Texas insurance appeal rights

Texas administers appeals through the Texas Department of Insurance (TDI) for most commercial plans, with separate routes for ERISA self-funded employer plans.

Internal appeal rights

Internal appeals must be filed within 180 days. Texas requires carriers to respond to standard internal appeals within 30 days; urgent appeals within 72 hours.

External review

Texas Independent Review Organization (IRO) review is available after exhaustion of internal appeals. The IRO decision binds the carrier.

TX regulator

Texas Department of Insurance (TDI). official site

Notable

Texas requires carriers to disclose clinical review criteria on request.
TDI Consumer Help: 800-252-3439.
Texas has aggressive surprise-billing protections; out-of-network denials should be cross-checked against state rules.

Filed a denial in Texas?

We work under TX rules and structure the appeal under the strongest available state and federal protections.

Start Your Appeal

State law information is provided for general guidance and is not legal advice. Confirm with your state regulator or a licensed attorney for your specific case.