Sec. 1201.212. POLICY PROVISION: CLAIM FORMS. (a) Except as provided by Subsection (b), an individual accident and health insurance policy must contain the following provision:
"Claim Forms: The insurer, on receipt of a notice of claim, will provide to the claimant the forms usually provided by the insurer for filing proof of loss. If the forms are not provided before the 16th day after the date of the notice, the claimant shall be considered to have complied with the requirements of this policy as to proof of loss on submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character, and the extent of the loss for which the claim is made."
(b) The provision required by this section is not required to be contained in a policy issued by a corporation operating under Chapter 842.
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