According to the Texas Prompt Payment Act, insurance companies are now obligated to make timely payments to their policyholders. In this article, the insurance claims attorneys at MMA Law Firm explain the history behind this law and the consequences of partaking in bad faith practices.
The Texas Prompt Payment of Claims Act, or TPPCA, was passed by the Texas Legislature in the early 2000s to encourage insurance companies to undertake prompt investigation and payment of claims to policyholders. The Act imposes an affirmative duty on insurers to promptly pay claims as soon as they become aware that the claims are subject to payment per the terms and conditions of the holder’s policy. In addition, the Texas prompt payment act sets some other important ground rules as described below.
Under the TPPCA, insurers must pay out claims within 60 days of receiving all necessary forms, statements, and other items. In addition, within 15 days of receiving these submissions, the insurer must notify their policyholders if the claim has been rejected and must provide a valid reason if this is the case. Alternatively, the insurer can ask for more time, up to 45 days, to review a claim. Together, these timeframes comprise the 60-day window afforded by insurance companies under the TPPCA.
Despite the efforts of the Texas legislature to reel in the conduct of insurance companies through the Texas prompt payment act, many have persisted in utilizing bad faith tactics to avoid their obligations to policyholders and, specifically, to avoid paying claims. Bad faith in the insurance arena is when an insurance company knowingly misrepresents policy language to avoid or delay payments, fails to disclose a policy limitation or exclusion, or makes unreasonable demands of a policyholder to prove a covered loss.
If found to have violated the provisions of the TPPCA and acted in bad faith, an insurer can be made to pay interest of up to 18% per year and pay back the attorneys’ fees incurred by the policyholder in having to pursue legal claims against the insurer.
The Texas Supreme Court recently passed down its opinion on Barbara Technologies
Corp. v. State Farm Lloyds, No. 17-0640, 2019 WL 2666484, at *1 (Tex. June 28, 2019). The court reversed the judgment of the court of appeals in this insurance dispute, holding that the invocation of a contractual appraisal provision after denying a claim does not, as a matter of law, insulate the insurer from liability under the Texas Prompt Payment of Claims Act. This ruling shows a broadening of TPPCA damages and, therefore, appraisal awards.
Factual Background:
Issue of whether a policyholder can recover TPPCA damages “when it is undisputed that the insurer investigated the claim, rejected it, invoked the policy’s provision for an appraisal process, and ultimately paid the insured in full in accordance with the appraisal.”
The Court:
The Decision:
Factual Background:
The policyholder filed suit against his insurer for breach of contract, common-law bad faith, statutory bad faith, and violations of the TPPCA. The insurer then invoked appraisal and paid the actual cash value of the appraisal award less than the deductible. The trial court granted, and the court of appeals affirmed, the insurer’s motion for summary judgment on all claims based on then-existing case law since the insurer timely paid the appraisal award
The Court:
The Decision:
The attorneys at McClenny Moseley & Associates are well positioned to protect clients against bad faith insurance practices and ensure that the Texas prompt payment act is followed. If you have been denied coverage or your claim was rejected by your insurance company, get in touch with our Houston insurance claims lawyers today.
This blog published by MMA Law Firm is available for informational purposes only and is not intended to be legal advice on any subject matter. The content available on this website may not constitute the most up-to-date legal or other information.
