reglab/housing_qa huggingface dataset:
TX Ins Code § 1201.202 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.202. Order of Required Policy Provisions

Sec. 1201.202.  ORDER OF REQUIRED POLICY PROVISIONS.  (a)  Except as provided by Subsection (b), policy provisions required by this subchapter or corresponding substitute provisions must be printed in the same consecutive order as provided by this subchapter.(b)  An insurer may print a policy provision required by this subchapter or a corresponding substitute provision as a unit in any part of the policy with other provisions to which the provision is logically related.(c)  A policy printed under Subsection (b) may not be wholly or partly unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered, or issued.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.203 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.203. Other Policy Provisions

Sec. 1201.203.  OTHER POLICY PROVISIONS.  A policy provision that is not otherwise subject to this subchapter may not make an individual accident and health insurance policy or any portion of the policy less favorable in any way to the insured or the beneficiary than the policy provisions that are subject to this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.204 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.204. Policy Provisions Required by Other Jurisdiction

Sec. 1201.204.  POLICY PROVISIONS REQUIRED BY OTHER JURISDICTION.  An individual accident and health insurance policy of a foreign or alien insurer may contain any provision that is:(1)  not less favorable to the insured or the beneficiary than the provisions of this chapter;  and(2)  prescribed or required by the law of the state under which the insurer is organized.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.205 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.205. Policy Provisions for Policy Delivered Outside This State

Sec. 1201.205.  POLICY PROVISIONS FOR POLICY DELIVERED OUTSIDE THIS STATE.  An individual accident and health insurance policy issued by a domestic insurer for delivery in another state or country may contain any provision permitted or required by the laws of that state or country.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.206 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.206. Filing Procedure

Sec. 1201.206.  FILING PROCEDURE.  (a)  The commissioner may adopt reasonable rules regarding the procedure for submitting policies subject to this chapter that are necessary, proper, or advisable for the administration of this chapter.(b)  This section does not limit any authority otherwise granted by law to the commissioner or department.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.207 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.207. Policy Provision: Entirety of Contract; Policy Changes

Sec. 1201.207.  POLICY PROVISION:  ENTIRETY OF CONTRACT;  POLICY CHANGES.  An individual accident and health insurance policy must contain the following provision:"Entire Contract;  Changes:  This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance.  A change in this policy is not valid until the change is approved by an executive officer of the insurer and unless the approval is endorsed on or attached to the policy.  An agent does not have authority to change this policy or to waive any of its provisions."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.208 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.208. Policy Provision: Incontestability

Sec. 1201.208.  POLICY PROVISION:  INCONTESTABILITY.  (a)  Except as provided by Subsection (c), an individual accident and health insurance policy must contain the following provision:"Time Limit on Certain Defenses:  (a) After the second anniversary of the date this policy is issued, a misstatement, other than a fraudulent misstatement, made by the applicant in the application for the policy may not be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) beginning after that anniversary."(b) A claim for loss incurred or disability (as defined in the policy) beginning after the second anniversary of the date this policy is issued may not be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss existed before the effective date of coverage of this policy."(b)  Clause (a) of the provision required by Subsection (a) does not:(1)  affect any legal requirement for avoidance of a policy or denial of a claim during the initial two-year period;  or(2)  limit the application of Section 1201.219, 1201.220, or 1201.221 in a case of a misstatement regarding age, occupation, or other insurance.(c)  For a policy that provides that the insured is entitled to continue the policy in force by the timely payment of premiums until the insured reaches at least 50 years of age or, if the policy was issued after the insured reached 44 years of age, until at least the fifth anniversary of the policy's date of issuance, an insurer may use the following clause instead of Clause (a) of the provision required by Subsection (a):"After this policy has been in force for a period of two years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestible as to the statements contained in the application."(d)  The provision provided by Subsection (c) must be under the caption "Incontestable."  An insurer that uses the provision may omit the parenthetical clause.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.209 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.209. Policy Provision: Grace Period

Sec. 1201.209.  POLICY PROVISION:  GRACE PERIOD.  (a)  An individual accident and health insurance policy must contain the following provision:"Grace Period:  A grace period of __________ (insert appropriate number) days will be granted for the payment of each premium due after the first premium.  During the grace period, the policy continues in force."(b)  The number of days of the grace period may not be less than:(1)  7 for a weekly premium policy;(2)  10 for a monthly premium policy;  or(3)  31 for any other policy.(c)  A policy that contains a cancellation provision may add, at the end of the provision required by Subsection (a):  "subject to the right of the insurer to cancel the policy in accordance with the policy's cancellation provision."(d)  A policy in which the insurer reserves the right to refuse any renewal must include the following provision at the beginning of the provision required by Subsection (a):"Unless, not less than five days before the premium due date, the insurer has delivered to the insured, or has mailed to the insured's last address as shown by the insurer's records, a written notice of the insurer's intention not to renew this policy beyond the period for which the premium has been accepted, ...."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.210 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.210. Policy Provision: Reinstatement

