Insurance Disputes - Whose Interpretation Is Right?
I disagree with my insurance company's interpretation of its policy. Do I have any rights?
Yes. Your insurance company's interpretation of its policy may not be binding on you. If an insurance policy is capable of more than one reasonable interpretation, courts use the interpretation that most favors the consumer.
The consumer's interpretation will be presumed correct as long as that interpretation is not unreasonable, even if the insurance company's interpretation appears to be more reasonable or a more accurate reflection of the policy's intended coverage.
Filing Claims - How Long Do They Have To Pay?
I filed a claim on my insurance policy, but I have not heard from my insurance company. Do I have any rights?
Yes. The Prompt Payment of Claims Act requires insurance companies in Texas to quickly investigate and, if owed, pay the claims of their policyholders.
Once the insurance company receives proof of a loss, it must either accept or reject the claim in writing within 15 business days and pay the claim, if owed, within 5 more business days. In addition, the insurance company must state its reasons in writing if it rejects your claim.
If the insurance company violates this law, it is liable for your attorney's fee and an 18% interest penalty along with the amount of your claim.