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Terms Used In Texas Insurance Code 843.257

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.

A complainant, or a designated representative if the enrollee is a minor or is disabled, is entitled to:
(1) appear in person before the complaint appeal panel;
(2) present alternative expert testimony; and
(3) request the presence of and question any person responsible for making the disputed decision that resulted in the appeal.