What to Do if an Insurance Company is Stalling in Texas: Best Steps to Take

Top Takeaways

• When experiencing insurance claims delays, call the insurance company immediately to see if there is a simple administrative issue that needs to be resolved and ask the insurer for a formal denial letter if the delays continue.
• Document everything related to interactions with the insurance company (dates, names, and a summary of each conversation) so that if you have to escalate the matter or pursue litigation, you will have a stronger position.
• Seek legal assistance from an attorney who specializes in insurance disputes and file a complaint with the Texas Department of Insurance if the insurer continues to delay your claim.

How to Act if an Insurance Company is Stalling Your Claim in Texas

If you believe your insurance company or insurance carrier is reasonably delaying payment on your claim, there are many things you can do to act to correct the situation. First, you should contact the insurance company to determine if there are any potential administrative problems with the claim that could be preventing it from being paid. Many times, claims are delayed because of simple mistakes such as miscommunication and/or missing documentation.

 If your claim is still being delayed, you should formally ask the insurance company to write you a formal denial letter. The denial letter will be your proof that the insurance company officially denied your claim, and it will be important if you choose to further pursue your claim.

Documenting All Interactions with Your Insurance Company

As you go through the claims process, document each and every interaction with the insurance company. Keep track of the date and name of each person you speak to, and a summary of the conversation. Documentation of all interactions with the insurance company will help you build a strong case if you choose to pursue your claim through escalation or litigation.

Why Insurance Companies Stall Claims

Insurance companies use tactics to stall claims to manage their liability and increase their profit margins. One of the most common tactics is to require the policyholder to provide excessive documentation. While it may seem reasonable for the policyholder to provide documentation to prove their claim, requiring too much documentation can slow down the claims process and may cause the policyholder to become frustrated and simply drop the claim rather than continuing to pursue it.

Another reason insurance companies stall claims is to delay payment to the policyholder until the statute of limitations expires and the policyholder is unable to pursue the claim. Insurance companies will use this tactic to limit their financial exposure and ultimately increase their profit margin.

How the Texas Insurance Claims Process Works

The Texas insurance claims process works in the following way. When a claim is filed, the insurance company must acknowledge the claim and assign a claim number to the claimant within fifteen days of receiving the claim. Once the claim is assigned, the insurance company begins the investigative stage of the claims process. During this stage, the insurance company will review all available documentation and interview witnesses to assist in determining whether to approve or deny the claim.

Following the investigation, the insurance company has fifteen days to either approve or deny the claim. If the claim is approved, the insurance company has five business days to complete the payment to the claimant. If the claim is denied, the claimant may file an appeal with the insurance company. If the claimant chooses to file an appeal with the insurance company and the insurance company denies the appeal, the claimant may choose to file a lawsuit against the insurance company.

Claims That Are Most Likely to Be Delayed

There are certain types of claims that are more likely to be delayed than others. Some examples of claims that are commonly delayed include:

• Car accidents
• Damage to property
• Medical bills
• Personal injury lawsuits

These types of claims are commonly delayed because the potential amount of money the insurance company will have to pay out to the claimant is higher.

As a result, insurance companies will do whatever they can to delay the payment to the claimant.

Acting Immediately Following a Car Accident

If you were involved in a car accident, you must act immediately to protect your rights and to ensure a smooth claims process. First, you should seek medical treatment for any injuries you suffered in the accident. Your health and safety come first. Next, you should contact law enforcement and file a report regarding the accident. Provide the officer with as much detail as you can remember regarding the accident. You should also take photographs of the damage to all vehicles involved and obtain the contact and insurance information of the other driver(s). Finally, you should notify your insurance company immediately and provide them with all of the necessary documentation and evidence to support your claim.

Insurance Company Denied My Claim – Now What?

If your insurance company denied your claim, you have the right to appeal the decision. To begin, you should carefully review your insurance policy to determine if you meet the requirements of your policy. Next, you should gather all of the documentation and evidence you obtained in support of your original claim. Examples of documentation and evidence you should gather include medical bills, police reports, and witness statements. Contact your insurance company and request a written explanation of the denial. Review the written explanation carefully to determine if there was a misunderstanding or a lack of information regarding your claim. If you are not satisfied with the written explanation provided by the insurance company, you should consider seeking legal representation from an attorney specializing in insurance disputes. A knowledgeable attorney can guide you through the appeals process and advocate for your interests to increase the chances of a successful appeal.

