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Statutes > Texas > Insurance-code > Title-7-life-insurance-and-annuities > Chapter-1153-credit-life-insurance-and-credit-accident-and-health-insurance

INSURANCE CODE

TITLE 7. LIFE INSURANCE AND ANNUITIES

SUBTITLE C. SPECIALIZED COVERAGES

CHAPTER 1153. CREDIT LIFE INSURANCE AND CREDIT ACCIDENT AND

HEALTH INSURANCE

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 1153.001. SHORT TITLE. This chapter may be cited as the

Act for the Regulation of Credit Life Insurance and Credit

Accident and Health Insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.002. PURPOSE; LEGISLATIVE INTENT; CONSTRUCTION. (a)

The purpose of this chapter is to promote the public welfare by

regulating credit life insurance and credit accident and health

insurance.

(b) This chapter is not intended to prohibit or discourage

reasonable competition.

(c) This chapter shall be liberally construed.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.003. DEFINITIONS. In this chapter:

(1) "Credit accident and health insurance" means insurance to

provide indemnity for payments that become due on a specific

credit transaction of a debtor when the debtor is disabled, as

defined in the insurance policy.

(2) "Credit life insurance" means insurance on the life of a

debtor in connection with a specific credit transaction.

(3) "Credit transaction" includes the lending of money.

(4) "Creditor" means:

(A) a person who lends money or who sells or leases goods,

services, property, rights, or privileges, for which the payment

is arranged through a credit transaction;

(B) a successor to the right, title, or interest of a person

described by Paragraph (A); or

(C) a person who is in any way associated with a person

described by Paragraph (A) or (B), including a director, officer,

employee, affiliate, associate, or subsidiary of the person

described by Paragraph (A) or (B).

(5) "Debtor" means a person who borrows money or who purchases

or leases goods, services, property, rights, or privileges, the

payment for which is arranged through a credit transaction.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.004. APPLICABILITY OF CHAPTER. (a) This chapter

applies to life insurance and accident and health insurance that

is sold in connection with a credit transaction that is charged

to or paid for by, in whole or part, the debtor, except insurance

that is issued or sold:

(1) in connection with a credit transaction of more than 10

years' duration;

(2) in connection with a credit transaction that is:

(A) secured by a first mortgage or deed of trust; and

(B) made to:

(i) finance the purchase of commercial real property or the

construction of or improvement to a building, other than a

single-family dwelling, on the real property if the purchase,

construction, or improvement is secured by a lien on the real

property; or

(ii) refinance a credit transaction made for a purpose described

by Subparagraph (i); or

(3) as an isolated transaction on the part of the insurer that

is not related to an agreement or a plan for insuring debtors of

the creditor.

(b) This chapter applies to insurance described by Subsection

(a) regardless of the nature, kind, or plan of the credit

insurance coverage or premium payment system and regardless of

whether the credit insurance is charged to or paid for by the

debtor directly or indirectly.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.005. RULES. After notice and a hearing, the

commissioner may adopt rules to implement this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.006. FILING FEE. (a) The department shall set and

collect a fee for a form or schedule filed under this chapter in

an amount not to exceed $200.

(b) Fees collected under this section shall be deposited in the

Texas Department of Insurance operating account.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.007. GAIN OR ADVANTAGE FROM INSURANCE NOT PROHIBITED

CHARGE. (a) The premium or cost of credit life insurance or

credit accident and health insurance authorized under this

chapter is not considered to be interest, a charge,

consideration, or an amount in excess of permitted charges in

connection with the underlying credit transaction.

(b) Any benefit, return, or other gain or advantage to the

creditor arising out of the sale or provision of the insurance

under this chapter is not a violation of any law of this state.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER B. FORMS

Sec. 1153.051. FILING OF FORM. (a) An insurer shall file with

the commissioner the form of each policy, certificate of

insurance, notice of proposed insurance, application for

insurance, endorsement, and rider to which this chapter applies

that is delivered or issued for delivery in this state.

(b) If a group policy of credit life insurance or credit

accident and health insurance is delivered in another state, the

insurer is required to file only the group certificate and notice

of proposed insurance delivered or issued for delivery in this

state, as specified in Section 1153.052.

(c) The commissioner shall approve a certificate filed under

Subsection (b) if it conforms with the requirements provided by

Section 1153.052 and if the schedule of premium rates applicable

to the insurance evidenced by that certificate or notice does not

exceed the presumptive premium rate established by the

commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.052. REQUIREMENTS RELATING TO INSURANCE POLICY OR

CERTIFICATE. (a) A policy or certificate of credit life

insurance or credit accident and health insurance must:

(1) specify:

(A) the name and home office address of the insurer;

(B) the name of each debtor;

(C) in the case of a certificate under a group policy, the

identity, by name or otherwise, of each insured;

(D) the full amount of premium or the total identifiable

insurance charge, if any, to the debtor, separately for credit

life insurance and credit accident and health insurance; and

(E) each exception or limitation to or restriction on the

coverage;

(2) describe the coverage, including the amount and term of the

coverage; and

(3) state that the benefits are to be paid to the creditor to

reduce or extinguish the unpaid amount of the debt and that any

amount of benefits that exceeds the unpaid debt is to be paid to

a beneficiary, other than the creditor, named by the debtor or to

the debtor's estate.

(b) The requirements of this section are in addition to the

other requirements of law.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.053. DISAPPROVAL OF FORM. (a) Not later than the

60th day after the date an insurer files a form under Section

1153.051, the commissioner shall disapprove the form if:

(1) the benefits provided are not reasonable in relation to the

premium charge; or

(2) the form contains a provision that:

(A) is unjust, unfair, inequitable, misleading, or deceptive;

(B) encourages misrepresentation of the coverage; or

(C) is contrary to this code or a rule adopted under this code.

