What you should know when you file a claim

I want to share some more information from the Consumer Bill of Rights from the Texas Department of Insurance. What you should know when you file a claim.

  • FAIR TREATMENT. You have the right to be treated fairly and honestly when you make a claim. If you believe an insurance company has treated you unfairly, call the Department of Insurance at 1-800-252-3439 (512-463-6515 in Austin) or download a complaint form from the TDI website at http://www.tdi.texas.gov. You can complete a complaint form on-line via the internet or fax it to TDI at 512-475-1771.
  • SETTLEMENT OFFER. You have the right to reject any settlement amount, including any unfair valuation, offered by the insurance company. If you reject a settlement offer, your options include continuing to negotiate with the insurer or pursuing legal remedies, such as mediation, arbitration or filing a lawsuit.
  • EXPLANATION OF CLAIM DENIAL. Your insurance company must tell you in writing your claim or part of your claim was denied.
  • TIME FRAMES FOR CLAIM PROCESSING AND PAYMENT. When you file a claim on your policy, you have the right to have your claim processed and paid promptly. If the insurance company fails to meet required claims processing and payment deadlines, you have the right to collect 18 percent annual interest and attorney’s fees in addition to your claim amount.
  • Generally, within 15 calendar days, your insurance company must acknowledge receipt of your claim and request any additional information reasonably related to your claim. Within 15 business days after receipt of all requested information, the company must approve or deny your claim in writing. The law allows the insurance company to extend this deadline up to 45 days if it notifies you that more time is needed and tells you why.
  • After notifying you that your claim is approved, your insurance company must pay the claim within five business days. If your claim results from a weather-related catastrophe or other major natural disaster as defined by TDI, these claims handling deadlines are extended for an additional 15 days.
  • CHOICE OF REPAIR SHOP AND REPLACEMENT PARTS. You have the right to choose the repair shop and replacement parts for your vehicle. An insurance company may not specify the brand, type, kind, age, vendor, supplier or condition of parts or products used to repair your automobile. The insurance company must provide you notice of the above requirements as follows:
  • claims submitted by telephone – written notice within three business days or immediate verbal notice, followed by written notice within 15 days.
  • claims submitted in person – immediate written notice at the time you present your vehicle to an insurer or an insurance adjuster or other person in connection with a claim for damage repair
  • claims submitted in writing – written notice must be provided within three business days of the insurance company’s receipt of the notice.
  • DEDUCTIBLE RECOVERY. If another person is liable for damage to your auto and you filed a claim and paid a deductible on your own policy, your insurance company must make a reasonable and diligent effort to recover the deductible from that person within twelve months from the date your claim is paid. If not, your company must:
  • authorize you, at least 90 days prior to the expiration of the statute of limitations, to pursue your own collection efforts, or
  • refund your deductible
  • NOTICE OF LIABILITY CLAIM SETTLEMENT. Your insurance company must notify you if it intends to pay a liability claim against your policy. The company must notify you in writing of an initial offer to compromise or settle a claim against you no later than the 10th day after the offer is made. The company must notify you in writing of any settlement of a claim against you no later than the 30th day after the date of the settlement.
  • INFORMATION NOT REQUIRED FOR CLAIM PROCESSING.You have the right to refuse to provide your insurance company with information that does not relate to your claim. In addition, you may refuse to provide your federal income tax records unless your insurer gets a court order or your claim involves lost income or a fire loss.

I hope this information is helpful in the event you have to file a claim. Have a wonderful day and be safe out there.

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