reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.201 - Texas Automobile Insurance Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) No insurer
					 or its agent may charge any policy fee, service charge, or any other fee or
					 charge to process or submit a Texas Automobile Insurance Plan application. Only
					 premiums and surcharges prescribed by the State Board of Insurance and included
					 in Rule 059.05.01.005 (concerning the Texas Automobile Manual) may be charged
					 an applicant to the Texas Automobile Insurance Plan.
(b) No insurer or its agent may charge a
					 notary fee in excess of the fees permitted by Texas Civil Statutes, Article
					 3945, for notarization of the Texas Automobile Insurance Plan
					 application.
(c) No portion of any
					 risk eligible for the Texas Automobile Insurance Plan which is able to be
					 placed through such plan is eligible for surplus lines insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.202 - Physical Examinations in Motor Vehicle Insurance Underwriting

Current through Reg. 49, No. 28; July 12, 2024
If a company requires physical examinations for motor
						vehicle insurance underwriting, the costs for the examinations are not
						chargeable to insureds. Such examinations constitute a hidden charge for
						insurance and have the same status as credit and driver record
						reports.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.203 - Certificates of Insurance to Third Parties, Automobile Insurance

Current through Reg. 49, No. 28; July 12, 2024
No insurer or agent may issue to a third party any
						certification of insurance indicating the amount and type of insurance held by
						an insured unless the certificate contains the following statement or a
						statement which is substantially the same as the following: "This Certificate
						of Insurance neither affirmatively or negatively amends, extends, or alters the
						coverage afforded by Policy No. ____ issued by __________."
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.205 - Motor Vehicle Crime Prevention Authority Pass-Through Fee

Current through Reg. 49, No. 28; July 12, 2024
(a) Each insurer must pay a fee of $4.00 per
					 "motor vehicle year of insurance" to the Motor Vehicle Crime Prevention
					 Authority, as required by Transportation Code §
											1006.153.
					 The insurer is authorized to recoup some or all of this fee from the
					 policyholder.
(b) If an insurer
					 recoups the fee from the policyholder under subsection (a) of this section, the
					 insurer must:
(1) provide the policyholder
					 with a notice using the following or similar language, in at least 10-point
					 type: "Your payment includes a $[_______] fee per vehicle each year. This fee
					 helps fund (1) auto burglary, theft, and fraud prevention, (2) criminal justice
					 efforts, and (3) trauma care and emergency medical services for victims of
					 accidents due to traffic offenses. By law, this fee funds the Motor Vehicle
					 Crime Prevention Authority.";
(2)
					 include the notice on or with each motor vehicle insurance policy, as defined
					 in 43 TAC §
												57.48(relating
					 to Motor Vehicle Years of Insurance Calculations), that is delivered, issued
					 for delivery, or renewed in this state, including those policies issued through
					 the Texas Automobile Insurance Plan Association; and
(3) if the notice language required by
					 paragraph (1) of this subsection is provided somewhere other than the
					 declarations page, renewal certificate, or billing, also include the following
					 or similar language on the declarations page of the policy, renewal
					 certificate, or billing: "Motor Vehicle Crime Prevention Authority Fee
					 $[______] (See enclosed explanation)."
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.206 - Designation of Underserved ZIP Codes

Current through Reg. 49, No. 28; July 12, 2024
(a) Class
					 4. The following ZIP Codes are designated as Class 4 ZIP Codes:
Attached
						Graphic
(b)
					 Class 3. The following ZIP Codes are designated as Class 3 ZIP Codes:
Attached
						Graphic
(c)
					 Class 2. The following ZIP Codes are designated as Class 2 ZIP Codes:
Attached
						Graphic
(d)
					 Class 1. The following ZIP Codes are designated as Class 1 ZIP Codes:
Attached
						Graphic
(e)
					 Class 0. Any ZIP Code not listed in subsections (a)-(d) of this section are
					 designated as a Class 0 ZIP Code.
(f) Changes to designations. After initial
					 designation of a ZIP Code, the designation may not be decreased (to a lower
					 numbered class) for three years. Any such decrease in designation shall not be
					 effective until one year after the changed designation is adopted as an
					 amendment to this rule. An increase in the designation of a ZIP Code (to a
					 higher numbered class) may occur at any time by amending this rule.
(g) In designating ZIP Codes as Class 0, 1,
					 2, 3 or 4, the Commissioner shall use the share of average vehicles on policies
					 in force in assigned risk and non-standard markets as a percentage of total
					 average vehicles on policies in force by ZIP Code.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.207 - Financial Responsibility Consumer Outreach Program

