Sec. 1701.057. WITHDRAWAL OF INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICY FORM APPROVAL. (a) Except as provided by Subsection (b), the commissioner may, after notice and hearing, withdraw approval of an individual accident and health insurance policy form if, after consideration of all relevant facts, the commissioner determines that:
(1) the benefits provided under the form are unreasonable in relation to the premium charged; or
(2) the reserve required by Section 862.102 is not maintained by the insurer on the policies issued on the form.
(b) If an individual accident and health insurance policy form has been on file with the department for at least 360 days and has been affirmatively approved by the commissioner, been considered approved under this chapter, or been exempted from the approval requirements of this chapter, the commissioner may withdraw the approval or exemption only if:
(1) the form violates this code or a rule adopted under this code; or
(2) the commissioner finds proof of gross misrepresentation or fraud to a policyholder.
(c) To enable the department to determine compliance with Subsection (b), the commissioner:
(1) shall require an insurer to file the rates charged by that insurer for individual accident and health insurance policies; and
(2) may adopt and require an insurer to file in conjunction with the annual statement required under Section 841.255, 982.101, or 982.103 a form for reporting the insurer's experience on individual accident and health insurance policy forms issued by the insurer.
(d) The commissioner shall, in accordance with Section 1201.007, adopt reasonable rules necessary to establish standards under which the approval of an individual accident and health insurance policy form may be withdrawn.
(e) This section does not grant the commissioner the authority to determine, fix, prescribe, or promulgate rates to be charged for an individual accident and health insurance policy.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 5, eff. April 1, 2005.
Structure Texas Statutes
Title 9 - Provisions Applicable to Life and Health Coverages
Subchapter B. Filing Requirement
Section 1701.051. Filing Required
Section 1701.052. File and Use
Section 1701.054. Approval of Form
Section 1701.055. Disapproval of Form or Withdrawal of Approval or Exemption
Section 1701.056. Use of Disapproved Form Prohibited
Section 1701.057. Withdrawal of Individual Accident and Health Insurance Policy Form Approval
Section 1701.058. Reconsideration of Form
Section 1701.059. Replacement or Amendment of Document
Section 1701.060. General Rulemaking Authority