Guide to Property Insurance Claim Denials – Longview, Texas

Introduction: Why Property Insurance Claim Denials Matter in Longview

Longview, Texas, sits in the heart of East Texas – a region known for severe spring hailstorms, powerful straight-line winds, and the occasional tornado. These weather events can leave homes along Loop 281 or in neighborhoods like Spring Hill and Pine Tree with roof damage, broken windows, and water intrusion. Fortunately, most Longview homeowners carry property insurance to protect against these risks. Unfortunately, insurers sometimes deny, underpay, or delay valid claims. When that happens, understanding Texas insurance law becomes crucial.

This comprehensive guide explains what every Longview policyholder needs to know about property insurance claim denials. It relies solely on authoritative sources such as the Texas Insurance Code, Texas Department of Insurance (TDI) publications, and published Texas court opinions. The aim is to empower you – the homeowner – with clear, factual information so you can make informed decisions if your claim is denied.

Understanding Your Rights in Texas

The Insurance Policy Is a Contract

Your homeowners policy is a legally binding contract. In exchange for premiums, the insurer promises to investigate, value, and pay covered losses. If the carrier fails to keep those promises, Texas law provides remedies.

Key Statutory Rights Under the Texas Insurance Code

• Prompt Payment of Claims Act (Texas Insurance Code Chapter 542) – Requires insurers to acknowledge, investigate, and either accept or deny a claim within defined deadlines. For example, §542.055 generally gives the insurer 15 days to acknowledge receipt and request additional information, while §542.056 gives 15 business days (30 in some cases) after receiving all requested information to accept or reject the claim.

• Unfair Settlement Practices (Texas Insurance Code Chapter 541) – Prohibits insurers from misrepresenting facts or policy provisions, failing to attempt good-faith settlement, or denying claims without a reasonable investigation. A successful policyholder may recover actual damages, court costs, and, if the insurer acted knowingly, up to three times the amount of actual damages.

• Attorney’s Fees & Interest – Under §542.060, if the insurer violates the prompt payment deadlines, it may owe the policyholder the amount of the claim, interest at 18% per year, and reasonable attorney’s fees.

Statute of Limitations

Texas typically provides a two-year limitations period from the date the unfair act occurred or from the date the policyholder discovered the act to file suit for violations of Chapters 541 or 542. Contract claims may have a four-year limitations period unless the policy validly shortens it. Missing these deadlines can bar recovery, so act quickly after a denial.

Right to Independent Appraisal (If in Policy)

Most Texas homeowners policies include an appraisal clause allowing either party to invoke appraisal when the only dispute is the amount of loss. This contractual process is separate from litigation and often resolves value disagreements.

Common Reasons Property Insurance Companies Deny Claims in Texas

1. Wear and Tear vs. Sudden Storm Damage

Insurers frequently deny roof claims by asserting pre-existing wear, deterioration, or manufacturer defects rather than recent hail or wind damage. Texas courts allow carriers to rely on exclusions for long-term deterioration, but policyholders can counter with storm reports, date-stamped photos, and expert opinions.

2. Late Notice of Claim

Policies require “prompt” or “timely” notice, yet Texas law is lenient: the insurer must show it was actually prejudiced by the delay. In Hamilton Properties v. American Insurance, 643 S.W.3d 400 (Tex. 2022), the Texas Supreme Court held that the insurer carries the burden of proving prejudice from late notice.

3. Alleged Misrepresentation

If an insurer believes the insured exaggerated loss details or submitted fraudulent invoices, it may deny the entire claim. Chapter 541 forbids denial without a reasonable investigation; demanding supporting documentation and contractor estimates helps defeat this tactic.

4. Excluded Perils

Typical exclusions include flooding, earth movement, and surface water. East Texas homeowners sometimes confuse flash-flood damage with wind-driven rain, leading to partial denials. Reviewing policy definitions closely is critical.

5. Failure to Mitigate

Policies require reasonable steps to prevent further damage after a loss—such as tarping a roof. Failing to mitigate can reduce or void coverage. Keep receipts for emergency repairs.

6. Policy Lapse or Non-Payment of Premium

The insurer may deny if the policy was not in force at the time of loss. However, Chapter 541 bars misrepresentations; if the carrier or agent incorrectly told you coverage would continue, you may have recourse.

Texas Legal Protections & Regulations

Prompt Payment Deadlines in Detail

• Notice of Claim – You must report damage “promptly.” The statute does not define a fixed number of days, but sooner is always better.

• Carrier’s Acknowledgment (Tex. Ins. Code §542.055(a)(1)) – 15 calendar days to acknowledge receipt.

