Texas Insurance Claim Resource Center

After a loss: a practical checklist

• Report the claim promptly and write down the claim number, the date, and who you spoke with.
• Protect the property from further damage (tarps, water extraction) and keep every receipt.
• Photograph and video everything before and during repairs, including dates and weather reports.
• Request a complete copy of your policy, with all endorsements; exclusions and limits are often in the endorsements.
• Put important communications in writing and keep copies of every letter, estimate, and report.
• Get your own estimate from a qualified contractor, and consider a licensed public adjuster or an attorney if the claim is disputed.
• Calendar your deadlines: the policy’s suit-limitation clause and any proof-of-loss requirement.

For the full printable version, see the Texas claim documentation checklist.

How appraisal works in Texas

Most property policies let either side demand appraisal when the parties disagree on the amount of loss. Each side picks an appraiser, and an umpire resolves disagreements. Key Texas Supreme Court decisions:

• State Farm Lloyds v. Johnson, 290 S.W.3d 886 (Tex. 2009): appraisal decides the amount of loss, not liability, and appraisers may decide some causation questions in valuing the damage.
• Ortiz v. State Farm Lloyds, 589 S.W.3d 127 (Tex. 2019): payment of an appraisal award generally bars a breach-of-contract claim and bad-faith claims that seek only policy benefits.
• Barbara Technologies Corp. v. State Farm Lloyds, 589 S.W.3d 806 (Tex. 2019): paying an appraisal award does not by itself bar prompt-payment damages under Chapter 542 when the insurer was liable and paid late.
• Rodriguez v. Safeco Insurance Co. of Indiana, 684 S.W.3d 789 (Tex. 2024): in a Chapter 542A case, an insurer’s full payment of the appraisal award plus any possible statutory interest forecloses recovery of attorney’s fees.

Unfair settlement practices

Texas Insurance Code § 541.060 lists claim-handling conduct that can create liability, including:

• Misrepresenting a material fact or policy provision relating to coverage.
• Failing to attempt in good faith to settle promptly and fairly once liability has become reasonably clear.
• Failing to promptly explain the basis for denying a claim or offering a compromise.
• Failing within a reasonable time to affirm or deny coverage or to send a reservation of rights.
• Refusing to pay a claim without conducting a reasonable investigation.
• Requiring a full release in exchange for a partial payment.

Whether an insurer’s conduct crosses the line depends on the facts. An attorney can evaluate your specific situation. See also Texas insurance bad faith warning signs.

Public adjusting

• A Texas license is required to act as a public adjuster (Tex. Ins. Code § 4102.051), subject to limited statutory exceptions.
• A contractor may not act as a public adjuster, or advertise to adjust claims, for any property on which the contractor is providing or may provide contracting services (§ 4102.163).

Deductibles and contracts

• A seller of goods or services may not, without the insurer’s consent, advertise or promise to pay, waive, or rebate an insured’s deductible. Covered contracts of $1,000 or more expected to be paid from insurance proceeds must include a bold-type notice, and a violation is a Class B misdemeanor (Tex. Bus. & Com. Code § 27.02).
• The insured is required to pay the deductible (Tex. Ins. Code § 707.002).
• Sales made away from the seller’s place of business may carry a three-business-day right to cancel under the Texas home solicitation statute (Tex. Bus. & Com. Code §§ 601.002, 601.051).

Permits and codes

• Cities may not base residential building permit or inspection fees on the value of the home or the cost of the work (Tex. Local Gov’t Code § 214.907).
• The International Residential Code is the baseline municipal residential code, subject to local amendments (§ 214.212).
• Coastal work in TWIA’s designated area generally needs a TDI Certificate of Compliance (WPI-8-E) for TWIA eligibility (Tex. Ins. Code § 2210.251).

Read the full Texas permit-cost guide →

Documentation that holds up

• Texas courts generally require the insured to separate damage caused by a covered peril from damage caused by excluded causes such as wear and tear (Wallis v. United Services Automobile Ass’n, 2 S.W.3d 300 (Tex. App.—San Antonio 1999, pet. denied)).
• Date-stamped photos, storm data, test squares, and a written explanation of what caused each item of damage make that separation possible.
• Keep estimates line-item specific and tie each line to the observed damage.

Read: wear-and-tear denials in Texas →

Burden of proof and exclusions

• Tex. Ins. Code § 554.002: the insurer bears the burden on avoidances and affirmative defenses, and exclusion language is an avoidance or affirmative defense.
• Tex. R. Civ. P. 94: an insurer may not rely on an exclusion unless it specifically pleads it.
• Gilbert Texas Construction, L.P. v. Underwriters at Lloyd’s London, 327 S.W.3d 118 (Tex. 2010): insured proves coverage; insurer proves an exclusion; insured proves an exception.
• National Union Fire Insurance Co. v. Hudson Energy Co., 811 S.W.2d 552 (Tex. 1991): exclusions are strictly construed against the insurer; the insured’s reasonable construction controls.

Concurrent causation

• Texas applies a segregation rule: when covered and excluded perils combine, the insured may recover only the damage attributable to the covered peril and generally bears the burden to allocate (Wallis, 2 S.W.3d 300).
• Anti-concurrent-causation language can bar coverage outright (JAW The Pointe, L.L.C. v. Lexington Insurance Co., 460 S.W.3d 597 (Tex. 2015)).
• The doctrine does not bar recovery where the evidence would allow a jury to find the covered peril caused all of the loss (Advanced Indicator & Manufacturing, Inc. v. Acadia Insurance Co., 50 F.4th 469 (5th Cir. 2022)).
• Questions certified by the Fifth Circuit on concurrent causation, including in Overstreet v. Allstate Vehicle & Property Insurance Co., 34 F.4th 496 (5th Cir. 2022), were dismissed without answer by the Supreme Court of Texas.

Chapter 542A

• Scope: actions on claims for damage to or loss of covered property caused wholly or partly by forces of nature, subject to statutory exceptions (Tex. Ins. Code §§ 542A.001(2), 542A.002).
• Pre-suit notice at least 61 days before filing, stating the specific amount owed and fees computed from contemporaneous time records (§ 542A.003).
• An insurer may elect to accept its agent’s liability; a pre-suit election requires dismissal of the agent with prejudice (§ 542A.006).
• Fee awards are capped by the ratio of the judgment to the amount demanded: full fees at 0.8 or above, none below 0.2 (§ 542A.007).
• Prompt-payment damages: 18% per year plus fees generally (§ 542.060(a)); for Chapter 542A actions, simple interest at the post-judgment rate plus 5% (§ 542.060(c)).

More detail: Texas Chapter 542A pre-suit notice explained and the Texas insurance claim timeline.