Guide to Property Insurance Claim Denials in Irving, Texas

Introduction: Why Irving Homeowners Need This Guide

Few events are more stressful for an Irving homeowner than discovering wind, hail, or water damage to your property—only to be met with a property insurance claim denial. The Dallas–Fort Worth metroplex, including Irving, regularly experiences springtime hailstorms, straight-line winds, and occasional tornadic activity. According to the National Weather Service Storm Events Database, Dallas County ranks among the top Texas counties in both frequency and severity of hail reports. As housing density grows along State Highway 183 and Belt Line Road, more roofs, fences, and HVAC units sit in the path of these storms—making timely, fair insurance claim handling crucial.

This guide focuses on property insurance claim denial Irving Texas issues. It pulls only from authoritative Texas sources—such as the Texas Insurance Code ("TIC"), the Texas Department of Insurance ("TDI"), and published Texas court opinions—to explain why claims are denied, what rights policyholders possess, and how to contest a denial.

1. Understanding Your Rights as a Texas Policyholder

1.1 The Insurance Contract

Property insurance in Texas is a contract between you and the carrier. You pay premiums; in exchange the company must investigate, evaluate, and—if coverage applies—pay covered losses. Texas law enforces this contractual promise. Under Tex. Civ. Prac. & Rem. Code §16.004, policyholders generally have four years to file a breach-of-contract lawsuit after a wrongful denial.

1.2 Prompt Payment Rights (Texas Insurance Code Chapter 542)

Texas has some of the nation’s strictest prompt-payment statutes. Chapter 542 requires:

• 15 business days to acknowledge the claim, begin investigation, and request documents (TIC §542.055).

• 15 business days after the insurer receives all requested items to accept or reject the claim (TIC §542.056). The deadline may extend to 45 days with written explanation.

• Five business days to pay once the insurer agrees to cover all or part of the claim (TIC §542.057).

Failure to comply adds statutory interest (currently 18 percent per year) and attorney’s fees.

1.3 Protection Against Unfair Settlement Practices (Texas Insurance Code Chapter 541)

Chapter 541 prohibits insurers from misrepresenting policy terms, failing to settle when liability is reasonably clear, or refusing timely, fair claims investigation. Homeowners have two years (plus a 180-day tolling period) from the date they knew or should have known of the unfair act to file suit (TIC §541.162).

1.4 Administrative Oversight

The Texas Department of Insurance regulates carriers through rules in the Texas Administrative Code, Title 28. Section 21.203 lists unfair claim practices, including failing to promptly provide a reasonable explanation for denial.

2. Common Reasons Property Insurance Companies Deny Claims in Texas

2.1 Wear and Tear vs. Sudden, Accidental Damage

Policies generally exclude ordinary deterioration. Insurers often argue that hail impact occurred years earlier or that roof shingles merely aged. Yet, if qualified experts can show fresh impact craters or granule loss consistent with a recent Irving hailstorm, the loss may be covered.

2.2 Late Notice of Claim

Most Texas homeowner policies require prompt notice—often within one year of the date of loss. However, Texas law recognizes that some damage (e.g., hidden leaks) is discovered later. Courts such as Hamilton v. State Farm Lloyds, 559 S.W.3d 755 (Tex. 2018), analyze whether the insurer was prejudiced by late notice. If no prejudice exists, denial may be improper.

2.3 Policy Exclusions and Limitations

Examples include:

• Flood (often requires separate NFIP policy)

• Surface water runoff

• Mold limits ($5,000 or $10,000 caps are common)

• Cosmetic roof damage exclusions added by endorsement

The insurer bears the initial burden of proving an exclusion applies, as reaffirmed in Lennar Corp. v. Great Am. Ins. Co., 200 S.W.3d 651 (Tex. App.—Houston [14th Dist.] 2006, pet. denied).

2.4 Alleged Misrepresentation or Fraud

If a carrier suspects inflated estimates or staged damage, it may deny coverage under the policy’s concealment/fraud clause. Under TIC §541.061, however, an insurer itself commits an unfair act by misrepresenting facts to support a fraud defense.

2.5 Improper or Incomplete Documentation

Missing photos, repair invoices, or sworn proofs of loss can stall or doom a claim. Carriers must specify missing items in writing under TIC §542.055(a)(3). Policyholders then have an opportunity to cure.

3. Texas Legal Protections & Regulations

3.1 Statutory Framework

The backbone of Texas insurance consumer protection rests on two chapters already discussed—Chapter 542 (Prompt Payment) and Chapter 541 (Unfair Practices). Other relevant statutes include:

• Tex. Prop. Code §5.008 – Seller disclosure of property condition, important in prior-damage disputes.

• Tex. Ins. Code §542A – Pre-suit notice requirements for property damage caused by "forces of nature," enacted in 2017. Homeowners must give 60 days’ written notice before filing suit, listing damages, attorney fees, and the amount in controversy.

3.2 The Texas Department of Insurance (TDI)

TDI issues bulletins, licenses adjusters, and enforces administrative penalties. Policyholders can file a complaint online, by mail, or by calling 800-252-3439. TDI cannot order a specific dollar payment but can pressure insurers to reopen a claim and may levy fines for systemic violations.

Complaint portal: Texas Department of Insurance Complaint Form

3.3 Claims-Handling Rules in the Texas Administrative Code

Under 28 TAC §21.203, insurers must adopt and implement reasonable procedures for prompt claim investigation. Repeated violations constitute a pattern of unfair practices, opening the door to administrative sanctions and treble damages under TIC §541.152(b) if the insurer acted knowingly.

