How to File a Property Damage Insurance Claim: An Ultimate Guide

When you insure your property, the insurance company will pay you after you suffer a covered loss. This usually means your property was damaged or destroyed in a manner covered in your insurance policy.

But your insurance company will not automatically pay you after your loss. You must file an insurance claim that explains what happened and describes the extent of the damage to your property. This guide describes the basic steps for preparing and filing insurance claims.

What May Be Covered by Texas Homeowner's Insurance?

The coverage offered in a Texas homeowners policy could depend on the insurer and your location. But most policies will pay for:

• Dwelling: When your home gets damaged or destroyed in a covered peril, the insurer will pay for repairs or cover its replacement cost up to the policy limits. Dwelling coverage includes attached structures like garages or decks but may or may not cover detached structures like a shed. This coverage includes systems in your home such as your air conditioning and heating system if they get damaged or destroyed in a covered peril.
• Personal Property: When your personal belongings get damaged, destroyed, or lost due to a covered peril, the insurer will pay you to have them repaired or replaced. The value used by the insurance company is based on the market value of the damaged items and does not include the sentimental value. Your homeowner's policy may not cover unusually valuable personal belongings, such as artwork or baseball cards, so you may need separate coverage for them.
• Additional Living Expenses: When the covered event renders your home uninhabitable, the insurance company will pay for living expenses above and beyond your normal expenses. Examples of additional living expenses include costs for hotel rooms, parking, and restaurants. This coverage pays only additional living expenses, so it will not pay your ordinary living expenses like the utilities or mortgage at the home where you cannot live.
• Trees and Shrubbery/Debris Removal: The insurance company will pay to clean up debris on the insured property that resulted from a covered peril. The insurance company will usually cap the amount it spends on debris removal at a fixed dollar amount, like $5,000, or a percentage of the policy limits, like 5%. Your insurance company should hire a debris removal company when it hires a contractor to repair your home.
• Water Damage: The insurance company will pay to repair water damage to your property that happened in connection with a covered peril. The insurer will usually cover water damage from broken plumbing inside the home, like a broken water pipe, but will not cover water damage from broken plumbing outside the home, like a broken water main. Water damage from firefighting as well as smoke damage from the fire usually fall under your fire coverage.

Remember that these losses must occur during a covered event. If the event is not covered, the loss is not covered.

Things Standard Homeowners Policies Don't Cover

The losses not covered by your homeowner's insurance will vary depending on the insurance company and where you live. For example, if you live on a floodplain, your policy will probably exclude floods. In these areas, you will need to buy a separate flood insurance policy.

This can complicate a claim if your property suffers multiple forms of damage. If a storm causes wind and water damage to your home, you may need to file multiple insurance claims. A claim under your homeowner's policy will cover wind damage and a claim under your flood insurance will cover flood damage.

Other common exclusions include:

• Earthquakes
• Sewage main and water main breaks
• Sewage backups
• Underground subsidence and sinkholes
• Damage during renovations
• Pest damage and infestations
• Wear and tear

You will need to review your policy after an event to determine what is excluded.

How to File a Property Damage Claim

Starting a property damage claim is not difficult. Start your claim by calling the insurance company or opening an insurance claim on the insurer's website. But after this point, your actions could affect what you receive.

1. Report Any Crime to the Police

If your loss resulted from theft, burglary, arson, vandalism, or another crime, report the crime to the police before doing anything else. You will do this for a few reasons.

First, you need to get the police started on solving the crime. By reporting your loss to the police, officers can open an investigation.

Second, the police need to gather evidence of the crime before you begin documenting your losses. For example, if your home was burglarized, police officers will need to take pictures and gather fingerprints before you or the claims adjuster touch anything in the house.

Third, the police report will help you document the crime. If you do not report the crime to the police, your insurer could raise questions about whether the crime actually happened. In fact, your policy may require you to report the crime if you plan to pursue the claim process.

Finally, walking around with the police officers will help you note all the lost, destroyed, or damaged items. When you file your claim, you will have a more complete list of your losses.

2. Notify Your Homeowner’s Insurance Company

Insurance companies can pay for losses only after you go through the claim process. This process usually begins with phone calls or online claims.

