reglab/statecodes huggingface dataset:
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter C. Certificate of Insurance Forms › Section 1811.101. Filing and Approval of Forms

Sec. 1811.101.  FILING AND APPROVAL OF FORMS.  (a)  Except as provided by Subsection (b), an insurer or agent may not deliver or issue for delivery in this state a certificate of insurance unless the certificate's form:
(1)  has been filed with and approved by the commissioner; and
(2)  contains the phrase "for information purposes only" or similar language.
(b)  If a certificate of insurance form does not contain the language required by Subsection (a)(2), the commissioner may approve the form if the form states:
(1)  that the certificate of insurance does not confer any rights or obligations other than the rights and obligations conveyed by the policy referenced on the form; and
(2)  that the terms of the policy control over the terms of the certificate of insurance.
(c)  A filed form is approved at the expiration of 60 days after the date the form is filed unless the commissioner by order approves or disapproves the form during the 60-day period beginning the date the form is filed.  The commissioner's approval of a filed form constitutes a waiver of any unexpired portion of the 60-day period.
(d)  The commissioner may extend by not more than 10 days the 60-day period described by Subsection (c) during which the commissioner may approve or disapprove a form filed by an insurer or agent.  The commissioner shall notify the insurer or agent of the extension before the expiration of the 60-day period.
(e)  A filed form for which an extension has been granted under Subsection (d) is considered approved at the expiration of the extension period described by that subsection absent an earlier approval or disapproval of the form.
(f)  A person may not use a form unless the form has been filed with and approved by the commissioner.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter C. Certificate of Insurance Forms › Section 1811.102. Disapproval of Forms; Withdrawal of Approval

Sec. 1811.102.  DISAPPROVAL OF FORMS; WITHDRAWAL OF APPROVAL.  (a)  The commissioner shall disapprove a form filed under Section 1811.101 or withdraw approval of a form if the form:
(1)  contains a provision or has a title or heading that is misleading, is deceptive, or violates public policy;
(2)  violates any state law, including a rule adopted under this code;
(3)  requires an agent to provide certification of insurance coverage that is not available in the line or type of insurance coverage referenced on the form; or
(4)  directly or indirectly requires the commissioner to make a coverage determination under a policy of insurance or insurance transaction.
(b)  The commissioner may not disapprove a form filed under Section 1811.101 or withdraw approval of a form based solely on the fact that the form contains language described by Section 1811.101(b).
(c)  An order issued by the commissioner disapproving a form, or a notice of the commissioner's intention to withdraw approval of a form, must state the grounds for the disapproval or withdrawal of approval in sufficient detail to reasonably inform the person filing the form of those grounds and the changes to the form necessary to obtain approval.
(d)  An order disapproving a form or withdrawing approval of a form takes effect on the date prescribed by the commissioner in the order.  An order withdrawing approval of a form may not become effective until the 30th day after the date of the order.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter C. Certificate of Insurance Forms › Section 1811.103. Standard Certificate of Insurance Forms

Sec. 1811.103.  STANDARD CERTIFICATE OF INSURANCE FORMS.  A standard certificate of insurance form promulgated by the Association for Cooperative Operations Research and Development, the American Association of Insurance Services, or the Insurance Services Office (ISO) is deemed approved on the date the form is filed with the department.  Notwithstanding this section, the commissioner may withdraw approval of a standard form under Section 1811.102.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter C. Certificate of Insurance Forms › Section 1811.104. Public Inspection of Information

Sec. 1811.104.  PUBLIC INSPECTION OF INFORMATION.  A certificate of insurance form and any supporting information filed with the department under this subchapter is open to public inspection as of the date of the filing.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter D. Effect of Approval of Certificate of Insurance Form › Section 1811.151. Confirmation of Policy Issuance

Sec. 1811.151.  CONFIRMATION OF POLICY ISSUANCE.  A certificate of insurance form that has been approved by the commissioner and properly executed and issued by a property and casualty insurer or an agent constitutes a confirmation that the referenced insurance policy has been issued or that coverage has been bound.  This section applies regardless of whether the face of the certificate includes the phrase "for information purposes only" or similar language.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter D. Effect of Approval of Certificate of Insurance Form › Section 1811.152. Certificate of Insurance Not Policy of Insurance

