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 FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 4 - PRESUMPTIVELY ACCEPTABLE RELATION OF CREDIT LIFE INSURANCE BENEFITS TO PREMIUMS › Section 3.5306 - Premiums Based on Age

Current through Reg. 49, No. 28; July 12, 2024
If the premiums are determined according to age of the
						insured debtor or by age brackets, appropriate adjustments in the rate and
						premium may be made according to age if such adjustments are actuarially
						consistent with the foregoing rates when applied regardless of actual age at
						issue and if such adjustments produce an aggregate premium not substantially
						greater than that produced by the foregoing rates, and such rates and
						actuarially consistent computations are filed with and approved by the
						commissioner of insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 4 - PRESUMPTIVELY ACCEPTABLE RELATION OF CREDIT LIFE INSURANCE BENEFITS TO PREMIUMS › Section 3.5307 - Standard for Additional Benefits

Current through Reg. 49, No. 28; July 12, 2024
If a contract of insurance includes other lawful benefit
						or benefits for which standards or reasonableness of benefits in relation to
						premium are not elsewhere in these sections determined or described, any
						premium charged therefor in excess of the rates set forth in these sections
						shall be shown to the satisfaction of the commissioner of insurance to be based
						upon credible statistics, and shall be reasonable in relation to the additional
						benefit provided.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 5 - STANDARDS OF BENEFITS FOR CREDIT ACCIDENT AND HEALTH INSURANCE › Section 3.5502 - Joint Credit Accident and Health Insurance

Current through Reg. 49, No. 28; July 12, 2024
(a) Joint debtors, for purposes of credit
					 accident and health insurance written under Insurance Code, Chapter 1153 means
					 only spouses or business partners, and such persons must be jointly and
					 severally liable for repayment of the single indebtedness and be joint signers
					 of the instrument of indebtedness. Endorsers and guarantors are not eligible
					 for credit insurance coverage. Joint accident and health coverage shall not be
					 written covering more than two debtors.
(b) Coverage may be provided by either of the
					 methods set forth in paragraphs (1) and (2) of this subsection:
(1) each debtor is insured for 100% of the
					 disability payment;
(2) each debtor
					 is insured for a portion of the disability payment. The total of the portions
					 shall equal 100% of the disability payment. The joint disability insurance
					 benefit cannot exceed the amount of insurance that would have been provided if
					 coverage had been issued on a single debtor.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5601 - Deviation by Case Allowed

Current through Reg. 49, No. 28; July 12, 2024
Two types of rate deviation are allowed, automatic
						deviation and approved deviation as defined in §
											3.5002 of
						this title (relating to Definitions).
(1) Automatic Deviation. An insurer electing
					 to deviate from the presumptive premium rate established by the commissioner
					 shall file with the commissioner the insurer's proposed rate for credit life
					 and credit accident and health insurance. On filing the rate with the
					 commissioner, the insurer may use the filed rate until the insurer elects to
					 file a different rate. Except as provided in paragraph (2) of this section, an
					 insurer may not use a rate that is more than 30% higher or 30% lower than the
					 presumptive premium rate.
(2)
					 Approved Deviation by Case. Notwithstanding the determination by the
					 Commissioner of Insurance of presumptive premium rates which are reasonable in
					 relation to the benefits of a policy providing the coverage to which the rates
					 are applicable, an insurer who has experienced excessive loss ratios or who
					 fails to develop the minimum loss ratio as defined in §
											3.5202
					 of this title (relating to Reasonable Relation of Benefits to Premiums for
					 Approved Deviations), for a case consisting of a single account or combination
					 of accounts, as defined in §
											3.5002 of
					 this title, will be permitted, at its own request, or may be required by the
					 commissioner, to adjust the premium rate or premium rate schedule for such case
					 in accordance with the deviation procedures set out in this subchapter. An
					 approved deviation request shall be presented with form CI-DRF and §3.5602
					 of this division (relating to Request for an Approved Deviated Premium
					 Rate).
(3) The commissioner may
					 disapprove a request for an approved deviated rate on the grounds that the rate
					 is not actuarially justified, or is unjust, unreasonable, excessive or
					 inadequate. A rate is excessive if it is unreasonably high for the coverage
					 provided and a reasonable degree of competition does not exist with respect to
					 the classification to which the rate would be applicable. A rate is inadequate
					 if the rate is insufficient to sustain projected losses and expenses, or the
					 rate substantially impairs, or is likely to substantially impair, competition
					 with respect to the sale of the product.
(4) The insurer may use the rate if the
					 commissioner does not disapprove it before the 60th day after the date the
					 insurer filed the rate.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5602 - Request for an Approved Deviated Premium Rate

