Frequently Asked Questions

Learn About Insurance Claims

Houston Skyline

 

If you are filing an insurance claim for property damage or other covered expenses and you are facing obstacles from your insurance company, we at Grisham & Kendall, PLLC can assist you. You may be concerned that you will not receive payment for all of your necessary repairs, or perhaps your claim has been denied altogether. Our Dallas insurance attorneys handle all insurance dispute cases and can answer any questions you may have about the legal process.

Below is a listing of frequently asked questions to help clarify some common concerns that individuals and business owners have when pursuing an insurance settlement. To speak in more detail with a Dallas insurance claims lawyer regarding your case, contact Grisham & Kendall, PLLC, at (713) 999-5085.

 

5 of 5 stars rating

Our large hotel was severely damaged by hail. After significant delays by the insurance company, our claim was denied. We hired Bill Kendall and Grisham & Kendall soon after. Through Bill’s efforts during our lawsuit, we were able to reach a favorable settlement close to trial. We would certainly recommend Grisham & Kendall, PLLC to any property owner whose insurance company isn’t treating them fairly.

D. Patel - Hotel Hail Claim
5 of 5 stars rating

My wife and I thought we were heading into a complicated legal odyssey with a destroyed commercial property until we hired Bill Kendall. His sustained focus and hard work was so effective that we had a great settlement within hours of the first deposition.

F. Jones - Multi-Family Property Claim (Dallas, TX)

How do I know if my representative deceived me?

Deceptive practices and misleading information is, unfortunately, common enough in the Dallas area. And, at Grisham & Kendall, PLLC, we know it can be hard to determine if your insurance company or provider has been deceptive. Fortunately, though, there are some things that you can look out for that may indicate deception. For example, frequent and random increases in rates, coverage changes, and difficulties contacting a provider can all be signs that you could have been the victim of deceptive practices by an insurance company or provider. To know for sure, however, you should speak about your situation with an experienced legal representative.

How long will an insurance litigation lawsuit last?

One of the first questions many people ask in their insurance litigation cases is how long will they have to fight against their insurance company until they agree to pay the requested amount to repair damages. Like any business, insurance companies want to receive monthly payments from customers, but they rarely want to pay out a high amount of money on claims. However, every situation is unique, and the length of your case will vary depending on many different factors, including how much money you need.

One thing is for certain, getting an experienced insurance litigation lawyer will help you get financial assistance in the shortest time possible. Contact the Dallas insurance litigation attorneys of Grisham & Kendall, PLLC, today at (713) 999-5085 to speak with a lawyer about your case.

How long will it take to get the money I’m owed by the insurance company?

One of the first questions many people ask in their insurance cases is how long will they have to fight against their insurance company until they agree to pay the requested amount to repair the covered damages. Like any business, insurance companies want to receive monthly payments from customers, but too often they resist paying their customers or insureds a fair amount under the specific insurance claim.

At Grisham & Kendall, PLLC , our insurance litigation attorneys have settled cases in as little as several weeks following delivery of an initial demand letter. Every claim, of course, is unique. On the other end of the spectrum, some cases may last multiple years where a trial or appeal of a jury verdict is involved. While it is impossible to predict with absolute certainty how any specific case will proceed, the experience we have gained as Texas policyholder attorneys for insureds involved in litigation with their insurance company over the last twelve years has provided us with insight into the many ways these claims often develop.

How long will it take to resolve my claim with the insurance company?

The answer to this question obviously depends on the facts and coverage specific to your particular claim, whether your insurance claim involves the denial of a homeowners, commercial, lifedisability, or other insurance claim.

As experienced Texas insurance attorneys, we have assisted policyholders in Texas, Oklahoma and Florida in obtaining full payment of their insurance claims from the insurance company. Individuals and businesses have retained Grisham & Kendall, PLLC to assist them with the initial presentation of their claim to the insurance company. We analyze the coverage available under your policy and retain qualified experts who may be needed to show coverage and damages under the policy.

While we have successfully obtained payment of insurance proceeds from the insurance company in as little as several weeks to one or two months without the need of initiating litigation on behalf of our clients, experience has shown us that the policyholder must be willing to file a lawsuit against their insurance company to prove their commitment. As is to be expected, settling your case in litigation or obtaining a verdict from the court will take some time.

At Grisham & Kendall, PLLC , we never forget the effect an unpaid insurance claim has on individuals and businesses. For this reason, our firm aggressively pursues your rights under the policy from the moment we are hired to represent you against the insurance company. As with any specialized area, it is essential that you hire a lawyer with long-term experience dealing with insurance companies.

How much will a lawsuit cost me?

The short answer is that it depends on your case. Although the attorneys of Grisham & Kendall, PLLC will not charge attorney’s fees if the case does not settle in your favor, it’s still hard to determine how much a case can cost you in the long run. Things like disputes with insurance providers, extensions in court, and contract investigations could make a lawsuit take more time, which could cost more. And while you might think you will save more by representing yourself, an attorney is likely to get you more financial support than you would on your own, which would cost you less in the long run. However, the best way to estimate the possible costs is to discuss your options with an attorney.

How much will I have to pay to pursue my claim against the insurance company?

Most insureds, whether a residential or commercial property owner, or an individual with a denied life insurance or health claim, are unable to finance a potentially lengthy lawsuit against a large insurance company. While your insurance company has virtually unlimited resources with which to contest your valid insurance claim, we have learned first hand over more than ten years representing policyholders against their insurance companies that without some assistance most people simply can’t fight their insurance company alone.

