InsuranceComplaintCheck

TEXAS MUTUAL INSURANCE COMPANY — workers-compensation Insurance Complaints

Analysis of 516 workers-compensation insurance complaints filed against TEXAS MUTUAL INSURANCE COMPANY, based on public NAIC and state DOI data.

Key Statistics

  • workers-compensation Complaints: 516
  • Total Complaints (All Types): 562
  • workers-compensation Share: 91.8%
  • NAIC Complaint Ratio: 1.72
  • AI Risk Score: 68/100

workers-compensation Complaint Issues

Issue TypeComplaints% of Total
Claim denial30158.3%
Delayed payment6011.6%
Provider or network dispute163.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue142.7%
Premium or billing dispute132.5%
Policy cancellation61.2%
DWC Quality Of Care | Contract Language/Legal Issue51.0%
DWC Medical Benefit Delivery | Contract Language/Legal Issue30.6%
DWC Medical Benefit Delivery; Timely Filing Deficiency | Contract Language/Legal Issue30.6%
DWC Medical Benefit Delivery | Information Furnished30.6%
DWC Quality Of Care | Information Furnished; Company Position Upheld20.4%
Cust Service Claim Handling | Information Furnished; Contract Language/Legal Issue20.4%
Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished20.4%
Access to Care; Continuity of Treatment | Information Furnished20.4%
Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue20.4%
DWC Communications | Information Furnished20.4%
Other | Insufficient Information20.4%
DWC Quality Of Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue20.4%
Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue20.4%
Access to Care; Cust Srvc Policy Holder Srvcs | Information Furnished; Question of Fact; Contract Language/Legal Issue10.2%
Cust Srvc Policy Holder Srvcs | Information Furnished; Corrective Action Taken10.2%
Cust Service Claim Handling | Company Position Upheld; Question of Fact; Information Furnished10.2%
Cust Srvc Policy Holder Srvcs | Company Position Upheld; Information Furnished; Contract Language/Legal Issue10.2%
Access to Care; Cust Srvc Policy Holder Srvcs | Information Furnished; Referred To; Contract Language/Legal Issue10.2%
Continuity of Treatment | Information Furnished; Contract Language/Legal Issue10.2%
Coordination of Benefits; Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished10.2%
Cust Service Claim Handling; Other | Information Furnished; Question of Fact10.2%
Den/N-Pymt MD Nec Trmt N-Emrg | Contract Language/Legal Issue; Information Furnished; Company Position Upheld10.2%
Access to Care | Corrective Action Taken; Information Furnished10.2%
Access to Care | Company Position Upheld; Information Furnished10.2%
Cust Service Claim Handling | Contract Language/Legal Issue10.2%
Other | Company Position Upheld; Information Furnished10.2%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished10.2%
Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished10.2%
Access to Care | Information Furnished; Company Position Upheld10.2%
Unsatisfactory Settle/Offer | Company Position Upheld10.2%
DWC Medical Benefit Delivery | Information Furnished; Company Position Upheld10.2%
Access to Care; Continuity of Treatment | Company Position Upheld10.2%
Access to Care | Insufficient Information10.2%
DWC Quality Of Care | Company Position Upheld; Information Furnished10.2%
DWC Quality Of Care | Question of Fact; Information Furnished; Contract Language/Legal Issue10.2%
DWC Quality Of Care | Information Furnished; Question of Fact10.2%
DWC Quality Of Care | Question of Fact; Information Furnished10.2%
Access to Care; Continuity of Treatment; Cust Service Claim Handling; DWC Quality Of Care | Question of Fact; Informatio10.2%
Timely Filing Deficiency; Unsatisfactory Settle/Offer | Company Position Upheld10.2%
Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue10.2%
Access to Care; Continuity of Treatment; Cust Service Claim Handling; DWC Quality Of Care; Unsatisfactory Settle/Offer |10.2%
Unsatisfactory Settle/Offer | Information Furnished; Failure to Timely Respond10.2%
DWC Medical Benefit Delivery; Unsatisfactory Settle/Offer | Contract Language/Legal Issue10.2%
DWC Quality Of Care; Unsatisfactory Settle/Offer | Information Furnished10.2%
DWC Quality Of Care | Information Furnished10.2%
