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1. What is the Texas Property and Casualty Insurance Guaranty Association?


The TPCIGA is a non-profit association created by the legislature to pay certain claims of Texas insurance consumers in the event that a property-casualty company becomes insolvent.  TPCIGA is not an insurance company; it does not issue policies, collect premiums or make a profit, or otherwise stand in the shoes of an insolvent insurance company.  We exist solely to pay claims when an insurer becomes insolvent.  All insurance companies that are licensed to sell property and casualty insurance in Texas are required to be members of the association and to contribute to our fund.  Our governing statute is found at Tex.Ins.Code chap. 462.


2. How do I contact the Texas Property and Casualty Insurance Guaranty Association?

We are located in Austin, Texas.  Please view our Contact Page.

TPCIGA
9120 Burnet Road
Austin, TX 78758
Phone: (512) 345-9335
Toll Free: (800) 856-0298
Fax: (512) 345-9341


3. What happens if my insurance company becomes insolvent?

TPCIGA has been set up by the legislature to protect you if your property or casualty carrier becomes insolvent. We can pay claims and provide a defense under a liability policy, so long as those obligations are “covered claims” under the TPCIGA Act.  


4. What types of insurance does the TPCIGA cover?

We cover property and casualty lines of insurance, such as auto, homeowner’s, worker’s compensation, general liability and professional liability policies.


5. What isn’t covered?

TPCIGA does not cover life, annuity, health or disability insurance - questions about those lines of insurance should be directed to the Texas Life, Accident, Health and Hospital Service Insurance Guaranty Association, 1-800-982-6362, www.txlifega.org.  

TPCIGA does not cover title insurance.  Please refer to the Texas Title Insurance Guaranty Association, (512) 474-1587, www.ttiga.org.

We also do not cover surplus lines, credit insurance, financial or mortgage guaranty, fidelity or surety bonds, or ocean marine coverage.  Please refer to § 462.007 for a more complete list of exceptions to coverage.


6. What does it mean when an insurance company is placed into liquidation?

It’s similar to bankruptcy, except the process is managed by state courts and state insurance departments.  When an insurance company has been found by a court to have insufficient funds to pay all of its claims, the court orders the company into liquidation, and the insurance department in the company’s home state becomes the Receiver or Liquidator of the company in order to liquidate its assets for the benefit of policyholders and claimants.  Claims payments are usually stopped, and all of the company’s insurance policies are canceled.  Existing claims are then referred to the appropriate state guaranty association for handling.


7. When does TPCIGA become responsible for handling the claims of an insolvent insurance company?

Our responsibilities are triggered when a court issues an order stating that the insurer is insolvent and the Texas Commissioner of Insurance issues an order designating the company as an "impaired insurer."  To be considered for coverage by the TPCIGA, either the claimant or the insured must be a Texas resident, or the claim must arise from property permanently located in Texas.  Insureds and claimants in other states may be covered by their own state guaranty associations.


8. I heard that my insurance company is going into receivership in another state. Will there be guaranty fund coverage for my claim in Texas?

If the company was licensed to write insurance in Texas and otherwise qualifies for membership in the association, the Texas Commissioner of Insurance will likely issue an order designating the company as an impaired insurer and trigger TPCIGA's duty to pay covered claims.  


9.  Will someone from TPCIGA contact me about my claim?

We will try to contact each person who had an open claim on file with the impaired insurer.  As soon as possible after we receive the claim files from the company's receiver, we will mail out letters detailing your rights under the Guaranty Act and letting you know how to contact us.  If you do not hear from us within a month from the date the company became impaired, feel free to contact us. However, we will be unable to give you specific information about your claim or to make any payments until we have received your claim file from the receiver.


10.  Will there be delays in the handling of my claim?

Some delays are likely, since we must first obtain the files from the insolvent insurer and have time to review them. Oftentimes, the files are disorganized or in poor condition when we receive them. We will make every effort to quickly identify and expedite the handling of any hardship cases, such as when your auto is in the repair shop and can’t be released until your claim is paid. Be patient, and we will handle your claim as soon as practicable. We will make every effort to ensure that workers compensation periodic indemnity claims continue to be paid without interruption.


