reglab/housing_qa huggingface dataset:
TX Ins Code § 1201.219 (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 1201.219. Policy Provision: Change of Occupation

Sec. 1201.219.  POLICY PROVISION:  CHANGE OF OCCUPATION.  An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:"Change of Occupation:  If the insured is injured or contracts a sickness after the insured changes the insured's occupation to one classified by the insurer as more hazardous than the occupation stated in this policy or while doing for compensation anything pertaining to an occupation so classified, the insurer will pay only the portion of the indemnity provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for the more hazardous occupation.  If the insured changes the insured's occupation to one classified by the insurer as less hazardous than the occupation stated in this policy, the insurer, on receipt of proof of the change of occupation, will reduce the premium rate accordingly, and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding the receipt of the proof, whichever date is more recent.  In applying this provision, the classification of occupational risk and the premium rates are the classification and rates that, before the occurrence of the loss for which the insurer is liable or before the date of proof of change in occupation, were:(1)  last filed by the insurer with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued;  or(2)  if filing was not required, last made effective by the insurer in the state where the insured resided at the time this policy was issued."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.220 (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 1201.220. Policy Provision: Misstatement of Age

Sec. 1201.220.  POLICY PROVISION:  MISSTATEMENT OF AGE.  An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:"Misstatement of Age:  If the age of the insured has been misstated, the amounts payable under this policy are the amounts the premium paid would have purchased at the correct age."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.221 (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 1201.221. Policy Provision: Excess Insurance

Sec. 1201.221.  POLICY PROVISION:  EXCESS INSURANCE.  An individual accident and health insurance policy must contain one of the following provisions if the policy addresses the subject matter of the provision:"Other Insurance With This Insurer:  If an accident or health or accident and health policy or policies previously issued by the insurer to the insured is in force concurrently with this policy, making the aggregate indemnity for __________ (insert types of coverages) in excess of $__________ (insert maximum limit of indemnity or indemnities), the excess insurance is void and all premiums paid for the excess shall be returned to the insured or to the insured's estate.""Other Insurance With This Insurer:  Insurance effective at any one time on the insured under the same type of policy or policies with this insurer is limited to the one policy elected by the insured, the insured's beneficiary, or the insured's estate, as the case may be, and the insurer will return all premiums paid for all other policies of the same type."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.223 (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 1201.223. Policy Provision: Unpaid Premium

Sec. 1201.223.  POLICY PROVISION:  UNPAID PREMIUM.  An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:"Unpaid Premium:  At the time of payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted from the payment."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.224 (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 1201.224. Policy Provision: Cancellation

Sec. 1201.224.  POLICY PROVISION:  CANCELLATION.  An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:"Cancellation:  The insurer may cancel this policy at any time by written notice delivered to the insured, or mailed to the insured's last address as shown by the records of the insurer, stating when the cancellation is effective, which may not be earlier than five days after the date the notice is delivered or mailed.  After this policy has been continued beyond its original term, the insured may cancel the policy at any time by written notice delivered or mailed to the insurer, effective on receipt or on a later date specified in the notice.  In the event of cancellation, the insurer will promptly return the unearned portion of any premium paid.  If the insured cancels, the earned premium shall be computed by the use of the short-rate table last filed with the state official having supervision of insurance in the state where the insured resided when the policy was issued.  If the insurer cancels, the earned premium shall be computed pro rata.  Cancellation is without prejudice to any claim originating before the effective date of cancellation."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.225 (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 1201.225. Policy Provision: Conformity With State Statutes

Sec. 1201.225.  POLICY PROVISION:  CONFORMITY WITH STATE STATUTES.  An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:"Conformity With State Statutes:  Any provision of this policy that, on its effective date, conflicts with the statutes of the state in which the insured resides on the effective date is by this clause effectively amended to conform to the minimum requirements of that state's statutes."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.226 (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 1201.226. Policy Provision: Illegal Occupation

Sec. 1201.226.  POLICY PROVISION:  ILLEGAL OCCUPATION.  An individual accident and health insurance policy must contain the following provision if the policy addresses the subject matter of the provision:"Illegal Occupation:  The insurer is not liable for any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation."|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.271 (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 F. Application for Policy|Section 1201.271. Alteration of Policy Application

Sec. 1201.271.  ALTERATION OF POLICY APPLICATION.  (a)  A person may not alter a written application for an individual accident and health insurance policy unless the person has the written consent of the applicant.(b)  Notwithstanding Subsection (a), an insurer may make an insertion to an application solely for administrative purposes in a manner that indicates clearly that the insertion is not attributed to the applicant.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.272 (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 F. Application for Policy|Section 1201.272. False Statements

Sec. 1201.272.  FALSE STATEMENTS.  The falsity of a statement in an application for an individual accident and health insurance policy does not bar a right to recovery under the policy unless the statement materially affected the acceptance of the risk or the hazard assumed by the insurer.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.273 (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 F. Application for Policy|Section 1201.273. Binding Statements

Sec. 1201.273.  BINDING STATEMENTS.  An insured may not be bound by a statement made in an application for an individual accident and health insurance policy unless a copy of the application is attached to or endorsed on the policy as a part of the policy when issued.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.274 (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 F. Application for Policy|Section 1201.274. Insurer's Evidentiary Use of Application for Reinstatement or Renewal

