Most basic and standard dwelling and homeowner policies in Texas cover the peril of fire, under the condition that the fire is hostile (not friendly) and the occurrence is sudden and unexpected. The definition of fire, according to standard dwelling policies, is “a rapid oxidation, accompanies by a flame, spark, or glow.” It must also be sudden and unexpected and not a long-term, predictable process such as scorching. A hostile fire is one that is spread beyond its intended place, and insurance policies will only cover these types of fires, including smoke resulting from the hostile fire. For example, a fire contained within a fireplace is considered “friendly and not hostile,” but if a log rolled out on to the carpet and lit the living room on fire, it becomes a hostile fire.
The first step after suffering a fire loss to your property is to immediately document all damages and report them to your insurance company, along with a proof of loss form, if requested by your insurance carrier. This includes photos of all structures destroyed or damaged by the fire, a list of items in need of repair or replacement as well as any receipts showing financial values of all items. When the insurance adjuster arrives at your property for inspection, make sure you obtain his or her name and proper identification for your protection. It is important to show the adjuster all damages throughout the entire building, document all communication with the adjuster and insurance company, and make copies of all documents. This includes dates and times the adjuster visited, missed appointments, unreturned phone calls, what was discussed during the inspection, and phone conversations with the insurance company.
In some cases, it may be necessary to get additional estimates if an adjuster does not know how to properly estimate the value of certain items. This is often true when you have custom work performed, in which case you may need the advice of an independent contractor or engineer. If your insurer denies your claim fully or partially or states that any damages are not covered under your policy, the company or representative should provide an explanation of their decision, in reference to policy conditions, exclusions, and limits of coverage. If you believe any language or statements in your insurance policy are ambiguous or misleading, consider contacting an attorney who specializes in insurance law. According to Consumer Federation of America, courts have consistently ruled in favor of policyholders in cases of policy ambiguities.
According to Texas law, an insurance company must acknowledge receipt of a claim within 15 days after being reported. After this, the insurer must notify the policyholder within 15 days regarding acceptance or denial of the claim. If the insurance company agrees to pay the claim, payment must be made within 5 days of acceptance.