Texas Prompt Payment Rules: How Fast Insurers Must Act on a Claim

Your hail claim has been open for weeks and nobody's calling back. Most homeowners have never heard of the Texas Prompt Payment Act, but it sets the clock on every insurance claim you file, roof included. It's the reason an insurer can't just sit on a claim for six months with no consequences. Know the basic deadlines and you've got something solid to point at when things stall.

The rules are in Chapter 542 of the Texas Insurance Code, Subchapter B, which people usually call the "prompt payment of claims" statute. What follows is a plain-English run through what it requires, the wrinkle weather claims add, and what you can do when your insurer misses a deadline. Policies vary and this isn't legal advice. If a lot is riding on it, read the statute itself and talk to an attorney.

What the Texas Prompt Payment Act Covers

Most first-party insurance claims in Texas fall under the prompt payment rules. First-party just means you're claiming against your own policy, say a homeowner's claim for storm damage to the roof. The rules put deadlines on the insurer at every stage, from first notice all the way to final payment.

The full text is on the Texas Legislature's statutes site, and the Texas Department of Insurance puts out consumer guides that summarize the claim process. Laws get amended. If a number below doesn't match what you find there, trust the official source.

A few kinds of policies and insurers come with their own rules or exceptions. Covered through a surplus lines carrier, a state plan or a commercial policy? Confirm which deadlines apply to you.

The Key Deadlines, Step by Step

For a typical homeowner claim, the clock under Chapter 542 generally runs like this.

Step 1: Acknowledge and start the investigation (15 days)

Once your insurer gets notice of the claim, it generally has 15 days to acknowledge it, start investigating and ask for whatever items, statements or forms it reasonably needs from you. It can ask in stages. The requests still have to be reasonable.

Step 2: Accept or reject the claim (15 business days)

After it receives everything it asked for, the insurer generally has 15 business days to tell you in writing whether it accepts or rejects the claim. A rejection has to come with the reason.

Need more time? It can say so in writing, explain why, and then take up to 45 additional days to decide. You'll see that extension a lot on storm claims, so a letter like that isn't cause for panic.

Step 3: Pay the claim (5 business days)

If the insurer accepts all or part of the claim, it generally has to pay within 5 business days of telling you. When payment hinges on something you have to do, like signing a form, the clock starts once you've done it.

Step 4: The 60-day rule

An insurer that delays paying a claim more than 60 days after receiving all the items it requested is, with some exceptions, treated by the statute as being in violation.

Catastrophe extensions

Big Texas hailstorms sometimes get declared weather-related catastrophes, and then the law generally hands insurers an extra 15 days on these deadlines. After a large spring storm, expect everything to move slower.

What Happens If the Insurer Misses a Deadline

Here the statute has some bite. An insurer that breaks the prompt payment rules and is found liable for the claim can owe more than the claim itself. Under Chapter 542 the policyholder can recover:

• The amount of the claim
• Interest on that amount as damages, at a rate set by statute
• Reasonable attorney's fees

Insurers take these deadlines seriously mostly because of that interest penalty. It's also a good reason to keep a dated record of every step.

Weather claims work a little differently. Texas added Chapter 542A to the Insurance Code in 2017, and it covers claims involving hail, wind and other weather events. Among other things, 542A generally requires written notice to the insurer at least 61 days before you file a lawsuit, laying out the specific complaint and the amount you're claiming. It also changed how interest and attorney's fees work in some weather cases. If you ever get to the point of thinking about a lawsuit, those rules matter a great deal, and you want a lawyer advising you then, not a roofer.

How to Keep Your Claim Moving

Nobody needs to quote statutes at an adjuster. Most claims go along fine on their own. When one doesn't, a little organization pays off.

• Report the claim in writing. Calling is fine to start. Follow up with an email, though, so there's a dated record of when you gave notice.
• Get your claim number and the adjuster's contact info. Keep them together in one place.
• Answer requests fast. The insurer's clock to accept or reject usually doesn't start until it has everything it asked for, so each week you sit on photos or forms is a week of delay on your end.
• Keep a log. The date, who you talked to, what they said. Boring, yes. It works.
• Ask for decisions in writing. Acceptance, rejection, extensions and explanations should all show up on paper.
• Know your own deadlines. Your policy may set deadlines for reporting damage, filing proofs of loss or finishing repairs to collect recoverable depreciation.

Getting ready for the inspection helps too. Our guide to what happens when the insurance adjuster inspects your roof covers getting the damage documented the first time around, so you aren't stuck waiting on a re-inspection.

Where a Roofing Contractor Fits In

We can't enforce the Prompt Payment Act for you, and we can't negotiate your claim. Texas law keeps claim advocacy for licensed public adjusters and attorneys; public adjuster vs roofing contractor in Texas explains where those lines are.

What a good contractor can do is make sure their piece of the process never slows you down:

• Inspecting the roof quickly and handing you clear photos and notes
• Meeting the adjuster on site so the damage gets seen on the first visit
• Sending supplement documentation right away when tear-off turns up something new
• Getting you completion paperwork as soon as the job's done so you can request any held-back depreciation

We built our insurance claim process around exactly that, six steps from a free estimate through final inspection and recoverable depreciation. Hail claim? Our page on hail damage insurance claims goes deeper.

And something we say to every homeowner: don't let anybody talk you into skipping your deductible to "speed things up." That's illegal in Texas, as we explain in can a roofer waive your deductible in Texas.

If You Think Your Claim Is Being Handled Unfairly

Go to the insurer first. In writing, ask where the claim stands, what's still outstanding and when you can expect a decision. Sometimes the whole thing is stuck on one missing form.

No luck? The Texas Department of Insurance takes consumer complaints and offers a help line through its website. A complaint costs nothing to file, and insurers have to answer TDI. If the fight is over the amount of the loss, your policy may have an appraisal clause too. And if you're thinking about legal action, particularly on a weather claim under Chapter 542A, get an attorney involved early so a notice requirement doesn't slip by.

Get Your Roof Documented Right From Day One

The deadlines are there to protect you. Better still is a clean, well-documented claim that never needs them. Our team has 30+ years of insurance claim experience, our in-house staff includes former insurance adjusters, and Texas-RRR is veteran owned, registered and insured.

Had hail or wind damage? Request a free estimate or call (210) 802-6906. We'll inspect the roof, document what the storm did and meet your adjuster on site.