Current through Reg. 49, No. 28; July 12, 2024
A request for an approved deviated rate must be made in
						writing and must include all of the information which is required under this
						subchapter. It must be accompanied by a list of the creditors whose experience
						is the basis for such request, and must be attested to by an officer of the
						insurer. The use of any approved rate deviation approved by the commissioner is
						limited to those creditors whose names appear on such list. No rate deviation
						may be used unless and until approved by the commissioner in writing. Any
						request for an approved deviated rate must be submitted to the commissioner
						through the Filings Intake Division in the manner prescribed on Form CI-DRF
						provided by the department for that purpose. The form can be obtained from the
						Texas Department of Insurance, Life and Health Division, Filings Intake,
						MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030. The form can also be
						obtained from the department's internet website at
www.tdi.texas.gov/forms
. In order
						to provide the commissioner sufficient time for review, all requests for
						approved rate deviations must be submitted a minimum of 60 days prior to the
						proposed effective date of the approved deviated rate.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5603 - Credibility Table

Current through Reg. 49, No. 28; July 12, 2024
The following table shall be used to determine the
						credibility factor of a case, as defined in §
											3.5002 of
						this title (relating to Definitions).
Attached
						Graphic
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5604 - Minimum Change

Current through Reg. 49, No. 28; July 12, 2024
(a) For credit life
					 insurance, the currently charged premium rates will be considered the case
					 rates if the single premium (or its equivalent) case rate per $100 of initial
					 amount of insured indebtedness repayable in 12 equal monthly installments as
					 determined under this subchapter is within 5.0% of the corresponding premium
					 under the currently charged premium rates for the case.
(b) For credit accident and health insurance,
					 the currently charged premium rates will be considered the case rate if the
					 case rate as determined under this subchapter is within 5.0% of the currently
					 charged premium rates for the case.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5605 - Effective Date of Deviated Rate

Current through Reg. 49, No. 28; July 12, 2024
An automatic rate deviation shall be effective
						immediately upon filing with the commissioner. The effective date for any
						approved rate deviation shall be the earlier of the date of approval in writing
						by the commissioner, or the 60th day after the date the insurer filed its
						request for approval of an approved deviated rate.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5606 - Effective Period of Downward Deviated Case Rate

Current through Reg. 49, No. 28; July 12, 2024
A downward approved deviated single account case rate as
						determined in §
											3.5609
						of this title (relating to Notice of Change of Insurer on Deviated Presumptive
						Rates Required) remains with the case, regardless of any change of insurers,
						and shall continue for a period equal to the experience period on which it was
						based, not to exceed three years, subject however to the provisions of §
											3.5608
						of this title (relating to Annual Review of Approved Deviated
						Rates).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5607 - Termination of Upward Deviated Case Rate

