reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS › Section 3.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this
					 subchapter, have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Alternate face page--A
				  face page of a group policy, certificate, or contract, which may be used in
				  place of the face page of a previously approved or exempted group policy,
				  certificate, or contract when the group policy, certificate, or contract will
				  be issued to a different or specific group (e.g., a policy that was filed as an
				  "ABC Multiple Employer Trust (MET)" that is later issued to a specific
				  MET).
(2) Department--The Texas
				  Department of Insurance.
(3)
				  Filing--A submission, made to the department by a company, that is accompanied
				  by either a transmittal checklist or a transmittal form, and which may include
				  policies, certificates, contracts, applications, certifications, informational
				  materials, insert pages, riders, limited partial refilings, matrix filings, and
				  rates.
(4) General use--A filing
				  that will be used with other forms submitted in the filing or with previously
				  approved and exempted forms for a certain product or products or a subset of a
				  product or type (e.g., an application that will be used with all life products;
				  an application that will be used with all universal life products; an
				  application that will be used with group life and accident and health products;
				  an application that will be used with major medical and hospital surgical
				  products).
(5) Insert page--A page
				  used to replace an existing page of a previously approved or exempted
				  contract.
(6) Limited, partial
				  refilings--A change to a previously approved or exempted life or annuity form
				  that meets one or more of the criteria set forth in subparagraphs (A) - (D) of
				  this paragraph as follows:
(A) a change in
				  the text, interest rate, guaranteed charges, or mortality table used to compute
				  nonforfeiture values for life insurance or annuities;
(B) a change in the current interest rate,
				  where such rates are guaranteed and shown in the policy or contract;
(C) a change in the reserves (if the change
				  in reserves impacts the text of the policy);
(D) a change to the separate account for
				  variable products when the separate account is bracketed as variable text on
				  the initial filing.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS › Section 3.4 - General Submission Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Submission. Companies must submit one copy of the filing to the Life and Health
				  Division at the address set forth in §
										3.3(a)
				  of this title (relating to Transmittal Information). A filing submitted
				  electronically must be submitted in such form and format as determined by the
				  department.
(b) Contact person. A
				  company submitting a filing to the department must :
(1) have one person designated as the contact
				  person for that filing;
(2) provide
				  the contact person's name, address, telephone number, and if available, email
				  address on the transmittal checklist or transmittal form;
(3) provide, for any filing submitted by
				  anyone other than the company, a dated letter of specific authorization which
				  must :
(A) designate the consulting firm,
				  actuary, legal counsel, or other person as the designated contact person for
				  that filing; and
(B) be signed by
				  an officer of the company or a person with authority to bind the company;
				  and
(4) notify the
				  department immediately of any change of information with regard to the contact
				  person for a pending filing, regardless of whether the contact person is the
				  company's employee or other authorized representative.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS › Section 3.5 - Filing Authorities and Categories

Current through Reg. 49, No. 28; July 12, 2024
(a) All filings submitted pursuant to this
				  subchapter must be identified under specific filing authorities as defined by
				  the Insurance Code or Administrative Code. The authorities under which all
				  filings are identified are described in paragraphs (1) - (4) of this subsection
				  as follows:
(1) review pursuant to Insurance
				  Code §
											1701.054;
(2) file and use pursuant to Insurance Code
				  §
											1701.052; however,
				  any form that has been previously disapproved pursuant to §
											3.7(d)
				  of this title (relating to Form Acceptance and Procedures) is not eligible for
				  filing under this category;
(3)
				  exempt pursuant to Insurance Code §
											1701.005 and
				  Subchapter Z of this title (relating to Exemption from Review and Approval of
				  Certain Life, Accident, Health and Annuity Forms and Expedition of Review);
				  and
(4) credit life insurance or
				  credit accident and health insurance pursuant to Insurance Code Chapters 1131,
				  1153, and 1251.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS › Section 3.6 - Certifications, Attachments, and Additional Information Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) A company must include the
				  certification(s), attachment(s), and additional information referred to in this
				  section as follows:
(1) A filing must include
				  the following certifications, as applicable:
(A) Specific certification. Filings submitted
				  as file and use pursuant to §
												3.5(a)(2)
				  of this title (relating to Filing Authorities and Categories) must certify
				  that:
(i) the certification is on behalf of
				  the company;
(ii) the company is
				  bound thereby;
(iii) the company
				  has reviewed, and is familiar with, all applicable statutes and regulations of
				  this state and of the United States;
(iv) the company has reviewed the filing;
				  and
(v) to the best of the
				  company's knowledge, information, and belief, the filing complies in all
				  respects with the applicable statutes and regulations of this state.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS › Section 3.7 - Form Acceptance and Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) Acceptance or
				  rejection.
(1) A filing received by the
				  department which is in compliance with the requirements of this subchapter and
				  §
											7.1302
				  of this title (relating to Billing System) will be accepted and processed
				  according to subsection (b) of this section.
(2) A filing received by the department which
				  fails to comply with this subchapter and §
											7.1302
				  of this title will be rejected and returned to the company with a letter or
				  electronic notification indicating the reason(s) for the rejection.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS › Section 3.8 - Effective Date

