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Insurance Complaints: How the Texas Department of Insurance Can Help You

Overview

The Texas Department of Insurance helps consumers resolve complaints against insurance companies, health maintenance organizations (HMOs), insurance agents, and adjusters. Each year, we help thousands of Texans get millions of dollars in additional claim payments and refunds.

To file a complaint, visit our website.

Note about privacy: To help resolve your complaint, we need to share the information you send us with the person or company named in your complaint. You’ll have to sign a consent form allowing us to share the information. If you don’t sign the consent form, we might not be able to fully help you.

Also, be aware that some of the information you give us can be released to anyone who requests it under the Texas Public Information Act. We will not release information that is confidential, however. Medical records, financial information, and email addresses are generally confidential under state and federal law and will not be released.

What We Can Help With

TDI can help you resolve complaints about property, title, health, and workers’ compensation insurance. We can only help with complaints against insurance companies and people we regulate. We don’t have jurisdiction over service providers, including body shops, building contractors, and doctors. If you have a complaint against a service provider, send it to the licensing or enforcement agency that regulates the provider.

We can help with these types of complaints:

  • late or slow payment of claims;
  • policy cancelations and non-renewals;
  • improper claim denials;
  • health care treatment or service denials;
  • poor customer service;
  • misrepresentation about what a policy covers;
  • discriminatory rate increases;
  • false or misleading advertising; and suspected insurance fraud.

While we make every effort to help you resolve your complaint, there are certain issues that we can’t help you resolve. We can’t:

  • find out who was at fault in an accident;
  • settle a dispute between you and the insurance company when the only evidence is your word;
  • make a company pay a claim if the company’s refusal to pay the claim didn’t violate any insurance laws or rules; or
  • give legal advice or make medical judgments.

Even if we can’t resolve your complaint, your complaints and questions help us identify issues and potential problems with insurance companies, HMOs, agents, or adjusters. Our involvement may also cause companies to look more closely at your concerns.

Before You File a Complaint

Call your insurance company first. Many complaints can be resolved by talking to the company about your issue.

Most insurance companies have a toll-free customer help line. The number is printed on your policy. You can call our Consumer Help Line to get the company’s number and address. You can also use the Company Lookup feature on our website.

When you call your insurance company:

  • have your policy number ready. If you’ve already filed a claim, have your claim number too.
  • follow up in writing. Describe your complaint and how you want the company to resolve it.
  • send copies (not originals) of letters, notes, invoices, canceled checks, advertising materials, or other documents that support your complaint.
  • ask the company to send you a written response.

Click the link below for more information

CLICK HERE For more information on How the Texas Department of Insurance can help you.