Insurance Claims & Bad Faith

You paid the premiums for years. When the claim finally came, they denied it, delayed it, or offered a fraction of what it costs to make you whole.

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There is a particular kind of anger that comes from being denied by your own insurance company. Jeff McCarthy spent years working for insurance carriers, so this firm knows what the internal process actually looks like — how a claim gets assigned, how reserves are set, what an adjuster is authorized to pay without approval, and when a denial reflects the policy language versus the department’s loss ratio.

Claims we take on

Property damage claims — storm, wind, hail, hurricane, water, fire and roof damage
Underpaid claims where the adjuster’s scope of loss omits real damage
Wrongful denials based on strained exclusions, alleged wear and tear, or claimed pre-existing damage
Unreasonable delay in acknowledging, investigating or paying a claim
Uninsured and underinsured motorist claims against your own auto carrier
Business interruption and commercial property claims
Life, disability and health benefit denials

Texas gives policyholders real leverage

Texas is more protective of policyholders than many states, and the statutory tools matter:

Texas Insurance Code Chapter 541 prohibits unfair settlement practices — misrepresenting policy provisions, failing to attempt a prompt and fair settlement once liability is reasonably clear, refusing to pay without conducting a reasonable investigation, and similar conduct.
Texas Insurance Code Chapter 542, the Prompt Payment of Claims Act, imposes firm deadlines to acknowledge, request information about, accept or reject, and pay a claim. A carrier that misses them can owe statutory interest plus attorney’s fees.
There is also a common law duty of good faith and fair dealing arising from the special relationship between insurer and insured.

Where a violation is knowing, additional damages may be available. These provisions are the reason a carrier’s posture on a file often changes once a lawyer is involved.

Before you accept “final”

A denial letter is a position, not a verdict. Ask for the denial in writing with the specific policy provisions relied on, request a complete copy of your policy including all endorsements, and keep a log of every call — date, time, name, and what was said. That record is frequently what makes a Chapter 541 claim provable later.

What we do first

We read the entire policy, not just the denial letter. Coverage frequently exists in an endorsement the adjuster never mentioned, and denials are often built on an exclusion that does not actually apply to the facts. Where the dispute is about the amount rather than coverage, we bring in our own estimators and engineers so the claim is not being valued solely by the carrier’s vendor.

Many of these claims resolve once the carrier realizes the file will be litigated by someone who knows the statutory framework and the deadlines. When they do not, we file.

A note on deadlines

Insurance policies contain their own contractual limitations periods, and they are frequently shorter than the statutory ones — some property policies require suit within two years and one day, and notice provisions can require prompt reporting of the loss. Delay can independently defeat an otherwise valid claim.

Questions we hear

Insurance Claims FAQs

My claim was denied. Is it worth fighting?

Very often, yes. A large share of denials rest on an exclusion that does not fit the facts, an investigation that was never really performed, or a scope of loss that simply missed damage. The first step is inexpensive: get the denial in writing with the policy provisions cited, and have the full policy reviewed.

Can I sue my own insurance company in Texas?

Yes. Texas policyholders can bring claims for breach of contract, for unfair settlement practices under Chapter 541 of the Insurance Code, for violations of the Prompt Payment of Claims Act under Chapter 542, and for breach of the common law duty of good faith and fair dealing. Attorney's fees and statutory interest may be recoverable.

What is 'bad faith' exactly?

Broadly, it is an insurer denying or delaying a claim when liability under the policy has become reasonably clear, or failing to conduct a reasonable investigation before denying. It is not merely being wrong about coverage — a genuine, well-investigated coverage dispute is not bad faith. The distinction usually comes down to what the carrier's own claim file shows.

The adjuster's estimate is far below my contractor's. What now?

That is a valuation dispute, and it is common. Get a detailed written estimate from a qualified contractor, document the damage thoroughly with photographs, and check whether your policy contains an appraisal provision — many do, and invoking it can resolve an amount dispute without litigation. We review which route makes sense before invoking anything, since appraisal has trade-offs.

Leveling the playing field

A denial letter is a position, not the final word.

Send us the letter and your policy. We will tell you whether the denial holds up — free of charge.

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