Sec. 1201.274.  INSURER'S EVIDENTIARY USE OF APPLICATION FOR REINSTATEMENT OR RENEWAL.  (a)  If an individual accident and health insurance policy is reinstated or renewed, and the insured or the beneficiary or assignee of the policy makes a written request for a copy of the application for reinstatement or renewal, the insurer shall, not later than the 15th day after the date the insurer receives the request at its home or branch office, deliver or mail a copy of the application to the person who made the request.(b)  An insurer that fails to comply with this section may not introduce the application for reinstatement or renewal as evidence in any action or proceeding based on or involving the policy or its reinstatement or renewal.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.701 (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 O. Enforcement|Section 1201.701. Civil Penalty

Sec. 1201.701.  CIVIL PENALTY.  A person, partnership, or corporation that wilfully violates this chapter or an order of the commissioner made under this chapter is liable to the state for a civil penalty in an amount not to exceed $5,000 for each violation.  The penalty may be recovered through a civil action.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1201.702 (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 O. Enforcement|Section 1201.702. Action Against Certificate of Authority or License

Sec. 1201.702.  ACTION AGAINST CERTIFICATE OF AUTHORITY OR LICENSE.  The commissioner may suspend or revoke the certificate of authority or license of an insurer or agent who wilfully violates this chapter or an order of the commissioner made under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1202.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1202 - Cancellation and Continuation of Policies in General|Subchapter A. Continuous Policies|Section 1202.001. Continuous Policies

Sec. 1202.001.  CONTINUOUS POLICIES.  (a)  A guaranteed renewable insurance policy or a noncancellable insurance policy is considered to be a continuous policy, subject only to the policy terms and conditions, including payment of the policy premium.(b)  A guaranteed renewable insurance policy or a noncancellable insurance policy:(1)  is continued in effect by the payment of the policy premium in accordance with the policy terms and conditions;  and(2)  may not be considered or treated as a renewed policy by the payment of the policy premium.(c)  This section does not apply to a small employer health benefit plan adopted in accordance with Chapter 1501.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1202.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1202 - Cancellation and Continuation of Policies in General|Subchapter B. Individual Health Insurance Policies|Section 1202.051. Renewability and Continuation of Individual Health Insurance Policies

Sec. 1202.051.  RENEWABILITY AND CONTINUATION OF INDIVIDUAL HEALTH INSURANCE POLICIES.  (a)  This section applies only to an individual health insurance policy that provides benefits for medical care under a hospital, medical, or surgical policy.(b)  Except as provided by Subsection (c), an insurer shall renew or continue an individual health insurance policy at the option of the individual.(c)  An insurer may decline to renew or continue an individual health insurance policy:(1)  for failure to pay a premium or contribution in accordance with the terms of the policy;(2)  for fraud or intentional misrepresentation;(3)  because the insurer is ceasing to offer coverage in the individual market in accordance with rules adopted by the commissioner;(4)  because an individual no longer resides, lives, or works in an area in which the insurer is authorized to provide coverage, but only if all policies are not renewed or not continued under this subdivision uniformly without regard to any health-status related factor of covered individuals;  or(5)  in accordance with federal law, including regulations.(d)  The commissioner shall adopt rules necessary to:(1)  implement this section;  and(2)  meet the minimum requirements of federal law, including regulations.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1202.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1202 - Cancellation and Continuation of Policies in General|Subchapter B. Individual Health Insurance Policies|Section 1202.052. Cancellation Prohibited for AIDS or HIV

Sec. 1202.052.  CANCELLATION PROHIBITED FOR AIDS OR HIV.  (a)  In this section, "AIDS" and "HIV" have the meanings assigned by Section 81.101, Health and Safety Code.(b)  Except as provided by Subsection (c), an insurer that delivers or issues for delivery an individual accident and health insurance policy in this state may not cancel that policy during its term because the insured:(1)  has been diagnosed as having AIDS or HIV;(2)  has been treated for AIDS or HIV;  or(3)  is being treated for AIDS or HIV.(c)  The insurer may cancel the policy for:(1)  failure to pay a premium when due;  or(2)  fraud or misrepresentation in obtaining coverage by not disclosing a diagnosis of an AIDS or HIV-related condition.(d)  The provisions of Chapter 1201, including provisions relating to the applicability, purpose, and enforcement of that chapter, construction of policies under that chapter, rulemaking under that chapter, and definitions of terms applicable in that chapter, apply to this section.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1203.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1203 - Coordination of Benefits Provisions|Subchapter A. Supplemental Insurance Policies|Section 1203.001. Applicability of Subchapter

Sec. 1203.001.  APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only to:(1)  a policy of group accident and health insurance as described by Chapter 1251;(2)  a policy of blanket accident and health insurance as described by Chapter 1251;(3)  a policy of individual accident and health insurance as defined by Section 1201.001; or(4)  an evidence of coverage as defined by Section 843.002.(b)  This subchapter does not apply to an individual accident and health insurance policy that is designed to fully integrate with other policies through a variable deductible.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2015, 84th Leg., R.S., Ch. 572 (H.B. 3024), Sec. 3, eff. September 1, 2015.|
TX Ins Code § 1203.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1203 - Coordination of Benefits Provisions|Subchapter A. Supplemental Insurance Policies|Section 1203.002. Certain Coordination of Benefits Provisions Prohibited