Current through Reg. 49, No. 28; July 12, 2024
The provisions of these sections shall apply to any form
					 received by the department on or after June 1, 2003. Forms received by this
					 department prior to June 1, 2003 shall be governed by the laws in effect at the
					 time of the submission.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.101 - Payment of Premiums

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  provide that premiums are payable in advance. The policy may provide that the
				  premium is payable at the home office; it may provide that the premium is
				  payable to an agent of the company; or it may provide that the premium is
				  payable at the home office of the company or to an agent of the
				  company.
(b) The policy must
				  provide that a receipt signed by one or more of the officers of the company
				  will be delivered upon payment of the premium. The policy must designate the
				  officers who may sign the receipt. Any manner of "designation" is acceptable if
				  it will enable the policyholder to determine that his receipt has been signed
				  by an authorized person.
(c) A
				  policy which permits a change in the manner of payment of premium (e.g., from
				  annual to semiannual, quarterly, etc.):
(1)
				  may either specify the amount of premiums required for the periods authorized
				  or the formula for the determination of such premiums; or
(2) may define the amounts by appropriate
				  reference to rates being charged at the date of issue.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.102 - Grace Period

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  provide for a grace period of at least one month for the payment of every
				  premium after the first, during which period the policy shall remain in full
				  force and effect. If the grace period is expressed in days, at least 31 days of
				  grace must be granted.
(b) The
				  policy may provide for an interest charge on the unpaid premium during the
				  grace period. If an interest charge is provided for, the interest rate must be
				  specified.
(c) The policy may
				  stipulate that if the insured should die during the grace period, the overdue
				  premium or overdue installment will be deducted from any settlement under the
				  policy. If an interest charge is provided against the overdue payment, the
				  accrued interest may also be deducted.
(d) This section is not applicable to single
				  premium policies.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.103 - Entire Contract

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  provide that the policy, or policy and application, shall constitute the entire
				  contract between the parties. Regardless of any statement to the contrary, the
				  policy will be deemed incomplete if it attempts to incorporate by reference the
				  provisions of any instrument which changes or adds to the terms of the
				  policy.
(b) Some policy forms
				  contain a provision that the application, if attached, shall constitute a part
				  of the contract. If a policy containing such a provision is submitted without
				  the application, the approval will authorize its issuance only without the
				  application.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.104 - Incontestable Clause

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  provide that it will be incontestable not later than two years from its date as
				  provided in Insurance Code §
										1101.006. If a
				  reinstatement is contested for misrepresentation, then no representation other
				  than one causing the reinstatement may be used to contest the policy. Any
				  contest of the reinstatement may be for a material and fraudulent
				  misrepresentation only and reinstatement may not be contested more than two
				  years after it is effectuated, provided that this provision does not affect the
				  company's right to contest a policy for a representation respecting the initial
				  policy issuance or a different reinstatement during the incontestable period
				  applicable to such issuance or reinstatement. Accidental death benefits and
				  disability benefits need not be subject to such provision.
(b) Any provision which could lengthen the
				  contestable period of a policy beyond two years from its date is prohibited.
				  For example, the policy may not state that it is incontestable after two years
				  "while the policy is continuously in force."
(c) The policy may contain provisions which
				  allow its validity to be contested at any time whatsoever for:
(1) nonpayment of premium; or
(2) violation of the conditions of the policy
				  relating to naval or military services in time of war. Note: War clauses are
				  discussed in §
											3.118(e)
				  of this title (relating to Conversion Provision).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.105 - Statements of the Insured

