Property Insurance Claim Denial Guide – Garland, Texas

Introduction: Why Garland Homeowners Face Unique Claim Challenges

Nestled northeast of Dallas, Garland, Texas is no stranger to severe thunderstorms, straight-line winds, and spring hail events that batter roofs, siding, and windows. According to the National Weather Service’s Dallas/Fort Worth office, Dallas County—where Garland sits—averages more than two hail reports each year of stones two inches or larger. Localized flooding along Duck Creek and the Rowlett Creek watershed also drives water-damage claims. Because the city’s housing stock includes many 1970s and 1980s single-story homes with aging asphalt shingles, insurers closely scrutinize claims, often alleging wear and tear rather than storm damage. When your insurer points to exclusions or alleges pre-existing deterioration, understanding Texas insurance law becomes critical. This guide explains what Garland homeowners need to know after a property insurance claim denial, outlining your rights, the relevant statutes, local resources, and when to involve a Texas attorney.

Understanding Your Rights in Texas

Foundational Policyholder Rights

Every homeowner’s insurance policy issued in Texas is a contract governed by both its written terms and the Texas Insurance Code. If your policy premiums are current, you have the legal right to:

• Prompt Processing: Under Texas Insurance Code Chapter 542 (the “Prompt Payment of Claims Act”), insurers must acknowledge, investigate, and accept or reject a claim within strict time limits.

• Fair Settlement Practices: Texas Insurance Code §541.060 prohibits unfair methods of competition and unfair or deceptive acts, including denying a claim without a reasonable investigation.

• Written Explanation: You are entitled to a written denial letter stating the specific policy provisions on which the decision is based (28 TAC §21.203).

• Right to Appeal: You may contest a denial internally, request an appraisal (if your policy contains an appraisal clause), or pursue legal remedies.

Time Frames That Matter

Texas imposes a two-year statute of limitations on many causes of action for unfair insurance settlement practices (Texas Insurance Code §541.162). Contract claims (e.g., breach of policy) generally must be filed within four years, unless your policy shortens that period. Mark your calendar as soon as you receive a denial to avoid waiving rights.

Common Reasons Property Insurance Companies Deny Claims in Texas

Garland homeowners frequently see these justifications in denial letters:

• Wear, Tear, and Deterioration Exclusions – Insurers argue that granule loss, brittle shingles, or pipe corrosion pre-dated the storm.

• Late Notice – Chapter 542 requires prompt notice by the insured; insurers sometimes assert that “prompt” means within days, not months. However, Texas courts evaluate whether the delay prejudiced the insurer (Hamilton v. State Farm Lloyds, 559 S.W.3d 755 (Tex. 2018)).

• Cosmetic Damage Limits – Some Texas HO-3 and HO-5 policies exclude damage that affects appearance but not function, particularly for metal roofs or siding.

• Faulty Construction or Code Violations – Garland’s adoption of the 2018 International Residential Code means older homes may not meet current standards; insurers may deny coverage citing policy exclusions for previous code non-compliance.

• Water Damage Within 14 Days – Texas policies often require the homeowner to reasonably mitigate water infiltration. If mold growth results, insurers argue failure to act bars coverage.

While some denials are valid, insurers occasionally overreach. A denial letter alone does not necessarily end your claim.

Texas Legal Protections & Regulations

Chapter 542: Prompt Payment of Claims Act

Key deadlines include:

• 15 Days – Insurer must acknowledge receipt of the claim and request any necessary documentation (TIC §542.055).

• 15 Business Days After All Items Received – Insurer must accept or reject the claim in writing (TIC §542.056). This may extend to 45 days with written notice explaining the delay.

• 5 Business Days – Once the claim is accepted, payment must issue within this period (TIC §542.057).

Failure to comply can trigger penalty interest of 18% per year plus reasonable attorney’s fees—powerful leverage for policyholders.

Chapter 541: Unfair Settlement Practices

Section 541.060 prohibits:

• Misrepresenting a material fact or policy provision.

• Failing to attempt in good faith to settle a claim when liability is reasonably clear.

• Refusing a reasonable request for documentation.

Violations open the door to additional damages, including possible treble damages if the insurer acted knowingly.

Texas Department of Insurance (TDI) Oversight

TDI licenses insurers and adjusts complaints. While TDI cannot order an insurer to pay, a well-documented complaint can prompt a re-examination of the file and apply regulatory pressure.

File online at the TDI Complaint Portal or mail Form GC-1 to: Texas Department of Insurance, Consumer Protection, MC 111-1A, P.O. Box 149091, Austin, TX 78714-9091.

Steps to Take After a Denial in Texas

1. Review the Denial Letter and Your Policy

Compare the cited exclusions with your declarations page and endorsements. Many Garland homeowners have endorsements for windstorm and hail coverage; confirm the insurer’s explanation truly applies.

2. Gather Evidence

• Date-stamped photos of damage immediately after the event.

• Weather data such as storm reports from the National Oceanic and Atmospheric Administration (NOAA) verifying hail size and wind speed.

• Independent contractor estimates on company letterhead.

• Correspondence logs detailing phone calls and e-mails with adjusters.

3. Request a Second Inspection or Appraisal

Texas policies often contain an appraisal clause. Either party can invoke it in writing. Each side selects an appraiser, and the two appraisers choose an umpire. While appraisal determines the amount of loss—not coverage—favorable findings often incentivize insurers to settle.

4. File a Written Appeal Internally

Ask for supervisory review, citing any overlooked evidence.

5. Complain to TDI

Attach your denial letter, policy, and photos. TDI typically responds within 30 days, requesting a detailed explanation from the insurer.

6. Preserve Deadlines

Send a Notice of Claim letter before filing suit, as required by TIC §541.154 and TIC §542A.003, giving the insurer 60 days to resolve the dispute.

7. Consider Mediation or Litigation

Some insurers participate in TDI’s voluntary mediation program for residential property damage claims under $75,000. If mediation fails, a lawsuit in Dallas County District Court may be appropriate.

When to Seek Legal Help in Texas

Consult a Texas-licensed attorney when:

• You suspect the insurer ignored clear evidence of storm damage.

• The claim value exceeds your deductible by several thousand dollars—you need cost-benefit clarity.

• Repair delays risk additional damage (e.g., water infiltration while a roof remains unrepaired).

• Statutory deadlines (two-year or four-year) loom close.

• You receive a Reservation of Rights letter, indicating potential future denial.

Texas attorneys handling first-party property claims typically work on contingency, advancing costs for engineering reports or meteorological experts. Under Chapter 542, reasonable attorney’s fees may be recoverable, lessening financial burden.

Local Resources & Next Steps

City of Garland Building Inspection Department

Before repairing, obtain permits and inspections: 800 Main Street, Garland, TX 75040, 972-205-2300. Confirmation that repairs meet code can rebut an insurer’s allegation of faulty construction.

North Texas Roofing Contractors Association (NTRCA)

Hiring an NTRCA-member roofer experienced with insurance negotiations can improve documentation.

Insurance Consumer Information

Texas Department of Insurance Consumer Help TDI Complaint Form Texas Insurance Code (Full Text) National Weather Service Dallas/Fort Worth

Print and save these resources in a claim folder.

Legal Disclaimer

This material is for informational purposes only and does not constitute legal advice. Laws change, and the application of legal principles varies by facts. You should consult a licensed Texas attorney about 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.