Rights and Responsibilities After a Loss

During the TWIA claims process, we work with our policyholders and together we identify the cause and extent of damaged property, as well as an appropriate claim payment amount. The major roles and responsibilities during this process are outlined below. More detailed information is included in the Conditions section of all TWIA policies.

Policyholder Rights and Responsibilities After a Loss

Below are the major actions policyholders are either required or encouraged to take during the TWIA claims process. Following this list will help support an accurate and timely resolution to your TWIA claim.

Keep Contact Information Up to Date. Keep TWIA up to date on the best way to reach you. This is especially important after a storm, when you may temporarily be without phone service or be staying at a location other than your primary residence. You can update your contact information in our online Claims Center, by emailing claims@twia.org, or by asking your agent to update your contact information for you.

Make Temporary Repairs. To protect your property from further damage, you are responsible for making temporary repairs such as boarding up broken windows, covering openings with a tarp or plastic, stopping interior leaks, and drying out water-damaged or wet areas.

Keep invoices and receipts for your temporary repairs - if your loss is covered by the policy, reasonable costs for temporary repairs are covered. Do not dispose of damaged property or make permanent repairs, such as a roof replacement or asphalt patches, without first getting approval from TWIA. Learn more about repairs here.

File Your Claim Within One Year. TWIA policyholders must file their claim for all damage no later than one year after the occurrence of the event that caused their damage..

Provide TWIA Access to Your Property. You must provide TWIA representatives access to the damaged property as often as reasonably required for us to assess the extent and cause of damage.

  • COVID-19 TWIA Claims Adaptations: In response to the COVID-19 pandemic, TWIA has introduced social distancing and safety provisions to its claim handling process. These include 1) requiring claims field adjusters to follow national, state, and local health safety guidelines while performing on-site inspections, and 2) offering policyholders the option to virtually document internal damage to their property without the need for a field adjuster to enter the home. Learn more about our COVID-19 Adaptations

Provide Requested Information to TWIA. Provide TWIA with information we may request to help assess the extent and cause of damage and whether it is covered under the policy.

To Prevent Payment Delays, Confirm the Correct Mortgage Company Is Listed on Your Policy. Your mortgage company may be named on your claim payment check. This is because mortgage companies generally require homeowners to carry property insurance. Due to their financial interest in an insured property they may require to be included on the policy which means they must be included claim payment checks.

  • What if my mortgage company changed and the old one is on my policy? If the wrong mortgage company is listed on your check, you will not be able to cash the check. To avoid this complication, review your TWIA policy as soon as possible and confirm that the correct mortgage company is associated with it (it will be listed on the Declarations page). If you are no longer working with the mortgage company on your policy, please reach out to your agent. Learn more about mortgage companies and claim payments here.

Submit Receipts for Additional Living Expenses (ALE). ALE is additional coverage you may have purchased (endorsement TWIA-320) with the TWIA policy for your primary residence. ALE is not available for secondary residences. If you are not able to live in your house because of damage caused by wind or hail, ALE coverage reimburses you for additional necessary and reasonable costs for housing and other needs. The ALE endorsement helps you maintain a normal standard of living. It is critical to save all receipts associated with your ALE expenses and submit them to a claims examiner for review and reimbursement. Learn more about ALE coverage here.

Provide Proof of Deductible Payment. You must keep an accurate record of repair or replacement expenses and proof that you paid the deductible applicable to your claim.

Texas law states that insurance companies may require proof that you paid your deductible. Policyholders must submit proof they paid the deductible before any withheld recoverable depreciation is paid. Proof of payment can be in the form of a cancelled check, money order receipt, credit card statement, or a copy of an executed installment plan contract or other financing arrangement that requires full payment of the deductible over time.

  • What is recoverable depreciation? Recoverable depreciation is the difference between a property’s replacement cost value (i.e. the cost to replace it with a similar new product) and its actual cash value (i.e. the replacement cost value minus depreciation). For policies with replacement cost coverage, TWIA claims are paid in at least two parts: first the actual cash value and then the recoverable depreciation after repairs or replacement are completed or incurred.

If Needed, Request More Money from TWIA. If you are unable to have repair or replacement work performed for the amount that TWIA has assessed it will take, you may be entitled to supplemental (additional) claim payments. To request a supplemental payment:

  1. Gather detailed contractor estimates for the cost to repair or replace the damaged property. Request line item estimates that break down and show labor and material costs (rather than a single cost or lump sum estimate).
  2. Submit these estimates and documentation of the damage to TWIA through our online Claims Center or by emailing them to claims@twia.org. We will review your estimates against our own and issue a supplemental payment if warranted.

Learn more about supplemental payments here.

Don’t Wait to Cash Your First Check. Cashing your first check doesn’t mean that more funds aren’t coming your way. The claims process can be long and sometimes multiple checks are issued to fully resolve a claim. Be sure to cash your check as soon as you can so you may  get repairs underway. Any additional payment amount will come in the form of another check.

Contact TWIA if You Disagree with Our Assessment of Your Claim. Please contact TWIA with any concerns you have about your claim. We will work with you to address any needs you have, issue supplemental payments if warranted, and try to provide a timely resolution.