Sec. 1811.152.  CERTIFICATE OF INSURANCE NOT POLICY OF INSURANCE.  A certificate of insurance is not a policy of insurance and does not amend, extend, or alter the coverage afforded by the referenced insurance policy.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter D. Effect of Approval of Certificate of Insurance Form › Section 1811.153. Rights Conferred by Certificate of Insurance

Sec. 1811.153.  RIGHTS CONFERRED BY CERTIFICATE OF INSURANCE.  A certificate of insurance shall not confer to a certificate holder new or additional rights beyond what the referenced policy or any executed endorsement of insurance provides.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter D. Effect of Approval of Certificate of Insurance Form › Section 1811.154. Reference to Other Contracts

Sec. 1811.154.  REFERENCE TO OTHER CONTRACTS.  A certificate of insurance may not contain a reference to a legal or insurance requirement contained in a contract other than the underlying contract of insurance, including a contract for construction or services.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter D. Effect of Approval of Certificate of Insurance Form › Section 1811.155. Notice

Sec. 1811.155.  NOTICE.  (a)  A person may have a legal right to notice of cancellation, nonrenewal, or material change or any similar notice concerning a policy of insurance only if:
(1)  the person is named within the policy or an endorsement to the policy; and
(2)  the policy or endorsement or a law, including a rule, of this state requires notice to be provided.
(b)  A certificate of insurance may not alter the terms and conditions of the notice required by a policy of insurance or the law of this state.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter D. Effect of Approval of Certificate of Insurance Form › Section 1811.156. Certificate of Insurance Issued in Violation of Chapter

Sec. 1811.156.  CERTIFICATE OF INSURANCE ISSUED IN VIOLATION OF CHAPTER.  A certificate of insurance that is executed, issued, or required and that is in violation of this chapter is void and has no effect.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter E. Enforcement and Remedies › Section 1811.201. Powers of Commissioner

Sec. 1811.201.  POWERS OF COMMISSIONER.  (a)  If the commissioner has reason to believe that an insurer or agent has violated or is threatening to violate this chapter or a rule adopted under this chapter, the commissioner may:
(1)  issue a cease and desist order;
(2)  seek an injunction under Section 1811.203;
(3)  request that the attorney general recover a civil penalty under Section 1811.203;
(4)  impose sanctions on the insurer or agent as provided by Chapter 82; or
(5)  take any combination of those actions.
(b)  This section does not prevent or limit any action by or remedy available to the commissioner under applicable law.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter E. Enforcement and Remedies › Section 1811.202. Hearing; Notice

Sec. 1811.202.  HEARING; NOTICE.  (a)  The commissioner may hold a hearing on whether to issue a cease and desist order under Section 1811.201 if the commissioner has reason to believe that:
(1)  an insurer or agent has violated or is threatening to violate this chapter or a rule adopted under this chapter; or
(2)  an insurer or agent has engaged in or is threatening to engage in an unfair act related to a certificate of insurance.
(b)  The commissioner shall serve on the insurer or agent a statement of charges and a notice of hearing in the form provided by Section 2001.052, Government Code.
(c)  A hearing under this section is a contested case under Chapter 2001, Government Code.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter E. Enforcement and Remedies › Section 1811.203. Civil Penalty; Injunction

Sec. 1811.203.  CIVIL PENALTY; INJUNCTION.  (a)  A person, including an insurer or agent, who wilfully violates this chapter is subject to a civil penalty of not more than $1,000 for each violation.
(b)  The commissioner may request that the attorney general institute a civil suit in a district court in Travis County for injunctive relief to restrain a person, including an insurer or agent, from continuing a violation or threat of violation of Subchapter B.  On application for injunctive relief and a finding that a person, including an insurer or agent, is violating or threatening to violate Subchapter B, the district court shall grant the injunctive relief and issue an injunction without bond.
(c)  On request by the commissioner, the attorney general may institute and conduct a civil suit in the name of the state for injunctive relief, to recover a civil penalty, or for both injunctive relief and a civil penalty, as authorized under this subchapter.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1811 - Certificates of Property and Casualty Insurance › Subchapter E. Enforcement and Remedies › Section 1811.204. Investigation of Complaints

