reglab/statecodes huggingface dataset:
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter D. Family Violence › Section 544.152. Applicability of Subchapter

Sec. 544.152.  APPLICABILITY OF SUBCHAPTER.  (a)  This subchapter applies only to:
(1)  a life insurer that delivers, issues for delivery, or renews a life insurance contract or policy in this state, including a group contract, policy, or certificate of life insurance;  and
(2)  a health benefit plan issuer that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:
(A)  an insurance company;
(B)  a group hospital service corporation operating under Chapter 842;
(C)  a fraternal benefit society operating under Chapter 885;
(D)  a stipulated premium company operating under Chapter 884;
(E)  a health benefit plan issuer under Chapter 1501;
(F)  a health maintenance organization operating under Chapter 843;
(G)  an employer under a multiple employer welfare arrangement as defined by Section 3, Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1002), or an analogous benefit arrangement, to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.);
(H)  an issuer of a Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);  and
(I)  an approved nonprofit health corporation that holds a certificate of authority issued under Chapter 844.
(b)  This subchapter does not apply to the issuer of:
(1)  a health benefit plan that provides coverage:
(A)  only for a specified disease;
(B)  only for accidental death or dismemberment;
(C)  for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;
(D)  as a supplement to liability insurance;
(E)  only for limited benefits;  or
(F)  only for dental or vision care;
(2)  hospital confinement indemnity coverage;
(3)  a credit insurance policy;
(4)  workers' compensation insurance coverage;
(5)  medical payment insurance coverage provided under a motor vehicle insurance policy;  or
(6)  a long-term care policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Subsection (a)(2).
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter D. Family Violence › Section 544.153. Prohibitions

Sec. 544.153.  PROHIBITIONS.  (a)  A health benefit plan issuer or life insurer may not, because of an individual's status as a victim of family violence:
(1)  deny coverage to the individual;
(2)  refuse to renew the individual's coverage;
(3)  cancel the individual's coverage;
(4)  limit the amount, extent, or kind of coverage available to the individual;  or
(5)  charge the individual or a group to which the individual belongs a rate that is different from the rate charged to other individuals or groups, respectively, for the same coverage.
(b)  A health benefit plan issuer or life insurer may not, as a part of an application for coverage, require an applicant to reveal whether the applicant has been or may become a victim of family violence.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter D. Family Violence › Section 544.155. Underwriting Criteria

Sec. 544.155.  UNDERWRITING CRITERIA.  Notwithstanding any other provision of this subchapter, a health benefit plan issuer or life insurer may underwrite a risk on the basis of an individual's physical or mental condition regardless of the underlying cause of the condition or on the basis of any underwriting criteria not prohibited by this code or another insurance law of this state or a rule adopted under this code or another insurance law of this state if the issuer or insurer consistently applies the criteria and does not merely use the criteria as a pretext to evade the application of Section 544.153.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter D. Family Violence › Section 544.156. Health Benefit Plan Issuer or Life Insurer Not Liable for Death or Bodily Injury

Sec. 544.156.  HEALTH BENEFIT PLAN ISSUER OR LIFE INSURER NOT LIABLE FOR DEATH OR BODILY INJURY.  A health benefit plan issuer or life insurer that delivers, issues for delivery, or renews a health benefit plan or a life insurance policy or contract for an individual who has been or may become a victim of family violence may not be held civilly or criminally liable for the death of or bodily injuries incurred by that individual as a result of family violence.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter D. Family Violence › Section 544.157. Right to Continued Coverage Unaffected

Sec. 544.157.  RIGHT TO CONTINUED COVERAGE UNAFFECTED.  This subchapter does not affect the right of an individual to continued coverage under Subchapter G, Chapter 1251.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter D. Family Violence › Section 544.158. Unfair or Deceptive Act or Practice

Sec. 544.158.  UNFAIR OR DECEPTIVE ACT OR PRACTICE.  A violation of this subchapter is an unfair or deceptive act or practice under Chapter 541.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter E. Fibrocystic Breast Condition › Section 544.201. Definition