Time Limits to Process Insurance Claims in Texas

Texas law provides specific time limits for insurance companies to process claims. Insurance companies are required to acknowledge a claim and provide the necessary paperwork within 15 days of receipt of the claim. The acknowledgement by the insurance company initiates the investigation period. The investigation period ends once the insurance company has received all of the information necessary to make a determination. The insurance company has 15 days to approve or deny a claim after all necessary information has been provided. In addition, Texas law allows insurance companies to extend the approval/denial period by an additional 30 days; however, the insurance company must provide a written explanation for the extension. 

Payment of an approved claim must occur within 5 business days after approval. If the insurance company fails to comply with these time limits, the policyholder may be entitled to statutory penalties. If the delay is beyond 60 days from the date the insurance company receives all of the required documentation, the policyholder may be entitled to double the amount owed under the policy. Having a basic understanding of the time limits set forth in Texas law will allow you to monitor your claim and ensure the insurance company is meeting its obligations to you.

Ways to Speed Up Your Insurance Claim

If you feel that your insurance company is stalling your claim, you can take several steps to speed up the process. First, you should compile and submit to the insurance company all necessary documentation and evidence to support your claim. Evidence that supports your claim may include photographs of property damage or injuries, and receipts for any expenses that you have incurred as a direct result of the incident. Providing the insurance company with all of the necessary evidence and documentation will help facilitate the claims process and will help you to obtain the compensation that you deserve.

Second, you should contact a personal injury attorney or insurance claim attorney who can provide you with the legal assistance and advocacy you need to pursue your claim. The attorney will help you navigate the complex claims process and will communicate with the insurance company on your behalf to advocate for your interests and the interests of your family.
Third, you should act promptly and follow up regularly with the insurance company. 

Demonstrating to the insurance company that you are committed to pursuing your claim will put pressure on the insurance company to move the claims process along and to provide you with the compensation you deserve.

How to Act if Your Insurance Company Has Denied Your Claim

If your insurance company has denied your claim, you have several options for proceeding. First, you should review your insurance policy to determine if you meet the requirements of your policy. Second, you should gather all of the documentation and evidence you obtained in support of your original claim. Third, you should contact your insurance company and request a written explanation of the denial. Fourth, you should contact an attorney specializing in insurance disputes and let them assist you in appealing the denial. Fifth, you should file a complaint with the Texas Department of Insurance.

Proactive Steps to Resolve Insurance Claims

Taking proactive steps can assist you in resolving your insurance claim more efficiently. Contacting the insurance company to inquire about the status of your claim is one step you can take. You can ask them to expedite the process. If you are able to get the information you need quickly from the insurance company, you will likely be able to resolve your claim faster.

Seeking Legal Representation

When your insurance company stalls your claim or denies your claim without any justifiable reason, it is advisable to seek representation from an experienced insurance dispute attorney. The attorney can explain the options you have legally and will advocate for you in negotiations with the insurance company. In certain circumstances, it may become necessary to bring a lawsuit against the insurance company, which would be appropriate if the insurance company acts in bad faith or unjustly denies claims.

Many attorneys provide complimentary consultations at no cost to you. A free consultation with an attorney can give you a better understanding of how strong your case is and what possible outcomes exist. If you choose to hire an attorney, the contingent fee system allows you to retain the services of an attorney without having to pay the attorney’s fees up front. Instead, the attorney receives a percentage of the total amount recovered.

Having an experienced insurance dispute attorney advocating on your behalf can greatly increase your chances of achieving a positive result. The attorney can battle the insurance company’s legal department to negotiate a reasonable settlement, and can take legal action on your behalf if the insurance company is unwilling to agree to a settlement. When you hire an attorney, you are assured that your rights will be represented and you will have a greater chance of recovering the compensation you are entitled to.

Texas Insurance Dispute Attorneys

If you find yourself in a situation where your insurance company is denying your claim or delaying your claim, obtaining the services of an experienced insurance dispute attorney in Texas is highly recommended. The attorney can inform you of your rights and options, negotiate with your insurance company, and represent you in court if necessary.

When searching for an attorney to handle your insurance dispute case, look for an attorney who specializes in handling insurance disputes and has a proven track record of successful results. Many attorneys will provide a free consultation, which allows you to discuss your case with the attorney without any upfront charges. During your initial consultation with an attorney, you will have the opportunity to learn valuable information and gain a better understanding of what course of action is most suitable for you. Having a skilled attorney representing you can greatly increase your opportunities of achieving a positive result and securing the compensation you are entitled to.

