Disclaimer: This article provides general information and does not constitute legal advice. Consult a licensed attorney for guidance on your specific situation.
Detailed Answer
When you file a claim with an insurance company in Texas, the insurer usually issues an initial settlement proposal. That opening offer often reflects the insurer’s goal to minimize its financial exposure. Under Texas law, you have the right to review, evaluate, and respond with a counteroffer if you believe the insurer’s figure undervalues your damages.
Why Counteroffer? A counteroffer lets you:
- Highlight additional damages (medical expenses, lost wages, pain and suffering).
- Provide supporting evidence, such as bills, records, and expert opinions.
- Encourage the insurer to reevaluate its liability assessment.
Legal Framework: Under the Texas Insurance Code, prompt payment rules apply:
- Texas Insurance Code §542.055 requires an insurer to accept or reject a written settlement offer within 15 days of receipt: §542.055.
- Section 542.056 allows you to submit a written counteroffer and obligates the insurer to respond within 15 days: §542.056.
These statutes do not guarantee a specific outcome, but they set deadlines and create leverage for negotiations. A timely counteroffer preserves your right to claim prompt-payment penalties if the insurer unreasonably delays or denies payment.
How to Prepare a Counteroffer:
- Gather Documentation: Collect all medical bills, wage statements, repair estimates, and other proof of loss.
- Calculate Your Damages: Add economic (medical, property damage, lost income) and non-economic (pain, suffering) losses.
- Draft a Written Demand: In a clear letter, state your total damages and explain how you arrived at that figure.
- Submit to the Adjuster: Send the counteroffer by certified mail or email, and keep proof of delivery.
- Track Deadlines: Note the 15-day response window under §§ 542.055–.056.
Negotiations may continue after your counteroffer. You can revise your demands, provide new evidence, or choose mediation if the insurer remains unresponsive. If talks stall, you can pursue a lawsuit before the applicable statute of limitations expires.
Helpful Hints
- Use plain, professional language; avoid emotional appeals.
- Include itemized calculations and attach supporting documents.
- Keep a negotiation log: dates, contacts, and offers exchanged.
- Consider hiring a public adjuster or attorney if negotiations stall.
- Review your policy limits to know the maximum exposure.
- Send all communications in writing and save digital copies.