Sec. 544.201.  DEFINITION.  In this subchapter, "health benefit plan issuer" means an insurer, a group hospital service corporation operating under Chapter 842, or a health maintenance organization operating under Chapter 843 that delivers or issues for delivery or renews any health insurance policy or contract in this state, including a group policy, contract, or certificate of health insurance or evidence of coverage.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter E. Fibrocystic Breast Condition › Section 544.202. Prohibition

Sec. 544.202.  PROHIBITION.  A health benefit plan issuer may not, solely or in part because an individual has been diagnosed with or has a history of a fibrocystic breast condition:
(1)  deny coverage to the individual;
(2)  refuse to renew the individual's coverage;
(3)  cancel the individual's coverage;
(4)  limit the amount, extent, or kind of coverage available to the individual for any other breast condition;  or
(5)  charge the individual or a group to which the individual belongs a rate that is different from the rate charged to other individuals or groups, respectively, for the same coverage.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter E. Fibrocystic Breast Condition › Section 544.203. Unfair or Deceptive Act or Practice

Sec. 544.203.  UNFAIR OR DECEPTIVE ACT OR PRACTICE.  A violation of this subchapter is an unfair or deceptive act or practice under Chapter 541.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter E. Fibrocystic Breast Condition › Section 544.204. Payment for Disease Not Required

Sec. 544.204.  PAYMENT FOR DISEASE NOT REQUIRED.  This subchapter does not require a health benefit plan issuer to pay benefits for fibrocystic breast disease.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter F. Church Property › Section 544.251. Definitions

Sec. 544.251.  DEFINITIONS.  In this subchapter:
(1)  "Church" means a facility that is owned by a religious organization and is used primarily for religious services.
(2)  "Religious organization" means a church, synagogue, or other organization or association organized primarily for religious purposes.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter F. Church Property › Section 544.252. Applicability of Subchapter

Sec. 544.252.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to an insurer that is admitted to engage in the business of insurance and authorized to write an insurance policy providing coverage for losses resulting from fire in this state, including a county mutual insurance company, a Lloyd's plan, a reciprocal or interinsurance exchange, or a farm mutual insurance company.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter F. Church Property › Section 544.253. Prohibition

Sec. 544.253.  PROHIBITION.  An insurer writing insurance for a church may not cancel or decline to renew an insurance policy solely because of:
(1)  an occurrence of arson against the church, if the religious organization that owns the church cooperated with police, fire, and other authorities in the investigation of the arson and in the prosecution of those responsible for the arson;  or
(2)  a verbal or written threat of arson against the church that was directed to the religious organization or an official of the religious organization and that the organization or official reported to the appropriate law enforcement agency within a reasonable amount of time.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter F. Church Property › Section 544.254. Unfair or Deceptive Act or Practice

Sec. 544.254.  UNFAIR OR DECEPTIVE ACT OR PRACTICE.  A violation of this subchapter is an unfair or deceptive act or practice in the business of insurance under Chapter 541.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter G. Mold Claim or Damage › Section 544.301. Definitions

Sec. 544.301.  DEFINITIONS.  In this subchapter:
(1)  "Insurer" means an insurance company, reciprocal or interinsurance exchange, mutual insurance company, capital stock company, county mutual insurance company, farm mutual insurance company, Lloyd's plan, or other legal entity authorized to write residential property insurance in this state.  The term includes an affiliate, as described by Section 823.003(a), if that affiliate is authorized to write and is writing residential property insurance in this state.  The term does not include:
(A)  an eligible surplus lines insurer regulated under Chapter 981;
(B)  the Texas Windstorm Insurance Association under Chapter 2210; or
(C)  the FAIR Plan Association under Chapter 2211.
(2)  "Mold" means any living or dead fungi or related products or parts, including spores, hyphae, and mycotoxins.
(3)  "Mold remediation" means the removal, cleaning, sanitizing, demolition, or other treatment, including preventive activities, of mold or mold-contaminated matter that was not purposely grown at that location.
(4)  "Residential property insurance" means insurance against damage to or loss of real or tangible personal property at a fixed location provided in a homeowners insurance policy or residential fire and allied lines insurance policy.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.014(a), eff. September 1, 2005.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2D.011, eff. April 1, 2009.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter G. Mold Claim or Damage › Section 544.302. Applicability of Subchapter

