How to file a complaint against a Texas insurance company

Step 1: Talk to the insurance company.

You can resolve many issues by talking to your insurance company or agent. If you disagree with the adjuster’s estimate, tell the company why. The company might raise the estimate if it finds out that it overlooked something or gets new information. Send the company any supporting documents, such as the body shop’s estimate for the repairs.

Most companies have a toll-free customer help line. The phone number is printed on your policy.

Step 2: Ask for an appraisal or hire a public adjuster.

Your policy may include an appraisal process to resolve complaints. Appraisal allows you and the company each hire an appraiser. The two appraisers then choose a third appraiser as an umpire. You must pay for your appraiser and half of the umpire’s costs.

The appraisers review your claim and estimate the amount of damage. If their estimates are different, the umpire decides.

You can only use appraisal to resolve disputes about the amount of damage. If there’s a dispute about whether something is covered, you can try to resolve that issue after the appraisal.

Check your policy for any deadlines to request appraisal. If you need help finding an appraiser, search for a “property damage appraiser” online or check with your contractor.

Public adjusters

Some people hire public insurance adjusters to help them negotiate claims with insurance companies. Public adjusters work for you, not the insurance company. They charge for their services. Before you hire a public adjuster, make sure you understand what you’ll have to pay.

Public adjusters must have a TDI license. To learn if a public adjuster is licensed, call our Help Line at 800-252-3439.

Step 3: File a complaint with the Texas Department of Insurance

TDI can help with complaints against the insurance companies, agents, and adjusters we regulate.

TDI can’t help with complaints about service providers, including body shops. If you have a complaint against a service provider, send it to the licensing or enforcement agency that regulates the provider.

Before you complain to us, understand that there are some things TDI can’t do:

· TDI can’t make a company pay a claim unless the failure to pay violates a law or the terms of your policy.

· TDI can’t help with complaints against another person’s insurance company. For instance, we probably won’t be able to help you if you’re in an accident and the other driver’s insurance company won’t accept liability.

· TDI can’t decide who was at fault in an accident.

File your complaint

Use the TDI online complaint system. You can attach up to 24 pages of supporting documents.

Have questions? Call TDI

Call the Texas Insurance Department Help Line at 800-252-3439 from 8 a.m. to 5 p.m. Central time.

Step 4: Get legal help

If you’re still not happy with the outcome of your claim and you want to sue your insurance company find legal help.

Role of the Office of Public Insurance Counsel

The Office of Public Insurance Counsel is the official state office that represents the interests of Texas consumers in regulatory matters involving:

• rates, forms, and rules affecting personal insurance coverages such as auto, residential property, title, and credit insurance, or
• forms and rules for life, accident, and health insurance.

When their Office receives complaints and information suggesting a widespread problem in one of these areas for Texas consumers, they may take action. The Office of Public Insurance Counsel represents the interests of Texas consumers as a group or class. By law, they cannot represent individual consumers.