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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 21TRADE PRACTICES
SUBCHAPTER CUNFAIR CLAIMS SETTLEMENT PRACTICES
RULE §21.204Special Claim Reports and Statistical Plan

If the department finds based on complaint or complaints of unfair claim settlement practices as described in §21.203 of this title (relating to Unfair Claim Settlement Practices), that an insurer should be subjected to closer supervision with respect to such practices, it may require the insurer to file a report at such periodic intervals as the department deems necessary. The periodical reports must contain the following information:

  (1) the total number of written claims filed, including the original amount filed for by the insured and the classification by line of insurance of each individual written claim, for the past 12-month period or from the date of the insurer's last periodic report, whichever time is shorter;

  (2) the total number of written claims denied for the past 12-month period or from the date of the insurer's last periodic report, whichever is shorter;

  (3) the total number of written claims settled, including the original amount filed for by the insured, the settled amount, and the classification by line of insurance of each individual settled claim, for the past 12-month period or from the date of the insurer's last periodic report, whichever time is shorter;

  (4) the total number of written claims for which lawsuits were instituted against the insurer, including the original amount filed for by the insured, the amount of final adjudication, the reason for the lawsuit, and the classification by line of insurance of each individual written claim, for the past 12-month period or from the date of the insurer's last periodic report, whichever time is shorter; and

  (5) the total number of complaints, their classification by line of insurance, the nature of each complaint, the disposition of these complaints, and the time it took to process each complaint. Such periodic reports must be filed with the department.


Source Note: The provisions of this §21.204 adopted to be effective January 1, 1976; amended to be effective September 9, 1982, 7 TexReg 3148; amended to be effective August 19, 1992, 17 TexReg 5458; amended to be effective November 7, 2021, 46 TexReg 7408

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