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Internet Complaints Information System (ICIS)

Complaints Data Summary

Search data summaries by quarter and by type of insurance

Download Complaints Data

2017 - 1st qtr (zip) | 2nd qtr (zip) | 3rd qtr (zip)
2016 - 1st qtr (zip) | 2nd qtr (zip) | 3rd qtr (zip) | 4th qtr (zip)
2015 - 1st qtr (zip) | 2nd qtr (zip) | 3rd qtr (zip) | 4th qtr (zip)
2014 - 1st qtr (zip) | 2nd qtr (zip) | 3rd qtr (zip) | 4th qtr (zip)
2013 - 1st qtr (zip) | 2nd qtr (zip) | 3rd qtr (zip) | 4th qtr (zip)

Download Help

What to Expect | Text Explanation

Note: ICIS download files only include confirmed (justified) complaints. Beginning with third quarter 2012, the download files include fewer columns as redundant data was removed.

Explanation of Complaint Database Files

Introduction

As required by law, the Texas Department of Insurance (TDI) has a program to facilitate the resolution of consumer complaints. Texas Insurance Code Ch. 521 and Sec. 843.282. TDI accepts written complaints against insurance companies, health maintenance organizations (HMOs), insurance agents or agencies, and other persons or entities regulated by TDI. Complaints generally involve such matters as claims and benefits, false advertising, misrepresentation of policies, and HMO quality of care.

TDI maintains information regarding such complaints in Sircon, a computerized tracking system. Selected information from Sircon is included in this Internet Complaint Information System (ICIS). For instructions on downloading this information, please refer to "How to Use TDI Download Files (ending in .zip)," found on the TDI Web site.

Each quarter of information on the ICIS contains about two megabytes of information. The files placed on the Web site have been compressed to make it easier to download or transfer the information to your computer. Downloading complaint information for a calendar quarter may take a few minutes, depending on your modem (and processor) speed(s).

The information contained in the ICIS is intended only as a guide and a resource. Although every effort has been made to ensure the accuracy of the information, TDI assumes no responsibility for omissions, inaccuracies, or ambiguities.

Available Information

The information included in Internet Complaint Information System (ICIS) is not the entire universe of available complaint information. Other information regarding complaints may be obtained under the Texas Public Information Act. If you would like additional information, please submit a written request to the Texas Department of Insurance. Requests sent by fax or by e-mail are also considered written requests. If you know the division of TDI that maintains the information, please submit your request to that division. (See, "Owner," below, in "Explanation of Information.") If you do not know which division maintains the information, please submit your request for information to the Agency Counsel office. Please try to be as specific as possible when requesting information.

Information Included

In selecting the information to include in the Internet Complaint Information System (ICIS), TDI considered, among other things, the categories of complaint information most often requested and the type of information generally considered most useful. TDI also considered the best way to protect the privacy interests of the complainants. Fields which may contain information protected by common law privacy or other legal principles are not included. The fact that a field or information type is excluded from the ICIS does not necessarily mean that everything about the complaint or about the field or information type is confidential. Portions of such excluded information may be available under the Texas Public Information Act. However, such information may require careful review by TDI staff and/or referral to the Office of the Attorney General for an opinion, prior to release of the information.

Closed Complaints

The ICIS contains only closed complaints. Usually, complaints are resolved within 45 to 60 days after TDI receives the complaint and all the information necessary to determine compliance. The length of the resolution process will depend on a number of factors, including the complexity of the complaint, the types of allegations contained in the complaint, and the willingness of the parties to resolve the matter. Some complaints require more extensive investigation and may require additional time to resolve. After a complaint is closed, the complaint will be included in the updated ICIS information.

Multiple Listings

A single complaint may be listed on more than one line in the ICIS. There are several reasons for such multiple listings: (1) the complaint is against multiple persons or entities; (2) there are multiple reasons for the complaint; (3) the complaint involves more than one type of insurance; or, (4) there is more than one disposition of a complaint. Therefore, simply adding the number of lines of complaints will not accurately identify the number of complaints. If you wish to count the number of complaints, you can count each unique complaint number. (See, "Complaint number," below, in "Explanation of Information.")

Time Period/Updates

The ICIS contains information regarding complaints received by TDI for the current calendar year and previous four years. Information contained in the ICIS will be updated periodically, at least quarterly. Information about a complaint will appear on the ICIS after the complaint is closed. If a closed complaint is reopened, the complaint will be removed from the ICIS when the ICIS is updated. The complaint will reappear on the next update of the ICIS after the complaint is reclosed.