Sec. 1811.204.  INVESTIGATION OF COMPLAINTS.  (a)  The commissioner may:
(1)  investigate a complaint or allegation of specific violations by a person, including an insurer or agent, who has allegedly engaged in an act or practice prohibited by Subchapter B; and
(2)  enforce the provisions of this chapter.
(b)  If the commissioner has reason to believe that a person, including an insurer or agent, is performing an act in violation of Subchapter B, the person shall immediately provide to the commissioner, on written request of the commissioner, information relating to that act.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1212 (S.B. 425), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1812 - Availability of Specimen Policies › Section 1812.001. Definition

Sec. 1812.001.  DEFINITION.  In this chapter, "specimen policy" means a standardized form, including an insurance policy form or endorsement, used by an insurer to write personal automobile, commercial automobile, inland marine, or residential property insurance in this state that does not contain personally identifiable information about an insured.
Added by Acts 2013, 83rd Leg., R.S., Ch. 101 (S.B. 852), Sec. 1, eff. September 1, 2013.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1812 - Availability of Specimen Policies › Section 1812.002. Availability of Certain Forms

Sec. 1812.002.  AVAILABILITY OF CERTAIN FORMS.  (a)  Notwithstanding any other provision of this code relating to the delivery of policy forms, an insurer may elect to make a personal automobile, commercial automobile, inland marine, or residential property insurance policy available to an insured by posting a specimen policy on the insurer's Internet website instead of other authorized means.  An insurer making the election must comply with Section 1812.003.
(b)  On request of and at no cost to an insured, an insurer shall provide to the insured a copy of a specimen policy applicable to the insured that is posted on the insurer's Internet website.
(c)  The office of public insurance counsel may post an insurer's specimen policy on the office's Internet website.  The posting, other than a posting described by Subsection (a), of an insurer's specimen policy on an Internet website does not create a duty to comply with the requirements of this chapter.
Added by Acts 2013, 83rd Leg., R.S., Ch. 101 (S.B. 852), Sec. 1, eff. September 1, 2013.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 842 (S.B. 494), Sec. 1, eff. September 1, 2015.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1812 - Availability of Specimen Policies › Section 1812.003. Notice of Availability of Certain Forms

Sec. 1812.003.  NOTICE OF AVAILABILITY OF CERTAIN FORMS.  (a)  An insurer that posts a specimen policy on the insurer's Internet website under this chapter must, on issuance or renewal of a policy incorporating the specimen policy:
(1)  on the declarations page of the insured's policy:
(A)  disclose that the specimen policy is available on the insurer's Internet website; and
(B)  clearly identify each posted specimen policy incorporated into the insured's policy;
(2)  explain that and how an insured, on request and at no charge, may obtain a copy of the specimen policy from the insurer; and
(3)  provide to the department and the office of public insurance counsel an electronic copy of the specimen policy that may be posted on the Internet website of the department or the office of public insurance counsel.
(b)  An insurer that during an insured's policy period posts a specimen policy or amends a posted specimen policy incorporated into an insured's policy must, on the date the specimen policy is posted or amended, in writing and in the insurer's customary manner of communicating with the insured:
(1)  notify the insured that the specimen policy is available on the insurer's Internet website;
(2)  clearly identify each added or amended specimen policy incorporated into the insured's policy; and
(3)  explain that and how the insured, on request and at no charge, may obtain a copy of the specimen policy from the insurer.
Added by Acts 2013, 83rd Leg., R.S., Ch. 101 (S.B. 852), Sec. 1, eff. September 1, 2013.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1812 - Availability of Specimen Policies › Section 1812.004. Accessibility of Certain Available Forms

Sec. 1812.004.  ACCESSIBILITY OF CERTAIN AVAILABLE FORMS.  A specimen policy posted on the insurer's Internet website under this chapter must be, until no policy incorporating the specimen policy is in force:
(1)  easily accessible on the website; and
(2)  provided in a format readily capable of being saved or printed using a widely available and free computer application or program.
Added by Acts 2013, 83rd Leg., R.S., Ch. 101 (S.B. 852), Sec. 1, eff. September 1, 2013.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle A - General Provisions › Chapter 1812 - Availability of Specimen Policies › Section 1812.005. Retention of Certain Available Forms

