Sec. 1201.060. REQUIRED DEFINITION OF "EMERGENCY CARE" IN INDIVIDUAL OR GROUP POLICY. An individual or group accident and health insurance policy that provides an emergency care benefit, including a policy issued by a corporation operating under Chapter 842, must define "emergency care" as follows:
"Emergency care" means bona fide emergency services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
(1) placing the patient's health in serious jeopardy;
(2) serious impairment to bodily functions; or
(3) serious dysfunction of any bodily organ or part.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle A - Health Coverage in General
Chapter 1201 - Accident and Health Insurance
Section 1201.051. Entire Consideration
Section 1201.052. Time of Effectiveness and Termination
Section 1201.053. Persons Insured
Section 1201.054. Appearance of Text
Section 1201.055. Exceptions and Reductions of Indemnity
Section 1201.057. Incorporation of or Reference to Other Documents
Section 1201.058. Notification That Policy Is Returnable; Effect of Return
Section 1201.060. Required Definition of "Emergency Care" in Individual or Group Policy
Section 1201.0601. Required Definitions: Specified Disease Policy
Section 1201.061. Coverage for Adopted Child
Section 1201.062. Coverage for Certain Children in Individual or Group Policy or in Plan or Program
Section 1201.064. Coverage for Child of Spouse in Individual or Group Policy