Explanation of Information

The following is an explanation of the information contained in the Internet Complaint Information System (ICIS):

Complaint number

The complaint number is a unique number identifying a specific complaint. If you would like to request a copy of a specific complaint, please refer to the complaint number to assist TDI in more promptly locating the complaint.

Owner

The owner is the TDI office where complaint information is maintained.  CR stands for the Complaint Resolution office in the Consumer Protection section of TDI.

Received Date

The received date is the date that TDI received the complaint.

Closed date

The closed date is the date the complaint was closed.

Correspondent

The correspondent is a description of the person or entity filing the complaint. Among the categories of correspondents included are insureds, senior citizens, relatives, providers and beneficiaries. The actual name of the correspondent is not included in the ICIS.

Correspondent location

The correspondent location is the region of Texas where the correspondent is located. These regions are determined by zip code. Zip codes beginning with 75 are referred to as "NE Texas." Zips codes beginning with 76 are referred to as "N Central Texas." Zip codes beginning with 77 are referred to as "SE Texas." Zip codes beginning with 78 are referred to as "S Texas." Zip codes beginning with 79 are referred to as "W Texas." All other zip codes are referred to as "Out of State." When the zip code is not available, the record will state "Unavailable."

Subject of complaint

The subject of complaint is a description of the person or entity against whom the complaint is filed. Among the categories of complaint subjects are active licensed insurance companies, third party administrators, insurance agencies, agents, and adjusters. A single complaint may involve more than one subject. Due to privacy issues, complaints against viatical settlement companies or viatical settlement brokers are not included in this ICIS.

Subject name

The subject name is the name of the person or entity against whom the complaint was filed. As stated previously, complaints against viatical settlement companies or viatical settlement brokers are not included. If the subject of the complaint is a medical provider, a mortgage lender, a premium finance company, a claimant/insured, other or there is no entity complained against, the ICIS will not identify that person or entity, but will state that the subject was a medical provider, a mortgage lender, a premium finance company, claimant/insured, other, or there is no entity complained against.

Subject ID

The subject ID is a unique number assigned to each subject person or entity. If the subject name is not included, the subject ID will likewise not be included.

Line of coverage

The line of coverage is the type of coverage about which the correspondent complains. Among the lines of coverage included are homeowners, group life, automobile multi-coverage, and group accident and health insurance. It is also possible for a single complaint to involve more than one line of coverage. Similarly, for each line of coverage involved in the complaint, there may be a different subject. Therefore, the subject name of the complaint will be listed after each line of coverage.

Due to potential privacy issues, complaints involving disability income, credit disability and specified disease insurance are not included in the ICIS.

Reason for complaint

The reason for complaint is a description of the reason the correspondent is complaining. Among the reasons included are excessive rates, misleading advertising, claim delays and denial of claim. A single complaint may have more than one reason for the complaint. Similarly, each reason for complaint may involve a different subject. Therefore, the subject name of the complaint will be listed after each reason for complaint.

Due to potential privacy issues, complaints involving an applicant´s or insured´s disability are not included in the ICIS.

Disposition of complaint

The disposition of complaint describes the resolution of the complaint by TDI. Among the dispositions are rate problem resolved, premium refunded and claim settled. A single complaint may have multiple dispositions. Similarly, each disposition of complaint may apply to a different subject. Therefore, the subject name of the complaint will be listed after each disposition of complaint.

Type of complaint

The ICIS summaries and download files include confirmed complaints. A complaint is confirmed if the department receives information indicating that a company committed any violation of an applicable state insurance law or regulation, a federal requirement the department has authority to enforce or the term or condition of an insurance policy or certificate. A complaint is also confirmed if the complaint and company's response, considered together, suggest that the company was in error or that the complainant had a valid reason for the complaint. Some examples of a confirmed complaint include the complainant has a reason to be dissatisfied with how the claim was handled; the amount paid was less than it should have been; the claim was denied when it should have been paid; or, the claim was not handled timely.

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What to expect . . .

  • TDI "closed" complaints for the current calendar year and previous four years
  • Auto, home, health and other insurance-related complaints
  • 15 categories of data from company name to type of complaint
  • ZIP files to download
  • Download Help file explaining how to "unwrap" compressed files and "view"
  • Requirements:
    • A spreadsheet or database program to view files
    • A computer hard drive


For more information, contact:

Last updated: 10/31/2017

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