Sec. 544.302.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to each insurer that writes residential property insurance in this state.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.014(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter G. Mold Claim or Damage › Section 544.303. Prohibition of Certain Underwriting Decisions Based on Previous Mold Claim or Damage

Sec. 544.303.  PROHIBITION OF CERTAIN UNDERWRITING DECISIONS BASED ON PREVIOUS MOLD CLAIM OR DAMAGE.  An insurer may not make an underwriting decision regarding a residential property insurance policy based on previous mold damage or a claim for mold damage if:
(1)  the applicant for insurance coverage has property eligible for coverage under a residential property policy;
(2)  the property has had mold damage;
(3)  mold remediation has been performed on the property; and
(4)  the property was:
(A)  remediated, as evidenced by a certificate of mold remediation issued to the property owner under Section 1958.154, Occupations Code, that establishes with reasonable certainty that the underlying cause of the mold at the property has been remediated; or
(B)  inspected by an independent assessor or adjustor who determined, based on the inspection, that the property does not contain evidence of mold damage.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.014(a), eff. September 1, 2005.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.021(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter G. Mold Claim or Damage › Section 544.304. Rules

Sec. 544.304.  RULES.  The commissioner shall adopt rules as necessary to implement this subchapter.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.014(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter G. Mold Claim or Damage › Section 544.305. Penalty

Sec. 544.305.  PENALTY.  An insurer that violates this subchapter is subject, after notice and opportunity for hearing, to sanctions as provided by Chapters 82, 83, and 84.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.014(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter H. Water Damage Claims › Section 544.351. Purpose

Sec. 544.351.  PURPOSE.  The purpose of this subchapter is to protect persons and property from being unfairly stigmatized in obtaining residential property insurance by the filing of a water damage claim or claims under a residential property insurance policy.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.015(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter H. Water Damage Claims › Section 544.352. Definitions

Sec. 544.352.  DEFINITIONS.  In this subchapter:
(1)  "Appliance" means a household device operated by gas or electric current, including hoses directly attached to the device.  The term includes air conditioning units, heating units, refrigerators, dishwashers, icemakers, clothes washers, water heaters, and disposals.
(2)  "Insurer" means an insurance company, reciprocal or interinsurance exchange, mutual insurance company, capital stock company, county mutual insurance company, farm mutual insurance company, association, Lloyd's plan, or other entity writing residential property insurance in this state.  The term includes an affiliate, as described by Section 823.003(a), if that affiliate is authorized to write and is writing residential property insurance in this state.  The term does not include:
(A)  the Texas Windstorm Insurance Association created and operated under Chapter 2210; or
(B)  the FAIR Plan created and operated under Chapter 2211.
(3)  "Residential property insurance" means insurance against loss to residential real property at a fixed location or tangible personal property provided in a homeowners policy, which includes a tenant policy, a condominium owners policy, or a residential fire and allied lines policy.
(4)  "Underwriting guideline" means a rule, standard, guideline, or practice, whether written, oral, or electronic, that is used by an insurer or an agent of an insurer to:
(A)  decide whether to accept or reject an application for a residential property insurance policy; or
(B)  determine how to classify the risks that are accepted for the purpose of determining a rate.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.015(a), eff. September 1, 2005.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.022(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.022(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter H. Water Damage Claims › Section 544.353. Restrictions on Use of Claims History for Water Damage