Sec. 1201.210.  POLICY PROVISION:  REINSTATEMENT.  (a)  Except as provided by Subsection (b), an individual accident and health insurance policy must contain the following provision:"Reinstatement:  If a renewal premium is not paid before the expiration of the period granted for the insured to make the payment, a subsequent acceptance of the premium by the insurer or any agent authorized by the insurer to accept the premium, without requiring in connection with the acceptance an application for reinstatement, reinstates the policy.  However, if the insurer or authorized agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the policy will be reinstated on approval of the application by the insurer or, if the application is not approved, on the 45th day after the date of the conditional receipt unless the insurer before that date has notified the insured in writing of the insurer's disapproval of the application.  The reinstated policy covers only loss resulting from an accidental injury sustained after the date of reinstatement and loss due to sickness that begins more than 10 days after the date of reinstatement.  In all other respects the insured and insurer have the same rights under the reinstated policy as they had under the policy immediately before the due date of the defaulted premium, subject to any provisions endorsed in the policy or attached to the policy in connection with the reinstatement.  Any premium accepted in connection with a reinstatement shall be applied to a period for which premium has not been previously paid, but not to any period more than 60 days before the date of reinstatement."(b)  The insurer may omit the last sentence of the provision required by Subsection (a) in a policy that provides that the insured is entitled to continue the policy in force by the timely payment of premiums until the insured reaches at least 50 years of age or, if the policy was issued after the insured reached 44 years of age, until at least the fifth anniversary of the policy's date of issuance.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.211 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.211. Policy Provision: Notice of Claim

Sec. 1201.211.  POLICY PROVISION:  NOTICE OF CLAIM.  (a)  Except as provided by Subsection (b), an individual accident and health insurance policy must contain the following provision:"Notice of Claim:  A written notice of claim must be given to the insurer before the 21st day after the date of the occurrence or beginning of any loss covered by the policy, or as soon after that date as is reasonably possible.  A notice given by or on behalf of the insured or the beneficiary to the insurer at __________ (insert the location of any office the insurer designates for the purpose), or to any authorized agent of the insurer, with information sufficient to identify the insured, constitutes notice to the insurer."(b)  In a policy that provides a loss of time benefit that may be payable for at least two years, an insurer may insert, between the first and second sentences of the provision required by Subsection (a), the following provision:"Subject to the qualifications below, and except in the event of a legal incapacity, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least two years, the insured shall, at least once in every __________ (insert appropriate number) months after having given notice of claim, give to the insurer notice of continuance of the disability.  In applying this provision, the period of __________ (insert appropriate number) months following a filing of proof by the insured or any payment by the insurer on account of the claim or any denial of liability in whole or in part by the insurer shall be excluded.  Delay in giving the notice does not impair the insured's right to any indemnity that would otherwise have accrued during the period of __________ (insert appropriate number) months preceding the date on which the notice is actually given."(c)  The number of months inserted in the clause permitted by Subsection (b) may not be less than one or greater than six.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.212 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.212. Policy Provision: Claim Forms

Sec. 1201.212.  POLICY PROVISION:  CLAIM FORMS.  (a)  Except as provided by Subsection (b), an individual accident and health insurance policy must contain the following provision:"Claim Forms:  The insurer, on receipt of a notice of claim, will provide to the claimant the forms usually provided by the insurer for filing proof of loss.  If the forms are not provided before the 16th day after the date of the notice, the claimant shall be considered to have complied with the requirements of this policy as to proof of loss on submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character, and the extent of the loss for which the claim is made."(b)  The provision required by this section is not required to be contained in a policy issued by a corporation operating under Chapter 842.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.213 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.213. Policy Provision: Proof of Loss

