reglab/housing_qa huggingface dataset:
TX Ins Code § 701.109 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 701 - Insurance Fraud Investigations|Subchapter C. Investigations|Section 701.109. Request for Investigation by Insurer

Sec. 701.109.  REQUEST FOR INVESTIGATION BY INSURER.  (a)  An insurer who conducts an independent investigation of suspected insurance fraud is not required to complete that investigation before requesting that the commissioner conduct an investigation.(b)  When requesting the commissioner to conduct an investigation, the insurer shall draft a report of the insurer's findings and submit the report and any related investigation file to the commissioner as soon as practicable on the conclusion of the insurer's independent investigation.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 1282 (H.B. 2388), Sec. 2, eff. September 1, 2005.|
TX Ins Code § 701.151 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 701 - Insurance Fraud Investigations|Subchapter D. Insurance Fraud Information; Confidentiality|Section 701.151. Confidentiality of Department Information

Sec. 701.151.  CONFIDENTIALITY OF DEPARTMENT INFORMATION.  (a)  Information or material acquired by the department that is relevant to an investigation by the insurance fraud unit is not a public record for the period the commissioner considers reasonably necessary to:(1)  complete the investigation;(2)  protect the person under investigation from unwarranted injury;  or(3)  serve the public interest.(b)  The information or material is not subject to a subpoena by another governmental entity, other than a grand jury subpoena, until:(1)  the information or material is released for public inspection by the commissioner;  or(2)  after notice and a hearing a district court determines that obeying the subpoena would not jeopardize the public interest and any investigation by the commissioner.(c)  This section does not affect the conduct of a contested case under Chapter 2001, Government Code.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 701.152 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 701 - Insurance Fraud Investigations|Subchapter D. Insurance Fraud Information; Confidentiality|Section 701.152. Confidentiality of Authorized Governmental Agency Information

Sec. 701.152.  CONFIDENTIALITY OF AUTHORIZED GOVERNMENTAL AGENCY INFORMATION.  Information or material acquired under this chapter by an authorized governmental agency is privileged and is not a public record.  The information or material is not subject to a subpoena, other than a grand jury subpoena, unless, after reasonable notice to the insurer and agency and a hearing, a district court determines that obeying the subpoena would not jeopardize the public interest and any investigation by the agency.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 701.153 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 701 - Insurance Fraud Investigations|Subchapter D. Insurance Fraud Information; Confidentiality|Section 701.153. Disclosure of Information to Certain Agencies

Sec. 701.153.  DISCLOSURE OF INFORMATION TO CERTAIN AGENCIES.  An authorized governmental agency may release to another authorized governmental agency or the department and the department may release to an authorized governmental agency information or material provided under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 701.154 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 701 - Insurance Fraud Investigations|Subchapter D. Insurance Fraud Information; Confidentiality|Section 701.154. Disclosure of Information to Public

Sec. 701.154.  DISCLOSURE OF INFORMATION TO PUBLIC.  (a)  Except as otherwise provided by law, an authorized governmental agency or an insurer that possesses or receives information or material under this chapter may not release that information or material to the public.(b)  Information provided under this chapter by an insurer to the insurance fraud unit or an authorized governmental agency is not subject to public disclosure.  The information may be used by the insurance fraud unit or authorized governmental agency only in performing duties described by this chapter.(c)  Notwithstanding Section 701.151, the commissioner may not release evidence obtained under Section 701.107 for public inspection if releasing the evidence would violate a privilege held by or a confidentiality requirement imposed on the agency from which the evidence was obtained.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.001 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter A. General Provisions|Section 703.001. Definition

