The following is a general guide to assist our LegalShield members with obtaining assistance for issues caused by hurricanes. This guide is based upon the law as it currently exists. Some changes, as discussed below, occur on September 1, 2017. Helpful telephone numbers and websites contacts are at the bottom of this document.
The following counties were declared disaster areas on August 23, 2017: Aransas, Austin, Bee, Brazoria, Calhoun, Chambers, Colorado, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Harris, Jackson, Jefferson, Jim Wells, Karnes, Kleberg, Lavaca, Lee, Liberty, Live Oak, Matagorda, Nueces, Refugio, San Patricio, Victoria, Waller, Wharton, and Wilson counties.
On August 26, 2017, the following additional counties were added: Atascosa, Bexar, Brazos, Caldwell, Cameron, Comal, Grimes, Guadalupe, Hardin, Jasper, Kerr, Lee, Leon, Madison, Montgomery, Newton, Tyler, Walker, Washington and Willacy.
On August 27, 2017, the following additional counties were added: Bastrop, Burleson, Polk, and San Jacinto. It is possible that additional counties may be added in the future.
First, determine what kinds of insurance you have, immediately file claims under each of the policies you have and get a claim number from each. It is a FEMA requirement that private insurance claims must be filed to be eligible for any FEMA benefits.
I. Insurance Coverage
- What kind of insurance do you have:
- Ranch and Farm
- Wind – Texas Windstorm Insurance Association (“TWIA”)
- Flood (FEMA- Standard Flood Insurance Policy)
- Give prompt notice. The policies have always required “written” notice, but in the past, they did not stand on that requirement. We suggest that you call and follow with written notice.
- Date of Loss: Do not guess about the date of loss. If you do not know the exact date advise the insurance company that it was “around 08/ xx/2017”
- Do not offer information which might allow the adjuster to open another claim and charge another deductible. Answer the questions posed to you.
- Do not guess at what the damage amount will be. The insurer will send an adjuster. You should also begin looking for a contractor;
- Do not sign anything from a contractor, even if they say it is just an “estimate.” Ask the contractor to indicate the “cause of loss.” This should be wind, hail, flood, hurricane, etc. The “condition” of the property is not a “cause of loss.”
- When reporting the claim, ask the insurer if they will require any forms. If they do or “might” request any forms, ask them to provide those forms to you now.
- Do not offer information without being asked. If you offer random information, the insurance company is free to twist your words and use them against you later if a dispute arises. Again, just answer questions.
II. TEXAS HOMEOWNERS POLICIES
- There are now MANY policy forms. You need to review your policy. Each form provides different coverages, and many are very limited now.
- Some of the forms are Actual Cash Value (“ACV”) and some are Replacement Cost Coverage (“RC”). Some policies require an endorsement for the replacement cost.
- Be aware of coverage changes made by endorsement.
- The Statute of Limitations in a homeowner policy has always been 2 years from the date the cause of action accrues. The policies have changes. Some now say 2 years from the Date of Loss and some still say when the cause of action accrues. Some even have a 1-year limitation.
- The policy should cover:
- The Dwelling;
- Contents; and
- Additional Living Expense (limited at 20% of the dwelling amount). This is for alternative housing and food if the home is uninhabitable. You must provide proof, maintain all receipts. (This will be assigned to another adjuster)
- Some policies, including “forced” policies placed by a mortgage company, provide for Dwelling coverage only
- The term “total loss” when applied to a homeowner policy only applies to fire. Even though the entire home may be gone or destroyed, the insurance company may still require you to comply with all of the conditions and duties set out in the policy.
- The current Texas homeowner policy does NOT have an arbitration provision. It contains an “Appraisal” provision in the event that you and the insurance company do not agree on the amount of loss. The policy is very specific. Each party may demand this procedure, if a demand is made, it then becomes mandatory. Be aware that “Appraisal” is now mandatory in the wind policy for coastal counties.
- There are also many changes and additions to the Texas Insurance Code effective September 1, 2017. These are mostly favorable to the insurance company when disputes arise.
III. FLOOD COVERAGE – FEMA
- Controlled by FEMA; the adjusters do not make the decisions. The adjusters “scope” the loss and FEMA makes the coverage decision.