Documentation of All Communication and Evidence

It is very important to keep a detailed record of all communication with your insurance company while you are attempting to deal with a stalling insurance company. You should document all telephone calls made to your insurance company. These documents should include the date, time, and name of each representative you spoke with. Maintaining a record of all interactions with your insurance company is beneficial in tracking the progress of your claim and providing a history of your attempts to resolve the matter.

Another key element to maintaining a record of all communication is creating a paper trail of your interactions with your insurance company. Each time your insurance company verbally agrees to perform a task or follows through with a promise to complete a particular task, you should follow up with an email or a letter confirming the agreement and documenting any subsequent agreements reached. This paper trail is beneficial if it becomes necessary to escalate the matter to a higher authority, including filing a lawsuit against your insurance company.

Additionally, it is helpful to write a letter to your insurance company asking them to respond by a certain date, which will create a deadline for your insurance company to respond. After sending important mail, it is also a good idea to follow up with a telephone call to remind your insurance company of the mail and confirm they received it. Keeping all of your communication professional and courteous will increase your opportunities of achieving a positive result with your claim and will show the insurance company that you are serious about achieving a fair resolution.

Filing a Complaint With the Texas Department of Insurance

If your insurance company continues to stall your claim after your consistent follow-throughs, you have the option to file a complaint with the Texas Department of Insurance. To file a complaint, you will need to gather all relevant documentation, including your insurance policy, all of your correspondence with your insurance company and any other documentation you may have regarding the delays caused by your insurance company. The documentation you submit is critical in helping to substantiate your complaint and to encourage the Texas Department of Insurance to investigate your complaint.

The Texas Department of Insurance investigating your complaint may result in various actions being taken against your insurance company. Filing a complaint is an excellent way to defend your rights and help to create a safer and more responsible environment for insurance companies to operate in. In addition to defending your rights, filing a complaint can help to prevent other consumers from experiencing similar problems with their own insurance companies.

Consequences of an Insurance Company’s Delayed Claim Payments

In Texas, insurance companies that cause unnecessary delays in making payments to their insureds are liable for a variety of consequences under the law. If your insurance company delays making payment of your claim for over sixty days (after they receive all necessary documentation), you may be eligible to collect a large amount of interest on the delayed payment, attorney’s fees, and other damages.

A knowledgeable insurance dispute attorney can help you understand your rights and help you collect the compensation you are owed. Do not allow an insurance company to use stalling tactics to avoid paying you for legitimate medical bills and other expenses. Seek the assistance of a knowledgeable attorney today. By holding your insurance company accountable, you can ensure you receive fair treatment and a timely resolution of your insurance claim.

Possible Actions to Pursue Regarding Bad Faith Claims

If an insurance company unreasonably delays or denies a claim without a valid basis, the insurance company may be acting in bad faith. Acting in bad faith occurs when an insurance company does not act reasonably and in good faith during the claims process, whether it is by denying a valid claim or by unreasonably delaying the payment of a valid claim. In this type of circumstance, you have the right to sue your insurance company for bad faith, particularly if your insurance company fails to meet its contractual obligations.

To establish a bad faith claim, you must prove that the insurance company did so with the intention of causing you to lose money or to otherwise deceive or harm you. As part of establishing proof of a bad faith claim, you must document all of your interactions with your insurance company, including any unreasonable delays or denials of your claim without a valid explanation. Such documentation can be used to demonstrate that the insurance company acted intentionally to deceive or harm you.

If the court finds that the insurance company acted in bad faith, you may recover the full amount of your original claim. Furthermore, you may be entitled to punitive damages. Punitive damages are assessed to punish the insurance company for engaging in wrongful conduct and to deter the insurance company from engaging in similar conduct in the future. By bringing a bad-faith lawsuit, you may be able to recover additional compensation for the wrong committed by your insurance company, in addition to the value of your claim.

Common Questions

What Should I Do if My Insurance Company is Stalling in Texas?

Why Do Insurance Companies Stall Claims?

What Types of Insurance Claims Are Most Likely to Be Delayed?

How Long Does an Insurance Company Have to Process a Claim in Texas?

At What Point Should I Hire a Lawyer to Represent Me in My Delayed Insurance Claim?