Sec. 1812.005.  RETENTION OF CERTAIN AVAILABLE FORMS.  An insurer that posts a specimen policy on the insurer's Internet website under this chapter must for at least five years after the latest date a policy incorporating the specimen policy is in force:
(1)  preserve an electronic copy of the specimen policy; and
(2)  make a printed or electronic copy of the specimen policy available on request at no cost.
Added by Acts 2013, 83rd Leg., R.S., Ch. 101 (S.B. 852), Sec. 1, eff. September 1, 2013.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter A. General Provisions › Section 1901.001. Definitions

Sec. 1901.001.  DEFINITIONS.  In this chapter:
(1)  "Health care provider" means:
(A)  a person, partnership, professional association, corporation, facility, or institution, or an officer, employee, or agent of the person or entity acting in the course and scope of authority, employment, or agency, as applicable, if the person or entity is licensed or chartered by this state to provide health care as:
(i)  a registered nurse;
(ii)  a hospital;
(iii)  a dentist;
(iv)  a podiatrist;
(v)  a chiropractor;
(vi)  an optometrist or therapeutic optometrist;
(vii)  a pharmacist;
(viii)  a veterinarian;
(ix)  a not-for-profit kidney dialysis center;
(x)  a blood bank that is a nonprofit corporation chartered to operate a blood bank and is accredited by the American Association of Blood Banks;
(xi)  a for-profit or not-for-profit nursing home; or
(xii)  a for-profit or not-for-profit assisted living facility; or
(B)  a health care practitioner or facility that the commissioner, in accordance with Section 2203.103(b), determines is eligible for coverage under this chapter.
(2)  "Hospital" means a public or private institution licensed under Chapter 241 or 577, Health and Safety Code.
(3)  "Physician" means a person licensed to practice medicine in this state.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter A. General Provisions › Section 1901.002. Applicability of Chapter

Sec. 1901.002.  APPLICABILITY OF CHAPTER.  This chapter applies to:
(1)  an insurer authorized to write or engaged in writing professional liability insurance for a physician or health care provider; and
(2)  a rating organization acting on behalf of an insurer described by Subdivision (1).
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter A. General Provisions › Section 1901.003. Applicability of Other Law

Sec. 1901.003.  APPLICABILITY OF OTHER LAW.  Chapters 2251 and 2301 and Article 5.13-2 apply to rates and forms for professional liability insurance for physicians and health care providers under this chapter.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter A. General Provisions › Section 1901.004. Annual Reports

Sec. 1901.004.  ANNUAL REPORTS.  (a)  An insurer that issues professional liability insurance policies covering physicians and health care providers shall file annually with the commissioner a report of:
(1)  all claims and the amounts of those claims;
(2)  amounts of claims reserves;
(3)  investment income of the insurer derived from medical professional liability premiums;
(4)  information relating to amounts of judgments and settlements paid on claims; and
(5)  other information required by the commissioner.
(b)  The commissioner may promulgate a form on which the information under Subsection (a) must be reported.  The form must require that the information be reported in an accurate manner and be reasonably calculated to:
(1)  facilitate interpretation; and
(2)  protect the confidentiality of the physician or health care provider.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter A. General Provisions › Section 1901.005. Rules

Sec. 1901.005.  RULES.  The commissioner shall establish by rule:
(1)  criteria that insurers must follow in establishing reconsideration procedures under Section 1901.101; and
(2)  standards and procedures to be followed in the review of rates and premiums by the commissioner.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.051. Considerations in Setting Rates

Sec. 1901.051.  CONSIDERATIONS IN SETTING RATES.  (a)  In setting rates, an insurer shall consider:
(1)  past and prospective loss and expense experience for all professional liability insurance for physicians and health care providers written in this state, subject to Subsection (b);
(2)  a reasonable margin for underwriting profit and contingencies;
(3)  investment income; and
(4)  dividends or savings allowed or returned by the insurer to the insurer's policyholders or members.
(b)  If the department finds that the group or risk to be insured is not of sufficient size to be credible, an insurer must also consider in setting rates past and prospective loss and expense experience for all professional liability insurance for physicians and health care providers written outside this state.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.052. Grouping of Risks

Sec. 1901.052.  GROUPING OF RISKS.  In setting rates, an insurer may group risks by classification, rating schedule, or any other reasonable method.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.053. Modification of Classification Rates

