What should I do if my insurance claim is denied?

Do not treat a denial as final. Request the written denial letter and your complete claim file, identify the exact reason for denial, gather supplemental documentation (dated photos, contractor estimates, an independent inspection), and submit a written challenge or invoke your policy's appraisal clause. A licensed public adjuster can re-inspect the loss, prepare a line-item estimate, and negotiate the denial. In Texas, claim handling is governed by Insurance Code Chapters 541 and 542; in Florida, by §627.70152 pre-suit notice. Legal questions about your specific situation should go to a licensed attorney.

What should I do if my insurance claim is delayed?

Insurers face statutory deadlines. In Texas, Insurance Code Chapter 542 (the Prompt Payment of Claims Act) generally requires an insurer to acknowledge a claim within 15 days, accept or reject it within 15 business days of receiving the items it requested, and pay an accepted claim within 5 business days - and late payment can trigger 18% annual interest plus attorney's fees. In Florida, §627.70131 generally requires the insurer to begin investigating within 14 days and pay or deny within 60 days (90 days for hurricane claims under recent law). Document every contact in writing, send a written demand referencing these deadlines, and consider a Department of Insurance complaint.

What should I do if my insurance claim is underpaid?

Compare the insurer's estimate to an independent contractor or public-adjuster estimate. Look for omitted rooms or categories, excessive or improper depreciation, below-market unit pricing, and missed code-upgrade or matching items. You can file a supplemental claim with the new documentation or invoke the binding appraisal process written into most policies. A public adjuster re-scopes the loss and pursues the difference. No recovery, no fee.

Can a denied insurance claim be overturned?

Yes. A denial letter is the insurer's initial coverage position, not a final legal ruling. Denials are frequently reversed or reduced when the policyholder provides additional documentation, an independent estimate, or professional representation that addresses the specific reason for denial. Results depend on the policy language and facts and are not guaranteed.

How long does an insurance company have to pay a claim in Texas?

Under the Texas Prompt Payment of Claims Act (Insurance Code Chapter 542), an insurer must generally acknowledge the claim within 15 days, accept or reject it within 15 business days after receiving all requested items, and pay an accepted claim within 5 business days of notifying you. If the insurer is liable and pays late, it generally owes 18% annual interest on the amount of the claim plus reasonable attorney's fees.

How long does an insurance company have to pay a claim in Florida?

Under Florida Statute §627.70131, the insurer must generally review and begin any investigation within 14 days of receiving notice and pay or deny the claim within 60 days of receiving notice of an initial, reopened, or supplemental claim (90 days for hurricane and other state-of-emergency claims under recent amendments), subject to factors beyond the insurer's control. Disputed claims also require the §627.70152 pre-suit notice process before litigation.

Is there a difference between a denied, delayed, and underpaid claim?

Yes. A denied claim means the insurer refused to pay, usually citing an exclusion or policy condition. A delayed claim means the insurer is missing statutory deadlines to investigate, decide, or pay. An underpaid claim means the insurer acknowledged the loss but paid less than the actual cost to repair it. All three are challengeable, and a single claim can involve more than one - for example, a claim that was delayed and then underpaid.

Does it cost anything to have a public adjuster review a denied or underpaid claim?

DCS PIA reviews denied, delayed, and underpaid property claims for free and works on contingency - our fee is a percentage of the additional recovery, capped at 10% of the claim recovery under Texas Insurance Code Chapter 4102. If we do not recover additional funds, you owe us nothing. Call 833-4UR-LOSS.

Denied · Delayed · Underpaid

Claim Denied, Delayed, or Underpaid? Here's What To Do.

A denial is not the final answer. A delay is not the law. A lowball offer is not your only option. Get a free review from licensed Texas & Florida public adjusters who work only for you.

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Quick Answer

If your property insurance claim was denied, request the written denial and claim file, fix the specific reason for denial with supplemental documentation, and challenge it or invoke appraisal. If it was delayed, your insurer is bound by prompt-payment deadlines - Texas Insurance Code Chapter 542 and Florida §627.70131 - and late payment can carry interest and attorney's fees. If it was underpaid, compare the insurer's estimate to an independent one, then file a supplemental claim or invoke binding appraisal. A licensed public adjuster can handle all three on your behalf.