Sec. 544.353.  RESTRICTIONS ON USE OF CLAIMS HISTORY FOR WATER DAMAGE.  (a)  Underwriting guidelines relating to a water damage claim or claims used by an insurer shall be governed by rules adopted by the commissioner in accordance with the purpose of this subchapter.  An insurer may not use an underwriting guideline relating to a water damage claim or claims that is not in accordance with the rules adopted by the commissioner under this subchapter.
(b)  An insurer shall file with the department its underwriting guidelines relating to a water damage claim or claims in accordance with the rules adopted by the commissioner.
(c)  Except as provided by Subsection (e), an insurer may not use a prior appliance-related claim filed by a person as a basis for determining the rate to be paid by the person for insurance coverage or for determining whether to issue, renew, or cancel an insurance policy to or for the person if the person:
(1)  properly remediated the prior appliance-related claim; and
(2)  had the remediation inspected and certified by a person or entity knowledgeable and experienced in the remediation of water damage.
(d)  Except as provided by Subsection (e), an insurer may not use a prior appliance-related claim filed regarding specific property as a basis for determining the rate to be paid by a person for insurance coverage for that property or for determining whether to issue, renew, or cancel an insurance policy to or for a person seeking insurance coverage for that property if the prior appliance-related claim was properly remediated and was inspected and certified by a person knowledgeable and experienced in remediation of water damage.
(e)  Subsections (c) and (d) do not apply to:
(1)  a person who has made and has received payment for three or more appliance-related claims within a three-year period; or
(2)  specific property that has been the subject of three or more appliance-related claims within a three-year period.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.015(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter H. Water Damage Claims › Section 544.354. Rules

Sec. 544.354.  RULES.  The commissioner shall adopt rules to accomplish the purposes of this subchapter, including rules with regard to the definition of a water damage claim.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.015(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter I. Criminal Offenses › Section 544.401. Offense: Certain Discrimination

Sec. 544.401.  OFFENSE:  CERTAIN DISCRIMINATION.  (a)  In this section, "person" means a legal entity listed below and engaged in the business of life insurance or an officer or director of one of those entities:
(1)  a capital stock insurance company;
(2)  a mutual insurance company;
(3)  a local mutual aid association;
(4)  a statewide mutual assessment company; or
(5)  a stipulated premium company.
(b)  A person commits an offense if the person recklessly:
(1)  offers insurance coverage at a premium based on a rate that is, because of race, color, religion, ethnicity, or national origin, different from another premium rate offered or used by the person for the same coverage, other than for classifications applicable alike to persons of every race, color, religion, ethnicity, or national origin; or
(2)  collects an insurance premium based on a rate that is, because of race, color, religion, ethnicity, or national origin, different from another premium rate offered or used by the person for the same coverage, other than for classifications applicable alike to persons of every race, color, religion, ethnicity, or national origin.
(c)  An offense under this section is a state jail felony.
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.016(a), eff. September 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter J. Prohibited Practices Relating to Exposure to Asbestos or Silica › Section 544.451. Definition

Sec. 544.451.  DEFINITION.  In this subchapter, "health benefit plan" means a plan that provides benefits for medical, surgical, or other treatment expenses incurred as a result of a health condition, a mental health condition, an accident, sickness, or substance abuse, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage or similar coverage document.  The term includes:
(1)  a small employer health benefit plan or a health benefit plan written to provide coverage with a cooperative under Chapter 1501;
(2)  a standard health benefit plan offered under Subchapter A or Subchapter B, Chapter 1507; and
(3)  a health benefit plan offered under Chapter 1551, 1575, 1579, or 1601.
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.023(a), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.023(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter J. Prohibited Practices Relating to Exposure to Asbestos or Silica › Section 544.452. Applicability of Subchapter

Sec. 544.452.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to any entity that offers a health benefit plan or an annuity or life insurance policy or contract in this state, including:
(1)  a stock or mutual life, health, or accident 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 insurance company operating under Chapter 884;
(5)  a Lloyd's plan operating under Chapter 941;
(6)  an exchange operating under Chapter 942;
(7)  a health maintenance organization operating under Chapter 843;
(8)  a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846;
(9)  an approved nonprofit health corporation that holds a certificate of authority under Chapter 844;
(10)  a statewide mutual assessment company operating under Chapter 881;
(11)  a local mutual aid association operating under Chapter 886; and
(12)  a local mutual burial association operating under Chapter 888.
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.023(a), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.023(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter J. Prohibited Practices Relating to Exposure to Asbestos or Silica › Section 544.453. Prohibition