If you disagree with the amount TWIA has agreed to pay for the covered portion of your claim, and we have declined to issue a supplemental payment, you may pursue a formal resolution process called “appraisal.” Unless otherwise stated by TWIA or the Texas Department of Insurance, the deadline to request appraisal on the actual cash value amount of a claim is 60 days from the date you received your claim assessment letter from TWIA (titled Notice of Claim Acceptance; Notice of Claim Denial; or Notice of Claim Acceptance in Part and Denial in Part). If you have replacement cost coverage, you will have additional time to request appraisal. That timeline will be included in your assessment letter.

Obtain Any Necessary Certificates of Compliance (WPI-8/WPI-8-E). Whether or not your damage was caused by wind and hail and covered by the TWIA policy, you may need to make permanent structural repairs to your property for it to remain in insurable condition and remain eligible for insurance through TWIA. Often, structural repairs will need a Certificate of Compliance (WPI-8/WPI-8-E) to certify that the structure conforms to applicable windstorm building codes in your area. The Texas Department of Insurance (TDI) issues all Certificates of Compliance. To learn more, visit the TDI website at www.tdi.texas.gov/wind or the TWIA website at www.twia.org/windstorm-certification.

TWIA Rights and Responsibilities After a Loss

Just as policyholders have certain duties after a loss, so does TWIA. Below are major actions TWIA either must or may take after a loss, as outlined in Texas law, TWIA policies, or our own businesses practices.

TWIA Must Uphold the Policy Contract. TWIA is required to follow the terms and conditions of the policy contract in effect at the time of a loss. This includes subtracting the deductible amount and any applicable depreciation from the claim payment amount on a covered loss, following specific claims handling timelines, and excluding certain types of property and damage (e.g., damage caused by flood) from claim payments.

TWIA Responds Promptly to All Reported Claims. TWIA will assign the claim to a field adjuster, who will reach out to the policyholder as soon as they are able to schedule an inspection of the damaged property.

If an In-Person Inspection Is Required, the Field Adjuster Must Fully Inspect Your Damaged Property. This may include a full inspection of the roof by climbing on top of it with a ladder, using a drone, or using other specialized equipment. If you feel that the field adjuster did not adequately inspect your property, let us know by sending a message through our online Claims Center or by emailing claims@twia.org.

Not all claims will require an in-person inspection. TWIA may use aerial imaging to assess the extent of damage to your covered property. This is a standard insurance industry practice.

TWIA May Enlist the Help of Building Structure Experts. We may send engineers or other experts to inspect your property. These experts help answer more complicated questions about the damage and repairs to your property. The experts provide us with information about what caused the damage, the extent of damage, and the cost to repair it. This helps us determine what damage is and isn’t covered and estimate how much the repairs or replacement will cost.

TWIA May Request Additional Information About Your Claim. TWIA may request additional information from you within 30 days of receiving your claim. This information will be used to determine whether the damaged property is covered by the TWIA policy and, if so, to estimate the cost to repair or replace it.

TWIA Must Send You Our Claim Assessment in Writing. Within 60 days of receiving your claim and all requested information, TWIA must assess your claim and send you a letter stating our assessment. We complete our assessment as quickly as possible, usually within 30 days. Depending on the result of our assessment, the letter we send you will be titled either: Notice of Claim Acceptance; Notice of Claim Denial; or Notice of Claim Acceptance in Part and Denial in Part.

If TWIA determines you are owed a claim payment, we must issue that payment within 10 days of sending this letter.

Upon Request, TWIA Must Provide You Materials Relevant to Your Claim. TWIA must, on request, provide a policyholder with all information relevant to our assessment of their claim. You, the policyholder, may copy the information yourself or ask us to provide a copy of all or part of the information. Per the TWIA policy contract, we might charge you the cost associated with making any copies, excluding labor.

TWIA May Request Proof of Deductible Payment. Texas law states that insurance companies may require proof that you paid your deductible before any withheld recoverable depreciation is paid. Proof of payment can be in the form of a cancelled check, money order receipt, credit card statement, or a copy of an executed installment plan contract or other financing arrangement that requires full payment of the deductible over time.

  • What is recoverable depreciation? Recoverable depreciation is the difference between a property’s replacement cost value (i.e. the cost to replace it with a similar new product) and its actual cash value (i.e. the replacement cost value minus depreciation). For policies with replacement cost coverage, TWIA claims are paid in at least two parts: first the actual cash value and then the recoverable depreciation after repairs or replacement are completed.

For More Information

To learn more about the TWIA claims process, you may contact your agent or visit our website at www.twia.org/claimscenter. If you currently have a claim with TWIA, the claims examiner team is available to answer any questions you might have – reach them through our online Claims Center, by emailing claims@twia.org (please include your claim number in the subject line), or by calling (800) 788-8247.

Another helpful resource is the Texas Department of Insurance’s Coastal Outreach and Assistance Services Team (COAST), which provides information and educational programs to help TWIA policyholders understand the claims process. COAST can help you: learn about your rights as a TWIA policyholder; learn about the TWIA claims process; know what to do if TWIA denies your claim; and resolve a concern about a TWIA claim.

Recommended Guides

Temporary and Permanent Repairs
Why is my mortgage company on my check?
How TWIA Estimates Repair Costs
What if TWIA's claim payment isn't enough?
Increased Cost of Construction (ICC) Coverage
Additional Living Expenses (ALE) Coverage
Windstorm Certificates of Compliance (WPI-8, WPI-8-E, WPI-8-C)