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What are my insurance company’s
responsibilities?
You have a contract
with your insurance company. The insurance company has a legal
duty to treat you with good faith. And the insurance company has
a legal duty to promptly pay your claim in the right amount. If
your insurance company improperly denies your claim, or fails
to promptly and correctly pay you for your damages, you may have
rights under the common law and statutes of Texas. Speights
Law Firm represents people against insurance companies
for Breach of the Insurance Contract, Violations of the Texas
Insurance Code and Breach of the Duty of Good Faith and Fair Dealing.
How do I know if my insurance company
acted improperly?
Under the Texas
Insurance Code, the following are unfair or deceptive acts by
your insurance company:
- To misrepresent the terms of
the policy;
- To misrepresent the benefits
or advantages promised by the policy;
- To misrepresent a material
fact or policy provision relating to coverage at issue;
- Failing to attempt in good
faith to effectuate a prompt, fair, and equitable settlement
of:
(1) a claim with
respect to which the insurance company’s liability has
become reasonably clear; or
(2) a claim
under one portion of a policy with respect to which the insurance
company’s liability has become reasonably clear to influence
the claimant to settle another claim under another portion of
the coverage unless payment under one portion of the coverage
constitutes evidence of liability under another portion;
-
Failing to promptly
provide to a policyholder a reasonable explanation of the basis
in the policy, in relation to the facts or applicable law, for
the insurance company’s denial of a claim or offer of
a compromise settlement of a claim;
-
Failing within
a reasonable time to:
(1) affirm
or deny coverage of a claim to a policyholder; or
(2) submit a reservation of rights to a policyholder;
-
Refusing, failing,
or unreasonably delaying a settlement offer under applicable
first-party coverage on the basis that other coverage may be
available or that third parties are responsible for the damages
suffered, except as may be specifically
provided in the policy;
-
Undertaking
to enforce a full and final release of a claim from a policyholder
when only a partial payment has been made, unless the payment
is a compromise settlement of a doubtful or disputed claim;
-
Refusing to
pay a claim without conducting a reasonable investigation with
respect to the claim;
-
It is an unfair
method of competition or an unfair or deceptive act or
practice in the business of insurance to misrepresent an insurance
policy by:
(1) making an untrue
statement of material fact;
(2) failing to state a material fact necessary to make other
statements made not misleading, considering the circumstances
under which the statements were made;
(3) making a statement
in a manner that would mislead a reasonably prudent person to
a false conclusion of a material fact;
(4) making a
material misstatement of law; or
(5) failing to
disclose a matter required by law to be disclosed, including
failing to make a disclosure in accordance with another provision
of this code.
What deadlines are imposed upon
my insurance company?
Your insurance
company must notify you in writing of the acceptance of rejection
of your claim no later than the 15th day after the date the insurer
receives all items, statements and forms required.
If your insurance company rejects your claim, they must state
the reason for the rejection.
If they are unable to accept or reject your claim before the 15th
day after they receive all items, statements and forms, they must
notify you the reasons why they need extra time, which can not
exceed an additional 45 days from the date of their request.
Your insurance company must pay your claim within five business
days after they notify you they have accepted the claim (or five
days after any conditions are met as put forth by your insurance
company).
**Please note that all
of the above deadlines are extended for an additional 15 days
if the claim was from a catastrophe or major natural disaster.
What penalties are available?
If your insurance
company acted improperly or failed to meet the deadlines imposed
by the Texas Insurance Code, the penalties are:
- If your insurance company acted
improperly, you can recover your actual damages, plus court
costs and attorneys fees. Additionally, if the insurance company
acted “knowingly” you can get an additional award
not to exceed three times the amount of your actual damages.
- If your insurance company failed
to meet the deadlines imposed by the Texas Insurance Code, you
recover the amount of the claim plus interest at 18% per year
and attorneys fees.
What
about Attorney's fees?
Speights Law Firm handles its cases
on contingency fee arrangements, meaning we are paid out of the
recoveries we obtain for you. If we don’t
recover, you don’t pay anything. However, we are
flexible and consider special arrangements as needed. Please contact
us for further information to discuss contingency fees or alternative
arrangements.
Speights Law Firm accepts cases from other lawyers and firms and
pays referral fees on those cases. Our firm will also Joint Venture
cases with other lawyers and firms when it adds value for the
client.
How do I know if I have a case?
Call
Speights Law Firm right now for a FREE CASE EVALUATION
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San Antonio Office – Principal Office
825 W. Bitters Rd., Suite 104
San Antonio, Texas 78216
(210) 495-6789 Phone
(210) 495-6790 Fax
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Houston/Galveston Office
2600 South Shore Blvd., Suite 300
League City, Texas 77573
(281) 245-3368 Phone
(281) 946-8125 Fax
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Rio Grande Valley Office
801 East Fern Avenue, Suite 150
McAllen, Texas 78501
(956) 467-1226 Phone
(956) 720-0893 Fax
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