reglab/statecodes huggingface dataset:
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 5.1712 - Loss Control Services

Current through Reg. 49, No. 28; July 12, 2024
The insurer shall maintain and make available to its
						policyholders loss control facilities reasonably commensurate to the loss
						exposures and experience of the policyholder's business, and each policyholder
						shall be informed of the type of such services available. The specific method
						or methods to be used are within the insurer's discretion but shall take into
						account the following.
(1) Risk
					 exposure. Classification by number and type of clinical patient care services
					 provided; specialty of clinical and medical staff employed; probability of loss
					 or injury; probability of illness; probability and frequency of negligent acts
					 (commission or omissions) of policyholder's agents; severity/acuity of illness;
					 location of services; and recent trends in malpractice litigation shall be
					 considered.
(2) Experience. Losses
					 incurred, loss frequency rate, and severity rate shall be considered.
(3) Size. Total number of employees, number
					 of locations, number of patients per location, and number of employees per
					 classification shall be considered.
(4) Other considerations. In addition to the
					 foregoing factors, items such as the extent of policyholder loss control
					 activities, acceptance of loss control services, 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 B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 8 - LOSS CONTROL INFORMATION FOR PROFESSIONAL LIABILITY INSURANCE FOR INSUREDS OTHER THAN HOSPITALS, FOR GENERAL LIABILITY INSURANCE, OR FOR MEDICAL PROFESSIONAL LIABILITY INSURANCE FOR INSUREDS OTHER THAN HOSPITALS › Section 5.1721 - Loss Control Information

Current through Reg. 49, No. 28; July 12, 2024
Any insurer desiring to write professional liability
						insurance for insureds other than hospitals, to write general liability
						insurance, or to write medical professional liability insurance for insureds
						other than hospitals in Texas shall provide loss control information to
						policyholders. The term "information" may include, 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 liability loss and hazard indication and
						analysis, selection of appropriate loss control measures, and supervisory
						techniques to include recordkeeping and recommendations resulting from surveys
						of policyholders and facilities; and monitoring personnel performance. The
						specific method or methods to be used to provide this information to a
						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. Classification by number and type
					 of services provided, type of staff employed, and probability of accidents, or
					 hazards with liability loss potential shall be considered.
(2) Exposures. Total number of employees,
					 agents, or contractors; type of services/operations; number of locations; and
					 number of contract services 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 loss 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 B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 8 - LOSS CONTROL INFORMATION FOR PROFESSIONAL LIABILITY INSURANCE FOR INSUREDS OTHER THAN HOSPITALS, FOR GENERAL LIABILITY INSURANCE, OR FOR MEDICAL PROFESSIONAL LIABILITY INSURANCE FOR INSUREDS OTHER THAN HOSPITALS › Section 5.1722 - Methods of Providing Loss Control Information

Current through Reg. 49, No. 28; July 12, 2024
The insurer shall establish procedures for, and 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 education,
						and for liability loss prevention techniques, etc.; and the knowledge and
						expertise of a qualified field safety representative.
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 8 - LOSS CONTROL INFORMATION FOR PROFESSIONAL LIABILITY INSURANCE FOR INSUREDS OTHER THAN HOSPITALS, FOR GENERAL LIABILITY INSURANCE, OR FOR MEDICAL PROFESSIONAL LIABILITY INSURANCE FOR INSUREDS OTHER THAN HOSPITALS › Section 5.1731 - 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, an
						insurer may employ qualified personnel, retain qualified independent
						contractors, may contract with the policyholder to provide qualified loss
						prevention personnel and services, or may use a combination of these methods.
						To be qualified to provide loss control information and services for
						professional liability insurance for insureds other than hospitals, for general
						liability insurance, or for medical professional liability insurance for
						insureds other than hospital policyholders, an individual must either:
(1) be a designated field safety
					 representative as prescribed by §
											5.1701
					 and §
											5.1702
					 of this title (relating to Qualification for Designation as Field Safety
					 Representative with Specialty in Hospitals and Course of Training for Field
					 Safety Representatives with Specialty in Hospitals) or by § 5.6001 and
					 § 5.6002 of this title (relating to Qualification for Designation as Field
					 Safety Representative and Course of Training);
(2) successfully complete the Associate in
					 Risk Management Program or Associate in Loss Control Management Program as
					 established under the auspices of the Insurance Institute of America;
					 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 B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B › Division 9 - BEST PRACTICES FOR RISK MANAGEMENT AND LOSS CONTROL FOR FOR-PROFIT AND NOT-FOR-PROFIT NURSING HOMES › Section 5.1740 - Purpose and Scope

