Claims Information
Once a member company is deemed insolvent and is designated an impaired insurer by the Texas Commissioner of Insurance, TPCIGA is responsible for processing claims by and against the insureds of the impaired company. After claims files are received from the Receiver of the insolvent and impaired estate, TPCIGA can begin handling the claims.
TPCIGA provides two essential services to the policyholders and claimants of insolvent insurance companies. First, we provide information about the status of claims that TPCIGA receives from the insolvent and impaired insurer. Our staff is available to answer general questions about the insolvency process, as well as specific questions concerning individual claims.
Second, TPCIGA pays “covered claims” as that term is defined by Chapter 462 of the Texas Insurance Code. This includes full worker's compensation benefits that may be owed arising out of a worker's compensation policy, except for claims for gross negligence or exemplary damages. Covered claims held by policyholders and third parties may be subject to certain limitations. Such limitations include those found in the insurance policy itself, as well as other limits described in Chapter 462. One such limitation is that a “covered claim” may be limited to an amount less than the limits of the applicable policy. The limitations placed on a particular claim may vary based on the date the company was designated as impaired. Please contact a TPCIGA representative for information regarding the limits applicable to a specific claim.
A covered claim may also include unearned premium, or that part of the premium paid in advance by a policyholder and unearned at the time the policy is canceled. Unearned premium claims are also subject to certain monetary limits depending on when the company became impaired. Please contact a TPCIGA representative for information regarding the limits applicable to a specific claim.
TPCIGA has the duty to defend insureds under a liability policy of the impaired insurer to the extent that the policy obligations are covered claims under Chapter 462. All proceedings pending in a Texas court in which the impaired insurer is a party or is obligated to defend a party is subject to a stay of at least six months from the date of impairment.