Insurance FAQs

Who can sue in a first party insurance dispute?

The insured party, a named beneficiary, an intended beneficiary, or an injured person seeking recovery under another's liability policy can sue another party who has injured them.

Who can be sued in a first party insurance dispute?

The exact answer depends on a number of factors, but parties who are potentially liable can include insurers, their agents, and their claims adjusters.

I have a new policy, but have not received a bill or made a payment yet. Can I still make a claim?

Once an insurance contract is in effect, the insurer is obligated to accept and cover legitimate claims. The timing of bills and payments can be a factor depending on the terms of the insurance contract, but they do not necessarily mean that you cannot make a claim. In some circumstances, even an agreement by an insurer's agent to provide insurance can be sufficient to represent an oral contract that obligates the insurer to consider your claim.

I submitted an insurance claim, and the insurance company denied my claim – but they didn't send me the rejection letter until more than two months after I sent in my claim. Is that legal?

In most cases, Texas law requires the insurer to respond within 15 business days and inform you whether your claim is accepted or denied. There are exceptions; the insurer can request a 45-day extension for more time to review your claim, but the insurer must inform you that additional time is needed.

I want to sue my insurance company for breach of contract. What do I have to prove to have a solid case?

A successful breach of contract suit against an insurance company must establish the following:

• An insurance contract existed and was valid at the time of your loss, accident, etc.
• You, as the insured party, were in compliance with the terms of the insurance contract; and
• The insurance company has breached the terms of the insurance contract.

If my insurance company does not pay my hurricane claim on time, what are my rights? How can I pay for an attorney when I am struggling to rebuild my home?

Texas law requires that all insurance companies respond to all claims within a certain time period. If your insurance company does not respond in a timely manner or does not pay your valid claim, you do have the right to sue. If the court finds that your insurer failed to meet its obligations, you can file for damages – including attorney fees.

After my accident, I filed a claim against the insurance company for the drunk driver who hit me. The insurance company still has not paid my claim, and they have told me to just let my health insurance cover my medical expenses. Shouldn't they pay for the medical expenses that I included in my claim?

Under Texas law, it is illegal for an insurance company to delay your personal automobile insurance claim simply because they know you have other insurance. The insurance company should pay for your claim, regardless of what other coverage you have.

I applied for an insurance policy and was denied coverage. I think I was denied because of my disability and not because of any other existing medical problems. Is a disability a legitimate "pre-existing condition" for an insurance company to use when determining coverage?

While insurance companies can use all kinds of health conditions against you when deciding whether to offer you coverage, in many cases, it is illegal to deny coverage because of a disability. An experienced insurance attorney can review your situation and advise you of any legal options.

For a free consultation with an experienced attorney, contact a Houston business lawyer from our office today.