Sec. 1251.114. PAYMENT OF BENEFITS. (a) A group accident and health insurance policy must provide that all benefits of the policy, other than benefits for loss of life, must be paid to the insured or the insured's assignee.
(b) A group accident and health insurance policy must provide that, subject to the provisions of the policy, benefits for loss of life of an insured must be paid to:
(1) the beneficiary designated by the insured or the beneficiary's assignee;
(2) the family member specified by the policy terms, if the policy contains conditions relating to family status; or
(3) the estate of the insured, if the designated or specified beneficiary is not living at the time the insured dies.
(c) A group accident and health insurance policy may provide that if any benefits are payable to the estate of an individual or to an individual who is a minor or is otherwise not competent to give a valid release, the insurer may pay the benefits, up to an amount established by the commissioner, to any individual related by consanguinity or affinity to the individual who is considered by the insurer to be equitably entitled to the benefits.
(d) This section does not apply to:
(1) a credit accident and health insurance policy; or
(2) a group contract issued by a group hospital service corporation.
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