- The policy will pay replacement cost only on principal residences used 80% of the year. Manufactured homes are “special loss settlement”. The home must be at least 16 feet wide and at least 600 square feet.
- For homes with a detached garage the coverage is limited to 10% of the dwelling limit. If used, it decreases the dwelling coverage by 10%. If the detached garage is use for residential, business or farming purposes, it is excluded.
- Manufactured homes must be anchored.
- Depending on the flood zone in which the property is located, the coverage may be further reduced. This is complicated and can be found in your policy.
- Coverage for Personal Property must be purchased separately. Any property located outside the main structure must be fully secured. If it floats away, it is presumed that it was NOT fully secured.
- There are special limits of $2,500 for any one loss of art, jewelry, furs, etc. They only pay for the “functional” value of antiques.
- They will pay up to $1,000 to protect the property from flood or imminent danger such as sandbags, pumps, lumber, etc. They will also pay up to $1,000 for moving property to a safe location;
- There are a lot of exclusions including fences, freestanding hot tubs, piers, etc.
- Loss of revenue, business interruption and economic damages usually are not covered.
- Additional Living Expenses are not covered.
- There are separate deductibles for the dwelling and the personal property.
- REQUIREMENTS IN CASE OF LOSS:
- Prompt written notice;
- Send proof of loss within 60 days of loss (be very careful with this and do not commit to a dollar amount). They should provide this form to you. If not ask for it.
- See policy for a complete listing
- Statute of Limitations for suing the company if they deny your claim is 1-year after the date they deny or partially deny claim. Exclusive jurisdiction is Federal District Court.
IV. TEXAS WINDSTORM – Tex. Ins. Code Chapter 2210
- This is a separate policy for Tier 1 counties on the coast. It is similar to the homeowner policy but covers wind/hail only. So, the homeowner will most likely have 3 policies – homeowner, wind and flood. Deductibles on each will be taken.
- The statutes do not require the policy to contain coverage for loss of use or additional living expenses unless they are excluded by a companion policy. Check for endorsements.
- Claims should be reported to the agent, or if unable to reach the agent, call 800-788-8247 or 800-979-6440. Iif the call center cannot be reached, the email@example.com is available to report the loss.
- Replacement coverage may be available. You need to check the endorsements.
- Usually, interior damage will only be covered if the wind or hail made an opening in the roof.
- NEW POLICY CHANGES FOR DISPUTE RESOLUTION: Access to Judicial Review is limited by Tex. Ins. Code 2210
- If the insurer accepts the claim in part and denies in part (underbids the damage) you MUST demand an appraisal no later than 60 days after the notice. Appraisal is now mandatory for a wind/hail damage dispute. This is under the TWIA policy not the standard homeowner policy) The process is set out in the policy. The appraisal result is binding. It also incurs additional costs for the you. The only way to further appeal is a showing of corruption, fraud or other undue means.
- If the claim is fully denied, the insurance company must provide a timely written notice.
- Coastal Outreach and Assistance Services Team (COAST) can assist with TWIA claims-contact: http://www.tdi.texas.gov/consumer/coast/ or call 1-855-352-6278.
HELPFUL CONTACTS AND TELEPHONE NUMBERS
The contacts and resources below can help you survive and recover from a disaster
American Red Cross – (800) HELP-NOW
Salvation Army – (800) SAL-ARMY
Missing Persons Registries – (866) GET-INFO
- State of Texas – (877) 452-9060
- Texas Emergency Preparedness Resources
- Texas Division of Emergency Management – (512) 424-2208
- Office of the Attorney General Consumer Protection – (800) 621-0508
- Texas Department of Insurance – (800) 578-4677
- Texas Department of Health and Human Services – (800) 436-6184
- Texas Rural Mediation Services – (866) 329-3522
- 2-1-1 Texas Information and Referral Network – (877) 541-7905
- Flu.gov – (800) 232-4636
- FEMA’s Federal Disaster Assistance Process for Individuals – (800) 621-FEMA (3362)
- Department of Homeland Security – (202) 282-8000
- Government Benefits Search – (800) 333-4636
- Administration for Community Living – (202) 619-0724
- Dept. of Health and Human Services – (877) 696-6775
- Centers for Disease Control – (800) CDC-INFO
- Small Business Administration – (800) 659-2955