Sec. 1201.201. POLICY PROVISIONS REQUIRED. (a) Except as provided by Subsections (b) and (c), an individual accident and health insurance policy must contain the provisions required by this subchapter in the words provided by this subchapter.
(b) An insurer may substitute for a policy provision required by this subchapter a provision with different wording approved by the commissioner in accordance with reasonable rules adopted by the commissioner. A substituted provision may not be less favorable to an insured or a beneficiary of the policy than the provision required by this subchapter.
(c) If a policy provision required by this subchapter is wholly or partly inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the commissioner's approval, shall:
(1) omit from the policy each inapplicable provision or part of a provision; and
(2) modify each inconsistent provision or part of a provision so that the provision as contained in the policy is consistent with the coverage provided by the policy.
(d) A policy provision required by this subchapter must be preceded by the caption for the provision provided by this subchapter or, at the option of the insurer, by an appropriate individual or group caption or subcaption approved by the commissioner.
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 E. Required Policy Provisions
Section 1201.201. Policy Provisions Required
Section 1201.202. Order of Required Policy Provisions
Section 1201.203. Other Policy Provisions
Section 1201.204. Policy Provisions Required by Other Jurisdiction
Section 1201.205. Policy Provisions for Policy Delivered Outside This State
Section 1201.206. Filing Procedure
Section 1201.207. Policy Provision: Entirety of Contract; Policy Changes
Section 1201.208. Policy Provision: Incontestability
Section 1201.209. Policy Provision: Grace Period
Section 1201.210. Policy Provision: Reinstatement
Section 1201.211. Policy Provision: Notice of Claim
Section 1201.212. Policy Provision: Claim Forms
Section 1201.213. Policy Provision: Proof of Loss
Section 1201.214. Policy Provision: Time of Payment of Claims
Section 1201.215. Policy Provision: Payment of Claims
Section 1201.216. Policy Provision: Physical Examinations and Autopsy
Section 1201.217. Policy Provision: Legal Actions
Section 1201.218. Policy Provision: Change of Beneficiary
Section 1201.219. Policy Provision: Change of Occupation
Section 1201.220. Policy Provision: Misstatement of Age
Section 1201.221. Policy Provision: Excess Insurance
Section 1201.222. Policy Provision: Relation of Earnings to Insurance
Section 1201.223. Policy Provision: Unpaid Premium
Section 1201.224. Policy Provision: Cancellation
Section 1201.225. Policy Provision: Conformity With State Statutes