How to file an insurance complaint in Texas

Step one is still the company

TDI's own complaint pages start with talking to your company or agent, because many problems get fixed that way. If you disagree with an adjuster's estimate, say why in writing and send supporting documents, such as a contractor's or body shop's repair estimate. Companies may raise an estimate when they learn they missed something.

If the disagreement is only about the amount of damage, your policy's appraisal clause may resolve it faster than a complaint. TDI describes appraisal as each side hiring an appraiser, the two choosing an umpire, and you paying your appraiser and half the umpire's cost. Appraisal decides the amount of loss, not whether something is covered.

What TDI can and can't do

TDI can help with complaints about the insurance companies, agents and adjusters it regulates. It says it can't:

• Make a company pay a claim unless not paying violates a law or the terms of your policy.
• Settle disputes about the facts, such as whether damage was caused by a storm or by normal wear and tear.
• Decide who was at fault in a car accident.
• Help with complaints against another person's insurance company, such as the other driver's insurer refusing to accept liability.
• Handle complaints about service providers such as mortgage companies, contractors, roofers or body shops. Those go to the agency that licenses that provider.

How to file

Use TDI's online complaint system and upload the documents you think TDI needs, such as photos and letters to and from the company. TDI will ask if it needs more. You can also call the Help Line at 800-252-3439, 8 a.m. to 5 p.m. Central, Monday through Friday.

A strong complaint is short and specific. Include:

• Your name, policy number and claim number, and the company's name exactly as it appears on your policy.
• A timeline: date of loss, date reported, date acknowledged, dates of each request and each document you sent.
• What you're asking for: a decision, an explanation in writing, a payment you believe is owed under a policy term.
• Copies of the denial or cancellation letter, estimates, photos and your written correspondence.
• Which deadline or right you believe was missed, if any (for example, a decision more than 15 business days after the company had everything it needed).

What happens next and how long it takes

TDI contacts the company and asks for a response. TDI says companies have 15 days to respond and can ask for a 10-day extension. When the response comes in, TDI reviews it and tells you what it means for your complaint.

Keep checking in. If TDI asks you for more information, send it promptly and keep a copy; a complaint can stall while it waits on you. Keep talking to the company, too. Don't assume a complaint pauses deadlines in your policy, such as any time limit to request appraisal; check the policy or ask an attorney.

If you're still not satisfied, TDI points you to legal options: suing the company, or alternative dispute resolution through mediation. Its legal-help page lists community dispute resolution centers, free legal hotlines, legal clinics, the State Bar of Texas lawyer referral service, TexasCourtHelp and TexasLawHelp.

Workers' compensation goes a different way

If you were hurt at work and your employer has workers' comp, start with TDI's Division of Workers' Compensation (DWC) at 800-252-7031, option 1. You can file a complaint with DWC online or by phone.

For disputes with the insurance carrier, the Office of Injured Employee Counsel (OIEC), a separate state agency, offers free ombudsman help to injured employees at 866-393-6432. Both agencies warn about scammers posing as DWC or court officials: you never have to pay to get your workers' comp benefits in Texas.

Check a company's complaint record before you buy

TDI publishes complaint data on the Texas Open Data Portal, including a dataset of confirmed complaints and policies in force by company and line of coverage, so you can compare complaint indexes. You can also call TDI's Help Line at 800-252-3439 with questions about a company.

TDI's complaint index compares a company's share of complaints in a line of insurance with its share of policies in that line. An index of 1.00 is average; above 1 means more complaints than its size would suggest, below 1 means fewer.

Read the numbers with care. A company with very few Texas policies can swing a lot on a handful of complaints, so look at the line you're buying (home or auto) and more than one year. A complaint record is one input alongside coverage, price and how the company handled claims for people you know.