reglab/statecodes huggingface dataset:
2023 Texas Statutes › Insurance Code › Title 5 - Protection of Consumer Interests › Subtitle C - Deceptive, Unfair, and Prohibited Practices › Chapter 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter G. Department Action for Refund of Premiums › Section 541.301. Refund of Premiums

Sec. 541.301.  REFUND OF PREMIUMS.  (a)  After notice and hearing as provided in Subchapter C, the department may require a person to make an accounting under Subsection (b):
(1)  in connection with a method of competition or act or practice that is the basis of a cease and desist order issued under Section 541.108;  or
(2)  on application of an aggrieved person, in connection with a determination by the department that the aggrieved person and other persons similarly situated were induced to purchase an insurance policy as a result of the person engaging in a method of competition or act or practice in violation of:
(A)  this chapter or a rule adopted under this chapter;  or
(B)  Section 17.46, Business & Commerce Code.
(b)  A person required to make an accounting under this section must account for all premiums collected for policies issued by the person during the preceding two years in connection with the acts in violation of this chapter described by Subsection (a)(1) or (2).
(c)  The department may require the person described by Subsection (a) to:
(1)  give notice to all persons from whom the premiums were collected;  and
(2)  refund the total of all premiums collected from each person who elects to accept a premium refund in exchange for cancellation of the insurance policy issued.
(d)  A person who refunds premiums under this section shall deduct from the amount of premiums refunded the amount of benefits actually paid by the person while the insurance policy was in force.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter G. Department Action for Refund of Premiums › Section 541.302. Time to Make Refunds

Sec. 541.302.  TIME TO MAKE REFUNDS.  The department shall specify a reasonable time within which a person required to make premium refunds under Section 541.301 must make the refunds.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter G. Department Action for Refund of Premiums › Section 541.303. Sanction

Sec. 541.303.  SANCTION.  (a)  The department may report to the attorney general a person's failure to comply with the department's requirement to refund premiums within the time specified under Section 541.302.  The department may request that the attorney general file an action to enforce the department's requirement to refund premiums.
(b)  Venue for the action is in a district court in Travis County.
(c)  The court shall enter an appropriate order to enforce the department's requirement to refund premiums if the court finds that:
(1)  the requirement was lawfully entered;  and
(2)  the person failed to comply with the requirement.
(d)  The court may enforce its order through contempt proceedings.
(e)  The sanction provided by this section is in addition to any other sanctions provided in this code or other applicable laws.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter G. Department Action for Refund of Premiums › Section 541.304. Evidentiary Use of Compliance or Attempt to Comply

Sec. 541.304.  EVIDENTIARY USE OF COMPLIANCE OR ATTEMPT TO COMPLY.  (a)  Compliance or an attempt to comply with the department's requirement to refund premiums is:
(1)  an offer to compromise;
(2)  not admissible as evidence;  and
(3)  not an admission of engaging in an unlawful act or practice.
(b)  A defendant may introduce evidence of compliance or an attempt to comply with the department's requirement for the purpose of:
(1)  establishing good faith;  or
(2)  showing compliance with the department's requirement.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter H. Assurance of Voluntary Compliance › Section 541.351. Acceptance of Assurance

Sec. 541.351.  ACCEPTANCE OF ASSURANCE.  (a)  In administering this chapter, the department may accept assurance of voluntary compliance from a person who is engaging in, has engaged in, or is about to engage in an act or practice in violation of:
(1)  this chapter or a rule adopted under this chapter;  or
(2)  Section 17.46, Business & Commerce Code.
(b)  The assurance must be in writing and be filed with the department.
(c)  The department may condition acceptance of an assurance of voluntary compliance on the stipulation that the person offering the assurance restore to a person in interest money that may have been acquired by the act or practice described in Subsection (a).
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter H. Assurance of Voluntary Compliance › Section 541.352. Effect of Assurance

Sec. 541.352.  EFFECT OF ASSURANCE.  (a)  An assurance of voluntary compliance is not an admission of a prior violation of:
(1)  this chapter or a rule adopted under this chapter;  or
(2)  Section 17.46, Business & Commerce Code.
(b)  Unless an assurance of voluntary compliance is rescinded by agreement, a subsequent failure to comply with the assurance is prima facie evidence of a violation of:
(1)  this chapter or a rule adopted under this chapter;  or
(2)  Section 17.46, Business & Commerce Code.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter H. Assurance of Voluntary Compliance › Section 541.353. Reopening

Sec. 541.353.  REOPENING.  A matter closed by the filing of an assurance of voluntary compliance may be reopened at any 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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter H. Assurance of Voluntary Compliance › Section 541.354. Right to Bring Action Not Affected

Sec. 541.354.  RIGHT TO BRING ACTION NOT AFFECTED.  An assurance of voluntary compliance does not affect the right of an individual to bring an action under this chapter, except that the right of an individual in relation to money received according to a stipulation under Section 541.351(c) is governed by the terms of the assurance.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter I. Rulemaking › Section 541.401. Rulemaking Authority