11.  How do I give you notice of my claim?

Refer to our Contact Page for our phone and fax numbers and email and mailing address.  


12. Am I still entitled to the same benefits under my policy?

Not necessarily.  Because the guaranty association is designed to be a safety net and not a complete replacement for insurance coverage, there are limitations on the kinds and amounts of claims that TPCIGA can pay.  With some exceptions, benefits are generally capped at $300,000 or the limits of the policy, whichever is less; however, TPCIGA will pay the full amount of a covered claim for statutory worker’s compensation benefits.  


13. What if I have other insurance coverage?

You must exhaust your rights under any other policy of insurance that might be available to pay your claim before obtaining coverage from the TPCIGA.  TPCIGA is entitled to a credit for the full limits of that policy.  For example, if you were in an automobile accident and you have uninsured motorists coverage with a solvent insurer, you must contact your agent to file a claim for your UM benefits.  If you have a claim for policy benefits in excess of the amount payable by TPCIGA, you may present that claim to the receiver or the liquidator of the impaired insurer. Such claims will be payable only to the extent that there are sufficient company assets remaining to pay them.


14.  I am a business owner. Will TPCIGA protect me?

Yes, unless you are a very large company -- TPCIGA does not handle non-workers’ compensation claims for insureds whose net worth equals or exceeds $50,000,000.00. TPCIGA handles the workers' compensation claims of such insureds, but it seeks reimbursement from the insured for all amounts paid on the claim.


15.  I wrecked my car or my car has been damaged by another driver -- will TPCIGA pay for it?

For covered claims, TPCIGA pays up to policy limits or $300,000.00 in property damage, whichever is less.  If you have uninsured motorists’ coverage with a solvent company, you should contact your agent to file a claim.


16.  I just paid my premium – will I get a refund?

A. Covered claims for unearned premium are covered up to $25,000.  TPCIGA will pay unearned premium claims after the Receiver processes the policy records and sends the unearned premium records to TPCIGA.  This may take several weeks or several months, depending on the condition of the data at the insolvent insurance company.


17.  I had already filed my claim with my insurance company; do I have to file it again with TPCIGA?

So long as your claim appears in the company's records, TPCIGA will have notice of your claim and there is no need to file it again. However, if it has been more than a month since your insurer became impaired and you have not yet heard from TPCIGA, you should contact us to be sure we have a record of your claim.


18.  Is there a deadline to file a claim with TPCIGA?

Yes.  Claims for statutory workers' compensation benefits must be timely filed in accordance with the procedures of the applicable workers' compensation act. For all other types of claims, the deadline is eighteen months after the date that the receivership court enters an order of liquidation. If you had already filed a claim with the insurer prior to receivership, TPCIGA considers your claim to have been filed prior to the deadline.


19.  I received a Proof of Claim, what should I do?

Proofs of Claim are sent by the receiver or liquidator of the insolvent insurer; they are not sent by the TPCIGA.  Contact the receiver or liquidator if you have questions about whether to file a Proof of Claim.  Information on contacting the receiver can be found on our Companies in Receivership page.


20.  Do I have to file a Proof of Claim with the Liquidator?

It is not necessary to file a Proof of Claim to assert a claim against the TPCIGA.  However, you must file a Proof of Claim to protect your rights to share in any distribution from the receivership estate, particularly for claims that are not covered by TPCIGA or that exceed our “cap.”


21.  What do I do if I receive notice of a new claim against me or if I am served with a lawsuit?

You should immediately contact TPCIGA and send a copy of the claim and/or lawsuit to our office by facsimile and by certified mail.


22.  Will TPCIGA take over the defense of my pending lawsuit?

If the lawsuit is within the coverage of the applicable policy, TPCIGA will continue to defend the insured to the extent of coverage under the policy and the Guaranty Act.  TPCIGA may choose to retain the same attorney, or we may decide to have the case referred to a different attorney.