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  provide that all statements made by the insured will, in the absence of fraud,
				  be deemed representations and not warranties. The policy may provide that
				  statements made on behalf of the insured will also, in the absence of fraud, be
				  deemed representations and not warranties.
(b) Policy applications sometimes contain
				  agreements which call attention to some, or all, of the elements which must be
				  proved in avoiding the policy for misrepresentation. Such agreements are
				  acceptable, provided:
(1) they do not attempt
				  to burden the insured's representations with the legal consequences of
				  warranties;
(2) they do not attempt
				  to require the insured to prove the nonexistence of grounds upon which the
				  insurer could contest the policy; and
(3) they do not attempt to permit the insurer
				  to avoid liability on grounds less stringent than under Insurance Code §
											705.004
				  or other applicable law.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.106 - Misstatement of Age

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  provide that if the age of the insured has been understated, the amount payable
				  under the policy shall be such as the premium paid would have purchased at the
				  correct age. The word "misstated" may be used instead of
				  "understated."
(b) If more than one
				  life is insured (e.g., by inclusion of premium payor benefits or under family
				  group plan) the amount payable on the death of deceased may be adjusted because
				  of a misstatement in the age of a surviving insured, if the actuarial
				  construction of the contract so requires.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.107 - Policy Loans

Current through Reg. 49, No. 28; July 12, 2024
(a) A policy loan
				  provision is not required in term insurance policies, nor in pure endowments
				  issued or granted as original policies or in exchange for lapsed or surrendered
				  policies.
(b) Loans must be made
				  available at any time while the policy is in force after premiums for three
				  full years have been paid and a cash value is available.
(c) The loan clause must provide for proper
				  assignment of the policy to the company.
(d) The policy must be the sole security for
				  the loan.
(e) Insurance Code
				  Chapter 1110 deals with interest rates. Insurers may comply with Chapter 1110
				  by refiling reprinted and renumbered policies with a new loan provision or by
				  filing a loan endorsement which may be attached to newly issued policies on and
				  after an effective date specified by the insurer. The maximum rate of interest
				  must be specified in the policy or loan endorsement. The policy may provide
				  that interest may be made payable in advance to the end of the current policy
				  year.
(f) The loan clause must
				  provide for lending a sum equal to, or at the option of the policy owner, less
				  than, the cash value of the policy and of any dividend additions
				  thereto.
(g) The policy may provide
				  that the company may deduct from such loan value any existing indebtedness on
				  the policy and any unpaid balance of the premium for the current policy year
				  and may collect interest in advance on the loan to the end of the current
				  year.
(h) The policy may provide
				  that loans may be deferred for not more than six months after application
				  therefor is made. The six-month period may commence with the date of receipt of
				  the request by the company, if the policy so provides.
(i) The loan clause must provide that failure
				  to repay any such advance, or to pay interest thereon, will not void the policy
				  until the total indebtedness thereon to the company equals or exceeds the cash
				  value. The policy may not be terminated merely for failure to pay loan interest
				  when due. Since the policy may be voided when the indebtedness equals or
				  exceeds the cash value, this provision may be so worded that benefits cease
				  upon the precise moment that the indebtedness equals such value.
(j) No condition other than as herein
				  provided will be exacted as a prerequisite to any such
				  loan.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.108 - Automatic Nonforfeiture Benefits

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Nonforfeiture values are governed by Insurance Code Chapter 1105.
(b) Occasionally, the cash value (because of
				  the inclusion of accumulated dividends, coupon benefits, or other guaranteed
				  returns) is more than sufficient to purchase the maximum amount of extended
				  term insurance available under the policy. In such cases, the policy must
				  clearly provide for the equitable disposition of the entire cash
				  value.
(c) Automatic nonforfeiture
				  benefits are not applicable to single premium policies.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.109 - Automatic Premium Loans

Current through Reg. 49, No. 28; July 12, 2024
(a) Automatic
				  premium loans do not constitute a stipulated form of insurance, and the
				  automatic premium loan provision must not be classified as a nonforfeiture
				  value. Provisions for automatic premium loans must be revocable at the option
				  of the owner of the policy.
(b) If
				  the automatic premium loan provision remains operative after loan values are
				  insufficient to pay the next premium or installment thereof, the policy must
				  define the premium rate to be charged in such a manner as to make possible the
				  determination of the expiry date of the coverage.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.110 - Cash Value

Current through Reg. 49, No. 28; July 12, 2024
The policy must stipulate that the company may defer
					 payment of cash surrender values for not more than six months after the
					 application therefor is made. The six-month period may commence with the date
					 of receipt of the request by the company, if the policy so
					 provides.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.111 - Reinstatement

