Property Insurance Claim Denial Guide – College Station, TX

Introduction: Why Property Insurance Claim Denials Matter in College Station

Few things are more frustrating for College Station homeowners than discovering storm damage, water intrusion, or fire loss and then receiving a claim denial from the insurance company you have faithfully paid for years. Brazos County sits in a part of Central Texas that regularly experiences spring hailstorms, straight-line winds, and the tail edges of Gulf hurricanes. According to National Weather Service statistics, the Bryan–College Station metro area has averaged multiple severe hail events each decade, and local building permits show steady residential growth. These realities make property insurance a financial necessity—and make denials an urgent local problem.

This guide provides a fact-checked, Texas-specific roadmap for homeowners confronting a property insurance claim denial in College Station, Texas. While the information favors policyholders, it is balanced, evidence-based, and grounded in authoritative sources such as the Texas Department of Insurance (TDI), the Texas Insurance Code, and published court decisions. By the end, you will understand your rights, deadlines, and options—so you can decide whether to appeal internally, file a complaint with TDI, or hire a qualified Texas attorney.

Understanding Your Rights in Texas

Texas law gives homeowners powerful tools to demand fair treatment from insurers. The starting point is your policy, which is a contract governed mainly by state contract law and the Texas Insurance Code. Among the most important consumer protections are:

• Prompt Payment of Claims Act (Texas Insurance Code Chapter 542) – Requires insurers to acknowledge, investigate, and pay or deny a claim within strict timeframes. Missing deadlines can trigger statutory interest and attorney’s fees.

• Unfair Claim Settlement Practices (Texas Insurance Code Chapter 541) – Prohibits misrepresenting policy provisions, failing to conduct a reasonable investigation, or refusing to pay without a reasonable basis.

• Four-Year Statute of Limitations on Contract Actions – Under Texas Civil Practice & Remedies Code §16.004(a)(3), a homeowner normally has four years from the date the claim is denied (or from accrual of the cause of action) to sue for breach of the insurance contract, absent a shorter policy limitation that meets Texas legal standards.

• Right to Independent Appraisal – Many Texas homeowner policies include an appraisal clause allowing either party to demand appraisal when the dispute concerns the amount of loss rather than coverage.

In addition, the Texas Deceptive Trade Practices-Consumer Protection Act (DTPA) may apply when an insurer’s conduct is deceptive. However, homeowners must follow strict notice and pleading rules, and federal courts often require specific factual allegations. When in doubt, consult a licensed Texas attorney.

Common Reasons Property Insurance Companies Deny Claims in Texas

Insurers must provide a specific reason for denial under Texas Insurance Code §542.056(c). In practice, College Station homeowners most often see the following denial rationales:

• Wear and Tear or Maintenance Exclusion – Policies generally cover sudden, accidental loss but exclude gradual deterioration. Roof hail damage claims can be rejected if the carrier asserts the shingles were aged or poorly maintained.

• Late Notice – Policies frequently require prompt notice of loss. Texas courts, including Hamilton Properties v. American Insurance Co., 643 Fed. App’x 437 (5th Cir. 2016), have upheld denial when the insurer shows it was prejudiced by delay.

• Coverage Lapse or Non-Payment of Premium – Failure to pay premiums on time can void coverage. TDI rules mandate specific cancellation notices, so confirm the timing and content of any lapse notice you received.

• Excluded Perils (Flood, Surface Water, Earth Movement) – Standard homeowner policies typically exclude flood. Separate National Flood Insurance Program (NFIP) coverage is needed.

• Pre-Existing Damage – Denial letters may contend that damage predates policy inception. Look for inspection reports, photos, or real-estate disclosures generated when you purchased the home.

• Failure to Mitigate Further Damage – Texas policies require reasonable steps—like tarping a damaged roof—to prevent additional loss. Keep receipts and photos.

The insurer carries the burden of demonstrating that an exclusion applies. Policyholders should demand documentation, including engineer reports, claim file notes, and photographs supporting the denial.

Texas Legal Protections & Regulations

1. Prompt Payment Deadlines

Under Texas Insurance Code §§542.055–.060:

• 15 days to acknowledge receipt of the claim and request any additional information.

• 15 business days after receiving all requested information to accept or deny the claim in writing. An insurer may extend this to 45 days if it states the reason for extension.

• Five business days to pay once liability is accepted.

If these deadlines are missed, the insurer owes 18% per-year interest on the amount due plus reasonable attorney’s fees (§542.060).

2. TDI Complaint Process

Policyholders can file a complaint online or by mail with the Texas Department of Insurance Consumer Protection division. TDI will:

• Contact the insurer for a detailed written response.

