What Texas Law Requires of Your Own Auto Insurer

Attorney Answer

The short version: Texas law gives you real, enforceable deadlines and duties when you deal with your own insurer. When you deal with the other driver's insurer, most of that protection does not travel with you.

Your own claim is a first-party claim. Tex. Ins. Code § 542.051(2) defines the claims covered by the prompt-payment rules as first-party claims made by an insured, a policyholder, or a named beneficiary that the insurer must pay directly to that person. Once you are inside those rules, the clocks are concrete. Tex. Ins. Code § 542.056(a) requires the insurer to notify you in writing that it accepts or rejects the claim not later than the 15th business day after it receives all items, statements, and forms it required to secure final proof of loss. Under § 542.056(d), if it cannot decide within that period, it must tell you within that same period why it needs more time, and then accept or reject not later than the 45th day after that notice. And Tex. Ins. Code § 542.058(a) provides that an insurer that delays payment past the applicable period — or past 60 days, where no other period is specified — owes the damages set out in § 542.060.

The conduct rules sit alongside those clocks. Tex. Ins. Code § 541.060(a) makes it an unfair settlement practice, as to a claim by an insured or beneficiary, to misrepresent a material fact or a policy provision relating to coverage at issue; to fail to attempt in good faith to effectuate a prompt, fair, and equitable settlement of a claim on which the insurer's liability has become reasonably clear; and to fail to give a policyholder a prompt, reasonable explanation of the basis for a denial or a compromise offer. For a Texas personal automobile policy, § 541.060(a)(8) also reaches delaying or refusing settlement solely because other insurance of a different kind may be available.

Here is the limit. Tex. Ins. Code § 541.060(b) states that subsection (a) does not give a cause of action to a third party asserting claims against someone covered under a liability policy, and § 542.051(2)'s first-party definition excludes you when you are claiming against the other driver's carrier. Against that insurer, your leverage is the underlying claim, not the Insurance Code.

Which is why the coverages on your own policy matter more than most people expect. Tex. Ins. Code § 1952.101 requires an insurer to include uninsured or underinsured motorist coverage in an automobile liability policy unless a named insured rejects it in writing. Tex. Ins. Code § 1952.152 requires personal injury protection on the same terms — provided unless rejected in writing. And § 1952.155(a) makes PIP benefits payable without regard to the fault or nonfault of the named insured and without regard to collateral sources, which means it can pay medical bills and lost income while fault is still being argued about. One caution: for a hit-and-run where the driver is never identified, Tex. Ins. Code § 1952.104(3) requires actual physical contact between the unknown vehicle and the insured's person or property before uninsured motorist coverage responds.

What you can do

1. Ask your insurer for a complete copy of your policy and the declarations page, and read what coverages you actually carry.

2. Ask, in writing, whether you have PIP and uninsured or underinsured motorist coverage, and if not, whether the company holds a written rejection you signed.

3. Report the accident to your own insurer if you have not, and ask what documents it needs for final proof of loss. Send them together and keep proof of the date — that date is what starts the § 542.056 clock.

4. Keep every medical bill, record, repair estimate, and pay record in one place.

5. If your insurer goes silent or denies without explanation, ask for the denial and its reasons in writing, and you can file a complaint with the Texas Department of Insurance.

6. Before giving a recorded statement to the other driver's insurer or signing anything it sends, talk to a Texas attorney.

Most lawyers offer a brief initial call at no cost, and a few minutes on your specific facts is worth more than any general guidance, including this page.

⏱ Time limits apply. Tex. Civ. Prac. & Rem. Code § 16.003(a) requires suit for personal injury and for injury to property to be brought not later than two years after the day the cause of action accrues, and your policy imposes its own, much earlier notice deadlines. Which dates control depends on your facts. Have a Texas attorney review them rather than relying on an open claim file to hold your place.