Current through Reg. 49, No. 28; July 12, 2024
These sections implement Insurance Code Article 5.15-4,
						concerning best practices for risk management and loss control that may be used
						by for-profit and not-for-profit nursing homes. A nursing home's adoption and
						implementation of these best practices may be considered by an insurance
						company or the Texas Medical Liability Insurance Underwriting Association in
						determining the nursing home's rates for professional liability insurance. The
						best practices for risk management and loss control adopted pursuant to these
						sections do not establish standards of care for nursing homes applicable in a
						civil action against a nursing home. The elements identified in the risk
						management and loss control program are designed to be feasible for
						implementation by the typical nursing home and to lead to a reduction in
						exposure to loss causing incidents. The anticipated benefits of implementing
						these risk management practices are reductions in the number of claims and
						mitigation of the severity of claims that do occur. The establishment of a risk
						management and loss control program in a particular risk exposure area or areas
						does not supplant or replace any other nursing home initiative established to
						address quality assurance and assessment (whether statutorily mandated or
						otherwise), but instead supplements and supports it.
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 9 - BEST PRACTICES FOR RISK MANAGEMENT AND LOSS CONTROL FOR FOR-PROFIT AND NOT-FOR-PROFIT NURSING HOMES › Section 5.1741 - Best Practices for Risk Management and Loss Control

Current through Reg. 49, No. 28; July 12, 2024
(a) A nursing home's adoption and
					 implementation of the best practices for risk management and loss control set
					 forth in this section should focus on the following risk exposure areas, which
					 are exposure areas that appear often in claim lists and claim prevention
					 materials published by leading nursing home insurers, and any additional areas
					 as may be determined to be risk exposures. The list is not inclusive and the
					 descriptions are illustrative only, but a nursing home focusing initially in
					 these areas may be more likely to succeed with its program.
(1) Falls--Slips and trips by a resident in
					 or about a nursing home.
(2)
					 Resident Abuse--Infliction of injury or mistreatment with resulting physical
					 harm or pain or mental anguish.
(3)
					 Pressure Ulcers--A clinical risk, also referred to as bedsores or decubitus
					 ulcers, that is a result of unrelieved pressure on a part of the
					 body.
(4) Nutrition and
					 Hydration--Providing adequate and nutritious food and liquid to nursing home
					 residents, including attention to individual needs or clinical
					 condition.
(5) Medication
					 Management--Prevention of drug-related problems including but not limited to
					 over- or under-prescribing; improper drug selection; and over-dosage.
(6) Restraints (if used)--Physical restraints
					 such as manual methods or physical devices that restrict freedom of movement or
					 access to a resident's body. Chemical restraints can be described as
					 psychotropic or behavior modifying drugs used to prevent a resident from
					 exhibiting behavioral symptoms.
(7)
					 Infection Control--Preventing, containing, and treating infections within a
					 nursing home facility.
(8) Burns
					 and Scalds--Injury due to exposure to heat, sun, or chemicals.
(9) Elopement--To slip away or run away from
					 a facility. For risk management purposes this includes wandering or movement
					 away from the usual or normal place within the nursing home facility.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter C - TEXAS MEDICAL LIABILITY INSURANCE UNDERWRITING ASSOCIATION › Section 5.2001 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
(a) Words defined in the Insurance Code .
				  Unless the context clearly dictates the contrary, words defined in Insurance
				  Code Chapter 2203 and Insurance Code Article 21.49-3, §2, and not
				  specifically defined in this section have the same definition when used in this
				  subchapter as they have in the Insurance Code .
(b) Words defined in this subchapter . The
				  following words and terms, when used in this subchapter, have the following
				  meanings unless the context clearly indicates otherwise:
(1) Act--The Texas Medical Liability
				  Insurance Underwriting Association Act, codified as Insurance Code Chapter 2203
				  and Insurance Code Article 21.49-3, §§2,11, 12, and 13.
(2) Application--An application for medical
				  liability insurance and general liability insurance issued in connection with
				  medical liability insurance.
(3)
				  Association--Texas Medical Liability Insurance Underwriting
				  Association.
(4) Board of
				  directors--The board of directors of the Texas Medical Liability Insurance
				  Underwriting Association.
(5)
				  Chairman of the board--The chairman of the board of directors of the Texas
				  Medical Liability Insurance Underwriting Association.
(6) Charter member of the association--An
				  insurer authorized to write and engaged in writing, in Texas on a direct basis,
				  automobile liability and/or liability other than automobile insurance at any
				  time between January 1, 1975, and the effective date of the Act.
(7) Commissioner--Commissioner of
				  Insurance.
(8) Department--Texas
				  Department of Insurance.
(9)
				  Member--An insurer required to be a member of the association by Insurance Code
				  §
											2203.055, or, where
				  the context indicates, any duly authorized agent or representative of such
				  insurer. "Members" means more than one member.
(10) Secretary--The secretary of the Texas
				  Medical Liability Insurance Underwriting Association.
(11) Treasurer--The treasurer of the Texas
				  Medical Liability Insurance Underwriting Association.
(12) Vice chair or vice chair of the
				  board--The vice chair of the board of directors of the Texas Medical Liability
				  Insurance Underwriting Association.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter C - TEXAS MEDICAL LIABILITY INSURANCE UNDERWRITING ASSOCIATION › Section 5.2003 - Members' and Policyholders' Participation in the Texas Medical Liability Insurance Underwriting Association