• Review whether the company complied with statutes and policy language.

• Issue a determination letter. Although TDI cannot order payment of disputed amounts, its involvement often prompts quicker, more transparent insurer action.

File online at TDI Consumer Complaint Portal.

3. Homeowners’ Bill of Rights

Texas requires insurers to provide the Homeowners’ Bill of Rights with each policy, outlining entitlements such as plain-language policy forms and freedom from retaliation for filing a claim.

4. Licensing of Adjusters and Attorneys

• Public Adjusters must hold a TDI license (Texas Insurance Code Chapter 4102) and disclose fees in writing.

• Attorneys must be licensed by the State Bar of Texas and follow Texas Disciplinary Rules of Professional Conduct. Only attorneys can give legal advice; adjusters cannot.

Steps to Take After a Denial in Texas

Receiving a denial letter is not the end of the road. Follow these evidence-based steps tailored to College Station homeowners:

1. Read the Denial Letter Carefully

Under §542.056(c), the insurer must explain the “specific reasons” for denial. Note each policy citation or factual assertion.

2. Gather and Secure Evidence

• Photographs or video of the damage.

• Roofing contractor or mitigation company reports.

• Receipts for temporary repairs and additional living expenses (ALE).

Weather data: The National Oceanic and Atmospheric Administration (NOAA) Storm Events Database and Texas A&M AgriLife Brazos County Extension can verify hail sizes or wind speeds on the date of loss.

3. Request a Certified Copy of Your Policy and Claim File

Texas courts recognize that policyholders are entitled to review the full policy. Send a written request via certified mail, return receipt requested (CMRRR).

4. Consider an Internal Appeal or Supplemental Claim

Many Texas carriers offer an escalation process. Provide additional documentation and, if applicable, a contractor’s rebuttal to the insurer’s estimate.

5. Demand Appraisal, If Appropriate

If the dispute concerns only the amount of loss, invoke appraisal in writing. The Texas Supreme Court in State Farm Lloyds v. Johnson, 290 S.W.3d 886 (Tex. 2009) affirmed appraisal’s role in resolving amount-of-loss disputes, though coverage issues remain for courts.

6. File a TDI Complaint

Prepare a concise timeline, attach the denial letter, and include copies of all correspondence. Keep your original documents.

7. Consult a Texas Attorney

If the insurer still refuses to pay, Texas law allows you to seek actual damages, policy benefits, interest, and attorney’s fees. Many lawyers offer free consultations. Verify licensure on the State Bar of Texas website.

When to Seek Legal Help in Texas

While some disputes resolve through appraisal or supplemental payment, certain red flags signal it is time to involve legal counsel:

• Bad Faith Indicators – Repeated requests for unnecessary documents, shifting denial reasons, or low offers unsupported by evidence.

• Large-Scale Losses – Fire, total roof replacement, or water mitigation bills exceeding $25,000 often warrant professional review.

• Statutory Deadlines Approaching – Do not let the four-year contractual statute or any policy-imposed limitations period lapse.

• Complex Coverage Issues – Anti-concurrent causation clauses, mold sub-limits, or questions about ordinance or law coverage can require legal interpretation.

Texas attorneys usually work on contingency in property insurance disputes, charging no fee unless they recover funds. Under §542.060, the insurer may be required to pay your attorney’s reasonable fees if you prevail.

Local Resources & Next Steps

College Station homeowners have several nearby or online resources:

• Brazos County District Courts – Venue for lawsuits exceeding $250,000 or seeking equitable relief.

• Brazos County Small Claims Court (Justice Court) – Handles disputes up to $20,000; may be appropriate for minor repair shortfalls.

• Texas A&M University Real Estate Center – Publishes research on Texas housing trends and disaster impacts.

• Bryan–College Station Association of Realtors® – May provide recommendations for licensed contractors and appraisers.

Before choosing litigation, consider:

• Cost-Benefit Analysis – Compare potential recovery to attorney fees and litigation costs.

• Alternative Dispute Resolution – Mediation is common in Texas insurance cases and can be faster and less expensive.

Summary Checklist

• Mark prompt-payment deadlines on your calendar.

• Request policy and claim file via CMRRR.

• Document all damage and mitigation efforts.

• File a complaint with TDI if the carrier remains unresponsive.

• Consult a licensed Texas attorney well before any limitations period expires.

Legal Disclaimer

This guide provides general information for educational purposes. It is not legal advice. Laws change, and individual facts matter. Consult a licensed Texas attorney 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.