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.
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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 |