Fort Worth insurance lawyers should be able to discuss with their clients when a claim is not being paid timely and who can hold the insurance company for failing to pay the claim in a timely manner.
Under the Prompt Payment of Claims statutes, Section 542.051 tells us a “claimant” is the person “making a claim.”
A claim is a first party claim that is made by an insured or a policyholder under an insurance policy or contract or by a beneficiary named in the policy contract, and that must be paid by the insurance company directly to the insured or beneficiary.
“Notice of claim” means any written notification by a claimant to an insurance company that reasonably apprises the insurance company of the facts relating to the claim.
The deadlines discussed in the Prompt Payment of Claims Act begin once the insurance company receives notice of a claim from a “claimant.” This is found in Section 542.055(a).
The term “claimant” does not limit the statute to those claims where the insurance company is dealing directly with the insured. The insured’s retention of legal counsel does not cause the insured to lose their “claimant” status under the statute. — In discussing this point, a 1999, Tyler Court of Appeals, in Dunn v. Southern Farm Bureau, held that:
Thus, the logical conclusion is that Dunn remains a “clamant” under the statute even though her claim was presented by an attorney … The impact on claimants by the practices condemned in (the act) is the same whether the claimant is represented by counsel or not.
One person who is not entitled to relief under the Prompt Payment of Claims Act is a judgment creditor.
There are many claims governed under the Prompt Payment of Claims Act. These include uninsured motorist claims, plumbing leak claims, life insurance claims, and business interruption claims, fire loss claims, and these are just a few examples of “first party” claims governed by the statute. An insured’s claim for a defense under a liability policy may also be considered a first party claim under this statute.
One thing for a claimant to keep in mind is to take notes or keep a timeline of the claim. For instance, keep a notepad that relates to the claim you are making.
First note the date of loss, the date it is reported to the insurance company, and dates you speak with the company and what they say and pay particular attention to the information they ask of you. Insureds have an obligation under a policy to cooperate with the insurance company investigation of the claim, so do help where requested and you can do so without a great deal of difficulty. The problem with lots of adjusters is they asking for information from you that they can get themselves. They are just being lazy and trying to get you to do their work for them. This would be why you would want to write down what they ask for and when they ask for it. It may be important to getting justice in a case where they drag their feet and attempt to wear you down and get you to accept way less than what you may be entitled to under the claim.
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