When a Claims Adjuster Will Not Answer About Repairs

Attorney Answer

How much leverage you have depends entirely on whose insurance company this adjuster works for. Your own carrier owes you deadlines Texas law enforces. The other driver's carrier owes you almost nothing directly, and that is the honest answer most people are not told.

If the adjuster is at your own insurer, Chapter 542 of the Insurance Code is on your side. Section 542.051(2) defines the claims this subchapter covers: a claim made by an insured or policyholder under the policy, or by a named beneficiary, that must be paid by the insurer directly to the insured or beneficiary. Once you have given notice of a claim, § 542.055(a) requires the insurer — not later than the fifteenth day after it receives that notice, or the thirtieth business day if the insurer is an eligible surplus lines insurer — to acknowledge receipt, commence any investigation, and request from you the items it reasonably believes will be required. Section 542.056(a) then requires written notice accepting or rejecting the claim not later than the fifteenth business day after the insurer receives all the items required to secure final proof of loss, except as subsections (b) and (d) provide: (b) substitutes thirty days where the insurer has a reasonable basis to believe the loss resulted from arson, and (d) lets an insurer that cannot decide in time say within that same period why it needs longer and then decide not later than the forty-fifth day after that notice. Section 542.058(a) attaches the damages set out in § 542.060 where an insurer that has received all items reasonably requested and required under § 542.055 delays payment beyond the period another applicable statute specifies or, if no other statute specifies one, for more than sixty days.

Chapter 541 adds standards for conduct. Section 541.060(a)(2)(A) makes it an unfair settlement practice 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 § 541.060(a)(4)(A) covers failing within a reasonable time to affirm or deny coverage to a policyholder.

Now the limit. If this adjuster works for the driver who hit you, you are a third-party claimant, not that company's customer. Tex. Ins. Code § 541.060(b) says in terms that subsection (a) does not provide a cause of action to a third party asserting claims against an insured covered under a liability insurance policy. Chapter 542's prompt-payment deadlines run only to first-party claims as § 542.051(2) defines them. Silence from the other side's adjuster is frustrating and it is often not, by itself, something you can force.

On the repair shop itself: which facility does the work generally turns on the terms of the policy that is paying. Do not accept a claim that you have no say without seeing it in the policy.

What you can do

1. Confirm in writing which company the adjuster works for and get the claim number. That single fact decides which rules above apply to you.

2. If you have collision coverage of your own, ask your agent or carrier what opening a claim on your own policy would mean for your deductible and repair timing. Your carrier can then pursue the other insurer.

3. Give your own insurer written notice of the claim. That is what starts the § 542.055 clock, and email or the carrier's portal is enough as long as you keep a copy.

4. Ask, in writing, for a written decision accepting or rejecting the claim and for the policy language on repair facility selection. Keep every reply.

5. Keep the car, the estimates and photographs as they are until someone with authority has documented the damage.

6. File a complaint with the Texas Department of Insurance if your own carrier is not responding. It costs nothing and it creates a record.

7. Ask a Texas attorney about a claim against the at-fault driver if the other carrier stays silent, since the driver, not the adjuster, is the one who owes you.

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) generally requires suit for injury to property to be brought not later than two years after the day the cause of action accrues, and a delay caused by an unresponsive adjuster does not extend it. When your clock started depends on your facts, so have a Texas attorney check the dates against your paperwork.