Types of Coverage and Reason for Complaint

Information Requests | Open Records Liaisons | Coverage & Complaint | Confidential Information | Public Information Only

• Type of Coverage
• Reason for Complaint

For each complaint filed with TDI, TDI records the type of coverage and the reason for the complaint, among other things. By using these descriptions and by specifying a time period, you can more accurately identify the complaints in which you are interested. The following descriptions regarding the types of coverage and the reasons for a complaining may assist you in obtaining the complaints you are seeking.

Type of Coverage          Return to Top

• C97  A AND H MISC
• C48  ACCELERATED BENEFITS
• C71  ACCIDENTAL DEATH AND DISMEMBERMENT
• C43  ANNUITIES
• C64  ASSUMPTION REINSURANCE
• C12  AUTO LIABILITY
• C14  AUTO MEDICAL PAY
• C11  AUTO MULTI-COVERAGE
• C13  AUTO PHYSICAL DAMAGE
• C15  AUTO UNINSURED/UNDERINSURED MOTORIST
• C16  AUTO NO-FAULT (IF APPLICABLE)
• C03  BUSINESS AUTOMOBILE
• C22  BUSINESS OWNERS
• C21  COMMERCIAL FIRE AND ALLIED LINES
• C36  CONDOMINIUM
• C55  CREDIT DISABILITY
• C65  CREDIT INVOLUNTARY UNEMPLOYMENT
• C44  CREDIT LIFE
• C47  DEFERRED COMPENSATION
• C50  DENTAL/VISION COVERAGES
• C52  DISABILITY INCOME
• C96  E.R.I.S.A. (DON'T USE AFTER 2/1/94, SEE B90)
• C32  FARMOWNERS/RANCHOWNERS
• C80  FIDELITY AND SURETY
• C01  GARAGE LIABILITY
• C60  GENERAL LIABILITY
• C54  GROUP A AND H
• C42  GROUP LIFE
• C69  GROUP MEDICARE SELECT PLAN
• C59  GROUP MEDICARE SUPP. PLAN
• C31  HOMEOWNERS
• C57  HOME HEALTH CARE
• C35  HOMEOWNER WARRANTY
• C72  HOSPITAL INDEMNITY
• C51  INDIVIDUAL A AND H
• C41  INDIVIDUAL LIFE
• C53  INDIVIDUAL MEDICARE SUPP. PLAN
• C58  INDIVIDUAL MEDICARE SELECT PLAN
• C45  INDIVIDUAL RETIREMENT ANNUITIES
• C92  INLAND MARINE
• C56  LONG TERM CARE
• C10  MECHANICAL BREAKDOWN
• C98  MEDICAID
• C61  MEDICAL MALPRACTICE
• C74  MEDICARE RISK
• C68  MISC. PROFESSIONAL LIABILITY
• C18  MOBILE OWNERS
• C66  MORTGAGE GUARANTY
• C17  MOTORCYCLE
• C99  NO LINE SPECIFIED
• C07  NON-RESIDENT POLICY
• C91  OCEAN MARINE
• C76  OCCUPATIONAL ACCIDENT
• C90  P AND C MISC
• C20  PERSONAL INJURY PROTECTION
• C86  PERSONAL T.C.P.I.A
• C49  PREFERRED PROVIDER ORGANIZATION
• C46  PRE-PAID FUNERAL PLAN
• C95  PREPAID LEGAL SERVICE
• C62  PRODUCT LIABILITY
• C83  RENTAL REIMBURSEMENT
• C33  RENTERS
• C63  RISK RETENTION
• C09  SINGLE INTEREST
• C75  SMALL EMPLOYERS HEALTH
• C73  SPECIFIED DISEASE
• C37  STANDARD FIRE/DWELLING & E/C
• C40  STUDENT LOAN
• C24  TCPIA
• C77  TERM LIFE
• C93  TITLE INSURANCE
• C05  TRUCKERS POLICY
• C79  UNIVERSAL LIFE
• C67  WARRANTY CONTRACT
• C70  WORKERS COMPENSATION
• C78  WHOLE LIFE

