Common Rejections For Life And Accident & Health Form Filings

Individual and Group Forms:

• Specimen language must be provided on all forms submitted to comply with 28 TAC §3.4(d)(1).

• Glossy stock, paste-ons, handwritten and/or white-out materials are unacceptable according to 28 TAC §3.4(c).

• Failure to provide a form number in the lower left-hand corner of the cover page or on the first page of the form is contrary to 28 TAC §3.4(c)(2)(b).

• Each form should be designated by a distinguishing form number according to 28 TAC §3.4(c)(2)(A).

• The required filing fee of [$100/$50] was not included with this submission. TAC §3.4(r) & §7.1301

• The required filing fee of $50.00 was not included with this "Resubmission" or "Withdrawal" filing. 28 TAC §3.4(r)(1)(H) & (I)

• The total required filing fee of [$#####] was not included. Please note that the filing fee is $100.00 for EACH form which requires approval, and $50.00 for EACH form which is EXEMPT from review. 28 TAC §7.1301 and §3.4(r).

• The Transmittal Checklist was not submitted with the filing submission. TAC §3.3(e)

• Filings that do not include a "completed" Transmittal Checklist including all REQUIRED CERTIFICATIONS OR SIGNATURES, do not comply with TAC §3.3(e), and will not be accepted by TDI.

• Failure to provide the Miscellaneous Checklist (Transmittal Checklist for Filing Miscellaneous Documents) with the filing of miscellaneous documents and information (reports, etc), is contrary to 28 TAC § 3.1(11)(B).

• The policy violates 28 TAC §1.601, in that it fails to contain a notice of the insurer's toll-free information and complaint number in English and Spanish. Said notice must appear on a full separate page and as the first, second, or third page of the policy. In addition, it should be no smaller than 10-point boldface type. Refer to subsection (b) of the said section for specific requirements. See 28 TAC §3.4(k)(1)

• Please provide a "letter of authorization" from ("provide insurance company name here"), giving your firm the authority to file submissions to our department on their behalf.

• New or modified text MUST BE UNDERLINED. High-lighted portions may be illegible when the form is scanned for purposes of tracking and retention. See 28 TAC §3.4(c)(1)(E)

• Forms and Corrections were not submitted on paper measuring 8 .5 x 11 inches. Form should not be submitted in any print format which consists of booklets which are bound. See 28 TAC §3.4(c)(1)(A) - (E)

• This submission fails to include the application and/or reference the application that will be used with this policy. See 28 TAC §3.4(k)(2)

• The form number on the form is not the same as the form number referenced in the Transmittal Checklist. See 28 TAC 3.3(b)(2)(c)

• A resubmission of previously disapprove forms must include all forms for which the company is seeking approval. See 28 TAC §3.6(a)(6)(A) - (F)

• The referenced forms are being returned to you with the suggestion that they be refilled with the Property and Casualty Intake Unit, Mail Code 104-3B. The forms in question provide Casualty insurance, and our records indicate that your company Is not licensed to write that line of insurance.

• Failure to include the outline of coverage is contrary to 28 TAC 3.4(i).

• This submission fails to include the rate/actuarial as required under 28 TAC §3.4(p) - (q).

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For more information contact: LifeHealth@tdi.state.tx.us