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Claims Process for Texas Windstorm Insurance Association Policies

Return to the Coastal Outreach and Assistance Services Team (COAST) page.

The following charts show some of the key changes of the new law:

Policy Issuance | Regulation and Governance of TWIA | Loss Funding after a Major Storm | New Programs | Claims

Policy Issuance

For policies issued or renewed on or after November 27, 2011 Changes the requirement that you provide TWIA with proof that you've been declined coverage by an insurance company. You must provide one declination to get a policy and to renew your coverage every three years. Previously, you only had to have a proof of declination to get coverage at each renewal.
Changes the amount you must pay if you cancel your TWIA policy, except in limited circumstances. Except in limited circumstances, you must pay the cost of at least 90 days of coverage if you cancel your policy early. Previously you had to pay the cost of at least 180 days of coverage if you canceled your policy.

Regulation and Governance of TWIA

Effective September 28, 2011 Strengthens TWIA's reporting requirements and allows TDI to randomly audit TWIA claims.
Requires TWIA to improve access to public information and to make TWIA board meetings more transparent. Also requires TWIA to post online all compensation and bonuses paid to TWIA employees, vendors, or contractors that are more than $100,000 for a calendar year.
Establishes standards of conduct for the TWIA board of directors and TWIA employees.

Loss Funding after a Major Storm

For storms occurring on or after July 1, 2011 Authorizes the issuance of up to $1 billion in public securities before a major storm. TWIA then repays these pre-event public securities with its revenues. TWIA may not use the money raised from the pre-event public securities sale to buy reinsurance.
Sets a $2.5 billion limit on the amount of public securities that may be issued as the result of a storm or series of storms in a calendar year.
Clarifies that public securities may be issued in the calendar year after a storm and that there may be multiple issues. (Catastrophe year is defined as a calendar year.)

Class 2 premium surcharges apply to the following types of policies that cover insured property located in the catastrophe area:

  • fire and allied lines
  • farm and ranch owners
  • residential property insurance
  • commercial and personal automobile liability and physical damage insurance
  • the property portion of commercial multiple peril policies.

Removes language from the current law that specified that Class 2 premium surcharges were nonrefundable.

New Programs

Ombudsman Program

TDI created an ombudsman program in 2012 to provide information and educational programs that assist policyholders with the TWIA claims process.

Expert Panel

For storms after September 28, 2011, state law authorizes the commissioner to create an expert panel to recommend to the commissioner methods or models for determining if a TWIA insured loss was caused by wind or water.

Claims

Issue for Consumer For policies issued or renewed on or after November 27, 2011
Filing a claim

You have one year from the date your property was damaged or destroyed to file your TWIA claim. You may ask TDI for a 180-day extension by sending a letter to TDI's Chief Clerk’s Office that explains why you weren’t able to file a claim by the one-year deadline. Explain in detail what happened that was beyond your control that caused you to miss the deadline. Send your signed request to the Chief Clerk by email to ChiefClerk@tdi.texas.gov or by mail to Texas Department of Insurance, Chief Clerk, MC 113-2A, P.O. Box 149104, Austin, Texas 78714-9104.

TWIA's claim decision After receiving all necessary information from you, TWIA has 60 days to investigate and tell you if it will accept or reject your claim.
TWIA payments TWIA has 10 days to pay a claim after it has accepted coverage for a claim and you have done everything TWIA has asked.
Dispute the amount TWIA offers to pay for your loss You must use the appraisal process to determine the loss amount.
Appraisal process decisions are binding. (Binding means the result is final and can't be disputed.) The result is binding.
Challenging the appraisal process You may challenge the appraisal result in court if you think the process was flawed based on reasons listed in the statute. If your lawsuit is successful, the court will order a second appraisal to determine the amount of your loss.
Disputing TWIA's Denial of Coverage If TWIA denies all or part of your claim, you may sue TWIA to dispute the decision.
TWIA may require you to first submit the dispute to mediation before taking the dispute to court.
Period to file lawsuit If you choose to file a lawsuit, you must file a lawsuit within two years of the date on which TWIA told you your claim was denied.
Limitations on lawsuit recovery If your lawsuit is successful, you may receive the covered loss payable under the policy and consequential damages. If it's proven that TWIA intentionally mishandled your claim, you may also receive twice the amount of your covered loss and consequential damages.


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Last updated: 07/12/2017

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