During this initial contact, you will probably need to answer only a few questions. You will give your name and a description of what happened. The insurer can use this information to determine your coverage and make sure your premiums are paid.

If your losses happened in a natural disaster, your insurance company's phone will probably be very busy since other people also need to start their claims. You should keep trying to get through. The sooner you start your claim, the sooner your insurer can pay you.

3. Secure the Premises and Your Personal Property

Your insurance policy might require you to make temporary repairs to prevent further damage. If the insurance company accepts your claim, it will reimburse you for these repairs.

For example, suppose wind damage broke a window in your house. If you do not repair your window, rain could get into your house and cause water damage to your floor. Your homeowner's policy probably requires you to make temporary repairs to the window to prevent further damage the insurer must pay for.

4. Document Damaged Property

Make a list of the property you intend to include in your insurance claim. You should also document its condition with photos and video. For big-ticket items, try to find receipts or credit card statements that show how much you paid for them. These documents can help you prove the value of your losses.

5. Demonstrate Damage to the Insurance Adjuster

Insurance adjusters protect the insurance company's profits. They do this by making sure the insurer pays only valid claims and only the minimum amount required under the policy. To make sure you get the best possible outcome from your claim, you need to demonstrate damage to the adjuster.

The best opportunity for you to do this will happen when the claims adjuster sends an appraiser to look at the damage you suffered. Point out everything that was damaged and make sure the appraiser gets photos.

What Happens After You File a Property Damage Insurance Claim?

After you file a claim, the insurance company assigns a claims adjuster to your case. The adjuster investigates your claim and tells you whether the insurer will accept or deny it. If the insurer accepts the claim, the adjuster determines how much you will get paid.

An appraiser will inspect your home and personal property. Based on the appraisal, the adjuster will determine the value of your insurance payout.

Your insurer will provide you with a list of approved contractors, but you do not need to use the suggested contractors. If you hire your own licensed contractors, follow the policy to make sure the contractors get paid. In most situations, you will need to submit a contractor's bid to the adjuster and receive approval before the work can start.

Your insurance provider should also explain how to document any out-of-pocket expenses. For example, you can get reimbursed for any necessary repairs you made before filing your claim.

When all the repairs have been completed, document the final condition of your repairs. Take photos and video of the finished job so you have a record of what was done. For the most part, insurers will not send someone else out at the end of the claim process. Instead, it will be your responsibility to document the end of the job.

The only step remaining will be to pay you for any remaining losses.

When and How Should You Get Payments?

The insurer will usually pay contractors and debris removal companies directly. The insurer will need to review the contractor's bid before work commences. But once that happens, the contractor will usually work with the insurer for payment.

The payment process for you to get paid for damaged or destroyed personal property will be more complicated. The insurance policy will define the amount you get paid. Insurance policies either pay the actual cash value or the replacement cost for the property. These property payments will get made after an appraiser has determined the value of your property.

An actual cash value payment will be based on the current market value of the property. So if you have a ten-year-old refrigerator, the actual cash value might be less than 50% of the cost of a new refrigerator.

A replacement cost payment will be based on the cost to replace the damaged or destroyed property. Again, if you have a ten-year-old refrigerator, a replacement cost policy will pay 100% of the cost of a new refrigerator.

You will also receive insurance payments for the out-of-pocket expenses you incurred, including an initial payment for any temporary repair work.

What Are the Limits in Property Damage Claims in Texas?

Texas law also imposes limits that may apply to certain claims. These limits apply when someone's actions damaged your property.

Suppose someone drives off the road and into your house. This situation involves two claims. The first claim is between you and your property insurance company. These limits do not apply to this claim.

The second claim is between you and the at-fault driver. This is the situation where these limits will apply.

Texas Statutory Limits

Texas limits the time you have to file a property damage lawsuit. Under Texas Civil Practice & Remedies Code section 16.003, the statute of limitations for property damage is two years from the date of the damage. If you miss the deadline, a judge can dismiss your case.

Comparative Negligence

Comparative negligence arises if the at-fault party blames you for the property damage. In the example, suppose local government officials placed a reflective arrow by your fence to warn drivers of a sharp turn. You removed the sign. The at-fault driver can argue that you share the blame. As a result, you might not receive your full damages.