Sec. 1901.053.  MODIFICATION OF CLASSIFICATION RATES.  (a)  An insurer may modify classification rates to produce rates for individual risks in accordance with rating plans that establish standards for measuring variations in hazards or expense provisions.
(b)  The standards may measure any difference among risks that can be demonstrated to have a probable effect on losses or expenses.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.054. Limitations on Rates

Sec. 1901.054.  LIMITATIONS ON RATES.  (a)  Rates set under this chapter may not be excessive or inadequate, as described by this section, or unreasonable or unfairly discriminatory.
(b)  A rate is not excessive unless  the rate is unreasonably high for the insurance coverage provided.
(c)  A rate is not inadequate unless the rate is unreasonably low for the insurance coverage provided and:
(1)  is insufficient to sustain projected losses and expenses; or
(2)  the use of the rate has or, if continued, will have the effect of destroying competition or creating a monopoly.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.034(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.034(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.0541. Use in Underwriting of Certain Information Related to Lawsuits; Refund

Sec. 1901.0541.  USE IN UNDERWRITING OF CERTAIN INFORMATION RELATED TO LAWSUITS; REFUND.  (a)  Notwithstanding any other provision of this code, an insurer may not consider for the purpose of setting premiums or reducing a claims-free discount for a particular insured physician's professional liability insurance a lawsuit filed against the physician if:
(1)  before trial, the lawsuit was dismissed by the claimant or nonsuited; and
(2)  no payment was made to the claimant under a settlement agreement.
(b)  An insurer that, in setting premiums or reducing a claims-free discount for a physician's professional liability insurance, considers a lawsuit filed against the physician shall refund to the physician any increase in premiums paid by the physician that is attributable to that lawsuit or reinstate the claims-free discount if the lawsuit is dismissed by the claimant or nonsuited without payment to the claimant under a settlement agreement.  The insurer shall issue the refund or reinstate the discount on or before the 30th day after the date the insurer receives written evidence that the lawsuit was dismissed or nonsuited without payment to the claimant under a settlement agreement.
(c)  This section does not prohibit an insurer from considering and using aggregate historical loss and expense experience applicable generally to a classification of physicians'  professional liability insurance to set rates for that classification to the extent authorized by Chapter 2251 and Article 5.13-2.  Notwithstanding Section 2251.052(c), an insurer may not assign a physician to a particular classification based on a factor described by Subsection (a).
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.035(a), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.035(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.055. Claim Surcharge

Sec. 1901.055.  CLAIM SURCHARGE.  A claim surcharge assessed by an insurer against a physician or health care provider under a professional liability insurance policy may be based only on claims actually paid by an insurer as a result of:
(1)  a settlement; or
(2)  an adverse judgment or decision of a court.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.056. Absolute Rates Prohibited

Sec. 1901.056.  ABSOLUTE RATES PROHIBITED.  (a)  In this section, "absolute rates" means rates, rating plans, or rating classifications that are filed under Chapter 2251 or Article 5.13-2 by an insurer or authorized rating organization and that are required to be used, to the exclusion of all others, by each insurer authorized to write policies.
(b)  A provision of this chapter, Chapter 2251, or Article 5.13-2 relating to the regulation of rates, rating plans, and rating classifications for professional liability insurance for physicians and health care providers does not:
(1)  give the commissioner the power to promulgate uniform or absolute rates; or
(2)  prevent different insurers or organizations authorized to file rates from filing different rates for risks in a given classification or modified rates for individual risks made in accordance with rating plans.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter B. Rate Standards › Section 1901.057. Considerations in Approving Rates

Sec. 1901.057.  CONSIDERATIONS IN APPROVING RATES.  In approving rates under this chapter, the department shall consider the impact of risk management courses taken by physicians and health care providers in this state.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.034(b), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.034(b), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter C. Review of Rates › Section 1901.101. Reconsideration of Rates and Premiums

Sec. 1901.101.  RECONSIDERATION OF RATES AND PREMIUMS.  (a)  Each insurer to which this chapter applies shall adopt a procedure for reconsideration of a rate or premium charged a physician or health care provider for professional liability insurance coverage.
(b)  The procedure must include:
(1)  an opportunity for a hearing before officers or employees who have responsibility for determining rates and premiums to be charged for professional liability insurance; and
(2)  a requirement that the insurer reconsider the rate or premium and provide the physician or health care provider a written explanation of the rate or premium being charged.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter C. Review of Rates › Section 1901.102. Appeal

