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Texas Department of Insurance

File Complaint Online

TDI uses information disclosed in this form to help resolve your complaint. Resolution may require TDI to share this information with the person or company named in your complaint. Although by law much of the information you submit may be considered public record, portions may be confidential. For example, you may include private information protected by the doctrine of common law privacy, medical records protected by the Medical Practice Act, or an e-mail address provided for the purpose of communicating electronically with TDI which is protected by the Texas Public Information Act. Sharing this information for purposes of processing your complaint does not waive these confidentiality protections. However, you may affirmatively consent to release of your e-mail address in response to a public information request or inquiry.

In addition, the Health Insurance Portability and Accountability Act (HIPAA) allows doctors and health care providers to provide information about a person´s health care to health oversight agencies such as TDI. The law permits doctors and providers to disclose this information without authorization if the disclosure is for any purpose for which the agency is legally authorized to collect information.

If you would like more information about the public or confidential nature of information maintained by TDI, please consult our Open Records Policy and our Web Site Privacy Policy.

This form is encrypted to meet privacy requirements.

Fields in bold are required.

  1. Physicians/ health care providers and their representatives filing the complaint must complete Attachment A
I. Complainant Contact Information

TDI may release my e-mail address in response to a public information request?

II. Insurance Policy Information

If the complainant is the policyholder, please go to III. Tell Us About Your Complaint.

III. Tell Us About Your Complaint

Title Insurance Only

Workers´ Compensation Claim Only

HMOs or Group Health Only

IV. Your Complaint

V. Resolution

VI. Submitting Your Complaint

Please submit insurance-related complaints by:

  • Mail:
    Texas Department of Insurance
    Consumer Protection (111-1A)
    P.O. Box 149091
    Austin, Texas 78714-9091
  • Fax: (512) 475-1771
  • Online. Print a copy for your records before clicking on the submit button.
  • Email: ConsumerProtection@tdi.texas.gov
  • In person or by delivery service:
    Texas Department of Insurance
    Consumer Protection (111-1A)
    333 Guadalupe St.
    Austin, Texas 78701

Submit complaints about a workers' compensation claim to the Division of Workers' Compensation by:

  • Mail:
    Texas Department of Insurance
    Division of Workers' Compensation, MS-8
    7551 Metro Center Drive, Ste 100
    Austin, Texas 78744
  • Fax: (512) 490-1030
  • Email: DWC-CRCSIntakeUnit@tdi.texas.gov

Tips for submitting supporting documentation:

  • Submit documentation within one day of filing your complaint.
  • Types of documentation that will help us resolve most complaints includes:
    • evidence that you paid for insurance (receipts, front and back copies of checks, billing statements, etc.)
    • certificates or other documents showing you had insurance coverage (copy of your policy, binder, ID/enrollment card, declaration page, plan description, etc.)
    • correspondence between you and your agent or insurance company (and/or any advertising) showing what you were told about your insurance coverage or your claims
    • evidence of unpaid claims (copies of unpaid bills or evidence that you have paid bills for which you seek reimbursement, accident/claim reports, etc.)
    • any other supporting documents that could help settle your complaint.
  • If you have a denial of claim or a slow claim payment issue, please attach each of the following items with your complaint:
    • the HCFA 1500 or the UB-92
    • evidence of claim submission
    • explanation of benefits (EOBs)
    • evidence of prior collecting activities and late payment, including mail receipts, copies of check stubs, and delivery confirmations (fax, postal, e-mail)
    • specific details regarding telephone and written communications with the insurance carrier, including names, dates and telephone numbers, if possible.

For questions or assistance with filing a complaint, call:

Consumer Help Line: 1-800-252-3439
Division of Workers´ Compensation 1-800-372-7713

VII. Signature [ Not necessary if submitted online. ]

TDI is required to notify a regulated entity - for example, insurer, agent, or HMO - of complaints received by TDI (see Texas Insurance Code Section 521.055). By submitting this complaint, you authorize TDI to share this documentation with the regulated entity(ies) identified in your complaint in order to resolve it.

Insured/claimant/representative signature _______________________________________

  1. Physicians/ health care providers and their representatives filing the complaint must complete Attachment A
VIII. Access and Correction of Personal Information

With few exceptions, you are entitled to be informed about the information that the Texas Department of Insurance (TDI) collects about you. Under sections 552.021 and 552.023 of the Texas Government Code, you have a right to review or receive copies of information about yourself, including private information. However, TDI may withhold information for reasons other than to protect your right to privacy. Under section 559.004 of the Texas Government Code, you are entitled to request that TDI correct information that TDI has about you that is incorrect. For more information about the procedure and costs for obtaining information from TDI or about the procedure for correcting information kept by TDI, please email the of TDI´s Legal Services Division or review TDI´s Corrections Procedures.