reglab/housing_qa huggingface dataset:
TX Ins Code § 542.001 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.001. Short Title

Sec. 542.001.  SHORT TITLE.  This subchapter may be cited as the Unfair Claim Settlement Practices Act.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.002 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.002. Applicability of Subchapter

Sec. 542.002.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to the following insurers whether organized as a proprietorship, partnership, stock or mutual corporation, or unincorporated association:(1)  a life, health, or accident insurance company;(2)  a fire or casualty insurance company;(3)  a hail or storm insurance company;(4)  a title insurance company;(5)  a mortgage guarantee company;(6)  a mutual assessment company;(7)  a local mutual aid association;(8)  a local mutual burial association;(9)  a statewide mutual assessment company;(10)  a stipulated premium company;(11)  a fraternal benefit society;(12)  a group hospital service corporation;(13)  a county mutual insurance company;(14)  a Lloyd's plan;(15)  a reciprocal or interinsurance exchange;  and(16)  a farm mutual insurance company.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.003 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.003. Unfair Claim Settlement Practices Prohibited

Sec. 542.003.  UNFAIR CLAIM SETTLEMENT PRACTICES PROHIBITED.  (a)  An insurer engaging in business in this state may not engage in an unfair claim settlement practice.(b)  Any of the following acts by an insurer constitutes unfair claim settlement practices:(1)  knowingly misrepresenting to a claimant pertinent facts or policy provisions relating to coverage at issue;(2)  failing to acknowledge with reasonable promptness pertinent communications relating to a claim arising under the insurer's policy;(3)  failing to adopt and implement reasonable standards for the prompt investigation of claims arising under the insurer's policies;(4)  not attempting in good faith to effect a prompt, fair, and equitable settlement of a claim submitted in which liability has become reasonably clear;(5)  compelling a policyholder to institute a suit to recover an amount due under a policy by offering substantially less than the amount ultimately recovered in a suit brought by the policyholder;(6)  failing to maintain the information required by Section 542.005;  or(7)  committing another act the commissioner determines by rule constitutes an unfair claim settlement practice.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.004 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.004. Examination of Tax Returns Prohibited

Sec. 542.004.  EXAMINATION OF TAX RETURNS PROHIBITED.  (a)  An insurer regulated under this code may not require a claimant, as a condition of settling a claim, to produce the claimant's federal income tax returns for examination or investigation by the insurer unless:(1)  the claimant is ordered to produce the tax returns by a court;  or(2)  the claim involves:(A)  a fire loss;  or(B)  a loss of profits or income.(b)  An insurer that violates this section commits:(1)  a prohibited practice under this subchapter;  and(2)  a deceptive trade practice under Subchapter E, Chapter 17, Business & Commerce Code.(c)  A claimant affected by a violation of this section is entitled to remedies under Subchapter E, Chapter 17, Business & Commerce Code.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.005 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.005. Record of Complaints

Sec. 542.005.  RECORD OF COMPLAINTS.  (a)  In this section, "complaint" means any written communication primarily expressing a grievance.(b)  An insurer shall maintain a complete record of all complaints received by the insurer during the preceding three years or since the date of the insurer's last examination by the department, whichever period is shorter.  The record must indicate:(1)  the total number of complaints;(2)  the classification of complaints by line of insurance;(3)  the nature of each complaint;(4)  the disposition of the complaints;  and(5)  the time spent processing each complaint.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.006 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.006. Periodic Reporting Requirement

Sec. 542.006.  PERIODIC REPORTING REQUIREMENT.  (a)  In this section, "claim" means a written claim filed by a resident of this state with an insurer engaging in business in this state.(b)  If, based on complaints of unfair claim settlement practices under this subchapter, the department finds that an insurer should be subjected to closer supervision with respect to the insurer's claim settlement practices, the department may require the insurer to file periodic reports at intervals the department determines necessary.(c)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 42 , Sec. 3.01(4), eff. September 1, 2015.(d)  If at any time the department determines that the requirement to file a periodic report is no longer necessary to accomplish the objectives of this subchapter, the department may rescind the reporting requirement.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.Amended by: Acts 2015, 84th Leg., R.S., Ch. 42 (S.B. 784), Sec. 3.01(4), eff. September 1, 2015.|
TX Ins Code § 542.007 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.007. Comparison of Certain Insurers to Minimum Standard of Performance; Investigation

Sec. 542.007.  COMPARISON OF CERTAIN INSURERS TO MINIMUM STANDARD OF PERFORMANCE;  INVESTIGATION.  (a)  The department shall compile the information received from an insurer under Section 542.006 in a manner that enables the department to compare the insurer's performance to a minimum standard of performance adopted by the commissioner.(b)  If the department determines that the insurer does not meet the minimum standard of performance, the department shall investigate the insurer to determine the reason, if any, that the insurer does not meet the minimum standard.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.008 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.008. Complaints Against Insurers; Investigation