Sec. 541.401.  RULEMAKING AUTHORITY.  (a)  The commissioner may adopt and enforce reasonable rules the commissioner determines necessary to accomplish the purposes of this chapter.
(b)  Notwithstanding a previous definition or interpretation of a term used in this chapter contained in or derived from the common law or other statutory law of this state, the commissioner may adopt an express provision necessary to accomplish the purposes of this chapter, including a provision the commissioner considers necessary to:
(1)  achieve necessary uniformity with the laws of other states or the United States;  or
(2)  conform to the adopted procedures of the National Association of Insurance Commissioners.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter I. Rulemaking › Section 541.402. Petition

Sec. 541.402.  PETITION.  (a)  A petition may be submitted to the commissioner to adopt, amend, or repeal a rule.  The petition must be:
(1)  signed by 100 interested persons;  and
(2)  supported by evidence that:
(A)  a particular act or practice has been or could be false, misleading, or deceptive to the insurance buying public;  or
(B)  an act or practice defined by department rule to be false, misleading, or deceptive is not false, misleading, or deceptive.
(b)  Not later than the 30th day after the date the department receives the petition, the department shall:
(1)  deny the petition as provided by Section 541.403;  or
(2)  initiate hearing proceedings under Section 541.404.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter I. Rulemaking › Section 541.403. Denial of Petition

Sec. 541.403.  DENIAL OF PETITION.  (a)  The department must state in writing the reason for denying a petition to adopt, amend, or repeal a rule.
(b)  The department is expressly authorized to deny the petition if the action sought would:
(1)  destroy uniformity with the laws of other states or the United States;  or
(2)  not conform to the adopted procedures of the National Association of Insurance Commissioners.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter I. Rulemaking › Section 541.404. Hearing on Petition

Sec. 541.404.  HEARING ON PETITION.  (a)  A hearing held by the department in response to a petition to adopt, amend, or repeal a rule must be open to the public.
(b)  At the hearing, any person may present to the department in writing or orally testimony, data, or other information regarding the act or practice under consideration.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter I. Rulemaking › Section 541.405. Judicial Review of Department Action

Sec. 541.405.  JUDICIAL REVIEW OF DEPARTMENT ACTION.  (a)  A person aggrieved by the denial of a petition under Section 541.402 or the adoption, amendment, or repeal of or failure to adopt a rule under this subchapter may file a petition in a district court in Travis County for:
(1)  a declaratory judgment on the validity or applicability of an adopted, amended, or repealed rule;  or
(2)  review of the denial of a petition under Section 541.402.
(b)  The commissioner must be made a party to the action.
(c)  An action of the commissioner under this subchapter in adopting, amending, repealing, or failing to adopt a rule or denying a petition may be invalidated only if the court finds that the action:
(1)  violates a constitutional or state statutory provision;
(2)  exceeds the commissioner's statutory authority;
(3)  is arbitrary or capricious or characterized by abuse of discretion or unwarranted exercise of discretion;
(4)  is so vague that it does not establish sufficiently definite standards to which conduct can be conformed;
(5)  is made following unlawful procedure;  or
(6)  is clearly erroneous in view of the reliable, probative, and substantial evidence in the whole record as submitted.
(d)  The court may issue an injunction in an action 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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter J. Construction of Chapter With Other Laws › Section 541.451. Liability Under Other Law

Sec. 541.451.  LIABILITY UNDER OTHER LAW.  An order of the department under this chapter or an order by a court to enforce that order does not relieve or absolve a person affected by either order from liability under another law of this state.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter J. Construction of Chapter With Other Laws › Section 541.452. Powers in Addition to Other Powers Authorized by Law

Sec. 541.452.  POWERS IN ADDITION TO OTHER POWERS AUTHORIZED BY LAW.  The powers vested in the department and the commissioner by this chapter are in addition to any other powers to enforce a penalty, fine, or forfeiture authorized by law with respect to a method of competition or act or practice defined as unfair or deceptive.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter J. Construction of Chapter With Other Laws › Section 541.453. Double Recovery Prohibited

Sec. 541.453.  DOUBLE RECOVERY PROHIBITED.  A person may not recover damages and penalties for the same act or practice under both this chapter and another law.
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 541 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices › Subchapter J. Construction of Chapter With Other Laws › Section 541.454. Penalties and Related Payments by Insurer

Sec. 541.454.  PENALTIES AND RELATED PAYMENTS BY INSURER.  (a)  Civil penalties, premium refunds, judgments, compensatory judgments, individual recoveries, orders, class action awards, costs, damages, or attorney's fees assessed or awarded under this chapter:
(1)  may be paid only from the capital or surplus funds of the offending insurer; and
(2)  may not take precedence over, be in priority to, or in any other manner apply to:
(A)  Chapter 462 or 463 or any other insurance guaranty act; or
(B)  Chapter 422.
(b)  The statutes described by Subsection (a)(2) and the priorities of funds created by those statutes are exempt from the provisions of this chapter.
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.006, eff. April 1, 2009.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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 542.059. Extension of Deadlines

