Property Insurance Claim Guide – New Braunfels, Texas

Introduction: Why Property Insurance Claim Denials Matter in New Braunfels

New Braunfels, Texas, sits right along the IH-35 corridor between San Antonio and Austin and experiences a unique blend of weather threats—large hail, flash flooding from the Guadalupe and Comal Rivers, and the occasional damaging windstorm. According to the Texas Department of Insurance (TDI), hail claims alone cost Texas homeowners more than $1.6 billion in a recent year. This local risk profile means New Braunfels homeowners often rely heavily on their property insurance policies to cover roof repairs, water damage, and structural losses. Unfortunately, claim denials—and partial underpayments—are common. This guide gives New Braunfels policyholders a clear, legally grounded path forward when their claim is denied, leaning slightly in favor of the homeowner while remaining strictly factual and Texas-specific.

Understanding Your Rights as a Texas Policyholder

The Policy Is a Contract

Your homeowners or commercial property insurance policy is a binding contract. Under Texas Insurance Code §541.060, insurers must not misrepresent coverage or attempt to unfairly deny benefits. Likewise, Texas Insurance Code Chapter 542—the Prompt Payment of Claims Act—gives you specific timelines and penalties if an insurer delays payment after liability is established.

The Duty of Good Faith and Fair Dealing

Texas common law recognizes an insurer’s duty of good faith and fair dealing. The Texas Supreme Court reaffirmed this standard in USAA Texas Lloyds Co. v. Menchaca, 545 S.W.3d 479 (Tex. 2018). Insurers must thoroughly investigate claims and base decisions on reasonable grounds. A failure to do so can expose them to extra-contractual damages.

Your Right to Access the Claim File

Under Texas Insurance Code §542.003(b)(5) and 28 Tex. Admin. Code §21.203, you may request copies of all claim-related documents, including adjuster reports and photographs. This transparency can reveal whether the insurer relied on incomplete or inaccurate information.

Common Reasons Texas Insurers Deny Property Claims

• Wear and Tear Exclusions – Policies often exclude “gradual deterioration.” However, hail or wind damage is sudden and accidental. An insurer may wrongly lump storm damage into normal aging.

• Late Notice of Loss – Texas policies typically require “prompt” notice. Courts look at reasonableness rather than rigid deadlines. Still, notify your carrier as soon as possible to avoid this defense.

• Alleged Policy Lapse for Non-Payment – Under Tex. Ins. Code §551.105, insurers must provide written notice before cancellation for non-payment. If that notice is defective, the coverage may still be in force.

• Pre-Existing Damage – Insurers may argue damage occurred before the current policy period. Independent contractor reports and prior inspection records can rebut this.

• Insufficient Documentation – Inadequate photos or repair estimates can trigger denial. Yet Texas Insurance Code §542.055 places the initial burden on the insurer to request all necessary information within 15 days of the claim.

• Application Misrepresentation – Carriers may rescind coverage if they prove an intentional material misrepresentation under Tex. Ins. Code §705.004. Honest mistakes usually are not grounds for denial.

Texas Legal Protections & Regulations You Can Invoke

Texas Insurance Code Chapter 542 – Prompt Payment Deadlines

• 15 Days – Insurer must acknowledge the claim and request any additional information (§542.055).

• 15 Business Days after receiving all requested items – Insurer must accept or deny (or provide a reasonable basis for continuing investigation) (§542.056).

• 5 Business Days – Once the claim is accepted, payment must be issued (§542.057).

• Penalty – Failure triggers 18% annual interest plus reasonable attorney’s fees (§542.060).

Texas Insurance Code Chapter 541 – Unfair Settlement Practices

Prohibits misrepresenting coverage, failing to promptly settle when liability is reasonably clear, and compelling policyholders to sue by offering substantially less than amounts ultimately recovered.

