Sec. 1201.213. POLICY PROVISION: PROOF OF LOSS. An individual accident and health insurance policy must contain the following provision:
"Proof of Loss: For a claim for loss for which this policy provides any periodic payment contingent on continuing loss, a written proof of loss must be provided to the insurer at the insurer's designated office before the 91st day after the termination of the period for which the insurer is liable. For a claim for any other loss, a written proof of loss must be provided to the insurer at the insurer's designated office before the 91st day after the date of the loss. Failure to provide the proof within the required time does not invalidate or reduce any claim if it was not reasonably possible to give proof within the required time. In that case, the proof must be provided as soon as reasonably possible but not later than one year after the time proof is otherwise required, except in the event of a legal incapacity."
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