The Texas Tort Claims Act

The Texas Tort Claims Act gives people the right to sue the state government for harm caused by it. It limits the damages you can recover. Suppose that a city bus hit your house in the example above. The Texas Tort Claims Act will limit your damage claim against the city.

Tips for Managing Property Damage Claims

The way you prepare and document your claim can affect when and how much you get paid. And the communications you have with the adjuster can determine whether the insurer even accepts your claim. Some steps that can improve your odds of a successful claim include:

1. Know Your Rights

You should be aware of your rights under the policy and the Texas Consumer Bill of Rights for Homeowners. These documents outline your rights to information and payments from your insurer. They also define when the insurance company can or cannot raise your rates.

The "consumer bill of rights" covers the regulations all insurers must follow — insurers cannot disclaim or change any of their obligations outlined in the consumer bill of rights.

The more clearly you know your rights, the more you can protect yourself when insurance companies try to take advantage of you. Some key provisions of the consumer bill of rights include:

• The Texas Department of Insurance posts complaint ratios for insurance companies
• It also posts financial health information about the insurance industry
• It regulates the licensing for every insurance agent
• Insurers cannot mislead you or lie to you

Additionally, insurers must inform you about any rate increases before the payment comes due.

2. Don't Throw Away Any Damaged Property Until the Insurance Company Has Inspected It

Insurance companies can pay for only verified losses. Make sure you keep your damaged or destroyed property until the company has inspected it. This might simply mean that you send photographs or videos of the property to the adjuster so they can see it virtually.

But if an appraiser has been assigned to your case, you will probably need to keep it. If it was destroyed, you may even need to keep the pieces until you can show them to the appraiser. Although this step may be burdensome, it will help validate your claim.

3. Keep a Log of Contacts and Communications with Your Insurance Company

If an insurance claim gets denied or underpaid, you may need to litigate against it. To win a lawsuit, you may need to prove who said what and when it was said. A communication log will help you refresh your recollection about:

• Who you talked to
• When you talked
• What was discussed

Even if you never litigate against the insurance company, a communications log can be helpful. If the claim process seems to be dragging, you can look back at your log to figure out how long the process has taken.

4. Communicate with Your Insurance Company in Writing and Confirm Telephone Conversations with a Letter

Another step toward "papering the file" in case a dispute arises is to communicate with the insurer in writing as much as possible. In this context, writing can include emails, text messages, and letters. But for electronic communications, make sure you make printed copies in case the electronic copies get deleted.

You should also confirm all telephone conversations with a written message. This written message should restate what you discussed and the understanding you took from it. You should also invite the company to respond if it disagrees with your understanding.

5. Be Wary of Signing a Release of Your Claim Without Consulting an Attorney

Insurance companies have some ways to resolve claims before you fully understand the extent of your losses. One way they do this is to offer an on-the-spot settlement during your appraisal. The other way insurers draw you into a release is by offering a final payment before your repairs have finished.

By rushing you, insurers are trying to close your case before you have a chance to find and claim all of your losses. In either case, you should consult a property damage lawyer before signing the release.

Why Your Property Damage Claim Can Be Denied

Property damage claims can get denied for many reasons, including:

• Your premiums were not paid
• The claim was filed too long after the loss
• Your losses were not caused by a covered peril
• The property that was damaged was not covered by your policy
• Your claim included false or misleading statements
• Your claim did not include documentation of the damage or value of your loss
• The damage was pre-existing
• Your loss fell into a policy exclusion
• You did not mitigate further damages after the loss

Claim adjusters do not need to pick only one ground for denial. If your claim gets denied, an adjuster could give multiple reasons for their action.

For example, suppose that you lost your home and personal effects in a storm. Your claim could get denied because some of the damage came from flooding that was excluded from the policy. The insurer could deny other parts of the claim because the damage to your roof was not due to wind but normal wear.

Need Legal Help with the Property Damage Insurance Claims Process?

Whether you need assistance maximizing your claim or resolving a dispute with a property damage insurer, you need experienced Texas property damage lawyers from Omar Ochoa Law Firm to help you along the way. We charge no fees until we win. Contact us for a free case review.