Filing a Claim

Filing a Claim

Texas law sets deadlines for insurance companies to act after you’ve filed a claim. Companies must:

• Respond within 15 days of the date it received your claim in writing. It will probably ask you to document your loss.
• Accept or reject your claim within 15 days after you submit any requested documentation
• Send your check or draft within five business days after it agrees to pay your claim.

A company that cannot meet these deadlines must send you a notice explaining why. The company then has 45 days to either approve or reject your claim.

If the insurance company rejects your claim, it must explain the rejection in writing. If the company says your policy doesn’t cover the loss, ask to see the policy language that they used to make the decision. A court usually will order the company to pay if the language is unclear and the policy could reasonably be read in your favor.

Note: The prompt payment law does not apply if another driver’s insurance company is paying the claim. However, the company is still required to act in good faith and to make a prompt and fair settlement.

Accidents Caused by Other Drivers

If you were in an accident caused by another driver, the other driver’s insurance company should pay the following costs, up to the liability policy’s limits:

• repair or replacement of your car
• car rental while your automobile is being repaired
• your medical and hospital bills
• wages lost because of an injury
• compensation for pain and suffering if anyone is hurt.

If the other driver’s insurance won’t cover all your medical bills, file a claim for the difference against your PIP coverage and (for amounts greater than that) against your UM/UIM coverage or your health insurance policy.

If the other driver’s policy won’t cover all of your auto repairs, file a claim against your collision or UM/UIM coverage for the difference (minus your deductible) between the damage to your car and what the other driver’s policy will pay.