09/05/2024
How to Dispute Denied Hail and Wind Roof Insurance Claims
Hello neighbors! My name is KJ, and I am the owner of Texas Water Doctor, a licensed IICRC water restoration technician. If you’ve recently experienced storm damage and your roof insurance claim has been denied, don’t worry—you’re not alone. Here’s a guide to help you understand your rights and the steps you can take to dispute a denied claim.
1. Breach of Contract
When an insurance company fails to honor the terms of your policy, it constitutes a breach of contract. This can happen if they deny a valid claim without a reasonable basis. Document all communications and gather evidence to support your claim.
2. Unfair Settlement Practices
Under Texas Insurance Code 541.060(a) and 541.151, unfair settlement practices include:
Misrepresenting material facts or policy provisions.
Failing to attempt in good faith to effectuate a prompt, fair, and equitable settlement.
Not providing a reasonable explanation for the denial of a claim12.
3. Misrepresentation of Insurance Policy Violations
According to Texas Insurance Codes 541.061 and 541.151, it is illegal for an insurer to misrepresent the terms or benefits of an insurance policy. This includes making untrue statements of material fact or failing to disclose pertinent information.
4. Prompt Payment of Claims Violation
Texas Insurance Code 542.060 mandates that insurers must pay claims promptly. If they fail to do so, they are liable to pay the policyholder the amount of the claim plus interest and attorney’s fees.
5. Breach of Duty of Good Faith and Fair Dealing / Bad Faith
Insurers have a duty to act in good faith and deal fairly with policyholders. Violations under Texas Insurance Codes 541.152 and 542.060, as well as Rule 47 of the Texas Rules of Civil Procedure, can include failing to properly investigate a claim or denying a claim without a reasonable basis. If proven, you may be entitled to monetary relief of $250,000 or less and damages of $75,000 or less.
Steps to Take
Review Your Policy: Understand the terms and conditions of your insurance policy.
Document Everything: Keep detailed records of all communications and gather evidence of the damage.
File a Complaint: Submit a complaint with the Texas Department of Insurance.
Seek Legal Advice: Consult with an attorney who specializes in insurance claims.
If you need assistance with water damage restoration or have questions about disputing a denied claim, feel free to contact me, KJ, at Texas Water Doctor. You can reach me at 469-215-7860. We’re here to help you navigate through these challenging times.
Stay safe and take care!