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Powers of the association. The association is created by the Act and will be
				  governed by the provisions of the Act and this subchapter.
(b) Collection and investment of funds.
(1) Collection. The treasurer is responsible
				  for the collection of all the premiums received by the association, all
				  assessments levied against the members, all assessments and charges levied
				  against policyholders (including contributions to the stabilization reserve
				  funds), and all proceeds from the investment of funds.
(2) Investment.
(A) All funds collected by the association
				  must be retained in appropriate accounts in any bank or banks doing business in
				  Texas and may be invested only in the following:
(i) interest-bearing time deposits or
				  certificates of deposit in any bank or banks doing business in Texas that are
				  members of the Federal Deposit Insurance Corporation;
(ii) treasury bills, notes, or bonds of the
				  government of the United States of America; or
(iii) other investments as may be proposed by
				  the board of directors and approved by the Commissioner.
(B) The board of directors must determine
				  what portion of such funds should be retained in a checking account or accounts
				  and what portion of such funds should be invested in the investments set forth
				  in subparagraph (A) of this paragraph, as well as which specific investments,
				  if any, should be made.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter C - TEXAS MEDICAL LIABILITY INSURANCE UNDERWRITING ASSOCIATION › Section 5.2005 - Amendments

Current through Reg. 49, No. 28; July 12, 2024
Amendments to this subchapter may be recommended by the
					 board of directors, subject to the approval of the Commissioner , or may be
					 made at the direction of the Commissioner .
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter C - TEXAS MEDICAL LIABILITY INSURANCE UNDERWRITING ASSOCIATION › Section 5.2006 - Reinsurance

Current through Reg. 49, No. 28; July 12, 2024
Pursuant to Insurance Code §
										2203.151(a)(3) and
					 (4), the Texas Medical Liability Insurance
					 Underwriting Association may cede and purchase reinsurance. The purpose of this
					 section is to implement Insurance Code §
										2203.151(a)(3) and
					 (4).
(1) The association may develop a reinsurance
				  program that will provide for the purchase of reinsurance and that will
				  maintain the purpose of the association to provide medical liability insurance
				  and general liability insurance on a self-supporting basis.
(2) A reinsurance program is subject to prior
				  approval by the Commissioner , and such prior approval must be obtained before
				  implementation of the reinsurance program. The program must include, but is not
				  limited to, the proposed reinsurance program structure and terms, including the
				  reinsurance proposal and proposed reinsurance contract terms and conditions;
				  cost of the proposed reinsurance program; the recommended percentage of
				  reinsured business to be assumed by each individual reinsurer; a summary of the
				  financial condition of each recommended reinsurer; the association's costs to
				  administer the reinsurance program; compliance with Subchapter F of Chapter 7
				  of this title (relating to Reinsurance), to the extent that provisions do not
				  conflict with this section or Chapter 2203 of the Insurance Code, or unless
				  such provisions are waived by the Commissioner ; and any other information the
				  Commissioner deems necessary to enable the Commissioner to determine whether to
				  approve or disapprove the reinsurance program. The association must submit to
				  the Commissioner , no later than 90 days before expiration of the reinsurance
				  contract, the proposed renewal reinsurance program or a statement of the
				  reasons why a reinsurance program is no longer necessary.
(3) The association must submit written
				  notice of any amendment to any existing reinsurance contract to the
				  Commissioner at least 60 days prior to the effective date of the proposed
				  amendment . The notice must include an explanation of the reason for the
				  amendment and a copy of the draft amendment . The amendment will be deemed
				  approved by the Commissioner unless within 60 days following the submission of
				  the written notice the Commissioner disapproves the amendment .
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter D - FIRE AND ALLIED LINES INSURANCE › Division 6 - STATISTICAL PLAN APPLICABLE TO NON-RATE REGULATED INSURERS › Section 5.3501 - Statistical Reporting of Property and Multiperil Insurance by Insurers Regulated under the Insurance Code, Chapters 17-19