Denied vs. Delayed vs. Underpaid: Know What You're Facing

Situation	What it means	Telltale signs	First move
Denied	The insurer refuses to pay, citing an exclusion or policy condition.	A denial letter referencing wear & tear, pre-existing damage, late notice, or excluded peril.	Get the claim file; challenge the specific stated reason.
Delayed	The insurer misses statutory deadlines to investigate, decide, or pay.	No acknowledgment, repeated re-inspections, "still reviewing" past the legal clock.	Send a written demand citing Ch. 542 / §627.70131 deadlines.
Underpaid	The insurer pays, but less than the actual cost to repair.	Missing rooms/scope, excessive depreciation, below-market pricing, contractor estimate far higher.	Re-scope independently; supplement or invoke appraisal.

If You're Denied

A denial is the carrier's opening position, not a verdict. Most denials cite a single reason - exclusion, documentation, causation, or late notice.

Request the written denial and full claim file, then attack that specific reason with an independent inspection and line-item estimate. Then challenge in writing or invoke appraisal.

Overturn a denied claim

If You're Delayed

Delay is not a carrier's prerogative - it's regulated. Texas Chapter 542 and Florida §627.70131 set hard deadlines to acknowledge, decide, and pay.

Document every contact in writing and send a demand citing the deadlines. In Texas, late payment can add 18% annual interest plus attorney's fees.

Texas prompt-payment deadlines

If You're Underpaid

If the check doesn't cover the repair, the claim was underpaid - usually from excessive depreciation, omitted scope, or low pricing.

Compare it to an independent estimate, then file a supplemental claim or invoke binding appraisal to recover the difference.

Recover an underpaid claim

What To Do, Step by Step

The same six-step process works for a denied, delayed, or underpaid property insurance claim in Texas and Florida.

1
Get the decision in writing
Request the written denial, delay explanation, or settlement breakdown, plus your complete claim file (adjuster report, photos, Xactimate estimate, engineering reports, and the full policy with endorsements).
2
Identify the exact reason
Pinpoint why the claim was denied, delayed, or underpaid - exclusion, documentation, causation, missed deadline, excessive depreciation, or omitted scope. Each reason requires a different response.
3
Document the loss independently
Obtain an independent inspection and a detailed, line-item estimate using the same Xactimate software insurers use, with dated photos and, where needed, moisture mapping or expert reports.
4
Cite your deadlines and rights
Reference the Texas Prompt Payment of Claims Act (Chapter 542) or Florida §627.70131 timelines and §627.70152 pre-suit notice in a written demand, creating a documented record.
5
Challenge, supplement, or invoke appraisal
Submit a written challenge with the new documentation, file a supplemental claim, or invoke the policy's binding appraisal clause to resolve a dispute over the amount of loss.
6
Escalate with professional help
Engage a licensed public adjuster to negotiate the claim, or a licensed attorney for legal questions and bad-faith issues. File a Department of Insurance complaint if the insurer violates claim-handling rules.

Your Prompt-Payment Deadlines: Texas vs. Florida

Stage	Texas (Ins. Code Ch. 542)	Florida (§627.70131)
Acknowledge claim	Within 15 days of notice	Review/begin investigation within 14 days
Accept or reject	Within 15 business days of receiving requested items	Pay or deny within 60 days (90 days for hurricane/emergency)
Pay accepted claim	Within 5 business days of notice of acceptance	Within the 60/90-day decision window
Penalty for late payment	18% annual interest + reasonable attorney's fees	Interest from date of notice; pre-suit notice via §627.70152

Deadlines are summarized for general information and are subject to statutory exceptions and factors beyond the insurer's control. This page does not make any coverage, liability, fee, or bad-faith determination. Legal questions about your specific claim should be directed to a licensed attorney in your state.

How DCS PIA Handles Denied, Delayed & Underpaid Claims

Independent re-inspection

We re-inspect the loss and document every item the carrier missed or mischaracterized.

Line-item Xactimate estimate

We build the same estimate format insurers use, capturing full scope, code upgrades, and matching.

Appraisal & supplements

We file supplemental claims and invoke the binding appraisal clause to resolve amount-of-loss disputes.

We work only for you

Licensed public adjusters, never for the insurer. No recovery, no fee. Fees capped at 10% under Texas law.

Frequently Asked Questions

Denied, delayed, or underpaid? Let us review it - free.

We'll tell you whether your claim was mishandled and what it's really worth. No recovery, no fee.

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