What if I disagree with my insurer’s decision?

If you believe your insurer didn’t pay enough to cover your damages or unfairly denied your claim, you have options. Click on the type of policy to learn more. You can also call our Consumer Help Line at 1-800-252-3439, 8 a.m. to 5 p.m. Monday to Friday.

You have one year from the date of loss to file a claim with the Texas Windstorm Insurance Association (TWIA). If TWIA determines you have a loss covered by your windstorm policy, you either get a check from TWIA or a notice that the loss is less than your deductible and there will be no payment. If you disagree with the amount estimated for your loss, you can ask TWIA to look at your claim again, use the appraisal process, or both. Be aware that there is a deadline to demand appraisal that applies even if you are still working with TWIA on your claim.

Work with TWIA

If you think TWIA’s estimate of your damage is too low, you can contact TWIA:

  • Call TWIA at 1-800-788-8247. Have your policy number and claim number. It’s a good idea to also make your request in writing and keep a copy.
  • Ask TWIA for a copy of its estimate if you didn’t get one with the payment.
  • Tell TWIA about damaged items missing from its estimate, where amounts are lower than your contractor’s estimate, newly discovered damage, and any other unmet needs.
  • Send copies of any contractor estimates and other items supporting your request to TWIA. Email claims@TWIA.org or use TWIA’s online portal at www.twia.org/claimscenter.
Demand appraisal

Appraisal is a formal process to handle disputes over the amount of a covered loss. It’s important to know the deadline to demand appraisal to protect your right to contest TWIA’s decision.

  • For Hurricane Harvey claims, you have 120 days to demand appraisal from the date of the notice from TWIA stating it accepted your claim.
  • For other claims, you have 60 days to demand appraisal.

To demand appraisal:

  • Use the form provided by TWIA, write a letter, or send an email to claims@TWIA.org with your claim number and state that you demand appraisal. Keep a copy of what you send.
  • Make notes of any conversations you have with TWIA about your claim or demand for appraisal.
  • You’ll split the cost of appraisal with TWIA. Check your policy for more details.
Why you may want to do both

If you do not demand appraisal before the deadline, you will lose the right to challenge the amount TWIA estimated for your loss. You can ask TWIA to review your claim and continue to work with them after the initial payment. If you are approaching your appraisal deadline and you still aren’t satisfied with your claims payment, you must demand appraisal to preserve your rights.

If TWIA denied your claim

If TWIA denied your claim, you may file a lawsuit. You must notify TWIA before filing the lawsuit. You have two years to provide notice and file the suit. TWIA may require you to go to mediation or another dispute resolution process before you can file suit.

File a complaint with TDI

You can file a complaint with TDI by using our online form or paper form. You also can call the Consumer Help Line at 800-252-3439 to get the complaint process started. Learn more about the type of complaints we can help with and the complaint process.

If you disagree with the adjuster's final estimate, tell the company why. The company may have overlooked something and may make adjustments. Make sure to send any supporting documentation, such as a contractor’s estimate for the repairs. If you still disagree, you have several options to challenge your insurer’s decision.

Demand appraisal

The appraisal process begins with you and the company each hiring an appraiser. The two appraisers then choose a third appraiser as the umpire. Your appraiser and the company's appraiser make their own estimates of your loss. If they are different, the umpire makes the final decision, which is binding on both you and the company. You are responsible for the expenses of the appraiser you hire and for half of the umpire's expenses. Check your policy for any deadlines to demand appraisal. If you need help finding an appraiser, search for a “property damage appraiser” or check with your contractor.

File a complaint

If you think an insurance company has treated you unfairly, you can file a complaint with us. You can file a complaint by using our online form or paper form. You also can call the Consumer Help Line at 800-252-3439 to get the complaint process started. Learn more about the type of complaints we can help with and the complaint process.

More options

Some people hire a public insurance adjuster if they disagree with the number or type of damages listed by the insurance company’s adjuster. Public adjusters, unlike the company’s adjusters, work for you, not the insurance company. Public adjusters charge fees for their services. Before you hire a public adjuster, make sure you understand what you’ll have to pay.

If you’re not satisfied with the outcome of your dispute, you have the right to sue the insurance company in a court of law. You can also ask for alternative dispute resolution, which uses mediation with a neutral third party to settle disputes outside court.

If you received a denial for all or part of your claim with the National Flood Insurance Program (NFIP) visit the Flood Claim Appeals and Guidance section of the FEMA website. The website includes information on how to appeal, request appraisal, and other options.

If you have a problem with your insurance company, first try to resolve it by talking to your adjuster or company. If you still aren’t satisfied, you have several options to challenge your insurer’s decision.

Demand appraisal

If you and your insurance company can't agree on the amount of your settlement, you can demand an appraisal. Appraisal allows you and the company to hire separate damage appraisers. The two appraisers choose a third appraiser to act as an umpire. The appraisers review your claim, and the umpire rules on any disagreements. The appraisal decision is binding on the amount of the damage. If there is a dispute about what is covered, you can pursue a settlement of the coverage issue after the appraisal. You must pay for your appraiser and half of the umpire's costs.

File a complaint

If you think an insurance company has treated you unfairly, you can file a complaint with us. You can file a complaint by using our online form or paper form. You also can call the Consumer Help Line at 800-252-3439 to get the complaint process started. Learn more about the type of complaints we can help with and the complaint process.

For more information about auto claims, see My car was flooded.

 

For more tips like these:

Like TDI on Facebook      Follow TDI on Twitter      Sign up for email updates      Subscribe to TDI's YouTube Channel



For more information, contact:

Last updated: 11/08/2017

Contact Information and Other Helpful Links