(b) The commissioner shall specify in the notice of disapproval

of a form the reason for the disapproval and state that, if the

insurer delivers to the commissioner a written request for a

hearing on the disapproval of the form, the hearing will be

granted not later than the 20th day after the date of the

request.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.054. WITHDRAWAL OF APPROVAL OF FORM. The commissioner

may hold a hearing on the withdrawal of the approval of a form

not earlier than the 21st day after the date written notice of

the hearing is given to the insurer who submitted the form. The

notice of the hearing must state the reason for the proposed

withdrawal of approval. At any time after the hearing, the

commissioner may withdraw approval of the form for any ground

provided by Section 1153.053(a).

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.055. PROHIBITIONS RELATING TO ISSUANCE OR USE OF FORM.

(a) A policy, certificate of insurance, notice of proposed

insurance, application for insurance, endorsement, or rider to

which this chapter applies may not be issued or used before the

61st day after the date the form is filed with the commissioner

under Section 1153.051, unless the commissioner gives prior

written approval of the issuance or use of the form.

(b) An insurer who is notified by the commissioner that a form

is disapproved may not issue or use that form.

(c) After the effective date of the withdrawal of the approval

of a form under Section 1153.054, the insurer may not issue or

use that form.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER C. RATES

Sec. 1153.101. FILING OF SCHEDULE OF RATES. An insurer shall

file with the commissioner each schedule of premium rates

relating to a document required to be filed under Section

1153.051.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.102. REVISION OF SCHEDULE OF RATES. (a) An insurer

may revise its schedules of premium rates for various classes of

business.

(b) The insurer shall file the revised schedules and classes of

business with the commissioner.

(c) An insurer may not issue a credit life insurance policy or

credit accident and health insurance policy for which the premium

rate exceeds the rate determined by using the appropriate

schedule for that class of business that the insurer has on file

with the commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.103. PRESUMPTIVE PREMIUM RATE. (a) After notice and

a hearing, the commissioner by rule may adopt a presumptive

premium rate for various classes of business and terms of

coverage. An insurer that does not file a different rate under

Section 1153.105 or 1153.106 shall file the presumptive rate

adopted by the commissioner.

(b) Except as provided by this chapter, any hearing conducted or

order adopting a presumptive rate under this subchapter shall be

held in accordance with the rulemaking provisions of Chapter

2001, Government Code.

(c) In the commissioner's order adopting a presumptive rate, the

commissioner shall set forth findings and conclusions on all

material issues presented at the hearing.

(d) In determining the presumptive premium rate, the

commissioner shall consider any relevant data, including

reasonable acquisition costs, loss ratios, administrative

expenses, reserves, loss settlement expenses, the type or class

of business, the duration of various credit transactions, and

reasonable and adequate profits to the insurers.

(e) In determining the presumptive premium rate, the

commissioner may not set or limit the amount of compensation

actually paid by a company to an agent but may request from an

insurer or agent any relevant data relating to the presumptive

premium rate, including information relating to compensation paid

for the sale of credit insurance, expenses, losses, and profits.

An insurer or agent shall provide the requested information to

the commissioner in a timely manner.

(f) The commissioner may not adopt a presumptive premium rate

that is unjust, unreasonable, inadequate, confiscatory, or

excessive to the insureds, the insurers, or the agents.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(a),

eff. Sept. 1, 2003.

Sec. 1153.104. APPEAL OF PRESUMPTIVE RATE. Any person who is

aggrieved by any action of the commissioner taken in the setting

of a presumptive rate may, not later than the 30th day after the

date the commissioner adopts a presumptive rate order, file a

petition for judicial review in a district court in Travis

County. Judicial review under this section is governed by

Subchapter B, Chapter 2001, Government Code.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(a),

eff. Sept. 1, 2003.

Sec. 1153.105. RATE WITHIN CERTAIN PERCENTAGES OF PRESUMPTIVE

RATE. (a) An insurer electing to deviate from the presumptive

rate shall file with the commissioner the insurer's proposed rate

for credit life and credit accident and health insurance.

(b) On filing the rate with the commissioner, the insurer may

use the filed rate until the insurer elects to file a different

rate.

(c) Except as provided by Section 1153.106, an insurer may not

use a rate that is more than 30 percent higher or more than 30

percent lower than the presumptive rate.

(d) Except as provided by this subchapter, a rate that complies

with this section is valid and in compliance with the

requirements of this subchapter and other applicable law.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

Sec. 1153.106. RATE OUTSIDE CERTAIN PERCENTAGES OF PRESUMPTIVE

RATE. (a) An insurer may file with the commissioner a proposed

rate for credit life and credit accident and health insurance

that is more than 30 percent higher or more than 30 percent lower

than the presumptive rate adopted by the commissioner under this

subchapter.

(b) The commissioner may disapprove a rate filed under this

section on the ground that the rate is not actuarially justified.

(c) A rate filed under this section is considered approved and

the insurer may use the rate if the rate is not disapproved by

the commissioner before the 60th day after the date the insurer

filed the rate.

(d) A hearing under this section is a contested case hearing

conducted under Chapter 2001, Government Code. Judicial review of

any action of the commissioner under this section is governed by

Subchapter D, Chapter 36.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

Sec. 1153.107. RATE STANDARD. (a) A rate filed under this

subchapter is not excessive unless the rate 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 is applicable.