Sec. 1901.102.  APPEAL.  A physician or health care provider that is not satisfied with a decision under procedures established under Section 1901.101 may appeal to the commissioner for:
(1)  a review of the rate or premium; and
(2)  a determination of whether the rate or premium being charged complies with criteria under Sections 1901.051-1901.054 and 1901.057.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter D. Best Practices for Nursing Homes › Section 1901.151. Best Practices

Sec. 1901.151.  BEST PRACTICES.  (a)  The commissioner shall adopt best practices for risk management and loss control that may be used by for-profit and not-for-profit nursing homes.
(b)  In developing or amending the best practices, the commissioner shall consult with the Health and Human Services Commission and a task force appointed by the commissioner.
(c)  The task force must be composed of representatives of:
(1)  insurers that write professional liability insurance for nursing homes;
(2)  the Texas Medical Liability Insurance Underwriting Association;
(3)  nursing homes; and
(4)  consumers.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter D. Best Practices for Nursing Homes › Section 1901.152. Consideration of Best Practices in Setting Rates

Sec. 1901.152.  CONSIDERATION OF BEST PRACTICES IN SETTING RATES.  In setting rates for professional liability insurance applicable to a for-profit or not-for-profit nursing home, an insurer or the Texas Medical Liability Insurance Underwriting Association may consider whether the nursing home adopts and implements the best practices adopted under this subchapter.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter D. Best Practices for Nursing Homes › Section 1901.153. Standard of Care for Civil Actions Not Established

Sec. 1901.153.  STANDARD OF CARE FOR CIVIL ACTIONS NOT ESTABLISHED.  The best practices for risk management and loss control adopted under this subchapter do not establish standards of care for nursing homes applicable in a civil action against a nursing home.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter E. Policy Forms › Section 1901.201. Standardized Policy Forms; Approval of Other Forms

Sec. 1901.201.  STANDARDIZED POLICY FORMS; APPROVAL OF OTHER FORMS.  (a)  The commissioner shall prescribe standardized policy forms for occurrence, claims-made, and claims-paid professional liability insurance policies for physicians and health care providers.
(b)  An insurer may not use a form other than a standardized policy form in writing professional liability insurance for physicians and health care providers unless the form has been approved by the commissioner.
(c)  An insurer writing professional liability insurance for physicians and health care providers may use an endorsement if the endorsement has been filed with and approved by the commissioner.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter F. Coverage › Section 1901.251. Premium Basis

Sec. 1901.251.  PREMIUM BASIS.  An insurer may not write a professional liability insurance policy under this chapter on less than an annual premium basis.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter F. Coverage › Section 1901.252. Coverage for Exemplary Damages

Sec. 1901.252.  COVERAGE FOR EXEMPLARY DAMAGES.  (a)  Except as provided by Subsection (b), a medical professional liability insurance policy issued to or renewed for a physician or health care provider in this state may not include coverage for exemplary damages that may be assessed against the physician or health care provider.
(b)  The commissioner may approve an endorsement form that provides for coverage for exemplary damages for use on a medical professional liability insurance policy issued to:
(1)  a hospital; or
(2)  a for-profit or not-for-profit nursing home or assisted living facility.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter F. Coverage › Section 1901.253. Notice of Premium Increase, Cancellation, or Nonrenewal

Sec. 1901.253.  NOTICE OF PREMIUM INCREASE, CANCELLATION, OR NONRENEWAL.  (a)  An insurer that issues a professional liability insurance policy for a physician or health care provider must provide to the insured written notice of at least 90 days if the insurer intends to:
(1)  increase the premiums on the policy; or
(2)  cancel or not renew the policy for a reason other than for nonpayment of premiums or because the insured is no longer licensed.
(b)  If the insurer intends to increase the premiums, the insurer shall state in the notice the amount of the increase.
(c)  If the insurer intends to cancel or not renew the policy, the insurer shall state in the notice the reason for cancellation or nonrenewal.
(d)  An insurer may provide notice of cancellation under this section only within the first 90 days from the effective date of the policy.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter F. Coverage › Section 1901.254. Prohibition of Use of Certain Information for Physician or Health Care Provider