Current through Reg. 49, No. 28; July 12, 2024
Insurers regulated under the Insurance Code, Chapters
						17-19, and subject to the Insurance Code, Articles 5.35 and 5.36, shall report
						in accordance with the current Texas property statistical plan for residential
						and commercial risks. The time and manner of reporting is as set forth in the
						statistical plan, which plan is adopted herein by reference. Copies of the
						statistical plan may be obtained by contacting the Staff Actuary, Property and
						Casualty Actuarial Division, State Board of Insurance, 1110 San Jacinto
						Boulevard, Austin, Texas 78701-1998, or by contacting the Texas Insurance
						Advisory Association, P.O. Box 15, Austin, Texas 78782.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter D - FIRE AND ALLIED LINES INSURANCE › Division 8 - UNDERSERVED AREAS FOR RESIDENTIAL PROPERTY INSURANCE › Section 5.3700 - Designation of Underserved Areas for Residential Property Insurance for Purposes of the Insurance Code, Articles 5.35-3 and 21.49-12

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose and scope. The purpose of this
					 section is to:
(1) designate the areas
					 determined by the Commissioner of Insurance to be underserved areas for
					 purposes of residential property insurance pursuant to the Insurance Code,
					 Article 5.35-3 (Property Protection Program for Underserved Areas);
(2) designate the areas determined by the
					 Commissioner of Insurance to be underserved areas for purposes of residential
					 property insurance pursuant to the Insurance Code, Article 21.49-12 (Market
					 Assistance Program); and
(3)
					 identify the factors and methodology used in determining such underserved
					 areas.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter D - FIRE AND ALLIED LINES INSURANCE › Division 8 - UNDERSERVED AREAS FOR RESIDENTIAL PROPERTY INSURANCE › Section 5.3701 - Designation of Underserved Areas for Residential Property Insurance for Purposes of the Insurance Code Article 21.49A

Current through Reg. 49, No. 28; July 12, 2024
The Commissioner designates all 254 counties of the State
						of Texas as the underserved areas for the FAIR Plan because it has been
						determined that residential property insurance is not reasonably available to a
						substantial number of owners of insurable property in these
						areas.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter D - FIRE AND ALLIED LINES INSURANCE › Division 8 - UNDERSERVED AREAS FOR RESIDENTIAL PROPERTY INSURANCE › Section 5.3702 - Designation of Underserved Areas for Residential Property Insurance for Purposes of the Insurance Code Article 5.13-2C

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose. The purpose of this section is
					 to:
(1) designate the areas determined by the
					 Commissioner of Insurance to be underserved areas for purposes of residential
					 property insurance pursuant to the Insurance Code Article 5.13-2C;
(2) identify the factors and methodology used
					 in determining such underserved areas, and
(3) provide a procedure that requires
					 insurers to certify their eligibility for the exemption provided by Article
					 5.13-2C.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter D - FIRE AND ALLIED LINES INSURANCE › Division 9 - VOLUNTARY INSPECTION PROGRAM PLAN OF OPERATION › Section 5.3800 - Voluntary Inspection Program Plan of Operation

