Insurance Adjuster Practices and Texas Deadlines in Houston, TX Chapter 542 Timelines and Written Answers

The acknowledgment and investigation deadline

Insurance Code §542.055(a) provides that not later than the 15th day, or the 30th business day for an eligible surplus lines insurer, after receiving notice of a claim, an insurer shall acknowledge receipt of the claim, commence any investigation of the claim, and request from the claimant all items, statements, and forms that the insurer reasonably believes will be required from the claimant. Those three obligations run together on the same clock. A rider whose claim notice was made by telephone should record the date and time, because every later deadline in the chapter is measured from a date somebody has to be able to establish.

Accepting or rejecting, in writing

Section 542.056(a) requires an insurer to notify a claimant in writing of the acceptance or rejection of the claim not later than the 15th business day after the date the insurer receives all items, statements, and forms required by the insurer to secure final proof of loss. Subsection (d) provides that if the insurer is unable to accept or reject the claim within that period, it shall notify the claimant within that period of the reasons it needs additional time, and shall then accept or reject the claim not later than the 45th day after the date it gives that notice. Section 542.057(a) requires payment of an accepted claim not later than the fifth business day after notice of acceptance.

The consequence of delay

Section 542.058(a) provides that an insurer that delays payment of a claim following its receipt of all items required to secure final proof of loss for more than the applicable period, or for more than 60 days where another statute specifies no period, is liable to pay damages under §542.060. Section 542.060(a) provides that a liable insurer is liable to pay the holder of the policy, in addition to the amount of the claim, interest on the amount of the claim at the rate of 18 percent a year as damages, together with reasonable and necessary attorney's fees. Section 542.059(b) extends the deadlines by 15 days for a weather-related catastrophe or major natural disaster.

The unfair settlement practices list

Section 541.060(a) identifies practices that are unfair, including failing to attempt in good faith to effectuate a prompt, fair, and equitable settlement of a claim with respect to which the insurer's liability has become reasonably clear, failing to promptly provide a reasonable explanation of the basis in the policy for the insurer's denial of a claim or offer of a compromise settlement, refusing to pay a claim without conducting a reasonable investigation, and delaying or refusing settlement of a claim under a Texas personal automobile policy solely because other insurance of a different kind is available. Subsection (b) provides that the section does not create a cause of action for a third party.

What a violation can carry, and where suit sits

Section 541.152(a) provides that a plaintiff who prevails may obtain actual damages plus court costs and reasonable and necessary attorney's fees, and subsection (b) provides that on a finding that the defendant knowingly committed the act complained of, the trier of fact may award an amount not to exceed three times the amount of actual damages. Insurance Code §1952.110 provides that an action on an uninsured or underinsured motorist claim may be brought only in the county in which the policyholder resided at the time of the accident or in the county in which the accident occurred.

What to keep, and what not to guess

Log every call with the date, time, name, and what was requested, and keep every letter, email, form, and authorization request with its attachments. Note whether a recorded statement, a medical authorization, or a release has been requested, and seek advice before signing a broad document or estimating a speed, distance, or symptom. Telephone Road accounts for 9 of the 906 half-mile segments on the City of Houston High Injury Network, and TxDOT recorded 66,236 total crashes in the city of Houston in 2024 across all road users. This page is general information about Texas statutes, not legal advice, and nothing here evaluates any insurer's handling of any claim.