Insurance Claim Denial

Denied, delayed or underpaid property and business insurance claims in San Antonio, Laredo and across Texas.

Texas law gives insurers firm deadlines, and when an insurer misses them or denies a valid claim without a reasonable basis, policyholders have remedies. Davila Cobos Law Firm, PLLC is a San Antonio litigation firm serving clients in San Antonio and Laredo, led by Christian A. Davila Cobos, a Texas attorney licensed since 2013 and formerly a senior attorney at a nationwide insurance defense firm, where he handled claim disputes from inception through trial.

Claims we handle

Denied or underpaid property claims
Storm, hail, wind, water and fire damage claims
Commercial property and business interruption claims
Bad faith and unfair claim-handling disputes
Appraisal and umpire disputes
Construction-related insurance disputes

Looking for help with a life insurance claim? See our page on life insurance claim denials.

Deadlines Texas places on insurers

Under Chapter 542 of the Texas Insurance Code, the Prompt Payment of Claims Act, an insurer generally must:

Acknowledge your claim, start investigating and request what it needs from you within 15 days of receiving notice (§ 542.055). Surplus lines insurers get 30 business days.
Accept or reject the claim in writing within 15 business days after it receives everything it requested, and give its reasons if it rejects (§ 542.056). If it needs more time, it must say why within that period, then decide within 45 days of that notice. Suspected arson has a 30-day deadline instead.
Pay within five business days after telling you it accepted the claim (§ 542.057). Surplus lines insurers get 20 business days.
Pay within 60 days of receiving all requested items, unless another statute sets a different period, or face liability under § 542.060 (§ 542.058).

Exceptions apply, and surplus lines insurers get longer deadlines.

What you can recover when an insurer breaks the rules

Late-payment interest and fees. An insurer that owes a claim and violates Chapter 542 owes the claim plus interest at 18 percent a year as damages, and reasonable attorney's fees (§ 542.060(a)). Weather-related property claims governed by Chapter 542A use a different rate: the judgment interest rate plus five percent (§ 542.060(c)).
Unfair settlement practices. Chapter 541 of the Insurance Code prohibits unfair claim practices. A policyholder who prevails can recover actual damages, court costs and reasonable attorney's fees, and up to three times actual damages if the insurer acted knowingly (§ 541.152).
The policy benefits themselves, plus other damages that follow from the denial or delay.

Weather claims: written notice before suit

For many hail, wind and other weather-related property claims, Chapter 542A requires written notice at least 61 days before you file suit (§ 542A.003). The notice must state what the insurer did or failed to do, the specific amount you say is owed, and the attorney's fees incurred so far (hours worked times a customary rate). Exceptions apply when there isn't enough time before limitations runs, and for counterclaims. Getting the notice wrong can delay your case, so it is worth handling before any suit is filed.

Your own deadlines

Many policies set their own notice requirements and a deadline to sue, sometimes as short as two years. Missing one can end a valid claim, so don't wait for an insurer to finish "reviewing" before getting advice.

What to do after a denial or low payment

Keep the denial or payment letter, the policy, and notes of every call and email.
Photograph the damage and keep repair estimates and invoices.
Read any release or "final payment" language before you sign or deposit anything.
Calendar every deadline in the policy and send notices in writing.
Talk to a lawyer before responding to a denial or offer you disagree with.

Why Davila Cobos Law Firm

Insurance-side experience. Christian handled construction defect, premises liability and claim disputes for a nationwide insurance defense firm before starting this one, so he knows how carriers evaluate and negotiate claims.
Litigation-first. Real estate, construction defect, business and insurance disputes in Texas state and federal courts.
Direct access. You work with the attorney handling your case, not a case manager.
Hablamos Español.

Frequently asked questions

How long does an insurer have to accept or reject my claim in Texas?

Generally 15 business days after it receives all the items, statements and forms it requested, and it must give its reasons in writing if it rejects the claim (§ 542.056). If it can't decide in that time, it must tell you why within the same period and then decide within 45 days of that notice. Different rules apply to surplus lines insurers and suspected arson.

What interest can I recover if my insurance company pays late?

For most claims, an insurer that violates Chapter 542 owes the claim plus 18 percent annual interest as damages and reasonable attorney's fees (§ 542.060(a)). For weather-related property claims under Chapter 542A, the rate is the judgment interest rate plus five percent, accruing from the date the claim was required to be paid (§ 542.060(c)).

What counts as bad faith or unfair claim handling in Texas?

Chapter 541 of the Insurance Code prohibits unfair settlement practices, such as not attempting in good faith to settle a claim when liability is reasonably clear, not giving a reasonable explanation for a denial, and refusing to pay without a reasonable investigation (§ 541.060). Texas courts also recognize a common-law duty of good faith and fair dealing in first-party claims. Whether an insurer crossed the line depends on the facts of the claim file.

Do I have to send notice before suing over a hail or storm claim?

Often, yes. For many weather-related property claims, Chapter 542A requires written notice at least 61 days before you file suit, stating the insurer's acts or omissions, the specific amount you claim is owed, and the attorney's fees incurred so far (§ 542A.003). The notice isn't required when there isn't enough time to give it before limitations runs, or for a counterclaim.

How long do I have to sue my insurance company?

It depends on the policy and the claims. Many policies set their own deadline to sue, sometimes as short as two years, and statutory claims carry their own limitations periods that can start on the date of loss, the denial or the discovery of the violation. Because the periods are short and policies differ, have the policy reviewed as soon as you receive a denial.

Do I need a lawyer to dispute a denied claim?

You aren't required to have one, but the deadlines, notice rules and policy language are technical. A lawyer can compare the denial letter with your policy and the statutory timeline, send the required notices, and handle appraisal or litigation if the dispute goes that far.

Talk to an insurance claim lawyer

Dealing with a denied, delayed or underpaid claim? Call (210) 660-8548 or email christian@davilacoboslaw.com.