The Texas Department Of Insurance Going Against Insurance Companies

Subchapter C, of the Texas Insurance Code deals with how the Texas Department of Insurance examines, investigates, and determines whether a person engaged in the business of insurance has engaged in an unfair method of competition or unfair or deceptive act or practice prohibited in the business of insurance. This is not a private cause of action, rather this is where the department is taking action.

Texas Insurance Code, Section 541.102, states that when the department has reason to believe a violation has occurred that it shall issue and serve on the person, 1) a statement of the charges, and 2) at least a six day notice of the hearing on the charges, including the time and place for the hearing. This hearing is required before the department issues a cease and desist order to the person.

Section 541.104 sets out the hearing procedures to be followed. Section 541.105 requires that a record be made of the hearing.

At the hearing, Texas Insurance Code,Section 541.107, requires the department to determine whether, 1) the method of competition or the act or practice is considered to be an unfair method of competition or a deceptive act or practice, or whether it is a false, misleading, or deceptive act or practice under Section 17.46, Business & Commerce Code, and 2) whether or not the person against whom the charges are filed actually engaged in the method of competition or act or practice in violation of the Insurance Code or the Business & Commerce Code.

If it is determined that a violation has occurred, then the department shall make a written finding and issue and serve on the person an order requiring the person to cease and desist. This is per Section 541.108.

Violations of the cease and desist order are discussed in Section 541.110 and 541.111. They are also discussed in Chapter 84. Section 84.022 allows up to a $25,000 penalty and sometimes more. The amount of the penalty is based on, 1) the seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation, plus the hazard or potential hazard created to the public, 2) the economic harm to the public interest, 3) past history of previous violations, 4) the amount necessary to deter future violations, 5) efforts to correct the violations, and 6) the intentional nature of the violation.

Keep in mind, that all of the above deals with actions taken by the Texas Department of Insurance against a person in violation of its rules. The above does not deal with the recourse a private person has against those who may have committed the wrongs. For a private person to seek recourse for these wrongs they would need to seek the advise of an experienced Insurance Law Attorney.