Sec. 544.453.  PROHIBITION.  An entity that offers a health benefit plan or an annuity or life insurance policy or contract may not use the fact that a person has been exposed to asbestos fibers or silica or has filed a claim governed by Chapter 90, Civil Practice and Remedies Code, to reject, deny, limit, cancel, refuse to renew, increase the premiums for, or otherwise adversely affect the person's eligibility for or coverage under the policy or contract.
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.023(a), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.023(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter K. Previous Denial of Health Benefit Plan Coverage › Section 544.501. Definition

Sec. 544.501.  DEFINITION.  In this subchapter, "individual health benefit plan" means:
(1)  an individual accident and health insurance policy to which Chapter 1201 applies; or
(2)  individual health maintenance organization coverage.
Added by Acts 2005, 79th Leg., Ch. 748 (H.B. 2810), Sec. 1, eff. September 1, 2005.
Renumbered from Insurance Code, Section 544.301 by Acts 2009, 81st Leg., R.S., Ch. 87 (S.B. 1969), Sec. 27.001(61), eff. September 1, 2009.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter K. Previous Denial of Health Benefit Plan Coverage › Section 544.502. Limitation on Certain Inquiries

Sec. 544.502.  LIMITATION ON CERTAIN INQUIRIES.  A health benefit plan issuer may ask an individual who is an applicant for an individual health benefit plan or any other person or entity whether the applicant has previously been denied health benefit plan coverage only for the purpose of determining whether to ask for other information relating to a factor used by the insurer in underwriting the coverage.  The insurer may not consider a determination that the applicant has or has not previously been denied health benefit plan coverage in underwriting the coverage for which the applicant has applied.
Added by Acts 2005, 79th Leg., Ch. 748 (H.B. 2810), Sec. 1, eff. September 1, 2005.
Renumbered from Insurance Code, Section 544.302 by Acts 2009, 81st Leg., R.S., Ch. 87 (S.B. 1969), Sec. 27.001(61), eff. September 1, 2009.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter K. Previous Denial of Health Benefit Plan Coverage › Section 544.503. Violation of Subchapter; Unfair Discrimination

Sec. 544.503.  VIOLATION OF SUBCHAPTER; UNFAIR DISCRIMINATION.  A health benefit plan issuer who violates this subchapter engages in unfair discrimination under Subchapter B.
Added by Acts 2005, 79th Leg., Ch. 748 (H.B. 2810), Sec. 1, eff. September 1, 2005.
Renumbered from Insurance Code, Section 544.303 by Acts 2009, 81st Leg., R.S., Ch. 87 (S.B. 1969), Sec. 27.001(61), eff. September 1, 2009.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter L. Consumer Inquiry › Section 544.551. Definition

Sec. 544.551.  DEFINITION.  In this subchapter, "consumer inquiry" has the meaning assigned by Section 551.113 for "customer inquiry."
Added by Acts 2013, 83rd Leg., R.S., Ch. 570 (S.B. 736), Sec. 1, eff. September 1, 2013.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter L. Consumer Inquiry › Section 544.552. Applicability

Sec. 544.552.  APPLICABILITY.  This subchapter applies only to:
(1)  a standard fire, homeowners, or farm and ranch owners insurance policy, including such policies written by:
(A)  a farm mutual insurance company;
(B)  a county mutual insurance company;
(C)  a Lloyd's plan; and
(D)  a reciprocal or interinsurance exchange; or
(2)  a personal automobile insurance policy, including a policy written by a county mutual insurance company.
Added by Acts 2013, 83rd Leg., R.S., Ch. 570 (S.B. 736), Sec. 1, eff. September 1, 2013.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 592 (S.B. 188), Sec. 1, eff. September 1, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1137 (S.B. 189), Sec. 1, eff. September 1, 2015.
Reenacted and amended by Acts 2017, 85th Leg., R.S., Ch. 324 (S.B. 1488), Sec. 10.001, eff. September 1, 2017.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter L. Consumer Inquiry › Section 544.553. Prohibition of Underwriting and Rating Decisions Based on Consumer Inquiry