Sec. 703.001.  DEFINITION.  In this chapter, "covered entity" means a health maintenance organization or insurer regulated by the department, 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 title insurance company;(10)  a stipulated premium company;(11)  a nonprofit legal services corporation;(12)  a statewide mutual assessment company;(13)  a local mutual aid association;(14)  a local mutual burial association;(15)  an association exempt under Section 887.102;(16)  a nonprofit hospital, medical, or dental service corporation, including a corporation subject to Chapter 842;(17)  a county mutual insurance company; and(18)  a farm mutual insurance company.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.Amended by: Acts 2017, 85th Leg., R.S., Ch. 967 (S.B. 2065), Sec. 5.005, eff. September 1, 2017.|
TX Ins Code § 703.002 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter A. General Provisions|Section 703.002. Right of Intervention

Sec. 703.002.  RIGHT OF INTERVENTION.  This chapter does not affect the right of any person, including a state agency, to intervene in an antifraud action brought under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.051 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter B. Antifraud Action; Certification|Section 703.051. Antifraud Action Authorized

Sec. 703.051.  ANTIFRAUD ACTION AUTHORIZED.  (a)  A covered entity acting alone or through a person, corporation, or legal entity affiliated with the covered entity may bring an action in a court, including a counter-action or cross-action, to:(1)  prevent a person from fraudulently engaging in the business of insurance or the business of a health maintenance organization in this state;  or(2)  redress the effects of a person who has fraudulently engaged in the business of insurance or the business of a health maintenance organization in this state.(b)  An action may be brought under this section if:(1)  the acts of the person may adversely affect or have adversely affected at least 10 residents of this state;  and(2)  the department has not brought an antifraud action in a court against the person.(c)  An action may be brought under this section regardless of whether the covered entity is directly affected by the person's acts.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.052 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter B. Antifraud Action; Certification|Section 703.052. Request for Certification

Sec. 703.052.  REQUEST FOR CERTIFICATION.  A covered entity may request the court to certify that the action is an antifraud action under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.053 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter B. Antifraud Action; Certification|Section 703.053. Notice of Request for Certification

Sec. 703.053.  NOTICE OF REQUEST FOR CERTIFICATION.  (a)  When a covered entity files a request for certification, the covered entity shall provide at least 10 days' notice of the request to the department and the attorney general by serving each with a copy of the request in the manner provided for service of notice under Rule 21a, Texas Rules of Civil Procedure.(b)  The covered entity shall provide the notice regardless of whether the department or the state is a party to the action.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.054 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter B. Antifraud Action; Certification|Section 703.054. Hearing on Request for Certification

Sec. 703.054.  HEARING ON REQUEST FOR CERTIFICATION.  As soon as practicable after a covered entity files a request for certification, the court shall hold a hearing to determine whether the action is an antifraud action under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.055 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter B. Antifraud Action; Certification|Section 703.055. Certification

Sec. 703.055.  CERTIFICATION.  The court shall certify that the action is an antifraud action if the court determines that:(1)  the requirements of Section 703.051 are met;  and(2)  the pleadings and evidence demonstrate that the covered entity has a probable right of recovery.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.101 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter C. Expenses of Antifraud Action|Section 703.101. Determination of Expenses

Sec. 703.101.  DETERMINATION OF EXPENSES.  (a)  The court that certifies an action as an antifraud action by order may determine the amount of reasonable and necessary expenses incurred in bringing the action, including court costs, reasonable attorney's fees, witness fees, fees of experts, and deposition expenses.(b)  In making the determination, the court may consider the contribution to the action of any person, including a state agency, that has intervened in the action.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.102 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter C. Expenses of Antifraud Action|Section 703.102. Deduction or Offset for Expenses; Reimbursement

Sec. 703.102.  DEDUCTION OR OFFSET FOR EXPENSES;  REIMBURSEMENT.  (a)  Subject to Subsection (b), a covered entity has a deduction or offset against any obligation, assessment, or debt owed by the covered entity to this state in the amount of the reasonable and necessary expenses determined by the court order.(b)  The covered entity shall reimburse the state the amount of any expenses actually recovered from the parties to the private antifraud action under a final judgment awarding, wholly or partly, expenses to or for the covered entity's benefit.  The amount of reimbursement may not exceed the actual amount of deductions or offsets taken by the covered entity.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.103 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter C. Expenses of Antifraud Action|Section 703.103. Assignment of Deduction or Offset