(b) A rate filed under this subchapter is not inadequate unless

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.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

SUBCHAPTER D. CREDIT INSURANCE REQUIREMENTS

Sec. 1153.151. FORMS OF CREDIT LIFE INSURANCE. Credit life

insurance may be issued only as:

(1) an individual policy of life insurance issued to a debtor on

a term plan; or

(2) a group policy of life insurance issued to a creditor on a

term plan providing insurance on the lives of debtors.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.152. FORMS OF CREDIT ACCIDENT AND HEALTH INSURANCE.

Credit accident and health insurance may be issued only as:

(1) an individual policy of accident and health insurance issued

to a debtor on a term plan;

(2) a disability benefit provision in an individual policy of

credit life insurance;

(3) a group policy of accident and health insurance issued to a

creditor on a term plan insuring debtors; or

(4) a disability benefit provision in a group policy of credit

life insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.153. EVIDENCE OF INSURANCE. Credit life insurance or

credit accident and health insurance shall be evidenced by an

individual policy or group certificate of insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.154. REQUIREMENTS FOR DELIVERY OR ISSUANCE OF CREDIT

INSURANCE POLICY. A policy of credit life insurance or credit

accident and health insurance that is delivered or issued for

delivery in this state may be delivered or issued for delivery

only by an insurer authorized to engage in the business of

insurance in this state and may be issued only through a holder

of a license issued by the commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.155. LIMITS ON AMOUNT OF CREDIT LIFE INSURANCE. (a)

The initial amount of credit life insurance on a debtor may not

exceed the total amount of debt repayable under the contract that

evidences the credit transaction.

(b) If the debt is repayable in substantially equal

installments, the amount of insurance may not at any time exceed

the greater of the scheduled or actual unpaid amount of the debt

under the contract.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.156. LIMITS ON AMOUNT OF CREDIT ACCIDENT AND HEALTH

INSURANCE. (a) The total amount of indemnity payable by credit

accident and health insurance may not exceed the total amount of

debt repayable under the contract that evidences the credit

transaction.

(b) The amount of a periodic indemnity payment may not exceed

the scheduled periodic installment payment on the debt.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.157. BEGINNING OF TERM OF CREDIT INSURANCE COVERAGE.

(a) Except as otherwise provided by this section, the term of

credit life insurance or credit accident and health insurance

begins, subject to acceptance by the insurer, on the date that

the debtor becomes obligated to the creditor.

(b) With respect to an obligation that exists when a group

policy takes effect, coverage begins on the later of the

effective date of the policy or the date of enrollment for

coverage under the policy.

(c) If evidence of insurability is required and is provided

after the 30th day after the date the debtor becomes obligated to

the creditor, the term of the insurance may begin on the date the

insurance company determines that the evidence is satisfactory.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.158. DELIVERY OF EVIDENCE OF INSURANCE TO DEBTOR. (a)

At the time a debt for which credit insurance is sold is

incurred:

(1) the individual policy or group certificate of insurance, as

appropriate, shall be delivered to the debtor; or

(2) a copy of the application for the policy or certificate of

insurance or a notice of proposed insurance that satisfies

Section 1153.159 shall be delivered to the debtor.

(b) If delivery to the debtor is made under Subsection (a)(2),

the insurer shall deliver the individual policy or group

certificate of insurance to the debtor on acceptance of the

insurance by the insurer and not later than the 45th day after

the date the debt is incurred.

(c) If the insurer named in the application or notice under

Subsection (a)(2) does not accept the risk, the debtor shall

receive a policy or certificate of insurance that specifies the

name and home office address of the substituted insurer and the

amount of the premium to be charged for the insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.159. REQUIREMENTS RELATING TO APPLICATION FOR

INSURANCE OR NOTICE OF PROPOSED INSURANCE. A copy of an

application for insurance or a notice of proposed insurance

delivered under Section 1153.158 must:

(1) be signed by the debtor;

(2) specify:

(A) the name and home office address of the insurer;

(B) the name of each debtor;

(C) the full amount of the premium or the total identifiable

insurance charge, if any, to be paid by the debtor, separately

for credit life insurance and credit accident and health

insurance; and

(D) the amount, term, and a brief description of the coverage to

be provided;

(3) refer exclusively to insurance coverage;

(4) be separate from the instrument or agreement for the loan or

sale or other credit statement of account, unless the information

required by this section is prominently set forth in that

instrument, agreement, or statement; and

(5) provide that on acceptance by the insurer, the insurance

becomes effective as provided by Section 1153.157.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.160. TERMINATION OF CREDIT INSURANCE. (a) The term

of credit life insurance or credit accident and health insurance

must end not later than the 15th day after the scheduled maturity

date of the debt unless the coverage after that date is without

additional cost to the debtor.

(b) If the debt is discharged by renewing or refinancing the

debt before the scheduled maturity date, the insurance in force

must terminate before new insurance may be issued in connection

with the renewed or refinanced debt.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.161. INSURANCE MAY BE PROVIDED BY DEBTOR. If credit

life insurance or credit accident and health insurance is

required as additional security for a debt, the debtor, on

request to the creditor, may provide the required amount of

insurance through:

(1) an existing insurance policy owned or controlled by the

debtor; or

(2) an insurance policy obtained from an insurer authorized to

engage in the business of insurance in this state.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER E. CHARGES, REFUNDS, ADJUSTMENTS, AND CLAIMS

Sec. 1153.201. MAXIMUM AMOUNT OF INSURANCE CHARGE TO DEBTOR. A

creditor may not charge a debtor for credit life or credit

accident and health insurance issued to the debtor an amount that

exceeds the amount of the premium that the insurer charges the

creditor for that insurance, as computed at the time the charge

to the debtor is determined.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.202. REFUND OF INSURANCE CHARGE ON TERMINATION OF DEBT

OR INSURANCE; FILING OF FORMULA. (a) Each individual policy or

group policy and group certificate must include a written notice

stating that:

(1) if the underlying debt or the insurance terminates before

the originally scheduled termination date of the insurance,

including the termination of a debt by renewing or refinancing

the debt, the debtor shall be entitled to a refund of unearned

premium; and

(2) in the event that the underlying debt or the insurance

terminates before the originally scheduled termination date of

the insurance, including the termination of a debt by renewing or

refinancing the debt, the person who is the holder of the

underlying debt instrument on the date the debt terminates shall,

no later than 60 days after the termination of the insurance,

provide notice to the insurer of the termination of the debt,

that includes the name and address of the insured and the payoff

date of the underlying debt.