Current through Reg. 49, No. 28; July 12, 2024
An upward approved deviated single account case rate
						shall continue for a period equal to the experience period on which it was
						based, not to exceed three years, subject however to the provisions of §
											3.5608
						of this title (relating to Annual Review of Approved Deviated Rates). If a
						change of insurers occurs, an upward approved deviated single account case rate
						may be continued by the replacement carrier by giving written notification to
						the commissioner, within 30 days of the effective date of providing coverage to
						the account, of the new carrier's intent to continue the upward approved
						deviated single account case rate. The period of continuance shall not go
						beyond the expiration date originally granted to the previous insurer for that
						account. If a change of insurers occurs, an approved deviated multiple account
						case rate shall not be continued by the replacement insurer beyond the date the
						original carrier lost the account unless all of the accounts forming the
						multiple account pool are taken over. If all accounts are taken over, the
						requirements for continuation are the same as mentioned in the preceding
						paragraph for single account cases.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5608 - Annual Review of Approved Deviated Rates

Current through Reg. 49, No. 28; July 12, 2024
All approved deviated rates shall be filed for review for
						each case in accordance with this subchapter each year for each case. At the
						time of such review of approved deviated rates, adjustments may be made in the
						rates if the commissioner finds that experience shows that an adjustment is
						appropriate.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5609 - Notice of Change of Insurer on Deviated Rates Required

Current through Reg. 49, No. 28; July 12, 2024
When a creditor changes insurers, and that creditor is
						charging a rate other than the presumptive premium rate, the previous insurer
						shall within 60 days file written notice of the change with the
						commissioner.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 6 - DEVIATION PROCEDURES › Section 3.5610 - Determination of Approved Deviated Case Rates

Current through Reg. 49, No. 28; July 12, 2024
(a) For cases which are not of credible size,
					 or have no experience, no approved deviation may be made in the presumptive
					 premium rates under these deviation procedures; except that nothing herein may
					 be construed as preventing any insurer from filing an automatic deviation
					 pursuant to Insurance Code §
											1153.105.
(b) For purposes of this section: if the
					 coverage for a single creditor which qualifies as a case has been in force with
					 the insurer for less than the experience period:
(1) the claim experience of the creditor
					 while covered by any prior insurer must be included to the extent necessary in
					 determining the appropriate case ratios; and
(2) the experience considered in the
					 determination of multiple state case rates must be Texas experience for the
					 case unless the insurer makes the one-time election to use only nationwide
					 experience. The election to use only nationwide experience must be accompanied
					 by a certification that the insurer uses the same nationwide basis in
					 determining the case ratios in each state in which the case has experience. A
					 grouping of states may be used subject to the same requirements of consistency
					 and certification.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 7 - EXPERIENCE CALL › Section 3.5701 - Statistical Data

Current through Reg. 49, No. 28; July 12, 2024
(a) Insurers
					 writing credit life insurance and accident and health insurance in Texas must
					 keep statistical data for a period of no less than five years to enable the
					 Commissioner to determine whether rates are reasonable in relation to the
					 benefits afforded by the various policy contracts together with appropriate
					 expenses. Each such insurer must retain the statistical data relevant to their
					 credit insurance business and provide it to the Commissioner upon request in a
					 format specified by the Commissioner.
(b) The retention of data required by
					 subsection (a) of this section does not replace other annual reports of credit
					 insurance experience. That data is separate and distinct from the NAIC annual
					 statement and from the deviation request permitted by §
											3.5601
					 of this title (relating to Deviation by Case Allowed) and is not used in any
					 manner to determine the financial condition of the company.
(c) Copies of all calculations, work papers,
					 and other data used in documenting the credit insurance experience must also be
					 maintained for no less than five years at the home office of the company and be
					 available for examination by the Commissioner.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 8 - ADDITIONAL COVERAGES › Section 3.5801 - Proposal for Other Types of Coverage

Current through Reg. 49, No. 28; July 12, 2024
If a company proposes to write any type of coverage other
						than those set forth in this subchapter, it may request the department to set a
						public hearing to determine if a public need exists for such coverage and to
						determine, through credible statistics, whether the rate proposed may be
						presumed to be reasonable in relation to the benefits offered, until such time
						that experience indicates a different rate.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 9 - PREMIUM REFUNDS › Section 3.5901 - Refund of Unearned Premiums

