Frequently Asked Questions
What is a deductible?
- “A deductible is the amount of a claim that you must pay yourself. For instance, if you have a $1,000 claim and your policy has a $300 deductible, the insurance company will deduct $300 from your claim amount and pay you $700. You have different deductibles for each type of coverage.”
- Texas Department of Insurance
Can my contractor waive my deductible?
- “No. A deductible is part of your home insurance policy. It’s illegal for contractors to waive your deductible or help you avoid paying it.”
- Texas Department of Insurance
What should I do if my contractor offers to waive the deductible?
- “Talk to your insurance company first. You can also report it to the Texas Attorney General’s Consumer Protection Hotline at 1-800-621-0508. Contractors who illegally waive deductibles could be fined or go to jail.”
After I file my insurance claim, what should I expect ?
“Texas law sets deadlines for insurance companies to act after you’ve filed a claim. Your company must:
- Tell you that it got your claim within 15 days. The company may ask you for a signed, notarized proof of loss form. You’ll need to list your damaged or lost items. Don’t forget to include small items like kitchen utensils and bathroom accessories. The company may ask you for other information. To help the claim process go smoothly, provide all the information as soon as you can.
- Send an adjuster to look at your damage. The adjuster will decide how much damage you have and estimate the cost to repair or replace your property. The insurance company will base its payment on the adjuster’s estimate. After the company assigns an adjuster to your claim, the adjuster will probably be your main contact with the company. If the damage turns out to be worse than the adjuster originally thought, you or your contractor can talk to the adjuster about raising the estimate.
- Accept or deny your claim within 15 business days of getting all the information it needs from you. If the company denies your claim, it must tell you why in writing. The deadline may be longer after major disasters.
- Send you a check within five business days after it agrees to pay your claim. If the insurance company doesn’t meet the payment deadline, you can sue the company for the amount of the claim, plus interest and attorney fees.
There are some exceptions to the deadlines:
- A company that needs more time can take 45 days to decide whether to pay your claim. It must tell you the reason for the delay.
- If a company suspects arson, it has 30 days to accept or deny your claim.
- A surplus lines company has 20 business days to pay your claim after it agrees to pay.
- TWIA has 60 days to tell you whether it will accept or deny your claim. It may ask you for more information. Once it’s gotten the information it needs and has accepted your claim, it has 10 days to pay.”
What can I do if I disagree with My Adjuster’s estimate for repairs?
“If you disagree with the adjuster’s estimate or the amount the company is offering to pay you, tell the insurance company why. You might be able to work things out by talking with the company or the adjuster. If that doesn’t resolve the issue, here are your options:
- Ask for an appraisal. The appraisal process is for disputes about the amount of your claim. It isn’t for disputes about whether your policy covers a loss. If you use appraisal, you and the insurance company each hire an appraiser. The two appraisers then choose a third appraiser as an umpire. Your appraiser and the company’s appraiser each estimate the amount of your loss. If the estimates are different, the umpire makes the final decision. The umpire’s decision is binding on both you and the insurance company. You pay for your appraiser and half of the umpire’s expenses.
- File Complaint to the Texas Department of Insurance
- Resolve your issue in court. You might have to file a lawsuit to resolve the issue. If the damage was caused by a disaster, you must tell the company in writing at least 61 days before you sue. You can give less notice if waiting would cause you to miss the deadline for filing a suit.
If your claim is for less than $10,000, you can use Justice Court. Justice Court is a special court that handles small-claims disputes. You don’t need an attorney, but you have to pay a filing fee and other court costs in advance. If you win, you can get that money back. For more information, call your county justice of the peace office.” – Texas Department of Insurance
If I have damage to my home under an insurance claim, do I have to put it back exactly the same?
- No, while its likely your insurance policy will only owe to go back to a “Pre-Loss” state, Dwyer Restoration will guide you through the material selections and change orders prior to commencement of repairs. This is where folks often see the “Silver Lining” and take the opportunity to correct or alter items in the home that they have always wanted.