(a-1) The refund of any amount of unearned premium paid by or

charged to the debtor for insurance shall be paid or credited

promptly to the person entitled to the refund no later than 30

days after receipt of the notice required to be sent to the

insurer under Subsection (a)(2).

(a-2) In any claim or action asserted by an insured against an

insurer for failure to refund any unearned premium in accordance

with this section, the insurer shall be entitled to indemnity

from a holder who failed to provide the notice required under

Subsection (a)(2).

(b) A refund is not required if the amount of the refund is less

than $3.

(c) The formula to be used in computing the refund of the amount

paid by or charged to the debtor for insurance if the underlying

debt or the insurance terminates before the scheduled maturity

date of the debt must be filed with and approved by the

commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

502, Sec. 1, eff. September 1, 2007.

Sec. 1153.203. CERTAIN REFUNDS OR ADJUSTMENTS REQUIRED. (a) If

the beginning of the term of insurance is delayed under Section

1153.157(c), the charge to the debtor for insurance shall be

adjusted or the appropriate amount shall be refunded to the

debtor.

(b) If insurance is substituted under Section 1153.158(c) and

the amount of premium for the substituted insurance is less than

the amount specified in the application or notice of proposed

insurance, the appropriate amount shall be refunded to the

debtor.

(c) If a creditor requires a debtor to make any payment for

credit life insurance or credit accident and health insurance and

an individual policy or group certificate of insurance is not

issued, the creditor shall:

(1) immediately give written notice to the debtor; and

(2) promptly make an appropriate credit to the debtor's account.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.204. CLAIM UNDER POLICY. (a) A claim for recovery

under a policy to which this chapter applies shall be reported

promptly to the insurer or the insurer's designated claim

representative.

(b) An insurer shall maintain adequate claim files.

(c) A claim shall be settled as soon as possible and in

accordance with the insurance contract.

(d) A claim shall be paid by a draft drawn on the insurer or by

check of the insurer to the order of the claimant to whom payment

of the claim is due under the policy or on direction of the

claimant to the person specified.

(e) A plan or arrangement may not be used to authorize an

individual, firm, or corporation, other than the insurer or the

insurer's designated claim representative, to settle or adjust a

claim. The creditor may not be designated as claim representative

for the insurer in settling or adjusting a claim. Notwithstanding

this subsection, a group policyholder, under an arrangement with

the group insurer, may draw drafts or checks in payment of claims

due to the group policyholder subject to audit and review by the

insurer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER O. ENFORCEMENT OF CHAPTER; PENALTY

Sec. 1153.701. COMPLIANCE ORDER. (a) If, after written notice

to an insurer or other person who holds a license or other

authorization issued by the commissioner and a hearing, the

commissioner determines that a violation of this chapter or a

rule adopted under this chapter has occurred, the commissioner

shall issue the details of that determination and an order for

compliance by a specified date.

(b) An order issued under this section is binding on the insurer

or other person to whom it is issued on the date specified in the

order unless:

(1) the order is withdrawn by the commissioner before that date;

or

(2) the order is appealed under Subchapter D, Chapter 36.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.702. PENALTY. (a) An individual, firm, or

corporation who violates a final order issued under this chapter

is liable to the state in a civil action for a penalty of not

more than:

(1) $250; or

(2) $1,000, if the court finds the violation to be wilful.

(b) The penalty provided by this section is in addition to any

other penalty provided by law.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.703. REVOCATION OR SUSPENSION OF AUTHORITY ON

VIOLATION OF ORDER. After notice and a hearing, the commissioner

may revoke or suspend the license or certificate of authority of

an individual, firm, or corporation that violates an order issued

under this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

State Codes and Statutes

Statutes > Texas > Insurance-code > Title-7-life-insurance-and-annuities > Chapter-1153-credit-life-insurance-and-credit-accident-and-health-insurance

INSURANCE CODE

TITLE 7. LIFE INSURANCE AND ANNUITIES

SUBTITLE C. SPECIALIZED COVERAGES

CHAPTER 1153. CREDIT LIFE INSURANCE AND CREDIT ACCIDENT AND

HEALTH INSURANCE

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 1153.001. SHORT TITLE. This chapter may be cited as the

Act for the Regulation of Credit Life Insurance and Credit

Accident and Health Insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.002. PURPOSE; LEGISLATIVE INTENT; CONSTRUCTION. (a)

The purpose of this chapter is to promote the public welfare by

regulating credit life insurance and credit accident and health

insurance.

(b) This chapter is not intended to prohibit or discourage

reasonable competition.

(c) This chapter shall be liberally construed.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.003. DEFINITIONS. In this chapter:

(1) "Credit accident and health insurance" means insurance to

provide indemnity for payments that become due on a specific

credit transaction of a debtor when the debtor is disabled, as

defined in the insurance policy.

(2) "Credit life insurance" means insurance on the life of a

debtor in connection with a specific credit transaction.

(3) "Credit transaction" includes the lending of money.

