SECTION 1.603. Complaint Information Available through the Texas Department of Insurance's Toll-Free Telephone Number

(a) The Texas Department of Insurance (TDI) will provide to the public through its toll-free telephone number the information specified by the Insurance Code §521.052, including information collected or maintained by TDI relating to the number and disposition of complaints received against an insurer that are justified, verified as accurate, and documented as valid, expressed as a percentage of the total number of insurance policies written by the insurer and in force on December 31 of the preceding year.

(b) TDI considers a complaint justified if the complaint is a confirmed complaint.

(c) A "confirmed complaint" is a complaint for which TDI receives information indicating that:

(1) an insurer committed any violation of:

(A) an applicable state insurance law or regulation;

(B) a federal requirement TDI has authority to enforce; or

(C) the term or condition of an insurance policy or certificate; or

(2) the complaint and insurer's response, considered together, suggest that the insurer was in error or that the complainant had a valid reason for the complaint.

(d) To determine the percentage described in subsection (a) of this section and required by Insurance Code §521.052, policy count information must be:

(1) prepared in accordance with the Policy Count Exhibit Form and Instructions, which are adopted by reference; and

(2) submitted only to TDI electronically as instructed on the Policy Count Exhibit Form and Instructions as part of the insurer's annual statement under §7.68 of this title.

Source Note: The provisions of this §1.603 adopted to be effective October 22, 2012, 37 TexReg 8320; amended to be effective December 22, 2016, 41 TexReg 9937