Texas Insurance Code § 542.056 – Insurer’s Duty to Timely Respond to Injury Claims
Table of Contents
Statutory Text:
Sec. 542.056. RESPONSE TO CLAIM.
(a) Not later than the 15th business day after the date an insurer receives all items, statements, and forms required by the insurer to secure final proof of loss, the insurer shall:
(1) notify the claimant in writing of the acceptance or rejection of the claim; or
(2) if the insurer is unable to accept or reject the claim within that period, notify the claimant of the reasons why the insurer needs additional time.(b) If the insurer provides notice under Subsection (a)(2), the insurer shall accept or reject the claim not later than the 45th day after the date the insurer provides the notice.
(c) An insurer may request additional time under this section only once.
What Does This Law Mean for Injury Victims?
This law is one of Texas’s strongest protections against insurance delay. After you submit a valid claim (such as PIP, MedPay, or UIM after an accident), your insurance company has 15 business days to either:
Accept the claim and pay,
Deny the claim in writing, or
Give one written extension, explaining why more time is needed
They must then make a final decision within 45 days of that extension notice.
Example Scenario
You’re rear-ended and submit a UIM claim with all your medical records and bills. Your insurer must respond in writing within 15 business days under § 542.056. If they delay, offer no explanation, or exceed 45 days after a requested extension, they may owe penalties and interest under § 542.058 and you may have a bad faith claim under § 541.060.
When This Law Applies
§ 542.056 applies to:
First-party insurance claims by injury victims (not third-party liability)
Personal injury protection (PIP)
Uninsured/Underinsured Motorist (UIM) coverage
Medical payments (MedPay)
Property damage claims following a crash
It ensures insurers can’t stall, ignore, or string out your injury claim indefinitely.
Related Statutes
§ 542.051 – Definitions (what triggers the claim deadline)
§ 542.058 – Delay Penalties and Interest
§ 541.060 – Bad Faith Insurance Conduct
§ 1952.101 – UIM Coverage Requirements
§ 542.003 – General Rules on Fair Claim Handling
Texas Case Law Interpreting § 542.056
The 15-day response clock begins once the insurer receives final proof of loss.
Explained the need for a written explanation if more time is needed, and the hard 45-day limit.
Confirmed that these deadlines apply to injury-related first-party insurance claims.
Frequently Asked Questions About § 542.056
Houston Personal Injury Lawyer - Joel A. Gordon
They must respond in writing within 15 business days of receiving everything they’ve asked for.
Yes, but only once and they must explain why. They still must decide within 45 days after that extension.
You may be entitled to interest penalties under § 542.058 and extra damages under bad faith laws.
No. This law only applies to first-party claims under your own insurance policy.