Sec. 1201.152. COVERAGE UNDER SIMPLIFIED APPLICATION FORM. (a) Notwithstanding Clause (b) of the provision required by Section 1201.208(a), an individual accident and health insurance policy must cover any loss that occurs after 12 months from a preexisting condition if the insurer uses a simplified application form that does not include a question concerning the applicant's health history or medical treatment history.
(b) This section applies regardless of whether the simplified application form includes a question regarding the applicant's health at the time of application.
(c) This section does not require an insurer to cover a loss from a condition that the policy specifically excludes from coverage.
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
Subchapter D. Preexisting Conditions
Section 1201.151. Compliance With Subchapter; Prohibition of Defense
Section 1201.152. Coverage Under Simplified Application Form
Section 1201.153. Coverage for Individuals Age 65 or Older
Section 1201.154. Coverage for Certain Previously Covered Persons