Current through Reg. 49, No. 28; July 12, 2024
(a) The purpose of this section is to
					 establish the requirements for the Financial Responsibility Consumer Outreach
					 Program (Program), which the department is required to establish under
					 Transportation Code §
											601.072(c).
(b) As required under Transportation Code
					 §
											601.072(c),
					 the Program shall inform consumers of the requirements of the Texas Motor
					 Vehicle Safety Responsibility Act (Act) (Transportation Code, Chapter 601) and
					 the ability to comply with the financial responsibility requirements of the Act
					 through motor vehicle liability insurance coverage.
(c) The department shall develop and
					 periodically update Program materials that are designed to encourage compliance
					 with the financial responsibility requirements of the Act.
(d) The Program materials shall include
					 information on:
(1) minimum coverage amounts
					 required to establish financial responsibility under the Act;
(2) how to comply with the Act through motor
					 vehicle liability insurance coverage; and
(3) how to obtain motor vehicle liability
					 insurance coverage.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 3 - MISCELLANEOUS INTERPRETATIONS › Section 5.208 - Terminology Describing Transportation-Related Accidents (Collisions)

Current through Reg. 49, No. 28; July 12, 2024
(a) House Bill 2190, 88th Legislature, 2023 (HB 2190) replaced the term "accident" with "collision" in Insurance Code §
											1952.155, concerning Benefits Payable Without Regard to Fault or Collateral Source; Effect on Subrogation, and §1954.056(b), concerning Financial Responsibility. However, the transition provision in Section 142 of HB 2190 states that these changes to the law are nonsubstantive and are intended to clarify rather than change existing law.
(b) Consistent with the transition provision in Section 142 of HB 2190, the Texas Department of Insurance (TDI) interprets the term "collision" when used in Insurance Code §
											1952.155 and §
											1954.056(b)  as having the same meaning that "accident" had before passage of HB 2190 and as having no impact on rules adopted pursuant to Insurance Code §
											1952.155 and §
											1954.056(b)  or forms filed for approval with TDI under those Insurance Code sections and rules before HB 2190.
(c) Because the transition provision in Section 142 of HB 2190 says the changes are nonsubstantive, they do not impact the rules in this subchapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 4 - LOSS CONTROL INFORMATION FOR COMMERCIAL AUTOMOBILE LIABILITY INSURANCE › Section 5.301 - Loss Control Information

Current through Reg. 49, No. 28; July 12, 2024
Any insurer desiring to write commercial automobile
						liability insurance in Texas shall provide loss control information to
						policyholders. The term "information" includes, but is not limited to, loss
						data and the results of analysis of that data; training materials such as
						films, videotapes, brochures, signs, etc.; classes for the training of
						policyholder supervisory personnel in vehicle maintenance and inspection, safe
						driving techniques, and supervisory techniques to include recordkeeping; and
						conclusions and recommendations resulting from surveys of policyholders'
						operations and facilities. The specific method or methods to be used to provide
						this information to the policyholder and the depth and quantity of the
						information provided are within the insurer's discretion, but shall take into
						account the following.
(1) Risks. Type
					 of operation, probability of catastrophic accidents, probability of serious
					 accidents, and probability of frequent accidents shall be considered.
(2) Exposures. Total number of vehicles, type
					 of vehicles, type of cargo carried, number of locations, number of drivers, and
					 number of miles driven per year shall be considered.
(3) Loss experience. Loss ratio, frequency
					 rate, and severity rate shall be considered.
(4) Other considerations. In addition to the
					 foregoing factors, items such as the extent of policyholder accident prevention
					 activities, acceptance of loss control information, recommendation compliance,
					 and unusual circumstances should be considered.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 4 - LOSS CONTROL INFORMATION FOR COMMERCIAL AUTOMOBILE LIABILITY INSURANCE › Section 5.302 - Methods of Providing Loss Control Information

Current through Reg. 49, No. 28; July 12, 2024
The insurer shall maintain the capability of providing
						loss control information to policyholders and may employ various methods of
						providing such information. Among these are computer products, such as loss
						summaries and analyses; printed matter, such as brochures and posters;
						audio-visual material, such as videotapes, films, and slide presentations;
						training programs for initial and continuing driver education, accident
						prevention techniques, etc.; and the knowledge and expertise of qualified loss
						control representatives.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 4 - LOSS CONTROL INFORMATION FOR COMMERCIAL AUTOMOBILE LIABILITY INSURANCE › Section 5.311 - Qualifications of Personnel Providing Loss Control Information and Services