Current through Reg. 49, No. 28; July 12, 2024
(a) All policies which have nonforfeiture
				  benefits must provide that if, in the event of default in premium payments, the
				  value of the policy shall be applied for the purchase of other insurance, and
				  if such insurance shall be in force and the original policy shall not have been
				  surrendered to the company and cancelled, the policy may be reinstated within
				  three years, or longer at the option of the company, from such default upon
				  evidence of insurability satisfactory to the company and payment of arrears of
				  premiums with interest. Evidence of insurability need not be restricted to
				  evidence of good health only.
(b)
				  If more than one life is insured, evidence of insurability may be required on
				  each individual as a condition precedent to reinstatement of the policy, but
				  the policy may provide for reinstatement of only those lives which are
				  insurable.
(c) This section is not
				  applicable to single premium policies.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.112 - Payment of Claims

Current through Reg. 49, No. 28; July 12, 2024
The policy must provide that settlement will be made upon
					 receipt of or not later than two months after due proof of death of the insured
					 and the right of the claimant to the proceeds.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.113 - Family Group Special Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  family group life insurance policy is considered to be any life insurance
				  policy, other than a regular joint life insurance policy, that grants benefits
				  upon the death of each of the insured members of the family. This does not
				  include individual policies with payor death benefits or beneficiary death
				  benefits when such benefits are provided as a part of the basic policy, or by
				  supplementary agreement and when such additional benefits are designed
				  primarily to promote the continuance of the basic policy. The requirements
				  pertaining to family group policies may not be avoided, however, by merely
				  adding insureds under an individual contract by means of riders or
				  supplementary agreements.
(b) There
				  shall be included on the face of the policy the name and age of each insured;
				  the name of the beneficiary; the maximum amount which is payable to the payee
				  in the policy in the case of death of such insured person or persons; and
				  designation of all paragraphs or provisions limiting or reducing the payment to
				  less than the maximum provided in the policy. Suicide clauses are the most
				  common type of reduction provision. The suicide clause, if used, should clearly
				  indicate any effect which the suicide of one insured would have on the
				  insurance of other insureds.
(c)
				  Premiums deductible by the terms of the policy and indebtedness to the company
				  on the policy are considered as counterclaims by the company against the
				  beneficiary. It is not necessary that provisions for such deductions be placed
				  on the face of the policy.
(d) The
				  "face" of the policy means the first page of the policy.
(e) If the policy provides for coverage which
				  will become effective on the lives of persons who become members of the family
				  group (by birth or adoption) after the policy is issued, information relative
				  to these future members need not be stated on the face of the policy. The
				  policy form will be acceptable if the provisions relative to these additional
				  members are clear and unambiguous.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.114 - Dependent Child Riders and Family Term Riders

Current through Reg. 49, No. 28; July 12, 2024
(a) The rider must specify the effect on the
				  rider of the death of the insured(s) under the base policy prior to the expiry
				  date(s) of the rider. The following are acceptable:
(1) the rider may terminate, in which case no
				  incontestability provision is required;
(2) the rider may convert to paid-up term
				  insurance;
(3) if paid-up term
				  insurance can be surrendered for its cash value, the rider must contain the
				  "surrender within 30 days" statement required by Insurance Code §
											1105.007;
				  or
(4) the premium for the rider
				  may be waived to the expiry date(s).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.115 - Requirements for a Package Consisting of a Deferred Life Policy with an Accidental Death Rider Attached

Current through Reg. 49, No. 28; July 12, 2024
(a) The application
				  must contain a statement which discloses the deferred nature of the insurance
				  and which reflects the amount of insurance in force during the deferred period.
				  It may not state only the ultimate amount.
(b) The brief description on the face page
				  and filing back, if any, must call attention to the deferred nature of the
				  insurance, and in no way refer to the accidental death benefit.
(c) If a separate premium is charged for the
				  accidental death benefit, the schedule page must reflect the gross premium
				  broken down in such a manner as to reflect the gross premium for the deferred
				  life insurance and the accidental death benefit independently.
(d) The policy schedule page must reflect the
				  reduced death benefit payable each year the reduction in benefits is
				  maintained, as well as the ultimate face amount payable after the full face
				  amount becomes available. This provision may be in the form of actual figures,
				  a percentage of the ultimate face amount, the premiums plus interest, if
				  applicable, or other provision not in violation of Insurance Code Chapter 1701
				  or other laws.
(e) The death
				  benefit during the period of deferred insurance must be as great as the sum of
				  the gross premiums paid (with or without interest). The death benefit may be
				  based on the gross annual premium even though other modes are available under
				  the policy.
(f) The accidental
				  death benefit must be made a part of the entire contract.
(g) The contract of deferred insurance and
				  accidental death benefit must reflect a different form number from any other
				  contract of deferred insurance the company offers.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.116 - Substitute or Change of Insured Riders

