Episode Description
The Texas Department of Insurance (TDI) makes sure insurance companies and agents follow state law. When they don't, the Fraud and Enforcement Division steps in to protect consumers, stop illegal activity, and help Texans get the money owed to them.
Here are answers to common questions about how the division holds the insurance industry accountable in a fair and transparent way.
How are insurance companies or agents punished if they do something wrong?
The penalties depend on the severity of the offense:
- For minor offenses: TDI may issue a warning letter, a suspension, or probation.
- For serious offenses: TDI can permanently take away a license, issue administrative fines, and force the rule-breaker to pay back the people they harmed.
What can cause an agent or company to lose their license?
TDI can take away a license for serious misconduct, like an agent stealing client money or taking payments without actually setting up the insurance policy. Before anyone loses a license, a formal hearing is held so both sides can present their case.
What kinds of criminal cases are referred to TDI’s Fraud Unit for prosecution?
TDI’s Fraud Unit investigates insurance crimes and hands them over to local district attorneys for prosecution. Common examples include:
- Agents stealing insurance premiums (the money consumers pay for coverage).
- Individuals selling insurance without a license. In Texas, selling insurance illegally is a third-degree felony.
How can the public see enforcement actions against a company or agent?
Consumers can search for disciplinary actions from the past five years on TDI’s website. For help finding a specific company or legal order, call TDI’s Help Line at 800-252-3439.
What’s the role of TDI fraud investigators?
How TDI's Help Line helps with insurance questions and complaints
TDI embeds prosecutors in DA offices to investigate insurance fraud
Forensic accounting and insurance fraud investigations
Fraud Files: William "Doc" Gallagher
TDI analysts work behind the scenes to stop insurance fraud
Insurance fraud investigations recover millions for Texans
00:00 How does TDI’s Enforcement Division hold insurance companies and agents accountable?
00:30 How does TDI enforce the insurance code and protect consumers?
00:56 How does TDI find cases for the Enforcement Division to investigate?
01:26 What kinds of possible code violations does TDI Enforcement Division investigate?
03:36 What is the process of a TDI Enforcement Division investigation?
05:37 How does restitution and revocation work in an insurance code enforcement investigation?
09:03 What happens when a code enforcement investigation uncovers criminal activity?
09:42 Can you look up companies or agents that have been investigated by the TDI Enforcement Division?
10:10 How does the TDI Enforcement Division help Texans?
11:05 If you need to file a complaint or have an insurance code question, call 800-252-3439 or visit tdi.texas.gov