You = policyholder
If you file a claim with your insurance company:
- Within 15 days after you file a claim with your insurance company, they must send a notice telling you:
- They got your claim.
- They are looking into (investigating) the claim.
- If they need more information from you and others.
- Your insurance company must send you a written notice saying a claim you filed is approved or denied, or that they need more time. The notice must be sent no later than 15 business days after the company gets all needed information.
- If the claim is denied: The notice must give the reasons for the denial.
- If the claim is approved: Your insurance company must send payment no later than 5 days after the notice is sent. If the company misses the payment deadline, they might also owe you interest and attorney’s fees.
- If the company thinks the claim might be due to a fire set on purpose (arson): Your insurance company has 30 days to send the notice.
- If the company needs more time: Your insurance company can extend the deadline 45 more days to give their decision to approve or deny your claim. To do this, the notice must say why more time is needed.
- If the claim is due to a disaster, the Texas Department of Insurance can extend all claim handling deadlines by 15 days.
If you have a problem with an insurance company:
- If you have a problem with a claim filed with an insurance company, call them first.
- If you can’t work out the issue, the Texas Department of Insurance may be able to help.
- Call the Help Line at 800-252-3439, Monday to Friday, 8 a.m. to 5 p.m. Central time.
- Learn how to file a complaint with the Texas Department of Insurance.
Texas Insurance Code: 521.005