Current through Reg. 49, No. 28; July 12, 2024
To provide loss control information and services, the
						insurer may employ qualified personnel, may retain qualified independent
						contractors, may contract with the policyholder to provide qualified accident
						prevention personnel and services, or may use a combination of these methods.
						To be qualified to provide loss control information and services for commercial
						automobile liability insurance policyholders, an individual must either:
(1) be a designated field safety
					 representative as prescribed by § 5.6001 of this title (relating to
					 Qualification for Designation as Field Safety Representative);
(2) successfully complete the Motor
					 Transportation Certification Program as established under the auspices of the
					 Texas Motor Transportation Association, the Texas Council of Safety
					 Professionals, and the Texas Safety Association; or
(3) be a graduate of a course of instruction
					 that has been approved by the Loss Control Regulation Division of the State
					 Board of Insurance, acting on behalf of the commissioner of
					 insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 5 - PRIVATE PASSENGER AUTOMOBILE LIABILITY INSURANCE REQUIREMENTS FOR UNDERWRITING TREATMENT AND DISCLOSURE › Section 5.401 - Temporary and Permanent Requirements Regarding Underwriting Treatment of and Disclosure to Applicants for Private Passenger Automobile Liability Insurance

Current through Reg. 49, No. 28; July 12, 2024
(a) Effective until December 31, 1992, each
					 previous "no-prior insurance" applicant who was written in a higher-rated
					 insurance company will be re-underwritten on the applicant's renewal date
					 subject to the underwriting criteria of each company to which the applicant
					 applies at each company's or group of companies' lowest applicable
					 rate.
(b) Insurers may not use an
					 applicant's lack of prior insurance in determining the appropriate rate for
					 private passenger automobile liability insurance where such applicant has not
					 been operating an uninsured motor vehicle in the state for more than 30 days
					 during the 12 months immediately preceding the date of the
					 application.
(c) Applicants for
					 automobile liability insurance currently or previously insured in a
					 higher-rated insurance company or through the Texas Automobile Insurance Plan
					 (the assigned risk plan) will be underwritten without consideration of the
					 applicant's prior insurance carrier.
(d) Insurers or agents who make a quote to an
					 applicant with no prior insurance having no more than one accident and one
					 violation within the past three years which quote equals or exceeds the premium
					 available through the assigned risk plan must inform the applicant of the
					 approximate cost of coverage available through the assigned risk
					 plan.
(e) If any provision of this
					 section or the application thereof to any person or circumstance is held
					 invalid for any reason, the invalidity shall not affect the other provisions or
					 any other application of said provisions which can be given effect without the
					 invalid provision or application. To this end all provisions of this section
					 are declared to be severable.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 6 - NOTICE REQUIREMENTS TO CLAIMANTS REGARDING MOTOR VEHICLE REPAIRS › Section 5.501 - Notice Requirements to Claimants Regarding Motor Vehicle Repairs

Current through Reg. 49, No. 28; July 12, 2024
(a) The following words and terms, when used
					 in this section, shall have the following meanings, unless the context clearly
					 indicates otherwise.
(1) Business day--A day
					 other than a Saturday, Sunday, or holiday recognized by the State of
					 Texas.
(2) Insurer--An insurer or
					 any person authorized to act on behalf of an insurer regarding damage to a
					 vehicle, regardless of whether employed by the insurer.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.601 - Purpose and Scope

Current through Reg. 49, No. 28; July 12, 2024
This division applies to insurers providing motor vehicle
						liability insurance in this state under personal automobile insurance policies.
						The division specifies the requirements, procedures, duties, and obligations of
						these insurers to comply with the Financial Responsibility Verification Program
						(program) established pursuant to Transportation Code, Chapter 601, Subchapter
						N.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.603 - Financial Responsibility Verification Program Guide and User Manual