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose and Scope. The purpose and scope
					 of this section is to adopt a plan of operation for the Voluntary Inspection
					 Program which specifies procedures, standards and forms for the implementation
					 of the inspection program. This section addresses the following:
(1) Procedures, standards and forms governing
					 the independent inspection of the condition of residential property to
					 determine insurability, pursuant to the Insurance Code, Article
					 5.33B;
(2) Procedures and forms
					 governing the licensing or certification of qualified inspectors to conduct
					 inspections of the condition of residential property to determine the
					 insurability of such property;
(3)
					 Enforcement provisions to protect the integrity of the inspection program;
					 and
(4) Procedures for handling
					 complaints relating to these inspections.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4012 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired, or to Which Additions Are Made on or after April 1, 2020

Current through Reg. 49, No. 28; July 12, 2024
(a) To be eligible
					 for catastrophe property insurance, structures located in the designated
					 catastrophe areas specified in paragraphs (1), (2), and (3) of this subsection
					 that are constructed, repaired, or to which additions are made on or after
					 April 1, 2020, must comply with the 2018 editions of the
International
					 Residential Code
and the
International Building Code,
which are adopted by reference and applicable beginning April 1, 2020. The
					 codes are published by and available from the International Code Council at
					 iccsafe.org or by calling toll-free 1-888-422-7233. The designated catastrophe
					 areas are:
(1) Areas seaward of the
					 intracoastal canal;
(2) Areas
					 inland of the intracoastal canal and within approximately 25 miles of the Texas
					 coastline and east of the specified boundary line and certain areas in Harris
					 County as described in §
												5.4008(b)(2)(A)
					 and (B) of this title; and
(3) Areas inland and west of the specified
					 boundary line as described in §
												5.4008(c)
					 of this title.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4021 - Agent Requirements

Current through Reg. 49, No. 28; July 12, 2024
A nonresident agent may not offer or sell a TWIA policy
						if the agent's state of residence does not authorize Texas residents to be
						agents for that state's windstorm and hail insurer of last resort. TWIA must
						implement a process to prevent unauthorized nonresident agents from offering or
						selling TWIA policies.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4023 - Per Risk Reinsured Excess Coverage

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose.
					 Under Insurance Code §
											2210.505,
					 the Texas Windstorm Insurance Association may issue a policy of windstorm and
					 hail insurance that includes coverage for an amount in excess of the maximum
					 limit of liability approved by the commissioner.
(b) Definitions. The following words and
					 terms when used in this section have the following meanings unless the context
					 clearly indicates otherwise.
(1) Available
					 reinsurance capacity--Amount of reinsurance purchased by the association
					 pursuant to the excess per risk reinsurance contract to provide reinsured
					 excess coverage to association policyholders as provided in Insurance Code
					 §
												2210.505.
(2) Excess per risk reinsurance contract--An
					 agreement entered into by the association with an approved reinsurer to provide
					 coverage to association policyholders for an amount in excess of the liability
					 limits approved by the commissioner.
(3) Reinsured excess coverage--Coverage
					 provided under a windstorm and hail insurance policy issued by the association
					 through a reinsurance agreement with an approved reinsurer for amounts of
					 insurance that are in excess of the maximum limits of liability available to
					 the individual risk from the association.
(4) Reinsured excess coverage program--The
					 program operated by the association to provide reinsured excess coverage, the
					 excess per risk reinsurance contract or contracts entered into between the
					 association and the commissioner-approved reinsurer or reinsurers, this
					 section, and any orders issued, including the collection of premium, issuance
					 of coverage under the windstorm and hail insurance policy, and the processing
					 and payment of claims for the reinsured excess coverage.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4029 - Applicability and Effective Date of 28 TAC Sections 5.4029 - 5.4041

Current through Reg. 49, No. 28; July 12, 2024
(a) This section
					 and §§ 5.4030- 5.4041 of this title prescribe guidelines that the
					 Texas Windstorm Insurance Association must use to prepare for and settle
					 residential slab claims in Zones V, VE, and V1-V30, as defined by the National
					 Flood Insurance Program.
(b) This
					 section and §§ 5.4030- 5.4041 of this title apply only to residential
					 slab claims resulting from an organized weather system that:
(1) has a defined surface circulation and
					 maximum sustained winds of not less than 39 miles per hour;
(2) the National Hurricane Center of the
					 United States National Weather Service names as a tropical storm or a
					 hurricane; and
(3) that the
					 association expects will result in more than 500 residential slab
					 claims.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4030 - Definitions Applicable to Sections 5.4029 - 5.4041

