Sec. 1201.219. POLICY PROVISION: CHANGE OF OCCUPATION. An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:
"Change of Occupation: If the insured is injured or contracts a sickness after the insured changes the insured's occupation to one classified by the insurer as more hazardous than the occupation stated in this policy or while doing for compensation anything pertaining to an occupation so classified, the insurer will pay only the portion of the indemnity provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for the more hazardous occupation. If the insured changes the insured's occupation to one classified by the insurer as less hazardous than the occupation stated in this policy, the insurer, on receipt of proof of the change of occupation, will reduce the premium rate accordingly, and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding the receipt of the proof, whichever date is more recent. In applying this provision, the classification of occupational risk and the premium rates are the classification and rates that, before the occurrence of the loss for which the insurer is liable or before the date of proof of change in occupation, were:
(1) last filed by the insurer with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued; or
(2) if filing was not required, last made effective by the insurer in the state where the insured resided at the time this policy was issued."
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