Current through Reg. 49, No. 28; July 12, 2024
(a) The user guide established in accordance
					 with SECTION 4 of SB 1670 (Acts 2005, 79th Leg., R.S., chap.892, SB 1670 sec.
					 4) will provide technical guidance to insurers on how to comply with the
					 requirements and procedures specified in §§5.601 - 5.611. The user
					 guide specifications are subject to change based on technology or program
					 experience. Such changes to the user guide shall not affect the substantive
					 requirements of this division.
(b)
					 The user guide may be obtained from the Data Services Division of the Texas
					 Department of Insurance, Mail Code 105-5D, P.O. Box 149104, Austin, Texas 78714
					 or the department website at www.tdi.state.tx.us.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.604 - Reporting Requirements for Insurers Using the Database Program

Current through Reg. 49, No. 28; July 12, 2024
(a) Unless an insurer provides the department
					 notice of its election to be a web services insurer under §
											5.606(b)
					 of this subchapter (relating to Requirements for Insurers Using the Web
					 Services Program), each insurer shall participate in the database program for
					 the event based and ongoing verification processes.
(b) Except as required in §
											5.606
					 and §
											5.609
					 of this subchapter (relating to Delegation and New Insurers) each database
					 insurer must begin compliance with this section and §
											5.605
					 of this subchapter (relating to Data Error Correction Requirements for Insurers
					 Using the Database Program) beginning not earlier than January 1, 2007 and not
					 later than June 30, 2007.
(c) Each
					 database insurer shall submit weekly data on all of the insurer's personal
					 automobile insurance policies in force in Texas. The data shall specify the
					 following for each policy, policyholder, listed driver, and vehicle covered,
					 and as necessary each policy, policyholder, listed driver, and vehicle
					 combination:
(1) company identifying
					 information;
(2) policy identifying
					 information, including applicable coverage dates;
(3) vehicle identifying
					 information;
(4) policyholder
					 and/or listed driver identifying information; and
(5) an insurer defined data field for insurer
					 use.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.605 - Data Error Correction Requirements for Insurers Using the Database Program

Current through Reg. 49, No. 28; July 12, 2024
(a) Each database insurer shall investigate
					 and correct data errors identified by the vendor as required in subsection (e)
					 of this section.
(b) Each database
					 insurer shall provide sufficient and accurate data to meet and maintain a 95
					 percent match rate beginning January 1, 2008 and a 98 percent match rate
					 beginning January 1, 2010.
(c) The
					 database insurer must be able to receive notice of data errors in the same
					 manner that data is transmitted to the vendor, or a method that is mutually
					 agreed upon by the vendor and the insurer.
(d) Insurers must re-submit corrected
					 data.
(e) The database insurer,
					 and/or its delegated MGA, shall receive notice of the following data errors
					 from the vendor, and shall comply with the following data correction
					 procedures:
(1) for data file format errors,
					 the database insurer will have three business days to correct errors and
					 resubmit the entire data file to the vendor; and
(2) for insurance policy records not matched
					 to a registered vehicle, the vendor will send the insurer, and/or its delegated
					 MGA, non-match notices:
(A) upon receipt of
					 the first non-match notice from the vendor, including notice for errors beyond
					 the database insurer's authority to correct, the insurer must:
(i) within 10 calendar days of receipt of the
					 non-match notice, request from the policyholder confirmation of the insurer's
					 existing information or corrected information;
(ii) request that the policyholder respond
					 within 14 calendar days; however, the insurer shall not be subject to, nor
					 shall the insurer subject the policyholder to, any penalty for the
					 policyholder's non-compliance; and
(iii) send any correction(s) received from
					 the policyholder to the vendor within the next two regularly scheduled data
					 transmissions; and
(B)
					 upon receipt of the second notice of the non-match error from the vendor, the
					 insurer may, but is not required to, provide additional notices to the
					 policyholder concerning that non-match error.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.607 - Web Services Program System Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) A web services insurer must design,
					 develop, maintain, and submit specifications for a web services program
					 application capable of verifying the status of a policyholder's insurance
					 information. The program must enable the insurer to receive and respond to the
					 vendor's insurance verification inquiries during the event based process and to
					 process batch inquiries of multiple vehicles during the ongoing verification
					 process.
(b) The web services
					 program transmission format and protocols must be compliant with XML standards
					 as published by the World Wide Web Consortium (W3C).
(c) The insurer's web services program must
					 incorporate basic web service infrastructure standards; select a common XML
					 standard to align with the other web services infrastructure standards; and set
					 forth procedures for agreement between insurers and the vendor to use one set
					 of web services security standards, adhere to SOAP 1.1 standards, and use one
					 set of authentication standards.
(d) The web services insurer must develop and
					 implement an algorithm that matches policy and policyholder data to information
					 provided by the vendor in the query process. The algorithm may also use
					 cascading data matching that may not result in a 100 percent match of all
					 fields, but a match may be made with a reasonable degree of accuracy. The
					 algorithm must match information using:
(1)
					 the VIN, if available, and one additional field; or
(2) at least two data fields provided by the
					 vendor.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.608 - Web Services Program Performance Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) The web services insurer must accept and
					 respond to insurance verification inquiries from the vendor.
(b) The web services insurer must respond to
					 inquiries in no more than 1.75 seconds, of which 0.25 seconds is allotted for
					 transmission from vendor to insurer, and 0.25 seconds is allotted for
					 transmission from insurer to vendor.
(c) The web services insurer must respond to
					 the vendor with either an affirmative response and applicable information, or
					 with a negative response as appropriate.
(d) Policy and policyholder data that the web
					 services insurer must return with an affirmative response includes, to the
					 extent that the information is at that time available from the insurer:
(1) company identifying
					 information;
(2) policy identifying
					 information, including applicable coverage dates;
(3) vehicle identifying
					 information;
(4) policyholder's
					 and/or listed driver's identifying information; and
(5) an insurer defined data field for insurer
					 use.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.609 - Delegation and New Insurers