Sec. 544.553.  PROHIBITION OF UNDERWRITING AND RATING DECISIONS BASED ON CONSUMER INQUIRY.  An insurer may not:
(1)  use an underwriting guideline based solely on whether a consumer inquiry has been made by or on behalf of the applicant or insured; or
(2)  charge a rate that is different from the rate charged to other individuals for the same coverage or increase a rate charged to an insured based solely on whether a consumer inquiry has been made by or on behalf of the applicant or insured.
Added by Acts 2013, 83rd Leg., R.S., Ch. 570 (S.B. 736), Sec. 1, eff. September 1, 2013.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter M. Political Affiliation and Expression › Section 544.601. Applicability of Subchapter

Sec. 544.601.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to:
(1)  any legal entity engaged in the business of insurance in this state, including:
(A)  a capital stock insurance company;
(B)  a mutual insurance company;
(C)  a title insurance company;
(D)  a fraternal benefit society;
(E)  a local mutual aid association;
(F)  a statewide mutual assessment company;
(G)  a county mutual insurance company;
(H)  a Lloyd's plan;
(I)  a reciprocal or interinsurance exchange;
(J)  a stipulated premium company;
(K)  a group hospital service corporation;
(L)  a farm mutual insurance company;
(M)  a risk retention group;
(N)  an eligible surplus lines insurer; and
(O)  an agent, broker, adjuster, or life and health insurance counselor; and
(2)  a health maintenance organization.
Added by Acts 2021, 87th Leg., R.S., Ch. 926 (H.B. 3433), Sec. 1, eff. September 1, 2021.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter M. Political Affiliation and Expression › Section 544.602. Prohibition

Sec. 544.602.  PROHIBITION.  Except as provided by Section 544.603, a person may not refuse to insure or provide coverage to an individual, refuse to continue to insure or provide coverage to an individual, limit the amount, extent, or kind of coverage available for an individual, or charge an individual a rate that is different from the rate charged to other individuals for the same coverage because of the individual's political affiliation or expression.
Added by Acts 2021, 87th Leg., R.S., Ch. 926 (H.B. 3433), Sec. 1, eff. September 1, 2021.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter M. Political Affiliation and Expression › Section 544.603. Exceptions

Sec. 544.603.  EXCEPTIONS.  A person does not violate Section 544.602 if the refusal, limitation, or charge is:
(1)  based on sound underwriting or actuarial principles reasonably related to actual or anticipated loss experience; or
(2)  required or authorized by law or a regulatory mandate.
Added by Acts 2021, 87th Leg., R.S., Ch. 926 (H.B. 3433), Sec. 1, eff. September 1, 2021.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter M. Political Affiliation and Expression › Section 544.604. Enforcement Actions

Sec. 544.604.  ENFORCEMENT ACTIONS.  (a) A health maintenance organization or legal entity engaged in the business of insurance that is found to be in violation of or to have failed to comply with this subchapter is subject to the sanctions provided by Chapter 82 or administrative penalties authorized under Chapter 84.
(b)  In addition to the procedures provided by Subsection (a), the commissioner may use the cease and desist procedures authorized by Chapter 83.
Added by Acts 2021, 87th Leg., R.S., Ch. 926 (H.B. 3433), Sec. 1, eff. September 1, 2021.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter N. Living Organ Donors › Section 544.651. Definition

Sec. 544.651.  DEFINITION.  In this subchapter, "living organ donor" means a living individual who donates an organ to another individual.
Added by Acts 2021, 87th Leg., R.S., Ch. 71 (H.B. 317), Sec. 2, eff. September 1, 2021.
Redesignated by Acts 2023, 88th Leg., R.S., Ch. 768 (H.B. 4595), Sec. 24.001(26), eff. September 1, 2023.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter N. Living Organ Donors › Section 544.652. Applicability of Subchapter

