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A complaint that exposes an apparent violation of a policy provision, contract provision, rule, or statute; or which indicates a practice or service that a prudent layperson would regard as below customary business or medical standards.
Texas Department of Insurance and Office of Public Insurance Counsel - Cite This Source - This Definition- Browse Related Terms: Actual cash value, Actual cash value (ACV), Additional Living Expenses, Additional living expenses (ALE), Depreciation, Earthquake Insurance, Exclusion, flood insurance, Full Replacement Policy, Guaranteed Replacement Cost Coverage, Justified complaint, Loss of use, Renters insurance, Replacement Cost