Current through Reg. 49, No. 28; July 12, 2024
(a) An insurer
					 may delegate by written contract the functions that the insurer is required to
					 perform under the program to one or more department licensed managing general
					 agents (MGA), and to the extent an insurer has contractually delegated any
					 requirement of §§5.601 - 5.611 to an MGA, the MGA shall be deemed an
					 insurer for the purposes of §§5.601 - 5.611. A copy of the delegation
					 agreement must be submitted to the department's Financial Responsibility
					 Verification Program Coordinator and the vendor. Under such delegation, both
					 the MGA and the insurer shall be jointly and severally responsible for full
					 compliance with this program and jointly and severally subject to disciplinary
					 actions from the department for failure to meet program requirements.
(b) An insurer or delegated MGA that
					 commences writing personal automobile insurance in the Texas market more than
					 10 business days after the effective date of §
											5.606
					 of this subchapter (relating to Requirements for Insurers Using the Web
					 Services Program), but before June 1, 2007, shall comply with the database
					 program as detailed in §
											5.604
					 and §
											5.605
					 of this subchapter (relating to Reporting Requirements for Insurers Using the
					 Database Program and Data Error Correction Requirements for Insurers Using the
					 Database Program) and must begin reporting data on or before June 30,
					 2007.
(c) An insurer that commences
					 writing personal automobile insurance in the Texas market on or after June 1,
					 2007 shall have 30 calendar days to comply with the database program
					 requirements in §
											5.604
					 and §
											5.605
					 of this subchapter and begin reporting data.
(d) An MGA that has been contracted to act on
					 behalf of an insurer under subsection (a) of this section has the same
					 reporting options as an insurer. An MGA that contracts to act on behalf of an
					 insurer under subsection (a) of this section more than 10 business days after
					 the effective date of §
											5.606
					 of this subchapter must comply with the database program requirements in §
											5.604
					 and §
											5.605
					 of this subchapter and begin reporting data as specified for an insurer in
					 subsections (b) and (c) of this section.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.610 - Penalties

Current through Reg. 49, No. 28; July 12, 2024
(a) The commissioner may after opportunity
					 for notice and hearing, discipline an insurer or license holder under the
					 Insurance Code Chapters 82, 83, and 84, and any other applicable law if the
					 commissioner determines the insurer or license holder is in violation of, or
					 has failed to comply, with any of the requirements of §§5.601 -
					 5.611.
(b) In accordance with
					 Transportation Code §
											601.454,
					 a person commits an offense if the person knowingly uses data obtained under
					 Chapter 601, Subchapter N, for any purpose not authorized under Subchapter N.
					 An offense under §601.454(d) is a Class B misdemeanor.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter A - AUTOMOBILE INSURANCE › Division 7 - FINANCIAL RESPONSIBILITY VERIFICATION PROGRAM › Section 5.611 - Participation in Voluntary Testing Transmission System

