Basic Insurer Requirements Understand the Required Processes of Insurance Companies

Understanding Basic Insurer Requirements

Lawyers Representing Clients in Texas, Louisiana & Mississippi

Insurance matters can be complex, calling for qualified and insightful counsel in these areas. If you are wondering what the basic insurer requirements in your state are and how those may affect your claim, Arnold & Itkin is here to provide answers. We understand that this can be an overwhelming and challenging time—especially when working with difficult insurance companies to get claims resolved. We are here to help.

Our insurance claim attorneys are proud to serve clients in Texas, Louisiana, Mississippi, and surrounding areas. If you have further questions, we encourage you to contact us today at (888) 493-1629.

What Are the Insurer Requirements in Texas?

Pursuing an insurance claim in Texas? There are few things you should know in regards to insurer requirements.

For example, within 15 business days of your notice, an insurer must:

  • Acknowledge their receipt of your claim;
  • Begin any necessary investigation of the claim; and
  • Request any items, statements, or forms needed.

Once the insurer has received all items they believe necessary, they are typically required to notify you whether they have accepted or rejected your claim within 15 more business days. Following this, an insurer must make provide payment of the claim (if accepted) within 60 days of receiving the materials they requested.

It is also important to know that insurers are obligated by a duty to deal fairly and in good faith when processing and paying claims. That means unnecessary delays or denials may leave room for further legal action. If insurers deny or delay a claim, they must be able to establish a bona fide reason as to why this action is appropriate to avoid liability.

Louisiana Insurer Requirements: What You Need to Know

In Louisiana, insurers are not held under as strict policies as they are in Texas. Under the law, an insurer must simply acknowledge a claim in a prompt timeframe and investigate this claim within a reasonable period of time, leaving much room for interpretation as to what “prompt” and “reasonable” mean. Claims filed under health and accident policies, however, must be paid within 30 days from when the insurer first receives notice of and evidence for the claim. Louisiana does have similar requirements on good faith and fair dealing under La. R.S. 22:1882 and 22:1973.

All insurance companies in Louisiana are expected to:

  • Treat their policyholders fairly and in good faith
  • Provide full payment of the validated claim within 30 days
  • Take steps to adjust the claim within 14 days of receiving it
  • Pay any settlement agreement in a reasonable and timely fashion
  • Avoid misrepresenting important facts or policy previsions
  • Adjust insurance claims fairly

If insurance companies fail to act within these requirements, they may be liable for damages suffered by their policyholders, including financial difficulties due to unpaid or delayed claims.

Mississippi Insurer Requirements

Similar to other states, Mississippi requires insurers to conduct a “reasonably prompt” investigation of all the relevant facts and information they have been given regarding a claim. The insurer has the duty to perform a full and adequate investigation of the claim in a prompt timeframe. Additionally, if an insurer wishes to deny a claim, they must be able to present an arguable basis for their denial of the policyholder’s claim and must do so in good faith.

Whether you need to file a homeowner, business, or bad faith claim, it is crucial that you understand your rights during this process. Contact our insurance claim lawyers or fill out a case evaluation form today!

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