Statute of Limitations

Contract actions in Texas generally have a four-year limitations period (Tex. Civ. Prac. & Rem. Code §16.004). However, most policies shorten this to two years plus one day from the date of loss, which Texas courts uphold. Always check your policy’s “Suit Against Us” clause.

Appraisal Clause

Most Texas property policies include an appraisal process for disputes over amount of loss. Either side can invoke appraisal in writing. The process is binding on the value of damage, but not on coverage issues or bad-faith claims.

Steps to Take After a Property Insurance Claim Denial in Texas

1. Review the Denial Letter Thoroughly

Under 28 Tex. Admin. Code §21.203(4), insurers must provide a written explanation for denial. Compare their cited policy language to your actual policy.

2. Request Your Complete Claim File

Cite Tex. Ins. Code §542.003(b)(5) in your written request. Having the desk adjuster’s notes, field adjuster photos, and engineer reports will illuminate the carrier’s reasoning—and mistakes.

3. Gather Independent Evidence

• Licensed Contractor or Public Adjuster Reports

• Weather Data – The National Weather Service recorded hail of two inches or larger in Comal County on multiple dates in the past five years, supporting storm-related damage.

• Photos & Videos – Time-stamped images showing the condition before and after the event.

4. Consider the Appraisal Process

If the dispute is purely over pricing or scope, appraisal can be faster than litigation. Remember: you and the insurer each select an appraiser, then those two choose an umpire. Costs are generally split.

5. File a Complaint with the Texas Department of Insurance

You can submit online, by fax, or mail. TDI will request a written response from the insurer, often prompting faster reconsideration or payment. File at: TDI Complaint Portal.

6. Send a Pre-Suit Notice Letter

Tex. Ins. Code §542A.003 requires policyholders to give at least 60 days’ written notice before filing a lawsuit for claim-handling violations. Include the amount in dispute, factual basis, and attorney’s fees incurred to date.

7. Preserve Evidence and Deadlines

Keep damaged materials until the insurer or its expert inspects. Calendar the two-years-plus-one-day contractual deadline and the four-year statutory deadline.

When to Seek Legal Help in Texas

Complex or High-Dollar Losses

Roof replacements in New Braunfels often run $15,000–$40,000. If an insurer denies or underpays by a significant margin, hiring a Texas-licensed attorney can shift leverage.

Bad-Faith Indicators

• Repeatedly changing denial reasons

• Ignoring key evidence (e.g., weather reports)

• Delays beyond Chapter 542 deadlines without explanation

Attorney Fee-Shifting Statutes

If you prevail under Tex. Ins. Code §542.060 or Chapter 541, the court must award reasonable attorney’s fees. This fee-shifting makes litigation economically feasible for homeowners.

Licensing Requirements

Only attorneys licensed by the State Bar of Texas may give legal advice or represent you in court. Verify your lawyer’s status on the Bar’s public lookup tool.

Local Resources & Next Steps for New Braunfels Homeowners

• Comal County District Courts – Primary venue for lawsuits when the amount in controversy exceeds $200,000.

• New Braunfels Inspection & Building Standards Office – Obtain copies of permits and code requirements that may affect repair estimates.

River Floodplain Maps – Available from the FEMA Flood Map Service Center to prove flood-related risk or to exclude a flood defense.

• TDI Help Line – 1-800-252-3439 for guidance on filing complaints.

By arming yourself with statutory deadlines, understanding common insurer tactics, and leveraging local data—like hailstorm reports along the IH-35 corridor—New Braunfels homeowners can level the playing field against large insurance companies.

Legal Disclaimer

This article is for informational purposes only and does not constitute legal advice. Every claim is unique. Consult a licensed Texas attorney to obtain advice regarding your individual situation.

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

Helpful Resources:

Texas Insurance Code Chapter 541 – Unfair Methods of Competition and Unfair or Deceptive Acts

Texas Insurance Code Chapter 542 – Prompt Payment of Claims

Texas Department of Insurance Official Site