► The Texas Department of Insurance (TDI) handles complaints against people and organizations licensed by TDI, such as companies, agents, and adjusters. To learn more, go to the TDI webpage, <a href="https://www.tdi.texas.gov/tips/ways-we-can-help.html" target="_blank"><u>How to get help with an insurance issue or file a complaint</u></a>.  ► This dataset includes a row for each person and organization named in a complaint. This means some complaint numbers are listed multiple times. To view a dataset that lists each complaint number once due to removing the “Complaint filed against” column, use <a href="https://data.texas.gov/dataset/Insurance-complaints-One-record-complaint/jjc8-mxkg" target="_blank"><u>TDI Complaints: One Record / Complaint</u></a>.
This dataset has the following 17 columns:
| Column Name | API Column Name | Data Type | Description | Sample Values |
|---|---|---|---|---|
| Complaint number | complaint_number | number | The number assigned to a specific complaint. | 17138 116023 160279 26968 57015 view top 100 |
| Complaint filed against | respondent_name | text | The name of the person or organization the complaint was filed against. | Blue Cross and Blue Shield of Texas, A Division of Health Care Service Corporation UnitedHealthcare Insurance Company Aetna Life Insurance Company PROGRESSIVE COUNTY MUTUAL INSURANCE COMPANY State Farm Mutual Automobile Insurance Company view top 100 |
| Complaint filed by | complainant_role | text | Shows who filed the complaint. For example, the insured person (insured), the insured person’s attorney (attorney), or a relative of the insured person (relative). | Insured Third Party Provider Third Party Billing Service Other view top 100 |
| Reason complaint filed | reason | text | Shows the reason the complaint was filed. | Denial Of Claim Delays (Claims Handling) Unsatisfactory Settle/Offer Balance Billing; Unsatisfactory Settle/Offer Cust Service Claim Handling; Delays (Claims Handling) view top 100 |
| Confirmed complaint | complaint_confirmed_code | text | A “Yes” answer means TDI confirmed the licensed person or organization was in error. | No Yes view top 100 |
| How resolved | disposition | text | Gives brief description of how the complaint was resolved. | Contract Language/Legal Issue No Jurisdiction Information Furnished Question of Fact Information Furnished; Contract Language/Legal Issue view top 100 |
| Received date | received_date | calendar_date | The date TDI received the complaint. | 2018-12-10T00:00:00.000 2016-04-25T00:00:00.000 2018-09-24T00:00:00.000 2021-02-22T00:00:00.000 2018-09-05T00:00:00.000 view top 100 |
| Closed date | closed_date | calendar_date | The date TDI closed the complaint. | 2019-08-23T00:00:00.000 2019-08-22T00:00:00.000 2012-09-19T00:00:00.000 2019-08-26T00:00:00.000 2019-08-27T00:00:00.000 view top 100 |
| Complaint type | complaint_type | text | Shows if the complaint was about “Property and Casualty” or “Life, Accident and Health” insurance. | Property and Casualty Life, Accident and Health Health Maintenance Org Employee Retirement System Medicare HMO view top 100 |
| Coverage type | coverage_type | text | Shows if the coverage was “Automobile,” “Homeowners,” “Accident and Health,” “Life & Annuity,” or “Miscellaneous.” | Accident and Health Automobile Homeowners Life & Annuity Miscellaneous view top 100 |
| Coverage level | coverage_level | text | Shows if the coverage was “Property or Casualty” or “Life, Accident and Health.” | Individual Private Pass Group A&H Individual A & H Homeowners Individual Life view top 100 |
| Others involved | involved_party_type | text | Shows the other types of people and organizations involved in the complaint. For example: provider, attorney, spouse, hospital. | Portal - Company; Portal - Insured Insured Correspondent Person; Insured Associated Subject Company; Correspondent Person; Insured Associated Subject Company view top 100 |
| Respondent ID | respondent_id | number | The number assigned to the person or organization the complaint was filed against. | 10047 1348 245 1708 1510 view top 100 |
| Respondent Role | respondent_role | text | Shows the role of the person or organization that a complaint was filed against. | Ins Co - Licensed/Active Self-Funded / Erisa Health Maintenance Org Agent Insurance Agency view top 100 |
| Respondent type | respondent_type | text | Shows if the complaint was filed against a person (individual) or organization. | Organization Individual view top 100 |
| Complainant type | complainant_type | text | Shows if the complaint came from a person (INDV) or organization (ORG). | INDV ORG view top 100 |
| Keywords | keyword | text | Shows more information about the complaint or category to help sort common issues. | CLAIM EVALUATION ADJUSTER'S HANDLING UNDERWRITING CRITERIA CLAIM EVALUATION; OUT-OF-NTWK PRVDR MEDIATION RQ CLAIM EVALUATION; MED PROVIDER/THIRDPARTY BILLER view top 100 |