Sec. 542.008.  COMPLAINTS AGAINST INSURERS;  INVESTIGATION.  (a)  The department shall establish a system for receiving and processing individual complaints alleging a violation of this subchapter by an insurer regardless of whether the insurer is required to file a periodic report under Section 542.006.(b)  The department shall investigate an insurer if the department determines that:(1)  based on the number and type of complaints against an insurer, the insurer does not meet the minimum standard of performance adopted under Section 542.007;  or(2)  the number and type of complaints against the insurer are not proportionate to the number and type of complaints against other insurers writing similar lines of insurance.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.009 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.009. Review of Investigation Results; Hearing

Sec. 542.009.  REVIEW OF INVESTIGATION RESULTS;  HEARING.  (a)  On receiving the results of an investigation instituted under Section 542.007 or 542.008, the department shall review those results considering the standards of this subchapter to determine whether further action is necessary.(b)  If the department determines that further action is necessary, the department shall:(1)  set a date for a hearing to review the alleged violations of this subchapter;  and(2)  notify the insurer of:(A)  the date of the hearing;  and(B)  the nature of the charges.(c)  The department shall provide the notice required by Subsection (b)(2) not later than the 30th day before the date of the hearing.(d)  At a hearing under this section, the insurer may present the insurer's case with the assistance of counsel.(e)  Evidence relating to the number and type of complaints or claims prepared by the department from information received or compiled under Section 542.006, 542.007, or 542.008 is admissible in evidence at:(1)  the hearing;  and(2)  any related judicial proceeding.(f)  The hearing shall be conducted in accordance with this code and rules adopted by the commissioner.(g)  An insurer may not be found to be in violation of this subchapter solely because of the number and type of complaints or claims against the insurer.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.010 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.010. Cease and Desist Order; Enforcement

Sec. 542.010.  CEASE AND DESIST ORDER;  ENFORCEMENT.  (a)  If the department determines that an insurer has violated this subchapter, the department shall issue a cease and desist order to the insurer directing the insurer to stop the unlawful practice.(b)  If the insurer fails to comply with the cease and desist order, the department may:(1)  revoke or suspend the insurer's certificate of authority;  or(2)  limit, regulate, and control:(A)  the insurer's line of business;(B)  the insurer's writing of policy forms or other particular forms;  and(C)  the volume of the insurer's:(i)  line of business;  or(ii)  writing of policy forms or other particular forms.(c)  The department shall exercise authority under this section to the extent that the department determines is necessary to obtain the insurer's compliance with the cease and desist order.(d)  At the request of the department, the attorney general shall assist the department in enforcing the cease and desist order.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.011 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.011. Time Limit to Appeal

Sec. 542.011.  TIME LIMIT TO APPEAL.  An insurer affected by a ruling or order of the department under this subchapter may appeal the ruling or order, in accordance with Subchapter D, Chapter 36, by filing a petition for judicial review not later than the 20th day after the date of the ruling or order.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.012 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.012. Attorney's Fees

Sec. 542.012.  ATTORNEY'S FEES.  The department is entitled to reasonable attorney's fees if judicial action is necessary to enforce an order of the department under this subchapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.013 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.013. Personnel

Sec. 542.013.  PERSONNEL.  The department may hire employees and examiners as needed to enforce this subchapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.014 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter A. Unfair Claim Settlement Practices|Section 542.014. Rules

Sec. 542.014.  RULES.  The commissioner shall adopt reasonable rules as necessary to implement and augment the purposes and provisions of this subchapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.051 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.051. Definitions

Sec. 542.051.  DEFINITIONS.  In this subchapter:(1)  "Business day" means a day other than a Saturday, Sunday, or holiday recognized by this state.(2)  "Claim" means a first-party claim that:(A)  is made by an insured or policyholder under an insurance policy or contract or by a beneficiary named in the policy or contract;  and(B)  must be paid by the insurer directly to the insured or beneficiary.(3)  "Claimant" means a person making a claim.(4)  "Notice of claim" means any written notification provided by a claimant to an insurer that reasonably apprises the insurer of the facts relating to the claim.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.052 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.052. Applicability of Subchapter

Sec. 542.052.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to any insurer authorized to engage in business as an insurance company or to provide insurance in this state, including:(1)  a stock life, health, or accident insurance company;(2)  a mutual life, health, or accident insurance company;(3)  a stock fire or casualty insurance company;(4)  a mutual fire or casualty insurance company;(5)  a Mexican casualty insurance company;(6)  a Lloyd's plan;(7)  a reciprocal or interinsurance exchange;(8)  a fraternal benefit society;(9)  a stipulated premium company;(10)  a nonprofit legal services corporation;(11)  a statewide mutual assessment company;(12)  a local mutual aid association;(13)  a local mutual burial association;(14)  an association exempt under Section 887.102;(15)  a nonprofit hospital, medical, or dental service corporation, including a corporation subject to Chapter 842;(16)  a county mutual insurance company;(17)  a farm mutual insurance company;(18)  a risk retention group;(19)  a purchasing group;(20)  an eligible surplus lines insurer; and(21)  except as provided by Section 542.053(b), a guaranty association operating under Chapter 462 or 463.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2D.007, eff. April 1, 2009.|
TX Ins Code § 542.053 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.053. Exception

