Make an Appeal

Suggested Appeal Procedure

To submit an appeal per Section 52 of the TAIPA Plan of Operation, certain procedures should be followed. Listed below are several suggestions to assist you in preparing and submitting your appeal.

• The appeal must be submitted in writing. Appeals submitted by insurance producers should be on agency letterhead. Your appeal letter should include a detailed explanation of your particular issue. You also need to include the name of the consumer, binder number, policy number, insurer, and effective date of coverage.

• Present written documents that support your position. If your position cannot be substantiated with any sort of proof, then it is your responsibility to write an argument that takes this into account, citing the proper section of the TAIPA Plan of Operation. If you have a disputed effective date, there are certain guidelines that should be kept in mind. In order to prove a mailing date, the best evidence is from the mail carrier, i.e. Certified Mail receipt with post office date stamp, Federal Express air bill which has been signed and dated by Federal Express, etc.

• Organize your documents. In cases of a disputed effective date, evidence that helps substantiate the mailing date may include such items as a series of checks or receipts in number and sequential order (in the event of voided, missing or out of sequence checks and receipts, please provide an explanation for the gap). To establish that an application was written on a particular date, it is helpful to provide copies of declination pages from other policies written on the same date (such as comp & collision policies).

Relevant Documents

• Producer’s copy of the application

• Declarations

• Any correspondence from the insured/producer to insurer

• Check register/Receipts

• Proof of mailing

• General Correspondence

• Police Reports/Accident Report/Loss Notice

TAIPA staff will add your appeal to the next meeting agenda of the TAIPA Governing Committee. The meetings are usually held 3-4 times each year.

Mail your appeal to:
TAIPA Governing Committee
Attn: Appeals Department
P.O. Box 162890
Austin, TX 78716-2890