Property Insurance Claim Denial Guide – Richardson, TX

Introduction: Why Richardson Homeowners Need a Local Guide

Richardson, Texas sits in the heart of North Texas’s so-called “hail alley.” According to National Weather Service data, the Dallas–Fort Worth metro area, which includes Richardson, routinely records some of the nation’s highest frequencies of severe hail and wind events. In 2023 alone, multiple storms dumped golf-ball-size hail across Dallas and Collin Counties, causing millions of dollars in roof and window damage. Because most Richardson residents secure their homes with property insurance policies—often required by mortgage lenders—a storm loss can quickly translate into a high-stakes insurance claim. Yet many policyholders are shocked to receive a denial letter or a payment that is only a fraction of what they expected.

This comprehensive legal guide explains what a property insurance claim denial Richardson Texas homeowners could face really means, why denials happen, and how Texas law protects policyholders. While the information slightly favors homeowners, it is strictly grounded in authoritative Texas sources such as the Texas Insurance Code, the Texas Administrative Code, published court opinions, and guidance from the Texas Department of Insurance (TDI). The goal is to empower you with factual, location-specific knowledge so you can navigate the claim process, challenge improper denials, and decide when to retain a Texas attorney.

1. Understanding Your Rights in Texas

1.1 The Texas Insurance Code Protects Policyholders

Two of the most important chapters for homeowners are:

• Texas Insurance Code Chapter 541 – Prohibits insurers from engaging in unfair or deceptive acts or practices, including misrepresenting policy terms or denying claims without a reasonable investigation.

• Texas Insurance Code Chapter 542 – Commonly called the Prompt Payment of Claims Act. It sets strict deadlines for insurers to acknowledge, investigate, and pay claims. Failure can trigger statutory interest (currently 18% per year) and attorney’s fees in favor of the policyholder.

These protections apply to all residential property policies issued in Texas, whether you bought coverage through a national carrier, a surplus lines insurer, or the state-backed Texas FAIR Plan.

1.2 Statute of Limitations for Lawsuits

• Breach of Contract: 4 years from the date the insurer allegedly breached the policy (Tex. Civ. Prac. & Rem. Code §16.004).

• Unfair Settlement Practices (Ch. 541): 2 years from the date the unfair practice occurred or should reasonably have been discovered (Tex. Ins. Code §541.162).

Missing these deadlines can bar your claim entirely, so calendar them as soon as a denial arrives.

1.3 The Richardson-Specific Angle

Local building codes enforced by the City of Richardson require roofing materials to meet International Residential Code (IRC) wind-uplift and impact-resistance standards. If your insurer denies a roof replacement claim by approving only “spot repairs,” confirm that the proposed repair meets local code. Texas policies typically include a “building ordinance and law” endorsement that should pay the increased cost of code-compliant replacement.

2. Common Reasons Insurers Deny Property Claims in Texas

Although every denial letter must cite at least one policy exclusion or limitation, the most frequent reasons seen by richardson homeowners include:

• Wear and Tear Exclusion: Insurers often label hail-damage claims as “long-term deterioration” rather than sudden storm damage. Photographs, meteorological data, and prior inspection reports can rebut this claim.

• Late Notice: Under Texas Insurance Code §542.055, the insurer must be put on notice “promptly.” While no fixed number of days appears in the statute, carriers routinely argue that waiting more than 30–60 days after a storm constitutes prejudice. Texas courts decide timeliness on a case-by-case basis.

• Misrepresentation or Concealment: If the insurer alleges the homeowner failed to disclose prior roof repairs or previous claims, it may rescind coverage altogether under the policy’s fraud provision. Texas law requires the misrepresentation to be material and intentional.

• Excluded Perils: Some policies issued in North Texas exclude “cosmetic hail damage.” Others may specify that foundation movement caused by soil expansion is excluded unless you purchased an endorsement.

• Matching Issues: Texas policies often exclude the cost of matching undamaged materials with new ones. However, if local ordinances require uniform appearance (as some Richardson subdivisions do), the cost may become covered under ordinance-and-law endorsements.

Texas Case Law Snapshot

In USAA Texas Lloyds Co. v. Menchaca, 545 S.W.3d 479 (Tex. 2018), the Texas Supreme Court clarified that policyholders must establish an entitlement to benefits before collecting statutory damages for bad faith. The decision underscores the importance of proving covered loss before pursuing extra-contractual penalties.