Current through Reg. 49, No. 28; July 12, 2024
With respect to policies issued and certificates
						delivered after the effective date of these sections:
(1) the refund of an unearned amount paid by
					 or charged to a debtor for credit life insurance, or for credit accident and
					 health insurance, on which charges to the debtor are payable by other than a
					 single sum must not be less than the pro rata gross unearned amount
					 charged;
(2) the refund of an
					 unearned amount paid by or charged to a debtor for credit life insurance, or
					 for credit accident and health insurance, on which the insurance charges to the
					 debtor are paid in a single sum must be computed by the rule of anticipation,
					 as defined in §
											3.5002 of
					 this title (relating to Definitions), or by another method which produces a
					 substantially equal amount and is approved by the commissioner of insurance.
					 This paragraph shall not be interpreted to preclude refunds for credit accident
					 and health insurance to be computed by the mean of the gross unearned premium
					 calculated by the "sum of the digits" (rule of 78) and the pro rata
					 method.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 9 - PREMIUM REFUNDS › Section 3.5902 - Procedures for Payment of Refunds

Current through Reg. 49, No. 28; July 12, 2024
Upon termination of insurance prior to maturity, and in
						accordance with the refund formulas prescribed herein, and in accordance with
						the insurer's established refund procedures, each insured debtor shall receive
						from the insurer any refund of unearned identifiable insurance charge either in
						cash, by check, or by credit to and against the insured debtor's indebtedness
						(provided that such credit shall be applied only to the indebtedness to which
						the insurance charges are attributable). Insurers shall be responsible for the
						establishment of procedures by which refunds or credits are to be made, and
						shall furnish to the creditors schedules or methods for the calculation of
						refunds or credits to be made in the event of termination of insurance.
						Insurers shall also furnish instructions to creditors with respect to the
						duties in making of such refunds or credits.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 9 - PREMIUM REFUNDS › Section 3.5903 - Responsibility for Refunds

Current through Reg. 49, No. 28; July 12, 2024
Where insurance charges or premiums were paid by or
						charged to the debtor, the insurer is responsible for making the refund to the
						debtor (or to the debtor's estate). Where discharge of the insurer's
						responsibility for completion of such refunds is delegated by the insurer to
						the creditor, the actions of such creditor will be deemed by the commissioner
						of insurance to be acts of the insurer.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 9 - PREMIUM REFUNDS › Section 3.5904 - Refund Formula in Policy

Current through Reg. 49, No. 28; July 12, 2024
The requirement for filing refund formulas will be
						satisfied if the formulas are set forth in the individual policy or group
						policy filed with the commissioner of insurance and not disapproved. All
						individual policies and certificates of insurance shall contain a description
						of the method used to calculate the refund of unearned
						premiums.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 9 - PREMIUM REFUNDS › Section 3.5905 - Refunds

Current through Reg. 49, No. 28; July 12, 2024
No refund of premium need be made of an amount paid or
						charged to the debtor for credit insurance regulated under the Insurance Code,
						Chapter 1153, in the event of termination of the indebtedness or the insurance
						prior to the scheduled maturity date of the indebtedness if the amount of such
						refund is less than $3.00. (For insurance coverage subject to Finance Code
						Chapters 342 - 348, a refund must be made, except that no cash refund shall be
						required if the amount thereof is less than $1.00.)
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 9 - PREMIUM REFUNDS › Section 3.5906 - Treatment of Partial Months

Current through Reg. 49, No. 28; July 12, 2024
In calculating refunds upon termination, no charge for
						credit insurance may be made for the first 15 days of a loan month, and a full
						month may be charged for 16 days or more of a loan month.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6001 - Responsibilities of Insurers

