Sec. 1251.111. CLAIM FORMS. (a) A group accident and health insurance policy must provide that the insurer will furnish to the person making a claim or to the policyholder for delivery to a person making a claim the forms usually provided by the insurer for filing a proof of loss.
(b) If the forms for a proof of loss are not provided before the 16th day after the date the insurer received notice of a claim under the policy, the person making the claim is considered to have complied with the requirements of the policy as to proof of loss on submitting, within the time set in the policy for filing proof of loss, written proof covering the occurrence, character, and extent of the loss for which the claim is made.
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 B - Group Health Coverage
Chapter 1251 - Group and Blanket Health Insurance
Subchapter C. Group Accident and Health Insurance: Required Provisions
Section 1251.101. Required Provisions
Section 1251.102. Payment of Premiums
Section 1251.103. Incontestability of Policy
Section 1251.104. Entire Contract
Section 1251.105. Statement Made by Policyholder or Insured
Section 1251.106. Distinction Based on Marital Status Prohibited
Section 1251.107. Evidence of Insurability
Section 1251.108. Exclusion or Limitation of Coverage for Preexisting Conditions
Section 1251.109. Adjustment of Premiums or Benefits if Age of Insured Is Misstated
Section 1251.110. Deadline for Notice of Claim
Section 1251.112. Deadline for Claim
Section 1251.113. Prompt Payment of Benefits Required
Section 1251.114. Payment of Benefits
Section 1251.115. Right to Conduct Physical Examination or Autopsy