Current through Reg. 49, No. 28; July 12, 2024
(a) An insurer or group of insurers
					 (participating insurers) may test a transmission system based on the
					 transmission of insurer provided key-data to provide verification of compliance
					 with the Texas Motor Vehicle Safety Responsibility Act.
(b) Further specifics for the test program
					 will be developed by the department, TxDOT, DPS, and the Texas Department of
					 Information Resources (implementing agencies), the participating insurers, and
					 the vendor.
(c) When the
					 participating insurers demonstrate a working test program for the event based
					 process, the ongoing verification process, or both, to the satisfaction of the
					 implementing agencies, the accepted test program will become an alternate means
					 of compliance with the Financial Responsibility Verification Program to the
					 extent it has been accepted for use by the implementing agencies to fulfill the
					 event based process and/or ongoing verification process of the
					 program.
(d) Insurers must comply
					 with either the database system or the web services system until such date as
					 the department and/or the other implementing agencies adopt rules detailing
					 technical, performance, and user requirements for use with the accepted test
					 program.
(e) Insurers are
					 responsible for funding all equipment and technical resources necessary for the
					 development, testing, and deployment of the test program and the accepted test
					 program, except for those funds the implementing agencies have authorized the
					 vendor to spend in connection with the test program.
(f) Sections
					 5.606,
					 5.607,
					 and
					 5.608
					 of this subchapter (relating to Requirements for Insurers Using the Web
					 Services Program, Web Services Program System Requirements, and Web Services
					 Program Performance Requirements) shall not apply to the test program. This
					 does not limit the insurers or the implementing agencies from requiring the
					 same or similar technical, performance, and user requirements described in
					 those sections as may be necessary to create a functioning system and obtain
					 implementing agency approval.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 1 - DIVIDEND PROCEDURES › Section 5.1101 - Permissible Dividend Classes, the Insurance Code, Chapter 5, Subchapter B

Current through Reg. 49, No. 28; July 12, 2024
The permissible classes for the payment of dividends for
						the lines of insurance regulated under the Insurance Code, Chapter 5,
						Subchapter B, are the same as the duly approved rating classifications for
						those lines of insurance. No insurer may declare or pay any dividend on any
						line of insurance regulated under the Insurance Code, Chapter 5, Subchapter B,
						unless the dividend is declared and paid on a class which is the same as one of
						the approved rating classifications for that line of
						insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 1 - DIVIDEND PROCEDURES › Section 5.1102 - Other Restrictions on the Payment of Dividends, the Insurance Code, Chapter 5, Subchapter B

Current through Reg. 49, No. 28; July 12, 2024
(a) No dividend
					 shall take effect or may be paid until approved by the State Board of
					 Insurance.
(b) A dividend may only
					 be paid out of earned surplus.
(c)
					 A pro rata earned dividend must be paid on a participating policy which is
					 terminated prior to its expiration date, if a dividend is otherwise declared
					 and paid for that class of policies.
(d) A dividend may not be paid until the
					 policy expires.
(e) A dividend may
					 not be promised or guaranteed to policyholders.
(f) Dividends shall be disbursed uniformly by
					 classes.
(g) The policy contract
					 must contain the standard participation language approved by the State Board of
					 Insurance.
(h) Earned dividends may
					 not be used by the company to extend or renew policies without the insured's
					 consent. A company may extend or renew policies by application of earned
					 dividends on individual company forms or billings which meet the following
					 minimum requirements:
(1) the insured must be
					 given written notice of his or her right to either accept his earned dividend
					 or agree to the application of his earned dividend to an extension or renewal
					 policy;
(2) the amount of the
					 earned dividend and the number of days the policy is to be extended must be
					 shown in the notice.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 1 - DIVIDEND PROCEDURES › Section 5.1103 - Dividend Application Form, the Insurance Code, Chapter 5, Subchapter B

Current through Reg. 49, No. 28; July 12, 2024
The State Board of Insurance adopts by reference Texas
						Casualty Dividend Disbursement Application, as applicable to the Insurance
						Code, Chapter 5, Subchapter B. This form may be obtained from the Deputy
						Insurance Commissioner, Casualty Group, State Board of Insurance, 1110 San
						Jacinto Street, Austin, Texas 78786.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 5 - PROCEDURES FOR RECONSIDERATION OF RATES OR PREMIUMS CHARGED A PHYSICIAN OR HEALTH CARE PROVIDER FOR MEDICAL PROFESSIONAL LIABILITY INSURANCE › Section 5.1501 - Procedure for Reconsideration

