Sec. 463.114. SUMMARY DOCUMENT; DISCLAIMER. (a) The association shall prepare a summary document describing the general purposes and limitations of this chapter and amend the document as necessary to comply with this chapter. The document must clearly and conspicuously contain on the document's face a disclaimer that:
(1) states the name and address of the association and department;
(2) warns the policy or contract holder that:
(A) the association may not cover the policy; or
(B) coverage, if available, is subject to substantial limitations and exclusions and requires continuous residence in this state;
(3) states that an insurer and the insurer's agent are prohibited by law from using the association's existence to sell, solicit, or induce the purchase of any kind of insurance;
(4) warns the policy or contract holder not to rely on association coverage in selecting an insurer; and
(5) provides other information the commissioner prescribes.
(b) The association shall submit the document to the commissioner for approval.
(c) At the expiration of the 60th day after approval of the document, a member insurer may not deliver a policy or contract with respect to which this chapter provides coverage as determined under Subchapter E to a policy, contract, or certificate holder or enrollee before a copy of the summary document is delivered to the policy, contract, or certificate holder or enrollee. The document must also be available on request of a policy, contract, or certificate holder or enrollee.
(d) The distribution, delivery, content, or interpretation of a summary document does not guarantee that a policy or contract or a policy, contract, or certificate holder or enrollee is provided coverage by this chapter if a member insurer becomes impaired or insolvent. Failure to receive the document does not give an insured or policy, contract, or certificate holder or enrollee any rights greater than those provided by this chapter.
(e) An insurer or agent may not deliver a policy or contract described by Section 463.202 that is excluded from the coverage provided by this chapter by Section 463.203 unless the insurer or agent, either before or in conjunction with delivery, gives the policy, contract, or certificate holder or enrollee a separate written notice clearly and conspicuously disclosing that the policy or contract is not covered by the association.
(f) The commissioner shall specify by rule the form and content of the disclaimer required by Subsection (a) and the notice required by Subsection (e).
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 10, eff. September 1, 2019.
Structure Texas Statutes
Title 4 - Regulation of Solvency
Subtitle D - Guaranty Associations
Chapter 463 - Texas Life and Health Insurance Guaranty Association
Subchapter C. General Powers and Duties of Association
Section 463.101. General Powers and Duties
Section 463.102. Plan of Operation; Amendments
Section 463.104. Association Records
Section 463.106. Delegation of Powers and Duties
Section 463.107. Exemption From Taxation
Section 463.108. Detection and Prevention of Impairment and Insolvency
Section 463.109. Association Appearance Before Court; Intervention
Section 463.110. Annual Report
Section 463.111. Board and Association Advice and Assistance
Section 463.112. Board Access to Records