Insurance

The Office of the Attorney General reviews the broad practices of insurance companies as they market their products and pay benefits. This agency has authority to sue under Chapter 541 of the Texas Insurance Code, as well as the Texas Deceptive Trade Practices Act, to prevent those in the "business of insurance" from taking advantage of Texas consumers.

The Office of the Attorney General accepts complaints about insurance practices. Complaints may form the basis for legal enforcement actions. These actions are taken on behalf of the State of Texas and the public interest, and may in some cases result in restitution to consumers.

The Texas Department of Insurance (TDI) is the state agency charged with regulating the state's insurance industry under the provisions of the Texas Insurance Code. TDI can refer some cases against insurance providers to the Office of the Attorney General for legal action.

Consumer Questions and Complaints

TDI's Consumer Protection Program helps consumers with insurance questions and problems. The program can be reached toll-free at (800) 252-3439. In addition, the TDI Web site offers a wealth of information, including a complete listing of licensed agents, agencies and insurers and records of enforcement and disciplinary actions by TDI as the regulator for the insurance industry.

Consumers with questions and/or complaints about their own insurance claims, agents and/or insurance companies should call the consumer protection line at TDI and can file complaints with TDI. TDI can investigate individual concerns and answers questions.

We encourage consumers to also file complaints with the Office of the Attorney General, but please understand that this agency cannot advise you about your specific situation or explain the law. We are prohibited by law from providing these services to private individuals.

The Office of Public Insurance Counsel (OPIC) represents the interests of Texas consumers in matters such as insurance rates and rules. OPIC is required by law to represent all consumers as a group. Individual complaints that suggest a widespread pattern of practices, or which indicate that a large number of consumers are affected, may lead to action by the agency. Therefore, consumers may wish to complain to OPIC as well.

Health Care Discount Cards

With the cost of health insurance soaring, and with many Texans facing the prospect of being uninsured, scammers are quick to offer what sound like easy, cheap solutions. One common scam is the phony, deceptive, or nearly worthless health care discount card.

TDI regulates discount health care programs. Consumers can visit TDI's Discount Health Care Programs Resource Page to learn more about these programs including program registration information and how to file a complaint.

For a consumer who is considering a heath care discount card, it is extremely important to verify whether the discount will be valid for your health care costs. Do your doctors recognize the plan? Are your prescriptions covered? Do not simply rely on the card's promotors, particularly if their claims are very broad and general, suggesting that all doctors, all treatments and all drugs will be covered.

Consumers should read all the literature about a discount card very carefully, as they would any contract. Do not assume that even common and routine expenses will be covered. Do not be misled by the use of terms associated with insurance (such as "claim" and "benefit"). The card is not insurance, and in fact, the programs are required to make that clear to you.

Consumers should also compare carefully whether the discount card is actually the least expensive option. If the card requires you to purchase drugs from a source with high prices, for example, you might actually pay less simply by obtaining generic drugs from a discount pharmacy.

Finally, since participation will probably involve your paying an up-front fee, be sure that you are dealing with a real company. Generally speaking, you should be cautious of unsolicited emails or internet ads that make extravagant promises, and you should make an effort to find independent information about any company that you know only from its emails or its Web site.

If you feel you have been deceived or cheated by someone selling a health care discount card, you may wish to file a consumer complaint with the Office of the Attorney General.

 

Revised: May 06 2010