Sec. 542.053.  EXCEPTION.  (a)  This subchapter does not apply to:(1)  workers' compensation insurance;(2)  mortgage guaranty insurance;(3)  title insurance;(4)  fidelity, surety, or guaranty bonds;(5)  marine insurance as defined by Section 1807.001; or(6)  a guaranty association created and operating under Chapter 2602.(b)  A guaranty association operating under Chapter 462 or 463 is not subject to the damage provisions of Section 542.060.(c)  This subchapter does not apply to a health maintenance organization except as provided by Section 1271.005(c).(d)  This subchapter does not apply to a claim governed by Subchapter C, Chapter 1301.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.009(a), eff. September 1, 2005.Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2D.008, eff. April 1, 2009.|
TX Ins Code § 542.054 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.054. Liberal Construction

Sec. 542.054.  LIBERAL CONSTRUCTION.  This subchapter shall be liberally construed to promote the prompt payment of insurance claims.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.055 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.055. Receipt of Notice of Claim

Sec. 542.055.  RECEIPT OF NOTICE OF CLAIM.  (a)  Not later than the 15th day or, if the insurer is an eligible surplus lines insurer, the 30th business day after the date an insurer receives notice of a claim, the insurer shall:(1)  acknowledge receipt of the claim;(2)  commence any investigation of the claim;  and(3)  request from the claimant all items, statements, and forms that the insurer reasonably believes, at that time, will be required from the claimant.(b)  An insurer may make additional requests for information if during the investigation of the claim the additional requests are necessary.(c)  If the acknowledgment of receipt of a claim is not made in writing, the insurer shall make a record of the date, manner, and content of the acknowledgment.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.056 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.056. Notice of Acceptance or Rejection of Claim

Sec. 542.056.  NOTICE OF ACCEPTANCE OR REJECTION OF CLAIM.  (a)  Except as provided by Subsection (b) or (d), an insurer shall notify a claimant in writing of the acceptance or rejection of a claim not later than the 15th business day after the date the insurer receives all items, statements, and forms required by the insurer to secure final proof of loss.(b)  If an insurer has a reasonable basis to believe that a loss resulted from arson, the insurer shall notify the claimant in writing of the acceptance or rejection of the claim not later than the 30th day after the date the insurer receives all items, statements, and forms required by the insurer.(c)  If the insurer rejects the claim, the notice required by Subsection (a) or (b) must state the reasons for the rejection.(d)  If the insurer is unable to accept or reject the claim within the period specified by Subsection (a) or (b), the insurer, within that same period, shall notify the claimant of the reasons that the insurer needs additional time.  The insurer shall accept or reject the claim not later than the 45th day after the date the insurer notifies a claimant under this subsection.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.057 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.057. Payment of Claim

Sec. 542.057.  PAYMENT OF CLAIM.  (a)  Except as otherwise provided by this section, if an insurer notifies a claimant under Section 542.056 that the insurer will pay a claim or part of a claim, the insurer shall pay the claim not later than the fifth business day after the date notice is made.(b)  If payment of the claim or part of the claim is conditioned on the performance of an act by the claimant, the insurer shall pay the claim not later than the fifth business day after the date the act is performed.(c)  If the insurer is an eligible surplus lines insurer, the insurer shall pay the claim not later than the 20th business day after the notice or the date the act is performed, as applicable.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 542.058 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle C - Deceptive, Unfair, and Prohibited Practices|Chapter 542 - Processing and Settlement of Claims|Subchapter B. Prompt Payment of Claims|Section 542.058. Delay in Payment of Claim

Sec. 542.058.  DELAY IN PAYMENT OF CLAIM.  (a)  Except as otherwise provided, if an insurer, after receiving all items, statements, and forms reasonably requested and required under Section 542.055, delays payment of the claim for a period exceeding the period specified by other applicable statutes or, if other statutes do not specify a period, for more than 60 days, the insurer shall pay damages and other items as provided by Section 542.060.(b)  Subsection (a) does not apply in a case in which it is found as a result of arbitration or litigation that a claim received by an insurer is invalid and should not be paid by the insurer.(c)  A life insurer that receives notice of an adverse, bona fide claim to all or part of the proceeds of the policy before the applicable payment deadline under Subsection (a) shall pay the claim or properly file an interpleader action and tender the benefits into the registry of the court not later than the 90th day after the date the insurer receives all items, statements, and forms reasonably requested and required under Section 542.055.  A life insurer that delays payment of the claim or the filing of an interpleader and tender of policy proceeds for more than 90 days shall pay damages and other items as provided by Section 542.060 until the claim is paid or an interpleader is properly filed.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.Amended by: Acts 2009, 81st Leg., R.S., Ch. 833 (S.B. 1812), Sec. 1, eff. June 19, 2009.|