Sec. 703.103.  ASSIGNMENT OF DEDUCTION OR OFFSET.  The covered entity may assign the covered entity's deduction or offset to any other covered entity or reinsurer.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 703.104 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 703 - Covered Entity's Antifraud Action|Subchapter C. Expenses of Antifraud Action|Section 703.104. Treatment of Deduction or Offset as Admitted Asset

Sec. 703.104.  TREATMENT OF DEDUCTION OR OFFSET AS ADMITTED ASSET.  A covered entity or a covered entity's assignee entitled to an offset or deduction that has not been used may show, in the covered entity's or assignee's books and records, the balance of the deduction or offset as an admitted asset for any purpose.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 704.001 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 704 - Antifraud Programs|Subchapter A. General Provisions|Section 704.001. Definition

Sec. 704.001.  DEFINITION.  In this chapter, "plan issuer" means:(1)  a health insurer, including a life, health, and accident insurer, a health and accident insurer, a health maintenance organization, and any other person operating under Chapter 841, 842, 843, 884, 885, 982, or 1501 who is authorized to issue, issue for delivery, or deliver insurance policies, certificates, contracts, or evidences of coverage in this state;(2)  an approved nonprofit health corporation that holds a certificate of authority issued under Chapter 844;  or(3)  an insurer authorized by the department to write workers' compensation insurance in this state.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 704.002 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 704 - Antifraud Programs|Subchapter A. General Provisions|Section 704.002. Notice Relating to False or Fraudulent Claims Required

Sec. 704.002.  NOTICE RELATING TO FALSE OR FRAUDULENT CLAIMS REQUIRED.  (a)  A plan issuer who provides a form for a person to make a claim against or to give notice of the person's intent to make a claim against a policy, certificate, contract, or evidence of coverage issued by the issuer must include on the form, in comparative prominence with the other content on the form, a statement that is substantially similar to the following:  "Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison."(b)  This section does not apply to a form provided to make a claim against a policy issued by a reinsurer.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 704.051 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 704 - Antifraud Programs|Subchapter B. Antifraud Plans|Section 704.051. Antifraud Plan Required for Certain Plan Issuers

Sec. 704.051.  ANTIFRAUD PLAN REQUIRED FOR CERTAIN PLAN ISSUERS.  A plan issuer who collects direct written premium shall adopt an antifraud plan under this subchapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 704.052 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 704 - Antifraud Programs|Subchapter B. Antifraud Plans|Section 704.052. Antifraud Plan Requirements

Sec. 704.052.  ANTIFRAUD PLAN REQUIREMENTS.  An antifraud plan adopted by a plan issuer under this subchapter must include a description of the issuer's procedures for:(1)  detecting and investigating possible fraudulent insurance acts;  and(2)  reporting possible fraudulent insurance acts to the insurance fraud unit.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 704.053 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 704 - Antifraud Programs|Subchapter B. Antifraud Plans|Section 704.053. Filing of Antifraud Plan

Sec. 704.053.  FILING OF ANTIFRAUD PLAN.  A plan issuer may annually file the issuer's antifraud plan adopted under this subchapter with the insurance fraud unit.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 704.054 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 704 - Antifraud Programs|Subchapter B. Antifraud Plans|Section 704.054. Fraud and Abuse Plans Under Certain State Programs; Enforcement

Sec. 704.054.  FRAUD AND ABUSE PLANS UNDER CERTAIN STATE PROGRAMS;  ENFORCEMENT.  (a)  A fraud and abuse plan put in place by a plan issuer participating in the Medicaid STAR or STAR + Plus program or the child health plan program under Chapter 62, Health and Safety Code, and approved by a health and human services agency meets the requirements of this subchapter.(b)  If a plan issuer described by Subsection (a) is required by law to report possible fraudulent insurance acts to a health and human services agency or the office of the attorney general, the issuer is not required to report those acts to the insurance fraud unit.(c)  The insurance fraud unit, the office of the attorney general, and the health and human services agencies shall coordinate enforcement efforts with respect to fraudulent insurance acts covered by this chapter relating to the Medicaid program or the child health plan program.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 705.001 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 705 - Misrepresentations by Policyholders|Subchapter A. General Provisions|Section 705.001. Definition