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The rider shall contain a statement requiring submission of an application
				  signed by both the owner and the substitute insured.
(b) The rider may require evidence of
				  insurability of the substitute insured.
(c) The following shall be clearly specified:
(1) policy date;
(2) face amount;
(3) premium structure, including a
				  description of the determination of premiums for a substitute insured;
				  and,
(4) the plan of
				  insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.117 - Preliminary Term Life Insurance

Current through Reg. 49, No. 28; July 12, 2024
The following requirements apply to a contract of life
					 insurance containing a preliminary term insurance rider:
(1) a grace period must be allowed for
				  payment of the first premium due on the principal policy;
(2) the date of commencement of the
				  preliminary term insurance, which is the date of inception of the contract as a
				  whole, must be used to measure the period of contestibility and
				  suicide.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.118 - Conversion Provision

Current through Reg. 49, No. 28; July 12, 2024
A conversion provision in a policy must comply with the
					 following:
(1) the conversion
				  provision shall state the plan and face amount of the new policy;
(2) the text of the provision shall state
				  what premium rates will apply to the new policy;
(3) the text of the provision shall discuss
				  the settlement of cash values under the original contract if the policy is
				  converted on a date other than the expiry date;
(4) the provision shall specify that evidence
				  of insurability is not required.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.119 - Limitations of Lawsuits

Current through Reg. 49, No. 28; July 12, 2024
The policy must not contain a provision limiting the time
					 within which any action at law or in equity may be commenced to less than two
					 years after the cause of action shall accrue.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.120 - Backdating Policies

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy must
				  not contain a provision by which it is issued or takes effect more than six
				  months before the original application for the insurance was made, if thereby
				  the insured would rate at an age younger than his age at the date when the
				  application was made, according to his age at the nearest birthday.
(b) The restrictions against backdating are
				  not violated by the exercise of conversion privileges contained in the original
				  policy and which relate back to the original issue date of the policy, even
				  though the conversion privilege by its terms is such that the amount of
				  insurance at the conversion may exceed that which was in force prior to
				  conversion.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.121 - Settlement at Maturity

Current through Reg. 49, No. 28; July 12, 2024
(a) If the policy
				  provides that proceeds may be paid in installments, it must contain a
				  representative table showing the amounts of such installments.
(b) If the settlement options provision
				  indicates that modes of payment other than monthly may be available, then the
				  amount of such payments must be determinable from the text. If the settlement
				  option indicates a commuted value or present value, to be paid upon death of a
				  payee, the interest rate used to determine this value must be given.
(c) No policy may contain a provision for any
				  mode of settlement at maturity of less value than the amount insured on the
				  face of the policy, plus dividend additions, if any, less any indebtedness to
				  the company on the policy, and less any premium that may, by the terms of the
				  policy, be deducted. The policy may provide an exception to this general rule,
				  and reduce the amount of insurance payable on maturity if death occurs from
				  either of the following causes:
(1) suicide,
				  while sane or insane;
(2) by
				  following stated hazardous occupations; or
(3) from aviation activities under conditions
				  specified by the policy.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.122 - Tontine Provisions

Current through Reg. 49, No. 28; July 12, 2024
Any life insurance policy which is a tontine policy or
					 which contains a tontine provision will be disapproved. Provisions by which
					 dividends during the participating period are not allocated or paid annually
					 are prohibited as being within the tontine principle unless the policyholder
					 acquires, on termination of the policy, a vested interest in the dividends
					 which have accrued.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.123 - Assignment Provisions

Current through Reg. 49, No. 28; July 12, 2024
There is no prohibition against a provision which permits
					 the assignment of the policy benefits or proceeds. However, policies which make
					 provision for dividends, coupon accumulations, or other guaranteed returns, and
					 which also contain provision for the assignment of these funds to a third party
					 for the purpose of establishing an investment for the policyholder are
					 prohibited.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.124 - Provisions Relating to Dividends, Coupon Benefits, or Other Guaranteed Returns