3. Texas Legal Protections & Regulations

3.1 Prompt Payment Deadlines

Under Chapter 542:

• 15 days to acknowledge the claim and request any necessary documentation.

• 15 business days after receiving the information to accept or deny the claim in writing (Tex. Ins. Code §542.056).

• 5 business days after notice of acceptance to pay the claim.

During a catastrophe such as a federally declared disaster, TDI may extend these deadlines by bulletin. For the April 2023 North Texas hailstorm, TDI Bulletin B-0024-23 extended the decision deadline to 30 business days.

3.2 Penalties for Unfair Settlement Practices

Chapter 541 lists prohibited acts, including:

• Failing to conduct a reasonable investigation.

• Misrepresenting policy provisions.

• Refusing to pay a claim without conducting a reasonable investigation.

Successful plaintiffs may recover actual damages, court costs, and treble damages if the insurer knowingly committed the violation.

3.3 Texas Administrative Code Title 28

Subchapter 21.203(5) requires that adjustment personnel be properly trained and supervised. If your claim was handled by an out-of-state adjuster who misapplied Texas law, cite this regulation in any complaint.

4. Steps to Take After a Denial in Texas

4.1 Request a Detailed Denial Letter

Texas Insurance Code §542.056(a) mandates a “written notice” stating the reasons for denial. If the letter cites vague phrases like “policy exclusion applies,” request clarification in writing.

4.2 Gather Evidence

Certified weather reports from the NOAA National Centers for Environmental Information.

• Before-and-after photos.

• Independent contractor estimates that comply with Richardson’s building code.

• A copy of your complete policy, including endorsements and declarations.

4.3 File an Internal Appeal

Most carriers offer a voluntary re-inspection or appraisal process. Under the typical Texas HO-3 policy, either party can invoke appraisal when the dispute is solely over the amount of loss. Follow policy timelines carefully—many require written demand within 60 days of the denial.

4.4 Complain to the Texas Department of Insurance (TDI)

TDI’s Consumer Protection division accepts online complaints, which must include the denial letter, claim number, and supporting documents.

Submit through the TDI Online Complaint Portal.

• TDI assigns a file number and notifies the insurer, which has 15 days to respond to TDI.

• You can track progress by email or phone (800-252-3439).

Although TDI cannot force an insurer to pay, the agency can fine the company or require corrective action. A TDI complaint also creates a paper trail if you later file suit.

4.5 Preserve Your Claim Statute of Limitations

Tolling agreements and appraisal do not automatically stop the limitations clock. Consider sending a written request for a tolling agreement while you pursue internal remedies.

5. When to Seek Legal Help in Texas

5.1 Indicators You Need a Lawyer

• The damages exceed $25,000 and the carrier refuses to appraise.

• The insurer alleges fraud or misrepresentation.

• Hidden policy exclusions are cited (e.g., anti-concurrent-cause clauses).

• Statutory deadlines in Chapter 542 have been blown by more than 30 days.

5.2 Choosing the Right Texas Attorney

Under Texas Government Code §81.102, only lawyers licensed by the State Bar of Texas may give legal advice regarding Texas law. Verify licensure at the Texas Bar’s Attorney Search. Look for attorneys who:

• Focus on first-party property claims.

• Have trial experience in Dallas or Collin County courts.

• Offer contingency-fee arrangements (allowed under Disciplinary Rule 1.04).

6. Local Resources & Next Steps

6.1 Richardson Building Inspection Department

Before repairs, contact the department at 972-744-4195 to confirm permit requirements, especially for roof replacements that exceed one square of shingles.

6.2 North Central Texas Council of Governments (NCTCOG)

NCTCOG publishes regional building code amendments that insurers sometimes overlook when calculating replacement cost. Their guidelines can bolster your argument that full replacement is required.

6.3 Disaster Assistance

If a federal disaster is declared, homeowners may apply for FEMA aid. However, FEMA assistance is secondary to insurance and will not cover losses your insurer is obligated to pay.

Conclusion

Navigating a property insurance claim denial Richardson Texas homeowners face can be daunting, especially after a costly hail or wind event. Texas law provides robust tools—Chapter 542’s prompt-payment deadlines, Chapter 541’s unfair-practice remedies, and the TDI complaint process—to level the field. By understanding your policy, gathering timely evidence, and knowing when to enlist a seasoned texas attorney, you can maximize your chances of overturning an improper denial.

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Laws and regulations change. 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.

External Resources:

Texas Department of Insurance Rules & Bulletins Texas Insurance Code Online Texas Courts Case Search NOAA Storm Data