Sec. 1203.002.  CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED.  (a)  An accident and health insurance policy or evidence of coverage may not be delivered, issued for delivery, or renewed in this state if:(1)  a provision of the policy or evidence of coverage excludes or reduces the payment of benefits to or on behalf of an insured or enrollee;(2)  the reason for the exclusion or reduction is that benefits are also payable or have been paid to or on behalf of the insured or enrollee under a supplemental policy of accident and health insurance;  and(3)  the supplemental policy is individually underwritten and individually issued as a plan of coverage for:(A)  hospital confinement indemnity;(B)  a specified disease;  or(C)  a limited benefit.(b)  Application of Subsection (a) to a provision of an accident and health insurance policy or evidence of coverage is not affected by:(1)  the mode or channel by which the premium for a supplemental policy of accident and health insurance is paid to the insurer;  or(2)  a reduction in the premium for a supplemental policy of accident and health insurance because of the insured's membership in an organization or status as an employee.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1203.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1203 - Coordination of Benefits Provisions|Subchapter A. Supplemental Insurance Policies|Section 1203.003. Certain Coordination of Benefits Provisions Void

Sec. 1203.003.  CERTAIN COORDINATION OF BENEFITS PROVISIONS VOID.  A provision of an accident and health insurance policy or evidence of coverage that violates Section 1203.002 is void.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1203.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1203 - Coordination of Benefits Provisions|Subchapter B. Dental Insurance|Section 1203.051. Applicability of Subchapter; Exception

Sec. 1203.051.  APPLICABILITY OF SUBCHAPTER; EXCEPTION.  (a)  This subchapter applies only to an insurance policy that provides benefits for dental expenses, including, except as provided by Subsection (b), an individual, group, blanket, or franchise insurance policy or insurance agreement, or a group hospital service contract, that is offered by:(1)  an insurance company;(2)  a group hospital service corporation operating under Chapter 842;(3)  a fraternal benefit society operating under Chapter 885;(4)  a stipulated premium company operating under Chapter 884;(5)  a reciprocal exchange operating under Chapter 942; or(6)  a Lloyd's plan operating under Chapter 941.(b)  This subchapter does not apply to a separate dental policy that exclusively provides a non-coordinated, fixed indemnity benefit, regardless of expenses incurred paid directly to the policyholder or to the provider under an assignment of benefits provision.|Added by Acts 2015, 84th Leg., R.S., Ch. 572 (H.B. 3024), Sec. 1, eff. September 1, 2015.|
TX Ins Code § 1203.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1203 - Coordination of Benefits Provisions|Subchapter B. Dental Insurance|Section 1203.052. Coordination of Benefits Between Primary and Secondary Insurers

Sec. 1203.052.  COORDINATION OF BENEFITS BETWEEN PRIMARY AND SECONDARY INSURERS.  (a)  This section applies if:(1)  an insured is covered by at least two different insurance policies; and(2)  each policy provides the insured dental benefits.(b)  The primary insurer, as determined under a coordination of benefits provision applicable to the policies, is responsible for dental expenses covered under the insurance policy issued by the primary insurer up to the full amount of any policy limit applicable to the covered dental expenses.(c)  Before the policy limit described by Subsection (b) is reached, the secondary insurer, as determined under a coordination of benefits provision applicable to the policies, is responsible only for dental expenses covered under the insurance policy issued by the secondary insurer that are not covered under the policy issued by the primary insurer.(d)  After the policy limit described by Subsection (b) has been reached, the secondary insurer, in addition to the responsibility described by Subsection (c), is responsible for any dental expenses covered by both policies that exceed the policy limit described by Subsection (b), not to exceed the policy limit of the secondary policy.|Added by Acts 2015, 84th Leg., R.S., Ch. 572 (H.B. 3024), Sec. 1, eff. September 1, 2015.|
TX Ins Code § 1203.053 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle A - Health Coverage in General|Chapter 1203 - Coordination of Benefits Provisions|Subchapter B. Dental Insurance|Section 1203.053. Certain Coordination of Benefits Provisions Prohibited

Sec. 1203.053.  CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED.  An insurance policy subject to this subchapter may not be delivered, issued for delivery, or renewed in this state if:(1)  a provision of the policy excludes or reduces the payment of benefits for dental expenses to or on behalf of an insured;(2)  the reason for the exclusion or reduction is that dental benefits are payable or have been paid to or on behalf of the insured under another insurance policy; and(3)  the exclusion or reduction would apply before the full amount of the dental expenses incurred by the insured and covered by both policies have been paid or reimbursed or the full amount of the applicable policy limit of the policy containing the exclusion or reduction is reached.|Added by Acts 2015, 84th Leg., R.S., Ch. 572 (H.B. 3024), Sec. 1, eff. September 1, 2015.|