(4) "Creditor" means:

(A) a person who lends money or who sells or leases goods,

services, property, rights, or privileges, for which the payment

is arranged through a credit transaction;

(B) a successor to the right, title, or interest of a person

described by Paragraph (A); or

(C) a person who is in any way associated with a person

described by Paragraph (A) or (B), including a director, officer,

employee, affiliate, associate, or subsidiary of the person

described by Paragraph (A) or (B).

(5) "Debtor" means a person who borrows money or who purchases

or leases goods, services, property, rights, or privileges, the

payment for which is arranged through a credit transaction.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.004. APPLICABILITY OF CHAPTER. (a) This chapter

applies to life insurance and accident and health insurance that

is sold in connection with a credit transaction that is charged

to or paid for by, in whole or part, the debtor, except insurance

that is issued or sold:

(1) in connection with a credit transaction of more than 10

years' duration;

(2) in connection with a credit transaction that is:

(A) secured by a first mortgage or deed of trust; and

(B) made to:

(i) finance the purchase of commercial real property or the

construction of or improvement to a building, other than a

single-family dwelling, on the real property if the purchase,

construction, or improvement is secured by a lien on the real

property; or

(ii) refinance a credit transaction made for a purpose described

by Subparagraph (i); or

(3) as an isolated transaction on the part of the insurer that

is not related to an agreement or a plan for insuring debtors of

the creditor.

(b) This chapter applies to insurance described by Subsection

(a) regardless of the nature, kind, or plan of the credit

insurance coverage or premium payment system and regardless of

whether the credit insurance is charged to or paid for by the

debtor directly or indirectly.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.005. RULES. After notice and a hearing, the

commissioner may adopt rules to implement this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.006. FILING FEE. (a) The department shall set and

collect a fee for a form or schedule filed under this chapter in

an amount not to exceed $200.

(b) Fees collected under this section shall be deposited in the

Texas Department of Insurance operating account.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.007. GAIN OR ADVANTAGE FROM INSURANCE NOT PROHIBITED

CHARGE. (a) The premium or cost of credit life insurance or

credit accident and health insurance authorized under this

chapter is not considered to be interest, a charge,

consideration, or an amount in excess of permitted charges in

connection with the underlying credit transaction.

(b) Any benefit, return, or other gain or advantage to the

creditor arising out of the sale or provision of the insurance

under this chapter is not a violation of any law of this state.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER B. FORMS

Sec. 1153.051. FILING OF FORM. (a) An insurer shall file with

the commissioner the form of each policy, certificate of

insurance, notice of proposed insurance, application for

insurance, endorsement, and rider to which this chapter applies

that is delivered or issued for delivery in this state.

(b) If a group policy of credit life insurance or credit

accident and health insurance is delivered in another state, the

insurer is required to file only the group certificate and notice

of proposed insurance delivered or issued for delivery in this

state, as specified in Section 1153.052.

(c) The commissioner shall approve a certificate filed under

Subsection (b) if it conforms with the requirements provided by

Section 1153.052 and if the schedule of premium rates applicable

to the insurance evidenced by that certificate or notice does not

exceed the presumptive premium rate established by the

commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.052. REQUIREMENTS RELATING TO INSURANCE POLICY OR

CERTIFICATE. (a) A policy or certificate of credit life

insurance or credit accident and health insurance must:

(1) specify:

(A) the name and home office address of the insurer;

(B) the name of each debtor;

(C) in the case of a certificate under a group policy, the

identity, by name or otherwise, of each insured;

(D) the full amount of premium or the total identifiable

insurance charge, if any, to the debtor, separately for credit

life insurance and credit accident and health insurance; and

(E) each exception or limitation to or restriction on the

coverage;

(2) describe the coverage, including the amount and term of the

coverage; and

(3) state that the benefits are to be paid to the creditor to

reduce or extinguish the unpaid amount of the debt and that any

amount of benefits that exceeds the unpaid debt is to be paid to

a beneficiary, other than the creditor, named by the debtor or to

the debtor's estate.

(b) The requirements of this section are in addition to the

other requirements of law.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.053. DISAPPROVAL OF FORM. (a) Not later than the

60th day after the date an insurer files a form under Section

1153.051, the commissioner shall disapprove the form if:

(1) the benefits provided are not reasonable in relation to the

premium charge; or

(2) the form contains a provision that:

(A) is unjust, unfair, inequitable, misleading, or deceptive;

(B) encourages misrepresentation of the coverage; or

(C) is contrary to this code or a rule adopted under this code.

(b) The commissioner shall specify in the notice of disapproval

of a form the reason for the disapproval and state that, if the

insurer delivers to the commissioner a written request for a

hearing on the disapproval of the form, the hearing will be

granted not later than the 20th day after the date of the

request.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.054. WITHDRAWAL OF APPROVAL OF FORM. The commissioner

may hold a hearing on the withdrawal of the approval of a form

not earlier than the 21st day after the date written notice of

the hearing is given to the insurer who submitted the form. The

notice of the hearing must state the reason for the proposed

withdrawal of approval. At any time after the hearing, the

commissioner may withdraw approval of the form for any ground

provided by Section 1153.053(a).

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.055. PROHIBITIONS RELATING TO ISSUANCE OR USE OF FORM.

(a) A policy, certificate of insurance, notice of proposed

insurance, application for insurance, endorsement, or rider to

which this chapter applies may not be issued or used before the

61st day after the date the form is filed with the commissioner

under Section 1153.051, unless the commissioner gives prior

written approval of the issuance or use of the form.

(b) An insurer who is notified by the commissioner that a form

is disapproved may not issue or use that form.

