During the TWIA claims process, we work with our policyholders to 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. Update your contact information in the Policyholder Hub 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 checking with your TWIA claims examiner. Learn more about repairs.

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

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

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.

Confirm the Correct Mortgage Company Is Listed on Your Policy. Because both you and the mortgage company are listed as having an interest in the property on the policy, claim payment checks may be written to both parties. Being included on the policy – as well as the claims payment process – helps protect the mortgage company’s financial interest in the property. Contact your mortgage company to find out how to endorse and process your claim payment check, as different mortgage companies have varying procedures.

• 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 listed. 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.

Submit Receipts for Additional Living Expenses (ALE). ALE is coverage you may have purchased as an endorsement to the TWIA policy for your primary residence. ALE is not automatically included in TWIA policies, and is not available for secondary residences.

If you are not able to live in your house because of a covered loss, ALE reimburses you for additional necessary and reasonable costs for housing and other needs, helping you maintain a normal standard of living. Make sure you save ALL receipts to document expenses and get reimbursed. TWIA can not provide ALE payments without documentation. Learn more about ALE coverage.

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 canceled 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 Supplemental Payments from TWIA. If you are unable to have repair or replacement work performed for the amount that TWIA has estimated, you may be entitled to supplemental (additional) claim payments. To request a supplemental payment:

• 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).
• Submit these estimates and documentation of the damage to TWIA through the Policyholder Portal. If you experience issues using the Policyholder Portal, you can email documents to claims@twia.org (include your claim number in the subject line); communicating by email may result in slower response times. For the sake of security and efficiency, only policyholders – not their contractors – should email information and documents to TWIA. We will review your estimates against our own and issue a supplemental payment if warranted.

Learn more about supplemental payments.

Don’t Wait to Cash Your First Check. Cashing your first check doesn’t mean that additional funds aren’t available. 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 begin repairs. Supplemental payments will come as additional checks.

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 attempt 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 your TWIA policy, you may need to make permanent structural repairs to your property for it to remain in insurable condition and 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 established 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 with a ladder, or using a drone or other specialized equipment. If you feel that the field adjuster did not adequately inspect your property, let us know by sending a message through the Policyholder Portal.

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 and provide us with information about what caused the damage, the extent of damage, and the ways 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 may 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 canceled 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 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 the Policyholder Portal 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.