent contractor or public adjuster estimates.

• Weather data for Arlington on the date of loss (NOAA Storm Events Database).

• All correspondence with the insurer.

3. Request the Claim File

Under Chapter 542.003(b)(5), you may request copies of most claim-related documents. Send a polite, written request (email and certified mail) so you can later show compliance.

4. Send a 60-Day Notice Letter (If You Plan to Sue)

Texas Insurance Code §541.154 and §542A.003 require a 60-day presuit notice outlining the specific violations, the amount of damages, attorney’s fees, and expenses. Failure to send this letter can result in abatement of a lawsuit.

5. File a Complaint with the Texas Department of Insurance

The TDI Consumer Protection division investigates written complaints, which can nudge insurers to revisit a claim. File online or mail Form 1507. Include your policy number, claim number, denial letter, and supporting documents. TDI cannot force payment but often facilitates resolution.

6. Consider an Appraisal Demand

Many Texas policies contain an appraisal clause allowing each party to appoint an appraiser who then selects an umpire. If the dispute centers on the amount of loss rather than coverage, appraisal can be faster than litigation.

7. Consult a Texas Attorney Early

Even a brief consultation can preserve evidence, calculate limitations, and draft the 60-day notice properly.

When to Seek Legal Help in Texas

Texas attorneys handling first-party property cases are regulated by the State Bar of Texas and must be licensed by the Texas Supreme Court. You should strongly consider hiring counsel if:

• The denial rests on complex exclusions such as anti-concurrent causation.

• The carrier offers significantly less than independent repair estimates.

• You suspect systemic bad faith (e.g., forged engineer reports, pattern of delayed payments).

• You face imminent limitations deadlines.

Most Texas insurance-coverage lawyers accept cases on a contingency fee, meaning you owe no attorney’s fees unless money is recovered. Under Chapter 542, reasonable attorney’s fees are often recoverable from the insurer.

Local Resources & Next Steps

Texas Department of Insurance (TDI)

TDI’s Consumer Help Line: 800-252-3439. Online complaint portal: File a Complaint with TDI.

City of Arlington Building Inspections

Before repairs commence, Arlington Building Inspections may require permits and adherence to the 2021 International Residential Code amendments adopted by the city. Visit Arlington Building Inspections.

Tarrant County District Courts

Most property-insurance suits exceeding $250,000 are filed in the 17th, 48th, 67th, 96th, 153rd, 236th, 342nd, 348th, or 352nd District Courts of Tarrant County. The clerk’s office can confirm filing fees and electronic filing requirements.

Public Adjusters

Public adjusters must hold a license under Texas Insurance Code Chapter 4102. Verify licenses at TDI Agent Lookup.

National Weather Service (NWS) Fort Worth Office

For hail and wind verification, the NWS Fort Worth office provides storm reports covering Arlington. Archived data can corroborate date-of-loss storms.

Authoritative References

Texas Insurance Code Chapter 541 Texas Insurance Code Chapter 542 28 Texas Administrative Code §21.203

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Laws change, and individual facts matter. Consult a licensed Texas attorney for advice specific to your situation.

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