23.  My lawsuit is scheduled for trial soon. What will happen?

The law provides for an automatic stay of all proceedings pending in a court in Texas for six months from the date of impairment. If additional time is needed, the receivership court may extend the period of the stay.


24.  Should I cancel existing coverage?

First, consult your agent.  Generally, it is in your best interest to replace coverage in an insolvent company as soon as possible, because the receivership court will cancel all policies, and the TPCIGA will only cover claims arising within the first 30 days after the company becomes impaired.


25.  How can I find out if my insurance company is licensed in Texas?

The Texas Department of Insurance (TDI) maintains complete and current records of all insurance companies licensed to do business in Texas.  You can look up the company at the TDI website at https://apps.tdi.state.tx.us/pcci/pcci_search.jsp.  You can also call TDI at 800-252-3439.  TPCIGA is comprised of authorized insurers writing association “covered” lines of business is Texas.


26.  Will TPCIGA report claim payments under the new Medicare reporting law?

In compliance with the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the TPCIGA will perform the appropriate CMS queries and serve as the Responsible Reporting Entity for any claim payments it makes that are subject to the MMSEA.


27.  Why is TPCIGA asking for my social security number?

TPCIGA uses social security numbers only for certain claims-related activities, as set forth in our Privacy Policy.  Beginning in 2011, the federal Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) will require that we also determine whether a person receiving a payment for bodily injury is a Medicare beneficiary.  To do so, we must obtain the claimant’s social security number.  For more information on MMSEA, go to http://www.cms.gov/MandatoryInsRep.


Workers’ Compensation FAQs


28.  Will there be an interruption in my workers' compensation benefits?

TPCIGA makes every effort to ensure that the payment of weekly workers' compensation benefits continues without interruption. However, our efforts are subject to the availability of claim files and necessary information from the insolvent company, and it is possible that there may be an interruption in your weekly benefits. In addition, our review of the file may result in a change in the amount or availability of benefits, in accordance with the Texas Workers’ Compensation Act.


29. May I continue to see the doctor treating me for my workers' compensation claim?

Yes. You should advise the doctor to contact TPCIGA for authorization and billing information.


30.  How will workers' compensation medical bills be processed?

Click here for more information


31. Doesn’t HIPAA prevent me from disclosing worker’s compensation patient information to TPCIGA?  

Employers, workers' compensation insurance carriers, physicians, and other participants in the workers' compensation system are permitted to share protected health information with each other in connection with workers' compensation claims and appeals.  More information is available through the Workers’ Compensation Division of the Texas Department of Insurance, see releasemedinfo.pdf and hipaa-faq.pdf.


Attorney Inquiries


32.  I have a lawsuit involving the impaired insurer or one of its insureds, what happens now?

The Act provides for an automatic six-month stay of litigation in any case in which the insurer is a party or was obligated to defend a party.  The stay applies to all parties for all purposes.   


33.  I have outstanding fees or expenses for the defense of an insured, where do I send my bill?

Legal fees and expenses incurred prior to the Commissioner’s order of impairment are not payable by TPCIGA.  You may file a proof of claim with the receiver for those amounts. No post-impairment fees and expenses will be paid by TPCIGA unless expressly authorized by TPCIGA.  TPCIGA will contact defense counsel to discuss continued handling or transfer of files.  In an emergency case, please contact our in-house counsel for instructions.


34.  Who is TPCIGA’s agent for service of process?

Our agent for service is our Executive Director, Marvin Kelly, who can be served at our offices in Austin.  



The information in this FAQ is only meant to be general in nature. You should refer to our complete statute listed in this website for full information. If there is any inconsistency between this FAQ and any applicable law, then such law will control. You may also contact the TPCIGA directly for further information.



FREQUENTLY ASKED QUESTIONS

TPCIGA- The Alamo

Information on this site is not legal advice and is not intended to be a comprehensive statement of the law or of the TPCIGA's policies and procedures.  References to the laws of any jurisdiction are for informational purposes only and are not a substitute for the official version of a statute. TPCIGA makes no warranty as to the accuracy or reliability of the content of this website or other related websites.  


© 2010 by Texas Property and Casualty Insurance Guaranty Association