Current through Reg. 49, No. 28; July 12, 2024
(a) Any provision
				  by which the insurer undertakes to pay specific amounts will be treated as
				  definite contract benefits and valued in accordance with Insurance Code §
										841.253.
(b) Any policy which contains a provision
				  promising to pay "dividends" from specified sources must clearly state that the
				  payment of such dividends must be made from profits or expense
				  loading.
(c) Any policy which
				  provides for the payment of dividends, coupon benefits, or other guaranteed
				  returns must specify the disposition which will be made of such accumulations
				  if no option is exercised by the policyholder either on their maturity or in
				  the event of default in premium payments. Acceptable dispositions are that they
				  be:
(1) applied to the purchase of additional
				  insurance;
(2) left to accumulate
				  at interest;
(3) withdrawn in cash;
				  or
(4) applied to the payment of
				  premiums.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.125 - Premiums Paid in Advance

Current through Reg. 49, No. 28; July 12, 2024
(a) The policy may
				  contain provisions under which the company will accept advance payments of
				  premiums; but in no event may the company undertake to accept deposits which
				  would exceed the maximum amount required to pay all future premiums which will
				  become due under the policy, including any options contained therein. The
				  contract may permit the insured to withdraw excess deposits in cash, but any
				  provisions which would cause a forfeiture of principal, or exact a surrender
				  charge are prohibited. The contract must state the interest rate used to
				  discount the future premiums and must provide for disposition of any unused
				  premiums on surrender of the contract or death of the insured.
(b) This section is not applicable to single
				  premium policies.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.126 - Annuity Contracts

Current through Reg. 49, No. 28; July 12, 2024
Sections
					 3.101-3.128
					 of this title (relating to Individual Life Insurance Policy Form Checklist and
					 Affirmative Requirements) apply to the review of ordinary life insurance
					 policies and are not applicable to annuity contracts. Any contract which
					 provides death benefits in excess of the total premium paid, without interest
					 or with interest at a specified rate, or the cash value at time of death, if
					 greater, will be considered a life insurance policy. This requirement cannot be
					 avoided by combining riders or endorsements to a basic annuity, as all
					 pertinent instruments collectively constitute the contract.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.127 - Certain Prohibited Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a) Any policy
				  which contains a title, heading, or other indication of its provisions which is
				  misleading will be disapproved. For example, a title, heading, etc., will be
				  misleading if it contradicts the provisions of the policy. A life insurance
				  policy may not be described or referred to as a "bond," nor may premiums be
				  described or referred to as "deposits."
(b) The policy may not contain the words
				  "Approved by the Texas Department of Insurance," "Approved by TDI," "Approved
				  by the commissioner of insurance," or words of a similar import or
				  nature.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter B - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS › Section 3.128 - Renewal Premium on Term Policies

Current through Reg. 49, No. 28; July 12, 2024
Renewable term policies may specify rates for renewal terms
					 in dollars and cents, by reference to rates in use by the company on the
					 original issue date or by reference to the rates in use by the company on the
					 renewal date. If such rates are specified by reference to the rates in effect
					 on the date of issue, such rates shall be submitted with the
					 policy.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter C - APPROVAL, DISAPPROVAL, AND WITHDRAWAL OF APPROVAL OF CERTAIN PARTICIPATING POLICY FORMS › Section 3.201 - Definition of Certain Participating Policies

Current through Reg. 49, No. 28; July 12, 2024
A "certain participating" policy is defined as any contract
					 of life insurance which contains a provision through which the policy holder
					 becomes, or which creates or tends to create the understanding that he will
					 become, an investor in the insurance company, and that, as an investor, he will
					 be entitled to participate in future corporate earnings as specified in the
					 contract of insurance. The "certain participating" policy defined in this
					 paragraph is to be contrasted to policies which employ participation provisions
					 which make no greater promise (or which neither create nor tend to create an
					 understanding of a greater promise) than that the policy holder may receive
					 back, by way of participation, part of the premiums which he has paid. This
					 latter type of participation provision, which is unobjectionable, raises no
					 inference that the insured occupies any status other than that of policy
					 holder. It does not, in other words, promise or tend to lead the policy holder
					 into the belief that he is an investor in the company and that his position is
					 comparable to a part owner of the company insofar as the distribution of
					 profits is concerned. In making the distinctions herein described, the
					 commissioner may also consider any regulations as applied by the Internal
					 Revenue Service relating to the taxation of corporate profits distributed as
					 dividends. This is to be contrasted to a partial refund of insurance premiums,
					 which is not taxable as income under Internal Revenue Service
					 regulations.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter C - APPROVAL, DISAPPROVAL, AND WITHDRAWAL OF APPROVAL OF CERTAIN PARTICIPATING POLICY FORMS › Section 3.202 - Specification of Certain Participating Policies