Current through Reg. 49, No. 28; July 12, 2024
The following definitions apply to §§5.4029 -
						5.4041:
(1) Applicable storm--An event
					 described in § 5.4029(b) of this title.
(2) Catastrophe area--A municipality, a part
					 of a municipality, a county, or a part of a county designated by the
					 commissioner of insurance under Insurance Code §
											2210.005.
(3) Damage estimation module--The module
					 incorporated by reference in § 5.4041 of this title.
(4) Expert panel--The panel created under
					 Insurance Code §
											2210.578.
(5) Hazard module--The component of the wind
					 damage evaluation in which the association gathers data from an applicable
					 storm and uses that data to generate wind speed time histories and surge and
					 wave time histories.
(6)
					 Residential slab claim--A first-party claim on a residential structure of which
					 nothing more remains than foundation elements such as pilings, floor framing
					 members, or concrete slab, and there is insufficient evidence to enable the
					 association to determine the extent to which the loss occurred as a result of
					 wind, waves, tidal surges, or rising waters not caused by waves or
					 surges.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4031 - Wind Damage Evaluation

Current through Reg. 49, No. 28; July 12, 2024
To estimate the extent to which damage to structures
						that are the subject of residential slab claims has been caused by wind, waves,
						tidal surges, or rising waters not caused by waves or surges, the association
						must employ both a probabilistic approach and an observational approach as
						described in §§ 5.4032- 5.4040 of this title. The association must
						use:
(1) a property database,
					 described in §5.4032;
(2) a
					 hazard module, described in §§5.4033 - 5.4037;
(3) a damage estimation module, described in
					 §5.4038;
(4) an economic loss
					 module, described in §5.4039; and
(5) a report generation module, described in
					 §5.4040.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4032 - Property Database

Current through Reg. 49, No. 28; July 12, 2024
To ensure the accuracy of information related to
						residential slab claims, the association must:
(1) gather and, not less frequently than once
					 every year, update applicable pre-event data on insured structures located in
					 the area described in § 5.4029(a) of this title. The pre-event data
					 consists of characteristics-specified in the damage estimation module-pertinent
					 to the performance of each insured structure during an applicable storm; and
(2) acquire pre-event
					 high-resolution aerial and on-ground photographs of structures located in the
					 area described in § 5.4029(a) of this title to define building
					 characteristics and terrain.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4033 - Hazard Module

Current through Reg. 49, No. 28; July 12, 2024
(a) The hazard
					 module must generate synchronous, site-specific wind speed and direction time
					 histories and storm surge and wave time histories.
(b) The hazard module must include one or
					 more wind field models and a storm surge and wave model.
(c) The association must develop plans and
					 capabilities to obtain reliable surge, wave, and wind field data, which is
					 necessary to implement the hazard module. To the extent possible, this task
					 should be performed in collaboration with federal agencies and other
					 organizations.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4034 - Hazard Module - Wind Measurements

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Before an applicable storm, the association must take steps to ensure the
					 deployment of mobile measurement platforms and fixed surface-level devices
					 that:
(1) provide real-time wind speed and
					 direction measurements during the applicable storm; and
(2) can be used both for forecasting and
					 producing post-event wind field hindcasts.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4035 - Hazard Module - Wind Field Model

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 association must develop one or more observational models for constructing a
					 wind field to obtain:
(1) site-specific wind
					 speed and direction time histories that are used for wind damage prediction;
					 and
(2) a wind field that can be
					 used as input for a surge and wave model that outputs time histories for surge
					 and wave damage prediction.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4036 - Hazard Module - Storm Surge and Wave Measurements

Current through Reg. 49, No. 28; July 12, 2024
(a) The association must obtain physical
					 measurements of surge, waves, and high-water marks during and after an
					 applicable storm. Physical measurements of surge, wave, and high-water marks
					 include:
(1) water-level time series during
					 the applicable storm from the National Oceanic and Atmospheric Administration
					 and other permanent tide gauges;
(2) post-event high-water marks;
(3) surge and wave heights from rapidly
					 deployed surge and wave gauges deployed at sites with the potential to be
					 significantly damaged by surge and waves; and
(4) other indications of surge and wave
					 magnitudes, such as elevations of surge and wave damage on buildings.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4037 - Hazard Module - Storm Surge and Wave Model

