Houston First Party Insurance Claims Denial Lawyer

Claims Against Your Own Insurance Policy Are Different

When you make a first-party insurance claim vs a third-party insurance claim, the rules that the insurance company must play by are entirely different.  States, such as Texas, have specific codes that lay out requirements insurers must follow when dealing with their own insurers and provide specific penalties if they fail to do so. This helps to level the playing field in a situation where the insurance company would otherwise have a much more lop-sided advantage of bargaining power since they write the contracts.

There are two main types of insurance where you may find yourself in a first-party claim situation: uninsured/underinsured motorist claims (UM/UIM claims) on an auto policy and property loss insurance such as home, renter, or business property insurance. UM/UIM claims are treated differently due to a requirement that a jury must reach a damage amount finding before a claim can truly be presented. This article will focus on the other type—property insurance claims. Property insurance claims come in the form of homeowners insurance claims renter’s insurance claims and, commercial property insurance.  The types of claims they face are very similar and treated similarly for the most part.

What Does Homeowners Insurance Cover?

Homeowner’s insurance policies typically provide coverage for damage to your home, your property inside the home, and liability coverage in the event you are sued. However, it is not without limitations. Homeowner’s policies are not all created equal. Depending upon where you live and what options you select when insuring your home, you may or may not find yourself covered when an unforeseen disaster strikes. How much you pay and what coverage you can obtain often depends upon factors such as where you live and when your home was built. Additionally, most homeowner’s policies have a deductible that may vary depending on the type of claim you are making. Thus, it is important to check your specific policy and ask questions of your agent when you acquire coverage.

Does My Homeowner’s Insurance Cover Flood Damage?

Flood insurance is not typically included in the standard homeowner’s insurance policy. You usually must purchase separate optional flood insurance coverage if you wish you insure your home against floods. In known flood plains—where the risk of flooding is higher—you may not find a private insurer who will insure you. In this case, you may have to purchase State-provided insurance.  Further, if you live on a beach and your older home was built before certain restrictions were set on minimum building height, you may not be able to find a private insurer who will insure it.

Does My Homeowner’s Insurance Cover Water Damage from Freezing and Pipes Bursting?

Most homeowner’s insurance policies will cover damage done as a direct result of a freeze such as broken pipes and water damage.  However, if the water damage comes from some other source, such as heavy precipitation caused flooding that got into your home, that would not be covered.

Will My Homeowner’s Insurance Fix My Roof Due to Hail Damage?

Hail damage is a weather event that your homeowner’s policy may or may not cover. Depending upon where you live, hail damage may be excluded from the typical policy. Unless you pay for additional coverage in those places, hail is excluded. Certain northern States experience a high volume of hail so the private insurers will not cover it absent a separate policy and premium. State insurance options may be available for purchase in these areas.

Will My Homeowner’s Policy Cover Fire Damage?

If your home is destroyed or damaged by a fire, typically your homeowner’s insurance will cover this.  It is often referred to in the policy as “content insurance” or “personal property insurance.” However, you need to have a detailed inventory of any high-valued items and documentation of their value if you want to be able to prove the cost of what you lost. An insurance company may deny your claim or even accuse you of insurance fraud if you are claiming a bunch of expensive property was lost but they can find no evidence of it in the fire remains. Fire insurance also typically covers lightning damage and fires caused by lightning. If your home is completely destroyed and/or unlivable, They will often cover the cost of living expenses incurred while the home is being repaired.

Will My Homeowner’s Policy Cover Windstorm Damage?

Damage from high winds caused by tornadoes and/or hurricanes can be high risk in certain parts of the country like coastal areas or tornado alley.  As a result of this increased risk, windstorm coverage is often excluded from private homeowner’s insurance policies. A supplemental policy may often be purchased from the state in which the home is situated. You should check your policy specifically to see if you need to seek additional coverage.

What is Liability Insurance Coverage in Homeowners Policy?

Personal liability insurance in a homeowner’s policy is liability insurance that covers the named insureds in the event they become liable to someone else for causing their injuries.

What Does Renter Insurance Cover?

The renter’s insurance covers the personal property within the rented space. If you are renting and have this coverage, then you have protection in case a fire or some other event occurs that causes the loss of your personal property. It will not pay to repair damage to the rented structure itself. It may also contain personal liability insurance.

What Does Commercial Property Insurance Cover?

Commercial property insurance is essentially homeowner’s insurance but for businesses. It will pay for the damages to the building incurred as a result of the ‘covered loss.’ The personal injury liability coverage also protects against liability incurred while advertising. In addition, it is common for there to be ‘business interruption’ coverage.  This coverage pays for losses incurred while the property is being repaired and cannot be used such as the COVID shutdown claims.

What Can I Do if There is a Coverage Dispute?

Coverage Disputes may arise for a couple of different reasons. First off, if you fail to pay the bill timely to renew or purchase the wrong type of insurance, coverage will be denied. Second, if you have a catastrophic event that encompasses damage that falls under more than one possible coverage type. For example, if the wind rips off your roof and allows rain and debris to fall in and cause property damage, does this fall under windstorm or standard homeowners as rain damage? Or, if your home is hit by a surge of water from a hurricane, should that be covered by flood insurance, windstorm insurance, or homeowner’s insurance? Questions such as these can give rise to a wrongful denial of coverage. If you experience a coverage dispute, contact an insurance claim denial lawyer to evaluate your coverage and see if it applies.

What Can I Do if My Claim is Wrongfully Denied?

Most States have enacted Insurance Codes that regulate insurer conduct when it comes to evaluating claims.  Texas imposes an 18% penalty on carriers for failure to follow certain response deadlines. Attorney’s fees and other remedies may be available when an insurer fails to follow the Texas Insurance Code. If you feel like you are getting the run-around, talk to an insurance claim denial attorney today to see if you may have legal recourse.

Free Consultation

Certain types of insurance disputes and coverage denials may give rise to a cause of action for unfair settlement practices and/or insurer bad faith. If you are getting the runaround by an insurance adjuster, some insurance bad faith attorneys will offer a free consultation to determine whether you have a claim. Call us to connect you with an insurance claim denial lawyer to discuss your rights today.

Note: some cases may be referred to another law firm with the written consent of the client if we cannot assist.