Sec. 1901.254.  PROHIBITION OF USE OF CERTAIN INFORMATION FOR PHYSICIAN OR HEALTH CARE PROVIDER.  (a)  For the purpose of writing professional liability insurance for physicians and health care providers, an insurer may not consider whether, or the extent to which, a physician or health care provider provides services in this state to individuals who are recipients of Medicaid or covered by the state child health plan program established by Chapter 62, Health and Safety Code, including any consideration resulting in:
(1)  denial of coverage;
(2)  refusal to renew coverage;
(3)  cancellation of coverage;
(4)  limitation of the amount, extent, or kind of coverage available; or
(5)  a determination of the rate or premium to be paid.
(b)  The commissioner may adopt rules as necessary to implement this section.
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.035(b), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.035(b), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1901 - Professional Liability Insurance for Physicians and Health Care Providers › Subchapter F. Coverage › Section 1901.255. Coverage for Volunteer Health Care Providers

Sec. 1901.255.  COVERAGE FOR VOLUNTEER HEALTH CARE PROVIDERS.  (a)  In this section:
(1)  "Charitable organization" has the meaning assigned by Section 84.003, Civil Practice and Remedies Code.
(2)  "Volunteer health care provider" has the meaning assigned by Section 84.003, Civil Practice and Remedies Code.
(b)  An insurer may make available professional liability insurance covering a volunteer health care provider for an act or omission resulting in death, damage, or injury to a patient while the person is acting in the course and scope of the person's duties as a volunteer health care provider as described by Chapter 84, Civil Practice and Remedies Code.
(c)  This section does not affect the liability of a volunteer health care provider who is serving as a direct service volunteer of a charitable organization. Section 84.004(c), Civil Practice and Remedies Code, applies to the volunteer health care provider without regard to whether the volunteer health care provider obtains liability insurance under this section.
(d)  An insurer may make professional liability insurance available under this section to a volunteer health care provider without regard to whether the volunteer health care provider is a "health care provider" as defined by Section 1901.001.
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.036(a), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.036(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1902 - Certain Liability Coverage for Physicians and Health Care Providers › Section 1902.001. Definitions

Sec. 1902.001.  DEFINITIONS.  In this chapter:
(1)  "Health care provider"  has the meaning assigned by Section 1901.001.
(2)  "Manufacturer" has the meaning assigned by Section 82.001, Civil Practice and Remedies Code.
(3)  "Physician" has the meaning assigned by Section 1901.001.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1902 - Certain Liability Coverage for Physicians and Health Care Providers › Section 1902.002. Coverage for Physicians or Health Care Providers Under Vendor Endorsements or Certain Policies

Sec. 1902.002.  COVERAGE FOR PHYSICIANS OR HEALTH CARE PROVIDERS UNDER VENDOR ENDORSEMENTS OR CERTAIN POLICIES.  A physician or health care provider is considered a vendor for purposes of coverage under a vendor's endorsement or a manufacturer's general liability or products liability policy.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1902 - Certain Liability Coverage for Physicians and Health Care Providers › Section 1902.003. Exclusions and Limitations on Coverage Under Vendor Endorsements Prohibited

Sec. 1902.003.  EXCLUSIONS AND LIMITATIONS ON COVERAGE UNDER VENDOR ENDORSEMENTS PROHIBITED.  An insurer may not exclude or otherwise limit coverage for physicians or health care providers under a vendor's endorsement issued to a manufacturer.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1903 - Loss Control Information and Services › Subchapter A. Loss Control Services for Professional Liability Insurance for Hospitals › Section 1903.001. Definition

Sec. 1903.001.  DEFINITION.  In this subchapter, "hospital" means a public or private institution licensed under Chapter 241 or 577, Health and Safety Code.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 10 - Property and Casualty Insurance › Subtitle B - Liability Insurance for Physicians and Health Care Providers › Chapter 1903 - Loss Control Information and Services › Subchapter A. Loss Control Services for Professional Liability Insurance for Hospitals › Section 1903.002. Inapplicability of Subchapter

Sec. 1903.002.  INAPPLICABILITY OF SUBCHAPTER.  This subchapter and Subchapter C do not apply to insurance policies that provide excess coverage issued by the Texas Medical Liability Insurance Underwriting Association under Chapter 2203, or to those policies if the policies are serviced by an insurer acting as a servicing carrier under an agreement entered into between the association and the insurer and approved by the commissioner.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.