3.4 Irving-Specific Building Code Considerations

Irving enforces the 2018 International Residential Code with local amendments. After a covered loss, the "ordinance or law" coverage in your policy may pay increased costs to meet updated codes—such as drip-edge requirements or high-wind nailing patterns. Confirm your sub-limits; underpayment disputes are common.

4. Steps to Take After a Property Insurance Claim Denial in Texas

4.1 Carefully Read the Denial Letter

Texas insurers must provide "the specific policy language" and factual basis for denial (28 TAC §21.203(6)). Compare the cited language with your own policy declarations and endorsements.

4.2 Gather Objective Evidence

• High-resolution photos of damaged areas

• Weather reports pinpointing hail size and wind speed in Irving on the loss date (from NOAA or CoreLogic reports)

• Independent contractor or public adjuster estimates

• Prior maintenance records showing the roof was in good condition

4.3 Request a Written Explanation Under Texas Law

If the denial letter is vague, demand a more detailed explanation pursuant to TIC §541.060(a)(3), which prohibits insurers from failing to explain the basis of the denial in plain language.

4.4 Invoke the Appraisal Clause (If Available)

Most Texas homeowner policies contain an appraisal provision allowing either party to demand an independent valuation. While appraisal determines only the amount of loss—not coverage—an agreed value can eliminate part of the dispute. After the 2020 Texas Supreme Court decision in State Farm Lloyds v. Johnson, 290 S.W.3d 886, appraisal awards are binding unless fraud, accident, or misconduct is proven.

4.5 File a Complaint with TDI

The process is free and may spur quicker action:

• Complete the online form or mail the PDF with supporting docs.

• TDI assigns a file number and requests a response from the insurer within two weeks.

• You receive periodic updates and, ultimately, a closing letter summarizing TDI’s findings.

Although TDI cannot award damages, the insurer’s regulatory department typically treats TDI inquiries as high priority.

4.6 Send Formal Pre-Suit Notice (When Appropriate)

Under TIC §542A, homeowners alleging property damage from wind or hail must send a 60-day notice letter before filing suit. The notice must:

• State the specific complaint

• List damages, attorney fees, and incurred costs

• Provide photos, estimates, and inspection reports, if available

Failure to comply can result in abatement of the lawsuit. Certified mail, return-receipt is recommended.

5. When to Seek Legal Help in Texas

5.1 Indicators You May Need a Texas Attorney

• Repeated lowball estimates despite solid contractor bids

• Denial based on alleged "pre-existing damage" contradicted by recent storm data

• Accusations of fraud without evidence

• Substantial damages exceeding $30,000 (typical small-claims jurisdictional limit)

• Threats to rescind the policy or cancel coverage

5.2 Attorney Licensing and Fees

Texas attorneys must be licensed by the State Bar of Texas and maintain professional liability coverage. Most property-damage lawyers work on a contingency basis (typically one-third to 40 percent), advancing costs for experts and filing fees. Under TIC §542.060 and §541.152, prevailing homeowners may recover reasonable attorney’s fees and, in bad-faith cases, up to three times actual damages.

5.3 Potential Causes of Action

• Breach of Contract: Nonpayment of covered loss.

• Prompt Payment Violations (Ch. 542): Statutory interest and fees.

• Unfair Settlement Practices (Ch. 541): Actual, mental-anguish, and treble damages if conduct was knowing.

• Texas Deceptive Trade Practices Act (Bus. & Com. Code §17.46): When insurer statements constitute consumer misrepresentation.

6. Local Resources & Next Steps for Irving Homeowners

6.1 City and County Assistance

• City of Irving Building Inspections: 972-721-2371 — can provide code requirements for roof repairs.

• Dallas County Law Library: Free access to Texas statutes for self-represented homeowners.

6.2 Reputable Public Adjusters and Contractors

Under 28 TAC §19.708, public insurance adjusters must hold a Texas license. Verify licenses at TDI’s Agent Lookup before hiring.

6.3 Document Storage and Disaster Preparedness

Store policies and photos in cloud storage or a fire-proof safe. After a major storm, Irving homeowners should photograph the exterior immediately—even before filing a claim—because Texas insurers may dispute the date of loss months later.

6.4 Statute of Limitations Checklist

• 2 years: Chapter 541 unfair-claim practices

• 4 years: Breach of insurance contract (Tex. Civ. Prac. & Rem. Code §16.004)

• 60-day pre-suit notice: Chapter 542A wind/hail claims

Conclusion

Insurance carriers in Texas must honor their contractual and statutory duties. Yet denial letters continue to arrive on kitchen tables from Valley Ranch to Las Colinas. By understanding your rights under Texas insurance law, documenting damage thoroughly, and taking advantage of administrative remedies through TDI, you can place yourself in the strongest position to overturn an unjust decision. When those efforts fall short, engaging a knowledgeable Texas attorney can level the playing field.

Legal Disclaimer: This article provides general information for Texas homeowners and is not legal advice. Laws can change, and their application varies by specific facts. Consult a licensed Texas attorney 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 references:

Texas Insurance Code Chapter 542 – Prompt Payment of Claims Texas Insurance Code Chapter 541 – Unfair Settlement Practices Texas Civil Practice & Remedies Code §16.004 – Four-Year Limitations Texas Department of Insurance: File a Complaint