Grisham & Kendall, PLLC share these risks with their clients. In the vast majority of cases, we front all cases expenses (e.g., filing fees, expert fees, court reporter fees, etc.) throughout the entire claim process all the way through trial, if necessary. If for whatever reason we fail to collect money from your insurance company, you owe us nothing. Likewise, we typically work for our clients on a contingency fee basis. Again, this simply means we don’t get paid unless we collect money from the insurance company.

For some clients with large commercial claims, the client may desire to retain our firm on an hourly basis rather than the contingency fee arrangement described above. If such an arrangement may be preferable to you or your company, we also represent certain clients on an hourly basis please let us know.

I just can’t agree with my provider about my coverage, what can I do?

In some cases, people find themselves unable to reach an agreement with their insurance provider or representative regarding the coverage that they think they are due via contract. Unfortunately, some of these disputes arise due to deceptive or misleading practices by the insurance company. If you think that this might be what’s happening in your own case, you may be able to file an insurance bad faith lawsuit, and with the help of an attorney, claim the compensation that you feel is your due.

Is my claim covered under my policy?

Not surprisingly, this question is one of the first questions you will seek the answer to in the event the insurance company denies your insurance claim. While there are varying insurance policies sold in the marketplace, whether homeowners or commercial, it is essential that you obtain legal advice from an experienced and knowledgeable Texas insurance attorney if your claim has been denied.

Of course, some insurance claims are justifiably denied by the insurance company. However, the fact that your insurance company sent you or your business a denial letter citing a specific exclusion or condition under your policy of insurance should not automatically be accepted as valid, especially where you have any questions regarding the insurance carrier’s findings and conclusions.

For example, it is not uncommon for an insurance company concerning a property damage claim to cite the commone exclusion of “wear and tear” as basis for their denial of a wind or hail claim when the home or commercial property is an older structure. Often times, the insurance company’s reliance on this exclusion amounts to little more than denying coverage for almost any home which is not brand new and absent any all, whether or not relevant to the damage claim at issue. Such denials very often ignore evidence of “new” damage to the property unrelated to the age of the home or building, and which can be shown to have been caused by the reported (covered) loss.

What are the most common causes of house fires?

Coverage for fires is one of the most important features of home insurance policies as fires often inflict extreme and expensive damage to houses. In addition, they are one of the most common types of hazards facing homeowners, with U.S. fire departments responding to 369,500 house fires in 2010 alone. House fires can be caused by any number of things, but the most frequent causes of house fires are cooking related, according to the National Fire Protection Agency. However, nearly a quarter of fire related fatalities occur in the bedroom, which may be caused by electrical and lighting defects or smoking.

What do I need to do after I file an insurance claim?

First, you should consult your insurance policy so that you are aware of your duties as an insured under the insurance policy. When filing your initial claim for damages, many residential and commercial policyholders call their agent to initiate the claims process. Again, check with your agent or policy when filing your claim as many policies require the initial claim to be in writing.

After a claim has been filed with the insurance company, the insured generally has duties created by the policy which must be satisfied. While not exhaustive, some common duties listed in many polices include the following: (i) providing prompt written notice of the claim, (ii) notifying the police in case of theft, (iii) protecting the property from further damage, (iv) furnishing a complete inventory of damaged property and related documents, and (v) providing access to the property as well as certain requested documents and records. If you have an active insurance claim, please consult your specific policy to identify your duties under the policy.

You should consult with a qualified Dallas insurance attorney if you have any questions regarding the documentation or presentation of your claim. Securing the assistance of an experienced Texas insurance claims lawyer is essential in obtaining the full amount you may be owed under the policy.

What Does it Take to Repair Flood Damage?

When your home is damaged by a flood, cleanup is almost always an expensive and intensive process. The first thing you should do is have an adjuster come in to determine how much the damage will cost. An adjuster will likely tell you that you will have to pay for the following:

These expenses can add up quickly, and without the help from your insurance company that is expected, many homeowners are left unable to pay for the damage.

What is “bad faith”?

In the context of an insurance claim (whether residential or commercial property, health, life, etc.), the insurance company in Texas as well as many other states are required to act in good faith when adjusting your insurance claim. For further discussion on this topic, please refer to the Dallas Insurance Bad Faith Attorney page.

What is the appraisal process?

Most homeowner and commercial property insurance policies include a provision commonly referred to as the appraisal clause. In Texas, these provisions typically enable either the insurance carrier or the insured to request appraisal where a dispute exists regarding the amount of loss or damage for a specific claim. Where appraisal is invoked by one side, the other side is typically required to hire an independent appraiser to represent the insured’s interest at the appraisal. Each side is generally responsible for the cost of their own appraisal. If the two appraisers agree on the amount of loss, the dispute is usually resolved without any additional steps. If the appraisers are unable to agree, an umpire must be appointed (by agreement or court order, if necessary) to resolve any remaining disputes between the appraisers. Generally speaking, each side is responsible for one-half of the cost for the umpire’s fee. While the insurance carrier may in some instances deny a claim following participation at appraisal, it is important that you obtain a qualified and experienced appraisal where such provision has been legitimately invoked, either by the insured or the carrier.

What is the most basic type of home insurance?

There are several levels of home insurance, of which the most basic one is called HO-1. With HO-1, your home, as well as any detached structures on your property and personal property within the home, is covered if any damage happens as a result of fire, lighting, wind, hail, riots/civil unrest, explosions, volcanic eruptions, theft or vandalism, smoke, and some self-caused situations. Higher levels of home insurance cover more hazards to your home, but they are also more expensive policies and may still exclude many things for which homeowners need coverage.