Sec. 1201.213.  POLICY PROVISION:  PROOF OF LOSS.  An individual accident and health insurance policy must contain the following provision:"Proof of Loss:  For a claim for loss for which this policy provides any periodic payment contingent on continuing loss, a written proof of loss must be provided to the insurer at the insurer's designated office before the 91st day after the termination of the period for which the insurer is liable.  For a claim for any other loss, a written proof of loss must be provided to the insurer at the insurer's designated office before the 91st day after the date of the loss.  Failure to provide the proof within the required time does not invalidate or reduce any claim if it was not reasonably possible to give proof within the required time.  In that case, the proof must be provided as soon as reasonably possible but not later than one year after the time proof is otherwise required, except in the event of a legal incapacity."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.214 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.214. Policy Provision: Time of Payment of Claims

Sec. 1201.214.  POLICY PROVISION:  TIME OF PAYMENT OF CLAIMS.  (a)  Except as provided by Subsection (c), an individual accident and health insurance policy must contain the following provision:"Time of Payment of Claims:  Indemnities payable under this policy for any loss, other than a loss for which this policy provides any periodic payment, will be paid immediately on receipt of due written proof of the loss.  Subject to due written proof of loss, all accrued indemnities for a loss for which this policy provides periodic payment will be paid __________ (insert period for payment) and any balance remaining unpaid on termination of liability will be paid immediately on receipt of due written proof of loss."(b)  The period for payment to be inserted in the clause required by Subsection (a) may not be less frequent than monthly.(c)  The provision required by this section is not required to be contained in a policy issued by a corporation operating under Chapter 842.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.215 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.215. Policy Provision: Payment of Claims

Sec. 1201.215.  POLICY PROVISION:  PAYMENT OF CLAIMS.  (a)  Except as provided by Subsection (d), an individual accident and health insurance policy must contain the following provision:"Payment of Claims:  Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting indemnity payments that may be prescribed in this policy and effective at the time of payment.  If such a designation or provision is not then effective, the indemnity will be payable to the insured's estate.  Any other accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid either in accordance with the beneficiary designation or to the insured's estate.  All other indemnities will be payable to the insured."(b)  An insurer may include with the provision required by Subsection (a) one or both of the following provisions:"If any indemnity of this policy is payable to the insured's estate, or to an insured or beneficiary who is a minor or is otherwise not competent to give a valid release, the insurer may pay the indemnity, up to an amount not exceeding $__________ (insert amount), to any relative by blood or connection by marriage of the insured or beneficiary who is considered by the insurer to be equitably entitled to the indemnity.  Any payment made by the insurer in good faith in accordance with this provision fully discharges the insurer to the extent of the payment.""Subject to any written direction of the insured, in the application or otherwise, all or a portion of any indemnity provided by this policy on account of hospital, nursing, medical, or surgical services may, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proof of the loss, be paid directly to the hospital or person providing the services.  It is not required that the service be provided by a particular hospital or person."(c)  The amount to be inserted in the clause permitted by Subsection (b) may not exceed $1,000.(d)  The provision required by Subsection (a) is not required to be contained in a policy issued by a corporation operating under Chapter 842.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.216 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.216. Policy Provision: Physical Examinations and Autopsy

Sec. 1201.216.  POLICY PROVISION:  PHYSICAL EXAMINATIONS AND AUTOPSY.  An individual accident and health insurance policy must contain the following provision:"Physical Examinations and Autopsy:  The insurer at its own expense has the right and opportunity to conduct a physical examination of the insured when and as often as the insurer reasonably requires while a claim under the policy is pending and, in case of death, to require that an autopsy be conducted if not forbidden by law."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.217 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.217. Policy Provision: Legal Actions

Sec. 1201.217.  POLICY PROVISION:  LEGAL ACTIONS.  An individual accident and health insurance policy must contain the following provision:"Legal Actions:  An action at law or in equity may not be brought to recover on this policy before the 61st day after the date written proof of loss has been provided in accordance with the requirements of this policy.  An action at law or in equity may not be brought after the expiration of three years after the time written proof of loss is required to be provided."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.218 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1201 - Accident and Health Insurance|Subchapter E. Required Policy Provisions|Section 1201.218. Policy Provision: Change of Beneficiary

Sec. 1201.218.  POLICY PROVISION:  CHANGE OF BENEFICIARY.  (a)  Except as provided by Subsection (b), an individual accident and health insurance policy must contain the following provision:"Change of Beneficiary:  Unless the insured makes an irrevocable designation of beneficiary, the right to change a beneficiary is reserved for the insured, and the consent of the beneficiary or beneficiaries is not required for the surrender or assignment of this policy, for any change of beneficiary or beneficiaries, or for any other changes in this policy."(b)  An insurer may omit the first clause of the provision required by Subsection (a) relating to an irrevocable designation of beneficiary.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|