Current through Reg. 49, No. 28; July 12, 2024
Each insurer transacting credit insurance business in
						this state shall, in compliance with the laws of this state and the regulations
						promulgated thereunder, be responsible for:
(1) the approval, production, reproduction,
					 amendment, and modification of its policies, certificates of insurance, and
					 other insurance forms including rate schedules, and for the issuance,
					 cancellation, or termination of such policies, certificates, or
					 forms;
(2) the selection and
					 appointment of its agents and representatives;
(3) the proper charge, collection,
					 remittance, and refund of credit insurance premiums;
(4) the receipt of copies of all certificates
					 of insurance and other insurance forms issued in its name by its agents and
					 representatives or the receipt of electronic or other data therefor which can
					 be substantiated by certificates of insurance or other insurance
					 forms;
(5) the computation and
					 maintenance of policy holder and claims reserves in accordance with §
											3.6101
					 and §
											3.6102
					 of this title (relating to Policy and Claim Reserves) of these sections;
					 and
(6) the investigation of claims
					 filed against the insurer and the payment, adjustment, settlement, or denial of
					 such claims. None of the foregoing ultimate responsibilities of the insurer may
					 be delegated to any other person, nor may the performance of such
					 responsibilities be assigned to any creditor or to any agent or representative
					 selected and appointed by the insurer, except as provided in these
					 sections.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6002 - Delegation by Insurer of Responsibilities of Policy Issuance and Premium Collection

Current through Reg. 49, No. 28; July 12, 2024
(a) The insurer, by
					 its group policy, may authorize the group policyholder-creditor to issue
					 certificates of group insurance or may authorize a legally appointed insurance
					 agent of the insurer to issue certificates of insurance or policies of
					 insurance, and respectively, to collect the insurance charge under the group
					 policy, or premium therefor under an individual policy, provided that the
					 master group insurance policy with the creditor or the agent's agreement with
					 the agent under which such authority is granted shall require that:
(1) the creditor issue such group
					 certificate, or the agent issue such certificate of insurance or insurance
					 policy in the name of the insurer, and payment of the respective policy premium
					 shall be by a check payable to the insurer or by deposit to an account of the
					 insurer under the sole control of the insurer;
(2) a "home office" copy of each certificate
					 or policy so issued, or electronic or other data therefor which can be
					 substantiated by such certificate or policy, together with the premium
					 therefor, shall be delivered to the insurer within 30 days after the close of
					 the calendar month in which the certificate or policy is issued;
(3) refunds of unearned premiums shall be
					 made in accordance with this subchapter; and
(4) no creditor or creditor agent may
					 knowingly issue any group certificate of insurance which, alone, or in
					 conjunction with other group certificates issued on the same risk, will in the
					 aggregate exceed the group credit life insurance limits 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 FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6003 - Restrictions on Interest of Creditors under Group and Individual Policies

Current through Reg. 49, No. 28; July 12, 2024
No group policy may be issued to other than a bona fide
						creditor. No first beneficiary may be designated except a creditor. No creditor
						may be designated as owner of the individual policy, nor have any rights
						thereunder other than that of first beneficiary except as specifically
						authorized by law.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6004 - Delegation by Insurer of Certain Functions

Current through Reg. 49, No. 28; July 12, 2024
The insurer may designate or engage one or more
						representatives for the purpose of investigating or settling claims, processing
						production reports, calculating reserves, printing of approved forms, and
						performing other administrative services authorized by law, provided:
(1) such services are performed under the
					 supervision and direction of the insurer and the insurer shall remain
					 responsible for their proper performance;
(2) the work product of representatives of
					 the insurer are the property of the insurer and are retained in the possession
					 of the insurer, together with the supporting data and information used in their
					 preparation; and
(3) all claims
					 shall be promptly reported to the insurance company, or its designated claim
					 representative, and all claims shall be settled as soon as reasonably possible
					 and in accordance with the terms of the insurance contract.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6005 - Claim Files Maintained by Insurer

Current through Reg. 49, No. 28; July 12, 2024
The insurance company shall establish and maintain an
						adequate claims register and claim files, which may be reviewed and examined by
						the commissioner of insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6006 - Proofs of Loss