(c) After the effective date of the withdrawal of the approval

of a form under Section 1153.054, the insurer may not issue or

use that form.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER C. RATES

Sec. 1153.101. FILING OF SCHEDULE OF RATES. An insurer shall

file with the commissioner each schedule of premium rates

relating to a document required to be filed under Section

1153.051.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.102. REVISION OF SCHEDULE OF RATES. (a) An insurer

may revise its schedules of premium rates for various classes of

business.

(b) The insurer shall file the revised schedules and classes of

business with the commissioner.

(c) An insurer may not issue a credit life insurance policy or

credit accident and health insurance policy for which the premium

rate exceeds the rate determined by using the appropriate

schedule for that class of business that the insurer has on file

with the commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.103. PRESUMPTIVE PREMIUM RATE. (a) After notice and

a hearing, the commissioner by rule may adopt a presumptive

premium rate for various classes of business and terms of

coverage. An insurer that does not file a different rate under

Section 1153.105 or 1153.106 shall file the presumptive rate

adopted by the commissioner.

(b) Except as provided by this chapter, any hearing conducted or

order adopting a presumptive rate under this subchapter shall be

held in accordance with the rulemaking provisions of Chapter

2001, Government Code.

(c) In the commissioner's order adopting a presumptive rate, the

commissioner shall set forth findings and conclusions on all

material issues presented at the hearing.

(d) In determining the presumptive premium rate, the

commissioner shall consider any relevant data, including

reasonable acquisition costs, loss ratios, administrative

expenses, reserves, loss settlement expenses, the type or class

of business, the duration of various credit transactions, and

reasonable and adequate profits to the insurers.

(e) In determining the presumptive premium rate, the

commissioner may not set or limit the amount of compensation

actually paid by a company to an agent but may request from an

insurer or agent any relevant data relating to the presumptive

premium rate, including information relating to compensation paid

for the sale of credit insurance, expenses, losses, and profits.

An insurer or agent shall provide the requested information to

the commissioner in a timely manner.

(f) The commissioner may not adopt a presumptive premium rate

that is unjust, unreasonable, inadequate, confiscatory, or

excessive to the insureds, the insurers, or the agents.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(a),

eff. Sept. 1, 2003.

Sec. 1153.104. APPEAL OF PRESUMPTIVE RATE. Any person who is

aggrieved by any action of the commissioner taken in the setting

of a presumptive rate may, not later than the 30th day after the

date the commissioner adopts a presumptive rate order, file a

petition for judicial review in a district court in Travis

County. Judicial review under this section is governed by

Subchapter B, Chapter 2001, Government Code.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(a),

eff. Sept. 1, 2003.

Sec. 1153.105. RATE WITHIN CERTAIN PERCENTAGES OF PRESUMPTIVE

RATE. (a) An insurer electing to deviate from the presumptive

rate shall file with the commissioner the insurer's proposed rate

for credit life and credit accident and health insurance.

(b) On filing the rate with the commissioner, the insurer may

use the filed rate until the insurer elects to file a different

rate.

(c) Except as provided by Section 1153.106, an insurer may not

use a rate that is more than 30 percent higher or more than 30

percent lower than the presumptive rate.

(d) Except as provided by this subchapter, a rate that complies

with this section is valid and in compliance with the

requirements of this subchapter and other applicable law.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

Sec. 1153.106. RATE OUTSIDE CERTAIN PERCENTAGES OF PRESUMPTIVE

RATE. (a) An insurer may file with the commissioner a proposed

rate for credit life and credit accident and health insurance

that is more than 30 percent higher or more than 30 percent lower

than the presumptive rate adopted by the commissioner under this

subchapter.

(b) The commissioner may disapprove a rate filed under this

section on the ground that the rate is not actuarially justified.

(c) A rate filed under this section is considered approved and

the insurer may use the rate if the rate is not disapproved by

the commissioner before the 60th day after the date the insurer

filed the rate.

(d) A hearing under this section is a contested case hearing

conducted under Chapter 2001, Government Code. Judicial review of

any action of the commissioner under this section is governed by

Subchapter D, Chapter 36.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

Sec. 1153.107. RATE STANDARD. (a) A rate filed under this

subchapter is not excessive unless the rate 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 is applicable.

(b) A rate filed under this subchapter is not inadequate unless

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.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

SUBCHAPTER D. CREDIT INSURANCE REQUIREMENTS

Sec. 1153.151. FORMS OF CREDIT LIFE INSURANCE. Credit life

insurance may be issued only as:

(1) an individual policy of life insurance issued to a debtor on

a term plan; or

(2) a group policy of life insurance issued to a creditor on a

term plan providing insurance on the lives of debtors.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.152. FORMS OF CREDIT ACCIDENT AND HEALTH INSURANCE.

Credit accident and health insurance may be issued only as:

(1) an individual policy of accident and health insurance issued

to a debtor on a term plan;

(2) a disability benefit provision in an individual policy of

credit life insurance;

(3) a group policy of accident and health insurance issued to a

creditor on a term plan insuring debtors; or

(4) a disability benefit provision in a group policy of credit

life insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.153. EVIDENCE OF INSURANCE. Credit life insurance or

credit accident and health insurance shall be evidenced by an

individual policy or group certificate of insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.154. REQUIREMENTS FOR DELIVERY OR ISSUANCE OF CREDIT

INSURANCE POLICY. A policy of credit life insurance or credit

accident and health insurance that is delivered or issued for

delivery in this state may be delivered or issued for delivery

only by an insurer authorized to engage in the business of

insurance in this state and may be issued only through a holder

of a license issued by the commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.155. LIMITS ON AMOUNT OF CREDIT LIFE INSURANCE. (a)

The initial amount of credit life insurance on a debtor may not

exceed the total amount of debt repayable under the contract that

evidences the credit transaction.