Current through Reg. 49, No. 28; July 12, 2024
(a) Before an applicable storm, the
					 association must take steps so that it will be able to obtain rapid, post-event
					 high-resolution surge and wave modeling to provide surge and wave time
					 histories.
(b) The surge and wave
					 hazard module must directly incorporate both numerical modeling and the
					 high-resolution aerial photographs and LIDAR measurements required under §
					 5.4036(a) and (b) of this title.
(c) The technical features of the storm surge
					 and wave model must include:
(1) a domain of
					 surge and wave modeling that extends from at least Pensacola, Florida to the
					 Mexican coast at latitude 23 degrees north, and at minimum, 500 km offshore of
					 Texas;
(2) for Texas and parts of
					 Louisiana west of longitude 93.5 degrees west, sufficiently high-resolution
					 nearshore and overland to show dunes and other significant features impeding
					 flow, such as a grid with 50 meter or finer resolution (resolution may be
					 coarser offshore and in other locations), with models run on the same grid, if
					 possible, to avoid interpolation errors;
(3) the same wind field used to compute wind
					 damage, which must be a best available reanalysis wind field that incorporates
					 measurements made during the applicable storm;
(4) a drag coefficient that features a high
					 wind cutoff that is defensible from observations or the scientific
					 literature;
(5) wave computations
					 that use a third-generation unsteady spectral wave model that has been tested
					 closely against data from Hurricane Ike and other storms in Texas;
(6) wave computations that include feedback
					 from velocities and water levels generated by the surge model;
(7) wave breaking dissipation that is
					 spectrally based and does not use a simple depth-limited cutoff;
(8) a shallow water model (either
					 depth-averaged or multilevel) that includes convective processes and bottom
					 friction that varies with substrate or vegetation;
(9) tides as an integral part of the
					 model;
(10) the ability to produce
					 initial estimates within 48 hours of landfall;
(11) the ability to readily incorporate new
					 LIDAR topographical data into the grid, and wind data into the surge and wave
					 model as it becomes available post-event, to rapidly produce improved surge and
					 wave model simulations;
(12) the
					 ability to quickly produce estimates of waves and surge as additional data
					 becomes available, and pass these estimates to the association for use in the
					 damage estimation module;
(13) the
					 ability to compare model estimates with measured wave and water level data as
					 it becomes available; and
(14) the
					 ability to produce error estimates for each applicable storm.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4038 - Use of Damage Estimation Module

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 association must use the damage estimation module to estimate damage to
					 components of a structure that is the subject of a residential slab claim. The
					 association must use the following inputs:
(1) outputs from the wind field and surge and
					 wave models described in §5.4035 and §5.4037, respectively, of this
					 title; and
(2) property database
					 information.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4039 - Economic Loss Module

Current through Reg. 49, No. 28; July 12, 2024
(a) The association
					 must adjust residential slab claims using the damage estimates obtained as
					 described in § 5.4038 of this title.
(b) The association must use the wind damage
					 estimates obtained as described in § 5.4038 of this title to determine the
					 scope of work and associated costs for each component that was likely damaged
					 by wind.
(c) The damage estimation
					 module does not generate estimates on damage to contents; association adjusters
					 must determine the amount to pay for contents by taking into consideration:
(1) the adjuster's knowledge and experience;
					 and
(2) information about the
					 particular property from the property database, the policyholder, and other
					 sources, including applicable information from the damage estimation
					 module.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4040 - Report Generation Module

Current through Reg. 49, No. 28; July 12, 2024
(a) Not later than
					 30 days after a policyholder files a residential slab claim, the association
					 must:
(1) notify the policyholder that the
					 association will use the wind damage evaluation method; and
(2) send the policyholder a request for any
					 information the policyholder has on:
(A) wind
					 speed and direction, and surge and waves, at the site of the structure for the
					 duration of the applicable storm;
(B) damage to the structure during the
					 applicable storm; and
(C) new
					 information on the characteristics of the structure. When it sends the request
					 for information, the association must also send the policyholder a copy of the
					 association's current data in the property database on the structure's
					 characteristics.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 1 - PLAN OF OPERATION › Section 5.4041 - Incorporation by Reference