Current through Reg. 49, No. 28; July 12, 2024
Adequate proofs of loss must be in the possession of the
						insurance company at the time its funds are disbursed in payment of claims,
						except as provided in §
											3.6008
						of this title (relating to Additional Restrictions on Settlement and Adjustment
						of Claims). Such proofs of loss shall include data sufficient for the insurer
						to determine proper amounts of any excess benefit payable to a beneficiary
						other than the creditor.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6007 - Method of Claims Payment

Current through Reg. 49, No. 28; July 12, 2024
All claims shall be paid either by draft drawn upon the
						insurance company or by check of the insurance company to the order of the
						specific beneficiary to whom payment of the claim is due.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6008 - Additional Restrictions on Settlement and Adjustment of Claims

Current through Reg. 49, No. 28; July 12, 2024
No plan or arrangement shall be used whereby any person,
						firm, or corporation other than the insurer or its designated claim
						representatives shall be authorized to settle or adjust claims. The creditor
						shall not be designated as a claim representative for the insurer in settling
						or adjusting claims; however, a group policyholder may, by arrangement with the
						group insurer, draw drafts or checks in payment of claims due only to the group
						policyholder subject to audit and review by the insurer. Nothing herein may be
						construed to relieve the insurance company from the responsibility for the
						proper settlement, adjustment, and payment of all claims to proper
						beneficiaries in accordance with the terms of the insurance
						contract.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6009 - Insurer's Annual Audit of Credit Insurance Operations

Current through Reg. 49, No. 28; July 12, 2024
On at least an annual basis and to assure compliance with
						the insurance laws of this state and the regulations promulgated thereunder,
						the insurer shall audit its credit insurance business with each of its
						creditors, general agents, and other persons or entities providing
						administrative services as authorized by law. Copies of the results of all such
						annual audits shall be maintained at the home office and shall be available
						upon request of the commissioner of insurance. Such review shall include, but
						not be limited to, a determination that:
(1) the proper charges to debtors are being
					 made by the creditor;
(2) the
					 proper refunds are being made by the creditor;
(3) all claims are being filed and properly
					 handled;
(4) amounts of insurance
					 payable on death in excess of the amounts necessary to extinguish the
					 indebtedness are properly calculated and reported to the insurer in proofs of
					 loss;
(5) the creditor is promptly
					 and fairly processing complaints concerning its credit insurance operations and
					 is maintaining proper procedures for and records of the complaints processed;
					 and
(6) authorized certificate and
					 policy forms are being used and delivered to insured debtors.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 10 - RESPONSIBILITIES AND OBLIGATIONS OF INSURANCE COMPANIES AND THEIR AGENTS AND REPRESENTATIVES › Section 3.6010 - Availability of Source Documents

Current through Reg. 49, No. 28; July 12, 2024
Upon request by the commissioner of insurance, the
						insurer shall procure and make available at its home office legally acceptable
						copies of all source documents relating to any of its credit insurance
						transactions. Such copies shall be made available at the home office within a
						reasonable time after request is made by the commissioner of
						insurance.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 11 - POLICY AND CLAIMS RESERVES › Section 3.6101 - Policy Reserves