Current through Reg. 49, No. 28; July 12, 2024
Consistent with the definitions and principles contained
					 and expressed in §
										3.201
					 of this title (relating to Definition of Certain Participating Policies), and
					 without limiting their generality, the types of policies described in
					 paragraphs (1) and (2) of this section are also defined as "certain
					 participating" policies.
(1) Charter
				  or founder's policies. A "charter policy" or "founder's policy" is that form of
				  life insurance policy or annuity contract, usually issued by a newly organized
				  insurer, which is sold on the basis that its availability will be limited to a
				  specific predetermined number of units of a fixed dollar amount and which
				  generally provides that the policyholder shall participate in the earnings
				  resulting from either the participating policies or the nonparticipating
				  policies sold by the insurer, or perhaps both. The prospective purchaser may be
				  led to believe that he will receive a special advantage in any future
				  distribution of earnings, profits, or dividends not available to those persons
				  holding other types of policies issued by the insurer.
(2) Profit-sharing policies. A
				  "profit-sharing policy" is that form of life insurance policy or annuity
				  contract which contains provisions representing or tending to create the
				  understanding that the policyholder will be eligible to participate in any
				  future distribution of general corporate profits, with special advantages not
				  available to persons holding other types of policies issued by the insurer to
				  individuals of the same class and equal expectations of life.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter C - APPROVAL, DISAPPROVAL, AND WITHDRAWAL OF APPROVAL OF CERTAIN PARTICIPATING POLICY FORMS › Section 3.203 - Instructions to Commissioner

Current through Reg. 49, No. 28; July 12, 2024
From and after the effective date hereof, the commissioner
					 will not approve any "certain participating" policy form as defined herein. The
					 commissioner will proceed to withdraw approval, under authority of Insurance
					 Code Chapter 1701, of any such forms which have heretofore been approved.
					 Without limiting the generality of the legal bases upon which disapprovals or
					 withdrawals of approvals heretofore granted will be predicated, the department
					 hereby finds and declares as follows:
(1) such policy forms are by their nature
				  unfair, inequitable, misleading, and deceptive, and encourage
				  misrepresentation; and
(2) such
				  policy forms are particularly subject to misleading sales techniques.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter C - APPROVAL, DISAPPROVAL, AND WITHDRAWAL OF APPROVAL OF CERTAIN PARTICIPATING POLICY FORMS › Section 3.204 - Material and Information for the Commissioner to Consider

Current through Reg. 49, No. 28; July 12, 2024
When any other type participating policies are being
					 reviewed by the commissioner of insurance for approval or disapproval, the
					 commissioner is authorized to study and take into consideration not only the
					 titles, terms, and text of such policy itself but also the following additional
					 materials, data, evidence, and information to determine whether such policy
					 complies with the provisions hereof and the requirements of the Insurance
					 Code:
(1) any and all advertisements,
				  estimates, comparisons, illustrations, circulars, statements, notices,
				  brochures, pamphlets, letters, posters, announcements, articles, projections,
				  literature, pictures, reports, books, newspapers, magazines, records, films, or
				  other matter of any nature whatsoever made, issued, circulated, published,
				  disseminated, delivered, used, referred to, or placed before the public in any
				  manner whatsoever relating to or in connection with such certain participating
				  policies of insurance;
(2) any and
				  all oral statements, assertions, or representations, the sales techniques or
				  procedures, and the training, study or learning devices or programs made, used,
				  followed, or employed by the agents, employees or representatives of the
				  insurance company;
(3) any other
				  matters set forth in Insurance Code Chapter 541 or other statute of the
				  Insurance Code;
(4) in the event
				  the commissioner finds that such participating policy and such materials
				  referred to previously do not truthfully, correctly, fairly, honestly,
				  adequately, or properly explain and represent such terms, conditions, promises,
				  and benefits of such policy, the commissioner will disapprove such policy under
				  the provisions of Insurance Code Chapter 1701.