Reason for Complaint          Return to Top

• D45  ACCESS TO CARE
• D54  AGENCY BALANCE
• D50  AGENT/AGENCY CONTRACT TERMINATION
• D56  AGENT CE COURSES
• D22  AGENT HANDLING
• D72  APPLICANT'S/INSURED'S DISABILITY
• D36  ASSIGNMENT OF BENEFITS
• D47  ASSUMPTION REINSURANCE
• D86  BALANCE BILLING
• D13  CANCELLATION
• D83  CAPITATION ISSUE(PATIENT PROTECTION RULES)
• D42  CASH VALUE
• D49  CHURNING
• D64  CLAIMANT FRAUD
• D03  COBRA
• D18  CONVERSION
• D52  COMMISSIONS
• D77  CONTINUITY OF TREATMENT(PATIENT PROTECTION RULES)
• D34  COORDINATION OF BENEFITS
• D94  CUSTOMER SERVICE
• D87  DELAYS IN AUTHORIZATIONS
• D35  DELAYS (CLAIMS HANDLING)
• D25  DELAYS (MARKETING AND SALES)
• D43  DELAYS (POLICYHOLDER SERVICE)
• D14  DELAYS (UNDERWRITING)
• D33  DENIAL OF CLAIM
• D79  DENIAL OF PAYMENT FOR EMERGENCY CARE(PATIENT PROTECTION RULES)
• D75  DISCLOSURE OF BENEFITS(PATIENT PROTECTION RULES)
• D20  DUPLICATION OF COVERAGE
• D16  ENDORSEMENT/RIDER
• D07  EXCESSIVE RATES
• D05  FAILURE TO PROVIDE DISCOUNT
• D78  FINANCIAL INCENTIVES(PATIENT PROTECTION RULES)
• D01  GROUP CONVERSION/CONTINUATION
• D29  IMPROPER INDUCEMENTS
• D19  LEAD CARDS
• D37  LIABILITY DISPUTE
• D91  LIABILITY LIMITS INCREASED
• D58  LICENSE APPLICATION
• D60  LICENSE RENEWAL
• D81  MATERIAL CHANGE MADE IN CONTRACT(PATIENT PROTECTION RULES)
• D30  MEDICAL NECESSITY
• D51  MEDICAL PROVIDER CONTRACT TERMINATION
• D09  MEDICARE SUPPLEMENT: REFUSAL TO INSURE AFTER OPEN ENROLL
• D08  MEDICARE SUPPLEMENT: REFUSAL TO INSURE DURING OPEN ENROLL
• D21  MISLEADING ADVERTISING
• D23  MISREPRESENTATION
• D84  NETWORK DENIAL/TERMINATION OF PROVIDER (PATIENT PROTECTION RULES)
• D27  NON-DISCLOSURE OF COVERAGE
• D10  NON-RENEWAL
• D48  OFFICER AND DIRECTOR FRAUD
• D82  OUT OF NETWORK REFERRAL(PATIENT PROTECTION RULES)
• D32  POST-CLAIM UNDERWRITING
• D71  PRE-EXISTING CONDITION
• D41  PREMIUM NOTICE
• D11  PREMIUM AND RATING
• D40  PRESSURE TO TAKE HIGHER DEDUCTIBLE
• D80  PRIMARY CARE PROVIDER SELECTION(PATIENT PROTECTION RULES)
• D65  PROVIDER FRAUD
• D88  PROVIDER NETWORK DISCLOSURE
• D46  QUALITY OF CARE
• D44  REFUND OF PREMIUM
• D26  REFUSAL OF POLICY
• D12  REFUSAL TO INSURE
• D76  RETALIATION BY MANAGED CARE PLANS(PATIENT PROTECTION RULES
• D17  TIE-IN SALES
• D85  TORT LIABILITY SHIFT TO PROVIDER(PATIENT PROTECTION RULES)
• D24  TWISTING
• D62  UNAUTHORIZED ACTS
• D70  (UNDERWRITING) OTHER
• D15  UNFAIR DISCRIMINATION
• D74  UNFAIR DISCRIMINATION(CLAIMS HANDLING)
• D31  UNSATISFACTORY SETTLE/OFFER
• D73  USE OF CREDIT/CLUE/MIB REPORTS
• D39  USUAL AND CUSTOMARY

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