Sec. 705.001.  DEFINITION.  In this subchapter, "insurance policy" means a contract or policy of insurance.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 705.002 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 705 - Misrepresentations by Policyholders|Subchapter A. General Provisions|Section 705.002. Applicability of Subchapter

Sec. 705.002.  APPLICABILITY OF SUBCHAPTER.  Except as provided by Section 705.005, this subchapter applies to each insurance policy issued or contracted for in this state.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 705.003 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 705 - Misrepresentations by Policyholders|Subchapter A. General Provisions|Section 705.003. Policy Provision: Misrepresentation in Proof of Loss or Death

Sec. 705.003.  POLICY PROVISION:  MISREPRESENTATION IN PROOF OF LOSS OR DEATH.  (a)  An insurance policy provision that states that a misrepresentation, including a false statement, made in a proof of loss or death makes the policy void or voidable:(1)  has no effect;  and(2)  is not a defense in a suit brought on the policy.(b)  Subsection (a) does not apply if it is shown at trial that the misrepresentation:(1)  was fraudulently made;(2)  misrepresented a fact material to the question of the insurer's liability under the policy;  and(3)  misled the insurer and caused the insurer to waive or lose a valid defense to the policy.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 705.004 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 705 - Misrepresentations by Policyholders|Subchapter A. General Provisions|Section 705.004. Policy Provision: Misrepresentation in Policy Application

Sec. 705.004.  POLICY PROVISION:  MISREPRESENTATION IN POLICY APPLICATION.  (a)  An insurance policy provision that states that false statements made in the application for the policy or in the policy make the policy void or voidable:(1)  has no effect;  and(2)  is not a defense in a suit brought on the policy.(b)  Subsection (a) does not apply if it is shown at trial that the matter misrepresented:(1)  was material to the risk;  or(2)  contributed to the contingency or event on which the policy became due and payable.(c)  It is a question of fact whether a misrepresentation made in the application for the policy or in the policy itself was material to the risk or contributed to the contingency or event on which the policy became due and payable.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 705.005 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 705 - Misrepresentations by Policyholders|Subchapter A. General Provisions|Section 705.005. Notice to Insured of Misrepresentations

Sec. 705.005.  NOTICE TO INSURED OF MISREPRESENTATIONS.  (a)  This section applies to any suit brought on an insurance policy issued or contracted for after June 29, 1903.(b)  A defendant may use as a defense a misrepresentation made in the application for or in obtaining an insurance policy only if the defendant shows at trial that before the 91st day after the date the defendant discovered the falsity of the representation, the defendant gave notice that the defendant refused to be bound by the policy:(1)  to the insured, if living;  or(2)  to the owners or beneficiaries of the insurance policy, if the insured was deceased.(c)  This section does not:(1)  make available as a defense an immaterial misrepresentation;  or(2)  affect the provisions of Section 705.004.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|
TX Ins Code § 705.051 (2021)
2021 Texas Statutes|Insurance Code|Title 5 - Protection of Consumer Interests|Subtitle F - Insurance Fraud and Identity Theft|Chapter 705 - Misrepresentations by Policyholders|Subchapter B. Special Provisions Related to Life, Accident, and Health Insurance Policies|Section 705.051. Immaterial Misrepresentation in Life, Accident, or Health Insurance Application

Sec. 705.051.  IMMATERIAL MISREPRESENTATION IN LIFE, ACCIDENT, OR HEALTH INSURANCE APPLICATION.  A misrepresentation in an application for a life, accident, or health insurance policy does not defeat recovery under the policy unless the misrepresentation:(1)  is of a material fact;  and(2)  affects the risks assumed.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.|