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Terms Used In Texas Insurance Code 1271.202

  • 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.

If a health maintenance organization denies a request under § 1271.201, the enrollee may appeal the decision through the health maintenance organization’s established complaint and appeals process.