(b) If the debt is repayable in substantially equal

installments, the amount of insurance may not at any time exceed

the greater of the scheduled or actual unpaid amount of the debt

under the contract.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.156. LIMITS ON AMOUNT OF CREDIT ACCIDENT AND HEALTH

INSURANCE. (a) The total amount of indemnity payable by credit

accident and health insurance may not exceed the total amount of

debt repayable under the contract that evidences the credit

transaction.

(b) The amount of a periodic indemnity payment may not exceed

the scheduled periodic installment payment on the debt.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.157. BEGINNING OF TERM OF CREDIT INSURANCE COVERAGE.

(a) Except as otherwise provided by this section, the term of

credit life insurance or credit accident and health insurance

begins, subject to acceptance by the insurer, on the date that

the debtor becomes obligated to the creditor.

(b) With respect to an obligation that exists when a group

policy takes effect, coverage begins on the later of the

effective date of the policy or the date of enrollment for

coverage under the policy.

(c) If evidence of insurability is required and is provided

after the 30th day after the date the debtor becomes obligated to

the creditor, the term of the insurance may begin on the date the

insurance company determines that the evidence is satisfactory.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.158. DELIVERY OF EVIDENCE OF INSURANCE TO DEBTOR. (a)

At the time a debt for which credit insurance is sold is

incurred:

(1) the individual policy or group certificate of insurance, as

appropriate, shall be delivered to the debtor; or

(2) a copy of the application for the policy or certificate of

insurance or a notice of proposed insurance that satisfies

Section 1153.159 shall be delivered to the debtor.

(b) If delivery to the debtor is made under Subsection (a)(2),

the insurer shall deliver the individual policy or group

certificate of insurance to the debtor on acceptance of the

insurance by the insurer and not later than the 45th day after

the date the debt is incurred.

(c) If the insurer named in the application or notice under

Subsection (a)(2) does not accept the risk, the debtor shall

receive a policy or certificate of insurance that specifies the

name and home office address of the substituted insurer and the

amount of the premium to be charged for the insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.159. REQUIREMENTS RELATING TO APPLICATION FOR

INSURANCE OR NOTICE OF PROPOSED INSURANCE. A copy of an

application for insurance or a notice of proposed insurance

delivered under Section 1153.158 must:

(1) be signed by the debtor;

(2) specify:

(A) the name and home office address of the insurer;

(B) the name of each debtor;

(C) the full amount of the premium or the total identifiable

insurance charge, if any, to be paid by the debtor, separately

for credit life insurance and credit accident and health

insurance; and

(D) the amount, term, and a brief description of the coverage to

be provided;

(3) refer exclusively to insurance coverage;

(4) be separate from the instrument or agreement for the loan or

sale or other credit statement of account, unless the information

required by this section is prominently set forth in that

instrument, agreement, or statement; and

(5) provide that on acceptance by the insurer, the insurance

becomes effective as provided by Section 1153.157.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.160. TERMINATION OF CREDIT INSURANCE. (a) The term

of credit life insurance or credit accident and health insurance

must end not later than the 15th day after the scheduled maturity

date of the debt unless the coverage after that date is without

additional cost to the debtor.

(b) If the debt is discharged by renewing or refinancing the

debt before the scheduled maturity date, the insurance in force

must terminate before new insurance may be issued in connection

with the renewed or refinanced debt.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.161. INSURANCE MAY BE PROVIDED BY DEBTOR. If credit

life insurance or credit accident and health insurance is

required as additional security for a debt, the debtor, on

request to the creditor, may provide the required amount of

insurance through:

(1) an existing insurance policy owned or controlled by the

debtor; or

(2) an insurance policy obtained from an insurer authorized to

engage in the business of insurance in this state.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER E. CHARGES, REFUNDS, ADJUSTMENTS, AND CLAIMS

Sec. 1153.201. MAXIMUM AMOUNT OF INSURANCE CHARGE TO DEBTOR. A

creditor may not charge a debtor for credit life or credit

accident and health insurance issued to the debtor an amount that

exceeds the amount of the premium that the insurer charges the

creditor for that insurance, as computed at the time the charge

to the debtor is determined.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.202. REFUND OF INSURANCE CHARGE ON TERMINATION OF DEBT

OR INSURANCE; FILING OF FORMULA. (a) Each individual policy or

group policy and group certificate must include a written notice

stating that:

(1) if the underlying debt or the insurance terminates before

the originally scheduled termination date of the insurance,

including the termination of a debt by renewing or refinancing

the debt, the debtor shall be entitled to a refund of unearned

premium; and

(2) in the event that the underlying debt or the insurance

terminates before the originally scheduled termination date of

the insurance, including the termination of a debt by renewing or

refinancing the debt, the person who is the holder of the

underlying debt instrument on the date the debt terminates shall,

no later than 60 days after the termination of the insurance,

provide notice to the insurer of the termination of the debt,

that includes the name and address of the insured and the payoff

date of the underlying debt.

(a-1) The refund of any amount of unearned premium paid by or

charged to the debtor for insurance shall be paid or credited

promptly to the person entitled to the refund no later than 30

days after receipt of the notice required to be sent to the

insurer under Subsection (a)(2).

(a-2) In any claim or action asserted by an insured against an

insurer for failure to refund any unearned premium in accordance

with this section, the insurer shall be entitled to indemnity

from a holder who failed to provide the notice required under

Subsection (a)(2).

(b) A refund is not required if the amount of the refund is less

than $3.

(c) The formula to be used in computing the refund of the amount

paid by or charged to the debtor for insurance if the underlying

debt or the insurance terminates before the scheduled maturity

date of the debt must be filed with and approved by the

commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

502, Sec. 1, eff. September 1, 2007.