Sec. 542.059.  EXTENSION OF DEADLINES.  (a)  A court may grant a request by a guaranty association for an extension of the periods under this subchapter on a showing of good cause and after reasonable notice to policyholders.
(b)  In the event of a weather-related catastrophe or major natural disaster, as defined by the commissioner, the claim-handling deadlines imposed under this subchapter are extended for an additional 15 days.
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 542 - Processing and Settlement of Claims › Subchapter B. Prompt Payment of Claims › Section 542.060. Liability for Violation of Subchapter

Sec. 542.060.  LIABILITY FOR VIOLATION OF SUBCHAPTER.  (a)  Except as provided by Subsection (c), if an insurer that is liable for a claim under an insurance policy is not in compliance with this subchapter, the insurer is liable to pay the holder of the policy or the beneficiary making the claim under the policy, in addition to the amount of the claim, interest on the amount of the claim at the rate of 18 percent a year as damages, together with reasonable and necessary attorney's fees. Nothing in this subsection prevents the award of prejudgment interest on the amount of the claim, as provided by law.
(b)  If a suit is filed, the attorney's fees shall be taxed as part of the costs in the case.
(c)  In an action to which Chapter 542A applies, if an insurer that is liable for a claim under an insurance policy is not in compliance with this subchapter, the insurer is liable to pay the holder of the policy, in addition to the amount of the claim, simple interest on the amount of the claim as damages each year at the rate determined on the date of judgment by adding five percent to the interest rate determined under Section 304.003, Finance Code, together with reasonable and necessary attorney's fees.  Nothing in this subsection prevents the award of prejudgment interest on the amount of the claim, as provided by law.  Interest awarded under this subsection as damages accrues beginning on the date the claim was required to be paid.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 151 (H.B. 1774), Sec. 2, eff. September 1, 2017.
2023 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 542.061. Remedies Not Exclusive

Sec. 542.061.  REMEDIES NOT EXCLUSIVE.  The remedies provided by this subchapter are in addition to any other remedy or procedure provided by law or at common law.
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 542 - Processing and Settlement of Claims › Subchapter C. Providing Certain Claims Information on Request › Section 542.101. Request by Named Insured Under Liability Insurance Policy

Sec. 542.101.  REQUEST BY NAMED INSURED UNDER LIABILITY INSURANCE POLICY.  (a)  In this section, "liability insurance" means:
(1)  general liability insurance;
(2)  professional liability insurance, including medical professional liability insurance;
(3)  commercial automobile liability insurance;  and
(4)  the liability portion of commercial multiperil insurance.
(b)  On written request of a named insured under a liability insurance policy, the insurer that wrote the policy shall provide to the insured information relating to the disposition of a claim filed under the policy.  The information must include:
(1)  the name of each claimant;
(2)  details relating to:
(A)  the amount paid on the claim;
(B)  settlement of the claim;  or
(C)  judgment on the claim;
(3)  details as to how the claim, settlement, or judgment is to be paid;  and
(4)  any other information required by rule of the commissioner that the commissioner considers necessary to adequately inform an insured with regard to any claim under a liability insurance policy.
(c)  A request for information under this section must be transmitted to the insurer not later than six months after the date of disposition of the claim.
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 542 - Processing and Settlement of Claims › Subchapter C. Providing Certain Claims Information on Request › Section 542.102. Request by Policyholder Under Property and Casualty Insurance Policy

Sec. 542.102.  REQUEST BY POLICYHOLDER UNDER PROPERTY AND CASUALTY INSURANCE POLICY.  (a)  On written request of a policyholder, an insurer that writes property and casualty insurance in this state shall provide the policyholder with a list of claims charged against the policy and payments made on each claim.
(b)  This section does not apply to a workers' compensation insurance policy subject to Section 2051.151.
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.009, eff. April 1, 2009.
2023 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 C. Providing Certain Claims Information on Request › Section 542.103. Deadline for Providing Requested Information

Sec. 542.103.  DEADLINE FOR PROVIDING REQUESTED INFORMATION.  (a)  An insurer shall provide the information requested under this subchapter in writing not later than the 30th day after the date the insurer receives the request for the information.
(b)  For purposes of this section, information is considered to be provided on the date the information is deposited with the United States Postal Service or is personally delivered.
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 542 - Processing and Settlement of Claims › Subchapter C. Providing Certain Claims Information on Request › Section 542.104. Rules

Sec. 542.104.  RULES.  The commissioner may by rule prescribe forms for requesting information and for providing requested information under this subchapter.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.