Current through Reg. 49, No. 28; July 12, 2024
This rule incorporates by reference the expert panel's
						damage estimation module (Section 6 and Appendix A), which is part of the
						expert panel's report, James R. Bailey, Samuel D. Amoroso, William Coulbourne,
						Andrew Kennedy, & Douglas A. Smith, A Proposed Methodology for Estimating
						Wind Damage to Residential Slab-Only Claims Resulting from a Hurricane
						Impacting the Texas Coastline, Section 6, Appendix A, April 18, 2016, available
						at tdi.texas.gov/reports/pc/documents/epfinalrpt.pdf.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 3 - LOSS FUNDING, INCLUDING CATASTROPHE RESERVE TRUST FUND, FINANCING ARRANGEMENTS, AND PUBLIC SECURITIES › Section 5.4101 - Applicability

Current through Reg. 49, No. 28; July 12, 2024
(a) This section and §§
											5.4102,
					 5.4111
					 -
					 5.4114,
					 5.4121,
					 5.4123
					 -
					 5.4127,
					 5.4133 -
					 5.4136,
					 and
					 5.4141
					 -
					 5.4145
					 (relating to Definitions, Operation of the Catastrophe Reserve Trust Fund,
					 Termination of the Catastrophe Reserve Trust Fund, Investments of Catastrophe
					 Reserve Trust Fund, Duties and Responsibilities, Financing Arrangements, Public
					 Securities Request, Approval, and Issuance, Issuance of Class 1 Public
					 Securities before a Catastrophic Event, Issuance of Public Securities after a
					 Catastrophic Event, Determination of the Association Surcharge Percentage,
					 Contingent Sources of Payment for Class 2 and Class 3 Public Securities, Public
					 Security Proceeds, Excess Public Security Proceeds, Marketable Public
					 Securities; the Amount of Class 1 Public Securities that Cannot be Issued;
					 Market Conditions and Requirements; and Cost-Benefit Analysis, Association Rate
					 Filings, Class 1 Public Securities Trust Fund, Class 2 and Class 3 Public
					 Securities Trust Funds, Premium Surcharge Trust Fund, Excess Premium Surcharge
					 Revenue, and Excess Net Premium and Other Revenue) of this division are a part
					 of the Texas Windstorm Insurance Association's plan of operation and will
					 control over any conflicting provision in §
											5.4001 of this
					 subchapter (relating to Plan of Operation). If a court of competent
					 jurisdiction holds that any provision of this division is inconsistent with any
					 statutes of this state, is unconstitutional, or is invalid for any reason, the
					 remaining provisions of the sections in this division will remain in
					 effect.
(b) Notwithstanding any
					 provision in this subchapter, the department retains regulatory oversight of
					 the association as required by Insurance Code Chapter 2210, including periodic
					 examinations of the accounts, books, and records of the association, and no
					 provision in this subchapter should be interpreted as negating or limiting the
					 department's regulatory oversight of the association.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 3 - LOSS FUNDING, INCLUDING CATASTROPHE RESERVE TRUST FUND, FINANCING ARRANGEMENTS, AND PUBLIC SECURITIES › Section 5.4111 - Operation of the Catastrophe Reserve Trust Fund

Current through Reg. 49, No. 28; July 12, 2024
(a) In general.
(1) The comptroller must administer the CRTF
					 in accordance with Insurance Code Chapter 2210 and this subchapter.
(2) The comptroller must ensure that all
					 money received from the association under subsection (b) of this section is
					 deposited with the trust company in the CRTF .
(3) The trust company must receive, disburse,
					 invest, hold, and manage all money deposited in the CRTF .
(4) All money, including investment income,
					 deposited in the CRTF constitutes state funds to be held by the comptroller
					 outside the state treasury on behalf of, and with legal title in, the
					 department until disbursed as provided by Insurance Code Chapter 2210 and this
					 subchapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 5 - PROPERTY AND CASUALTY INSURANCE › Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION › Division 3 - LOSS FUNDING, INCLUDING CATASTROPHE RESERVE TRUST FUND, FINANCING ARRANGEMENTS, AND PUBLIC SECURITIES › Section 5.4112 - Termination of Catastrophe Reserve Trust Fund

Current through Reg. 49, No. 28; July 12, 2024
(a) The catastrophe reserve trust fund may be
					 terminated only by law.
(b) On
					 termination of the trust fund, all assets of the catastrophe reserve trust fund
					 revert to the state and shall be used by the department to provide funding for
					 the annual loss mitigation and preparedness plan established under the
					 Insurance Code §
											2210.454.