Current through Reg. 49, No. 28; July 12, 2024
(a) Except as
					 provided in §
											3.6102
					 of this subchapter (relating to Claims Reserves), the minimum reserves for
					 premium refunds required by these rules and the payment of benefits under
					 outstanding credit life insurance policies and certificates issued prior to
					 January 1, 2009, may not be less in the aggregate than 130 percent of the
					 reserves computed on the 1958 CSO Mortality Table with interest not to exceed
					 5.5 percent; or, at the option of the company, such reserves may be maintained
					 at 100 percent of the reserves computed on the 1941 CSO Mortality Table or the
					 1958 CET Mortality Table with interest not to exceed 5.5 percent; or 150
					 percent of the 1980 CSO Mortality Table with interest not to exceed 5.5
					 percent; provided, however, notwithstanding any other law or rule, the minimum
					 reserve requirements for policy reserves applicable to credit life policies and
					 certificates issued prior to January 1, 2009, under the Insurance Code Chapter
					 1153 or these rules are met if, in aggregate, the reserves are maintained at
					 100 percent of the 1980 CSO Mortality Table, with interest not to exceed 5.5
					 percent. Subchapter EE of this chapter (relating to Valuation of Life Insurance
					 Policies) shall not apply to credit life insurance. For credit life insurance
					 policies and certificates issued on or after January 1, 2009, the minimum
					 reserve requirements are as follows:
(1) The
					 minimum standard for both male and female insureds shall be the 2001 CSO Male
					 Composite Ultimate Mortality Table. This table contains rates of mortality that
					 do not distinguish between smokers and nonsmokers and is one of the tables
					 contained in the 2001 CSO Mortality Table adopted by reference in §
												3.9103(d)
					 of this chapter (relating to 2001 CSO Mortality Table).
(2) Where the credit life insurance policy or
					 certificate insures two lives, the minimum standard shall be twice the
					 mortality in the 2001 CSO Male Composite Ultimate Mortality Table based on the
					 age of the older insured.
(3) The
					 interest rates used in determining the minimum standard of valuation shall be
					 the calendar year valuation interest rates as defined in the Insurance Code
					 §§
												425.060
					 -
					 425.063.
(4) The method used in determining the
					 minimum standard for valuation shall be the commissioners reserve valuation
					 method as defined in the Insurance Code §
												425.064.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 11 - POLICY AND CLAIMS RESERVES › Section 3.6102 - Claims Reserves

Current through Reg. 49, No. 28; July 12, 2024
(a) The insurer
					 shall set up adequate reserves for claims on credit life and credit accident
					 and health insurance, in addition to the policy reserves already described in
					 §
											3.6101
					 of this subchapter (relating to Policy Reserves). Claim reserves for single
					 premium credit accident and health insurance contracts issued on or after
					 January 1, 2009, must comply with the claim reserve requirements in §
											3.7002
					 of this chapter (relating to Claim Reserves). Claim reserves for all other
					 credit accident and health insurance contracts and credit life insurance
					 contracts shall be based upon appropriate consideration for liability under
					 each of the following categories:
(1) the
					 liability on claims which are known to be due and already payable, but which
					 have not yet been paid;
(2) the
					 additional reserve on claims for ongoing and now continuing disability benefits
					 which have already been reported, and on which future payment will be due
					 during the continuance of this disability;
(3) the liability on claims which are
					 incurred and benefits now due but not yet reported, but which will be payable
					 when they are reported;
(4) the
					 reserve on claims for disability benefits which are incurred but not yet
					 reported, and on which future payments will be due during the continuance of
					 this disability.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 12 - PROHIBITED TRANSACTIONS › Section 3.6201 - Unfair Methods of Competition

Current through Reg. 49, No. 28; July 12, 2024
The following practices, when engaged in either directly
						or by reciprocal agreement by an insurer or by any insurance agent in
						connection with the sale or placement of credit insurance as an inducement
						thereto, shall constitute unfair methods of competition:
(1) the offer or grant by an insurer or by
					 any insurance agent to a creditor or to any person connected with the creditor
					 or to any person connected with the creditor of any special advantage or any
					 service not set out in the group insurance contract;
(2) agreement by an insurer or by an
					 insurance agent to deposit with a bank or financial institution money or
					 securities of the insurer with the design or intent that the same shall affect
					 or take the place of a deposit of money or securities which otherwise would be
					 required of the creditor by such bank or financial institution as a
					 compensating balance or offsetting deposit for a loan or other advancement;
					 and
(3) deposit as an inducement to
					 insurance by an insurer or by an insurance agent of money or securities,
					 regardless of interest or yield, in a creditor bank or financial institution.
					 This paragraph shall not be construed to prohibit the maintenance by an insurer
					 of such demand deposits or premium deposit accounts as are reasonably necessary
					 for use in the ordinary course of the insurer's business. However, premiums
					 shall be remitted to the insurer within 60 days of their due dates and for
					 purposes of this subchapter only, the deposit of such premiums to any such
					 demand deposit account with the creditor and their continued retention therein
					 for more than 60 days shall not be deemed remittance to the insurer.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 13 - COMPENSATIONS AND ADJUSTMENT IN RATES › Section 3.6301 - Experience Refunds