Sec. 544.652.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies only to a life insurance policy or contract, disability insurance policy, or long-term care insurance policy.
Added by Acts 2021, 87th Leg., R.S., Ch. 71 (H.B. 317), Sec. 2, eff. September 1, 2021.
Redesignated by Acts 2023, 88th Leg., R.S., Ch. 768 (H.B. 4595), Sec. 24.001(26), eff. September 1, 2023.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 544 - Prohibited Discrimination › Subchapter N. Living Organ Donors › Section 544.653. Prohibitions

Sec. 544.653.  PROHIBITIONS.  (a) An insurer may not, based solely on the status of an individual as a living organ donor:
(1)  deny coverage to the individual;
(2)  refuse to renew the individual's coverage;
(3)  cancel the individual's coverage;
(4)  limit the amount, extent, or kind of coverage available to the individual; or
(5)  charge the individual or a group to which the individual belongs a rate that is different than the rate charged to other individuals or groups, as applicable, for the same coverage unless the rate differential is based on sound actuarial principles or sound underwriting related to actual or anticipated loss experience for a particular risk.
(b)  An insurer may not prevent an insured from donating all or part of an organ as a condition of continuing coverage.
Added by Acts 2021, 87th Leg., R.S., Ch. 71 (H.B. 317), Sec. 2, eff. September 1, 2021.
Redesignated by Acts 2023, 88th Leg., R.S., Ch. 768 (H.B. 4595), Sec. 24.001(26), eff. September 1, 2023.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter A. General Provisions › Section 545.001. Definitions

Sec. 545.001.  DEFINITIONS.  In this chapter:
(1)  "AIDS" has the meaning assigned by Section 81.101, Health and Safety Code.
(2)  "Applicant" means an individual who applies to an issuer for coverage.
(3)  "HIV" has the meaning assigned by Section 81.101, Health and Safety Code.
(4)  "Issuer" means a person who delivers, issues for delivery, or renews coverage in this state, including a group policy, contract, or certificate of health insurance or evidence of coverage delivered, issued for delivery, or renewed in this state by an insurer, including a group hospital service corporation operating under Chapter 842, or by a health maintenance organization operating under Chapter 843.
(5)  "Test result" means a statement:
(A)  that an identifiable individual is positive, negative, at risk, or has or does not have a certain level of antigen or antibody;  or
(B)  that indicates that an identifiable individual has or has not been tested for AIDS or HIV infection, antibodies to HIV, or infection with any other probable causative agent of AIDS.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter A. General Provisions › Section 545.002. Exclusive Applicability

Sec. 545.002.  EXCLUSIVE APPLICABILITY.  This chapter and rules adopted under this chapter exclusively govern the practices of an issuer in testing applicants to determine or help determine if an applicant has:
(1)  AIDS or HIV infection;
(2)  antibodies to HIV;  or
(3)  an infection with any other probable causative agent of AIDS.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter A. General Provisions › Section 545.003. Rules

Sec. 545.003.  RULES.  The commissioner may adopt:
(1)  reasonable rules and forms necessary to implement this chapter;  and
(2)  rules to be followed for an HIV-related test requested or required by an issuer.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.051. HIV-Related Testing Authorized

Sec. 545.051.  HIV-RELATED TESTING AUTHORIZED.  An issuer may request or require an applicant to take an HIV-related test in connection with the application.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.052. Nondiscriminatory Basis Required

Sec. 545.052.  NONDISCRIMINATORY BASIS REQUIRED.  (a)  An issuer that requests or requires applicants to take an HIV-related test must request or require the test on a nondiscriminatory basis.
(b)  An issuer may require an applicant to take an HIV-related test only if:
(1)  the test is based on the applicant's current medical condition or medical history;  or
(2)  underwriting guidelines for the coverage amounts require all applicants in the risk class to be tested.
(c)  In determining who will be requested or required to take an HIV-related test, an issuer may not use the marital status, occupation, sex, beneficiary designation, or territorial classification, including zip code, of an applicant.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.053. Explanation and Authorization Required