• Request for Information (§542.055(a)(2)) – 15 days to request documents needed to process the claim.

• Acceptance or Denial (§542.056) – 15 business days (30 if arson suspected) after receiving all information.

• Payment (§542.057) – Must pay within 5 business days of notifying you of acceptance.

Missing these deadlines triggers the 18% statutory interest and attorney’s fees under §542.060.

The Texas Department of Insurance Complaint Process

Policyholders may file a written complaint with TDI’s Consumer Protection division if they believe an insurer mishandled a claim. TDI will request a response from the carrier and can impose fines for Code violations. Although TDI cannot order the insurer to pay your claim, its findings create leverage in settlement discussions.

Download the complaint form or file online through TDI’s Consumer Complaint Portal.

• Include the claim number, policy number, copies of correspondence, photos, and contractor estimates.

• TDI aims to respond within 45 days. You will receive a written summary of the insurer’s position and any regulatory action.

Regulations on Adjusters and Contractors

Under Texas Occupations Code Chapter 4102, public insurance adjusters representing policyholders must be licensed by TDI. Homeowners should verify licenses before hiring assistance.

The Texas Deceptive Trade Practices Act (DTPA)

Insurance-related misrepresentations can also violate the DTPA (Tex. Bus. & Com. Code §17.46). Coupling DTPA and Chapter 541 claims may enhance recovery for “knowingly” wrongful denials.

Steps to Take After a Denial in Texas

1. Review the Denial Letter Thoroughly

Texas Insurance Code §542.056(b) requires insurers to state “the reasons for the denial.” Compare the cited policy provisions to your loss. Look for ambiguous language or inaccurate facts.

2. Gather Evidence

• Date-stamped photos and videos.

• Weather reports for Longview on the date of loss (e.g., National Weather Service storm data).

• Independent contractor or engineer reports.

• Receipts for temporary repairs and hotel stays.

3. Request a Certified Copy of Your Policy

Obtain the entire policy, including endorsements and exclusions. Insurers must provide it under Texas law.

4. Invoke the Appraisal Clause (When Appropriate)

Send written notice invoking appraisal if the dispute is only about the dollar amount, not coverage. Each side selects an appraiser; together they select an umpire. The signed appraisal award is generally binding absent fraud or procedural defects.

5. File an Internal Appeal or Re-Open the Claim

Some insurers have an escalation process. Provide new evidence and request a re-inspection. Keep communications in writing.

6. Submit a Formal Complaint to TDI

A complaint is free and often prompts a quicker response from the carrier.

7. Consult a Licensed Texas Attorney

If the carrier still refuses to pay, litigation or a bad-faith action may be necessary. Under §542.060, a favorable judgment can include attorney’s fees and interest.

When to Seek Legal Help in Texas

Indicators You Need a Lawyer

• The insurer alleges fraud or misrepresentation.

• The denial cites complex exclusions or policy language.

• Significant structural damage or six-figure losses are at stake.

• Deadlines under Chapters 541 or 542 are approaching.

Choosing the Right Texas Attorney

Under Texas Government Code §81.102, only attorneys licensed by the State Bar of Texas may provide legal advice. Verify licensure at the State Bar website and ask about experience with bad-faith or prompt-payment litigation.

Fee Arrangements

Many property-insurance lawyers work on contingency, meaning no fee unless money is recovered. Texas Disciplinary Rule 1.04(c) requires that contingency agreements be in writing.

Local Resources & Next Steps for Longview Homeowners

City and County Offices

• City of Longview Building Inspections – Permitting and code enforcement information if you need to rebuild.

• Gregg County Appraisal District – Property tax relief for damaged structures may be available under Tax Code §11.35.

Local Contractors & Public Adjusters

Use TDI’s Adjuster License Lookup before hiring. Get at least three written estimates from reputable Longview contractors familiar with International Residential Code amendments adopted by the city.

Disaster Assistance

In federally declared disasters, Longview homeowners can register with FEMA for temporary housing aid while pursuing insurance claims.

Continuing Education

TDI’s Homeowners Insurance Consumer Guide Texas Insurance Code Chapter 542 Texas Insurance Code Chapter 541 TDI Help with Property Claim Disputes

Conclusion

A property insurance claim denial can feel overwhelming, but Longview homeowners have strong rights under Texas law. By understanding prompt-payment rules, gathering solid evidence, and seeking experienced legal help when necessary, you can level the playing field and pursue full, fair compensation for storm, fire, or water damage.

Legal Disclaimer: This guide provides general information and is not legal advice. Laws can change, and every claim is unique. Consult a licensed Texas attorney for guidance on your specific situation.

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