Current through Reg. 49, No. 28; July 12, 2024
Retroactive adjustment of rates of premiums for group
						insurance policies based upon the loss or expense experience thereunder
						(experience refunds) may only be made in accordance with the terms of the group
						insurance policy and may be made only at the end of a policy year and may be
						retroactive only for the immediately preceding policy year.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 14 - EFFECTIVE DATE, SAVINGS CLAUSE, AND SEVERABILITY CLAUSE › Section 3.6401 - Effective Date

Current through Reg. 49, No. 28; July 12, 2024
The effective date of this subchapter is October 1,
						1980.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 14 - EFFECTIVE DATE, SAVINGS CLAUSE, AND SEVERABILITY CLAUSE › Section 3.6402 - Savings Clause

Current through Reg. 49, No. 28; July 12, 2024
Each cause of action, pending litigation, matter in
						process before the Texas Department of Insurance, or matter hereafter arising
						from an event occurring prior to the time the amendments to this subchapter
						became effective shall be determined in accordance with and governed by the
						provisions of statutes, sections, orders, or interpretations of the Texas
						Department of Insurance in effect at the time of the occurrence of the subject
						event; and this section operates to save the application of such past procedure
						and law to any such event from amendment, change, or repeal notwithstanding any
						provision of these sections or any conflict or ambiguity
						therein.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter FF - CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE › Division 14 - EFFECTIVE DATE, SAVINGS CLAUSE, AND SEVERABILITY CLAUSE › Section 3.6403 - Severability

Current through Reg. 49, No. 28; July 12, 2024
If any provision of this subchapter or the application
						thereof to any person or circumstance is held invalid for any reason, the
						invalidity shall not affect the other provisions or any other application of
						said sections which can be given effect without the invalid provisions or
						application. To this end, all provisions of this subchapter are declared to be
						severable.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter GG - MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP ACCIDENT AND HEALTH INSURANCE › Section 3.7002 - Claim Reserves

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) Claim reserves are required for all
				  incurred but unpaid claims on all health insurance policies.
(2) Appropriate claim expense reserves are
				  required with respect to the estimated expense of settlement of all incurred
				  but unpaid claims.
(3) All such
				  reserves for prior valuation years must be tested for adequacy and
				  reasonableness along the lines of claim runoff schedules in accordance with the
				  statutory financial statement including consideration of any residual unpaid
				  liability.
(4) Claim reserves for
				  single premium credit accident and health insurance contracts issued on or
				  after January 1, 2009, must comply with the claim reserve requirements in this
				  section. Claim reserves for all other credit accident and health insurance
				  contracts must comply with the claim reserve requirements in §
											3.6102
				  of this chapter (relating to Claims Reserves).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter GG - MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP ACCIDENT AND HEALTH INSURANCE › Section 3.7003 - Premium Reserves

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) Unearned premium reserves are required
				  for all contracts with respect to the period of coverage for which premiums,
				  other than premiums paid in advance, have been paid beyond the date of
				  valuation.
(2) Single premium
				  credit accident and health insurance, both individual and group, is excluded
				  from the unearned premium reserve requirements of this subchapter.
(3) If premiums due and unpaid are carried as
				  an asset, such premiums must be treated as premiums in force, subject to
				  unearned premium reserve determination. The value of unpaid commissions,
				  premium taxes, and the cost of collection associated with due and unpaid
				  premiums must be carried as an offsetting liability.
(4) The gross premiums paid in advance for a
				  period of coverage commencing after the next premium due date which follows the
				  date of valuation may be appropriately discounted to the valuation date and
				  shall be held either as a separate liability or as an addition to the unearned
				  premium reserve which would otherwise be required as a minimum.