Sec. 545.053.  EXPLANATION AND AUTHORIZATION REQUIRED.  (a)  An issuer that requests or requires an applicant to take an HIV-related test in connection with an application must:
(1)  provide an explanation to the applicant, or another person legally authorized to consent to the test, of how the test will be used;  and
(2)  obtain a written authorization from the person to whom the explanation is provided.
(b)  The authorization must:
(1)  be on a form adopted by the commissioner;  and
(2)  be separate from any other document presented to the applicant or other person legally authorized to consent to the test.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.054. Inquiries Regarding Previous Tests

Sec. 545.054.  INQUIRIES REGARDING PREVIOUS TESTS.  (a)  An issuer may inquire whether an applicant has:
(1)  tested positive on an HIV-related test;  or
(2)  been diagnosed with HIV or AIDS.
(b)  An issuer may not inquire whether an applicant has been tested for or has received a negative result from a specific test for:
(1)  exposure to HIV;  or
(2)  a sickness or a medical condition derived from infection with HIV.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.055. Notice of Positive Test Result; Fee

Sec. 545.055.  NOTICE OF POSITIVE TEST RESULT;  FEE.  (a)  An applicant must be given written notice of a positive HIV-related test result by:
(1)  a physician designated by the applicant;  or
(2)  the Texas Department of Health, if the applicant has not designated a physician.
(b)  The Texas Department of Health by rule may set a fee, not to exceed $25, to cover the cost of giving written notice under this section.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.056. Adverse Underwriting Decision; Test Protocol Rules

Sec. 545.056.  ADVERSE UNDERWRITING DECISION;  TEST PROTOCOL RULES.  An issuer may not make an adverse underwriting decision based on a positive HIV-related test unless a test protocol established by commissioner rule is followed.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter B. Issuer Powers and Duties › Section 545.057. Confidentiality of Test Result Required

Sec. 545.057.  CONFIDENTIALITY OF TEST RESULT REQUIRED.  (a)  An HIV-related test result is confidential.
(b)  An issuer may not release or disclose the test result or otherwise allow the test result to become known except as:
(1)  required by law;  or
(2)  requested or authorized in writing by the applicant or a person legally authorized to consent to the test on the applicant's behalf.
(c)  A test result released under Subsection (b)(2) may be released only to:
(1)  the applicant;
(2)  a person legally authorized to consent to the test;
(3)  a licensed physician, medical practitioner, or other person designated by the applicant;
(4)  an insurance medical information exchange under procedures designed to ensure confidentiality, including the use of general codes that cover results of tests for other diseases or conditions not related to AIDS, or for the preparation of statistical reports that do not disclose the identity of any particular applicant;
(5)  a reinsurer, if the reinsurer is involved in the underwriting process, under procedures designed to ensure confidentiality;
(6)  persons within the issuer's organization who have the responsibility to make underwriting decisions for the issuer;  or
(7)  outside legal counsel that needs the information to effectively represent the issuer regarding the applicant.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter O. Sanctions; Penalties; Injunctions › Section 545.701. Sanctions

Sec. 545.701.  SANCTIONS.  The commissioner may impose sanctions under Chapter 82 on an issuer that violates this chapter.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 545 - HIV Testing › Subchapter O. Sanctions; Penalties; Injunctions › Section 545.702. Civil Action; Penalty

Sec. 545.702.  CIVIL ACTION;  PENALTY.  (a)  A person who is injured by a violation of Section 545.057 may bring a civil action for damages.
(b)  A person may bring an action to restrain a violation or threatened violation of Section 545.057.
(c)  If it is found in a civil action that a person or entity has released or disclosed a test result or allowed a test result to become known in violation of Section 545.057, the person or entity is liable for:
(1)  actual damages;
(2)  a civil penalty of:
(A)  not more than $1,000 if the release or disclosure was negligent;  or
(B)  not less than $1,000 or more than $5,000 if the release or disclosure was wilful;  and
(3)  court costs and reasonable attorney's fees incurred by the person bringing the action.
(d)  A defendant in a civil action brought under this section is not entitled to claim a privilege as a defense to the action.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.