Current through Reg. 49, No. 28; July 12, 2024
Each insurer covered by the Insurance Code, Article
						5.15-1, shall adopt a procedure for reconsideration of the rate or premium
						charged a physician or health care provider, as defined in §2 of said
						article, for professional liability insurance coverage. The procedure so
						adopted must:
(1) afford any insured
					 physician or health care provider the opportunity to file a written grievance
					 with, or request a hearing before, officers or employees of the insurer who
					 have responsibility for determining rates and premiums to be charged for
					 professional liability insurance;
(2) require that the insurer reconsider the
					 rate or premium of the insured physician or health care provider;
(3) require the insurer to provide a written
					 explanation of the rate or premium being charged; and
(4) provide that the insurer shall file a
					 copy of any grievance or request for hearing, together with the insurer's
					 response thereto, with the Professional Liability Division of the State Board
					 of Insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 5 - PROCEDURES FOR RECONSIDERATION OF RATES OR PREMIUMS CHARGED A PHYSICIAN OR HEALTH CARE PROVIDER FOR MEDICAL PROFESSIONAL LIABILITY INSURANCE › Section 5.1502 - Grievance and Hearing Procedures

Current through Reg. 49, No. 28; July 12, 2024
Each insurer shall file its written procedures with the
						Director of Professional Liability Insurance, Mail Code 012-4, State Board of
						Insurance, 1110 San Jacinto Boulevard, Austin, Texas 78701-1998, within 60 days
						after the effective date of this section and, thereafter, when these procedures
						are amended. The director shall review each filing for compliance with the
						following criteria.
(1) The insurer
					 must file with the Professional Liability Division of the State Board of
					 Insurance the names, titles, and mailing addresses of at least two officers or
					 employees responsible for receiving, reviewing, and hearing any
					 grievance.
(2) Prior to a request
					 for hearing, the insured must file a written grievance with the insurer
					 including a short and plain statement of the matters asserted.
(3) Upon receipt of the insured's written
					 grievance, the insurer shall promptly provide a written response to the
					 grievance, by certified mail to the insured's last known address, with a copy
					 to the Professional Liability Division of the State Board of
					 Insurance.
(4) If the matter in
					 dispute is not resolved to the insured's satisfaction, the insured may request
					 a hearing.
(5) Upon receiving an
					 insured's written request for a hearing, the insurer shall promptly provide, by
					 certified mail to the insured's last known address, with a copy to the
					 Professional Liability Division of the State Board of Insurance, a written
					 notice of a hearing which shall include:
(A)
					 the time, place, and nature of the hearing;
(B) a reference to the Insurance Code,
					 Article 5.15-1, §4B, and to this section; and
(C) an explanation of any procedures to be
					 followed at, or prior to, the hearing.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 5 - PROCEDURES FOR RECONSIDERATION OF RATES OR PREMIUMS CHARGED A PHYSICIAN OR HEALTH CARE PROVIDER FOR MEDICAL PROFESSIONAL LIABILITY INSURANCE › Section 5.1503 - Appeal to the State Board of Insurance

Current through Reg. 49, No. 28; July 12, 2024
If the insured physician or health care provider is not
						satisfied with a decision under the procedures established in §
											5.1501
						and §
											5.1502
						of this title (relating to Procedure for Reconsideration and Grievance and
						Hearing Procedures), the insured may appeal to the State Board of Insurance for
						a review of the rate or premium and request a determination of whether the rate
						or premium being charged complies with criteria of the Insurance Code, Article
						5.15-1, §3.
(1) Any insured who
					 wishes to appeal the final decision of the insurer under these rules shall
					 file, with the chief clerk of the State Board of Insurance, a written notice of
					 intent to appeal, which includes a copy of the final decision of the
					 insurer.
(2) The appeal shall be
					 filed within 30 days after receipt by the insured of the final decision of the
					 insurer.
(3) The insured shall
					 certify that a copy of the written notice of intent to appeal has been sent by
					 certified mail to the insurer.
(4)
					 The appeal will be conducted in accordance with the contested case provisions
					 of the Administrative Procedure and Texas Register Act (Texas Civil Statutes,
					 Article 6252-13a, §§13-17).
(5) The decision of the State Board of
					 Insurance will be final and may not be appealed.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 7 - STANDARDS FOR PROVIDING LOSS CONTROL SERVICES FOR PROFESSIONAL LIABILITY INSURANCE FOR HOSPITALS › Section 5.1701 - Qualifications for Designation as Field Safety Representative with Specialty in Hospitals