Access to Care | Contract Language/Legal Issue10.2%
Access to Care; Continuity of Treatment; Unsatisfactory Settle/Offer | Question of Fact; Information Furnished; Contract10.2%
DWC Quality Of Care | Company Position Upheld10.2%
Access to Care; DWC Communications | Company Position Upheld10.2%
Cust Service Claim Handling; DWC Medical Benefit Delivery | Contract Language/Legal Issue10.2%
Coordination of Benefits | Contract Language/Legal Issue10.2%
DWC Indemnity Benefit Delivery | Company Position Upheld10.2%
Access to Care; Other | Information Furnished10.2%
Access to Care; Continuity of Treatment; Primary Care Providr Selection | Information Furnished; Contract Language/Legal10.2%
Timely Filing Deficiency | Contract Language/Legal Issue10.2%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information Furnished10.2%
DWC Medical Benefit Delivery; Unsatisfactory Settle/Offer | Information Furnished10.2%
Continuity of Treatment; DWC Medical Benefit Delivery | Contract Language/Legal Issue10.2%
Continuity Of Treatment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Question of Fact10.2%
DWC Medical Benefit Delivery | Contract Language/Legal Issue; Information Furnished; Company Position Upheld10.2%
Unsatisfactory Settle/Offer | Information Furnished; Complainant Retained Attorney10.2%
DWC Medical Benefit Delivery | Insufficient Information; Low Priority10.2%
Unsatisfactory Settle/Offer | Insufficient Information10.2%
DWC Quality Of Care | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken10.2%
Unsatisfactory Settle/Offer | Information Furnished; Other10.2%
DWC Medical Benefit Delivery; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue10.2%
Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished10.2%
Unsatisfactory Settle/Offer | Other; Information Furnished10.2%
Unsatisfactory Settle/Offer | Other10.2%
Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Contract Language/Legal Issue10.2%
Other10.2%
Den/N-Pymt MD Nec Trmt N-Emrg; IRO Notice Of Review | Information Furnished; Referred To10.2%
Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled10.2%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Failure to Timely Respond; Information Furnished10.2%
Other | Information Furnished10.2%
DWC Medical Benefit Delivery | Question of Fact; Contract Language/Legal Issue; Information Furnished10.2%
DWC Medical Benefit Delivery | Referred for Disciplinary Actn; Information Furnished10.2%
Continuity Of Treatment | Contract Language/Legal Issue10.2%
Agent Handling | Information Furnished10.2%
Unsatisfactory Settle/Offer | Insufficient Information; Information Furnished10.2%
DWC Medical Benefit Delivery | Other10.2%
Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue10.2%
Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished10.2%
Refusal to Insure | Information Furnished; No Jurisdiction10.2%
DWC Medical Benefit Delivery | Information Furnished; Additional Monies Received10.2%
Unsatisfactory Settle/Offer | Information Furnished10.2%
Coordination of Benefits | Record Only10.2%

workers-compensation Complaints by State

StateComplaints
Texas516

Recent workers-compensation Complaints Against TEXAS MUTUAL INSURANCE COMPANY

Frequently Asked Questions

How many workers-compensation complaints does TEXAS MUTUAL INSURANCE COMPANY have?

TEXAS MUTUAL INSURANCE COMPANY has 516 workers-compensation insurance complaints on file, according to NAIC and state DOI data.

What are the most common workers-compensation complaint issues with TEXAS MUTUAL INSURANCE COMPANY?

The most common workers-compensation complaint issues for TEXAS MUTUAL INSURANCE COMPANY are: Claim denial (301), Delayed payment (60), Provider or network dispute (16), Unsatisfactory Settle/Offer | Contract Language/Legal Issue (14), Premium or billing dispute (13).

Which states have the most workers-compensation complaints against TEXAS MUTUAL INSURANCE COMPANY?

The states with the most workers-compensation complaints against TEXAS MUTUAL INSURANCE COMPANY are: Texas (516).

workers-compensation Complaints by State

TEXAS MUTUAL INSURANCE COMPANY Complaints by State

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