Sec. 842.260. PAYMENT OF CLAIM; PROOF OF CLAIM. (a) After receipt of due proof of claim, a group hospital service corporation shall pay each claim presented under a membership certificate in full not later than the 60th day after the date on which the applicable services prescribed in the certificate have been provided.
(b) Written notice of a claim given to a group hospital service corporation is considered due proof of claim under this section if the corporation does not provide the claimant with the forms usually provided by the corporation for filing a claim before the 16th day after the date notice is received.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.
Structure Texas Statutes
Title 6 - Organization of Insurers and Related Entities
Subtitle C - Life, Health, and Accident Insurers and Related Entities
Chapter 842 - Group Hospital Service Corporations
Subchapter F. Plan of Operation; Provision of Benefits to Members
Section 842.251. Plan of Operation
Section 842.252. Membership Certificate; Contract
Section 842.253. Policy, Certificate, and Application Forms
Section 842.254. Deposit Requirements
Section 842.255. Advance Payments to Hospital Prohibited
Section 842.256. Contracts With Health Care Providers
Section 842.257. May Limit Benefits
Section 842.258. Limitations on Contracts for Medical Services
Section 842.259. Use of Indemnity Plan Authorized
Section 842.260. Payment of Claim; Proof of Claim
Section 842.261. Information Available Through Internet Site