Current through Reg. 49, No. 28; July 12, 2024
(a) The following
					 are eight ways to qualify as a field safety representative under the Insurance
					 Code, Article 5.15-2:
(1) an individual with a
					 baccalaureate in science or engineering;
(2) an individual with a baccalaureate in
					 nursing, pharmacy, or physical therapy;
(3) an individual with a master's degree in
					 hospital administration;
(4) an
					 individual who is a certified safety professional or a registered professional
					 engineer;
(5) an individual who is
					 certified for specific practice in industrial hygiene by the American Board of
					 Industrial Hygienists;
(6) an
					 individual with 10 years of experience in occupational safety and
					 health;
(7) an individual who has
					 completed a course of training as specified in §
												5.1702
					 of this title (relating to Course of Training for Field Safety Representatives
					 with Specialty in Hospitals); and
(8) an individual recognized as a field
					 safety representative by the Texas Workers' Compensation Commission.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 7 - STANDARDS FOR PROVIDING LOSS CONTROL SERVICES FOR PROFESSIONAL LIABILITY INSURANCE FOR HOSPITALS › Section 5.1702 - Course of Training for Field Safety Representatives with Specialty in Hospitals

Current through Reg. 49, No. 28; July 12, 2024
An individual may qualify under the Insurance Code,
						Article 5.15-2, as a field safety representative with specialty in hospitals,
						and satisfy §
											5.1701
						of this title (relating to Qualifications for Designation as Field Safety
						Representative with Specialty in Hospitals) by completing the approved course
						of training, which consists of 10 units of experience credit and/or educational
						credit as established by the criteria described in paragraphs (1)-(4) of this
						section.
(1) Experience credit. Each
					 year of experience in occupational safety, health-care risk management, law,
					 medicine, clinical nursing, pharmacy, hospital administration, psychology, or
					 clinical health services, while not working directly under the supervision of a
					 qualified field safety representative and acceptable to the State Board of
					 Insurance, equals one unit.
(2)
					 Internship experience credit. An individual having completed four units of
					 educational credit, and desiring to become a qualified field safety
					 representative, may serve as an intern to become a field safety representative
					 with specialty in hospitals, while working directly under the supervision of a
					 qualified field safety representative while qualifying to complete paragraph
					 (4) of this section. The internship may not exceed 36 months. Two units per
					 calendar year are allowed. The maximum units allowable are four.
(3) Educational credit. Graduation from an
					 accredited college or university with a baccalaureate degree and coursework in
					 occupational safety, health-care risk management, law, medicine, clinical
					 nursing, pharmacy, hospital administration, psychology, or clinical health
					 services equals eight units of training. Satisfactory completion of each
					 academic year (30 semester hours or equivalent) from an accredited college or
					 university equals two units of training. The maximum units allowable are
					 eight.
(4) Examination credit. In
					 addition to any points under any combination of paragraphs (1)-(3) of this
					 section, the individual shall successfully complete the core examination of the
					 Board of Certified Safety Professionals, the core examination of the American
					 Board of Industrial Hygiene, or an examination approved by the State Board of
					 Insurance. Successful completion of any one of these examinations equals four
					 units of training. The maximum units allowable are four.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 7 - STANDARDS FOR PROVIDING LOSS CONTROL SERVICES FOR PROFESSIONAL LIABILITY INSURANCE FOR HOSPITALS › Section 5.1711 - Methods of Providing Loss Control Facilities

Current through Reg. 49, No. 28; July 12, 2024
Any insurer desiring to write professional liability
						insurance for hospitals in Texas shall have available adequate facilities and
						field safety representatives to furnish to policyholders the services described
						in paragraphs (1)-(5) of this section.
(1) Surveys. On-site identification and
					 subsequent evaluation of exposures relative to employees, patients, visitors,
					 material, equipment, processes, and facilities, and contract and credentialed
					 professional staff must be furnished.
(2) Training programs. Training aids,
					 programs, and materials to assist in the control of exposures to accident,
					 injury, or illness must be made available.
(3) Consultations. Counsel and advice to
					 policyholders relative to risk, exposures, and experience in the policyholder's
					 business must be furnished.
(4)
					 Analysis. Review of policies and procedures used by policyholders to identify
					 causes and trends of incidents and occurrences must be furnished.
(5) Recommendations. Communication to
					 policyholders with reference to the control of patient, employee, contract and
					 credentialed professional staff, and visitor exposures to malpractice loss,
					 injury, or illness must be furnished.