Sec. 1153.203. CERTAIN REFUNDS OR ADJUSTMENTS REQUIRED. (a) If

the beginning of the term of insurance is delayed under Section

1153.157(c), the charge to the debtor for insurance shall be

adjusted or the appropriate amount shall be refunded to the

debtor.

(b) If insurance is substituted under Section 1153.158(c) and

the amount of premium for the substituted insurance is less than

the amount specified in the application or notice of proposed

insurance, the appropriate amount shall be refunded to the

debtor.

(c) If a creditor requires a debtor to make any payment for

credit life insurance or credit accident and health insurance and

an individual policy or group certificate of insurance is not

issued, the creditor shall:

(1) immediately give written notice to the debtor; and

(2) promptly make an appropriate credit to the debtor's account.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.204. CLAIM UNDER POLICY. (a) A claim for recovery

under a policy to which this chapter applies shall be reported

promptly to the insurer or the insurer's designated claim

representative.

(b) An insurer shall maintain adequate claim files.

(c) A claim shall be settled as soon as possible and in

accordance with the insurance contract.

(d) A claim shall be paid by a draft drawn on the insurer or by

check of the insurer to the order of the claimant to whom payment

of the claim is due under the policy or on direction of the

claimant to the person specified.

(e) A plan or arrangement may not be used to authorize an

individual, firm, or corporation, other than the insurer or the

insurer's designated claim representative, to settle or adjust a

claim. The creditor may not be designated as claim representative

for the insurer in settling or adjusting a claim. Notwithstanding

this subsection, a group policyholder, under an arrangement with

the group insurer, may draw drafts or checks in payment of claims

due to the group policyholder subject to audit and review by the

insurer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER O. ENFORCEMENT OF CHAPTER; PENALTY

Sec. 1153.701. COMPLIANCE ORDER. (a) If, after written notice

to an insurer or other person who holds a license or other

authorization issued by the commissioner and a hearing, the

commissioner determines that a violation of this chapter or a

rule adopted under this chapter has occurred, the commissioner

shall issue the details of that determination and an order for

compliance by a specified date.

(b) An order issued under this section is binding on the insurer

or other person to whom it is issued on the date specified in the

order unless:

(1) the order is withdrawn by the commissioner before that date;

or

(2) the order is appealed under Subchapter D, Chapter 36.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.702. PENALTY. (a) An individual, firm, or

corporation who violates a final order issued under this chapter

is liable to the state in a civil action for a penalty of not

more than:

(1) $250; or

(2) $1,000, if the court finds the violation to be wilful.

(b) The penalty provided by this section is in addition to any

other penalty provided by law.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.703. REVOCATION OR SUSPENSION OF AUTHORITY ON

VIOLATION OF ORDER. After notice and a hearing, the commissioner

may revoke or suspend the license or certificate of authority of

an individual, firm, or corporation that violates an order issued

under this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.


State Codes and Statutes

State Codes and Statutes

Statutes > Texas > Insurance-code > Title-7-life-insurance-and-annuities > Chapter-1153-credit-life-insurance-and-credit-accident-and-health-insurance

INSURANCE CODE

TITLE 7. LIFE INSURANCE AND ANNUITIES

SUBTITLE C. SPECIALIZED COVERAGES

CHAPTER 1153. CREDIT LIFE INSURANCE AND CREDIT ACCIDENT AND

HEALTH INSURANCE

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 1153.001. SHORT TITLE. This chapter may be cited as the

Act for the Regulation of Credit Life Insurance and Credit

Accident and Health Insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.002. PURPOSE; LEGISLATIVE INTENT; CONSTRUCTION. (a)

The purpose of this chapter is to promote the public welfare by

regulating credit life insurance and credit accident and health

insurance.

(b) This chapter is not intended to prohibit or discourage

reasonable competition.

(c) This chapter shall be liberally construed.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.003. DEFINITIONS. In this chapter:

(1) "Credit accident and health insurance" means insurance to

provide indemnity for payments that become due on a specific

credit transaction of a debtor when the debtor is disabled, as

defined in the insurance policy.

(2) "Credit life insurance" means insurance on the life of a

debtor in connection with a specific credit transaction.

(3) "Credit transaction" includes the lending of money.

(4) "Creditor" means:

(A) a person who lends money or who sells or leases goods,

services, property, rights, or privileges, for which the payment

is arranged through a credit transaction;

(B) a successor to the right, title, or interest of a person

described by Paragraph (A); or

(C) a person who is in any way associated with a person

described by Paragraph (A) or (B), including a director, officer,

employee, affiliate, associate, or subsidiary of the person

described by Paragraph (A) or (B).

(5) "Debtor" means a person who borrows money or who purchases

or leases goods, services, property, rights, or privileges, the

payment for which is arranged through a credit transaction.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.004. APPLICABILITY OF CHAPTER. (a) This chapter

applies to life insurance and accident and health insurance that

is sold in connection with a credit transaction that is charged

to or paid for by, in whole or part, the debtor, except insurance

that is issued or sold:

(1) in connection with a credit transaction of more than 10

years' duration;

(2) in connection with a credit transaction that is:

(A) secured by a first mortgage or deed of trust; and

(B) made to:

(i) finance the purchase of commercial real property or the

construction of or improvement to a building, other than a

single-family dwelling, on the real property if the purchase,

construction, or improvement is secured by a lien on the real

property; or

(ii) refinance a credit transaction made for a purpose described

by Subparagraph (i); or

(3) as an isolated transaction on the part of the insurer that

is not related to an agreement or a plan for insuring debtors of

the creditor.

(b) This chapter applies to insurance described by Subsection

(a) regardless of the nature, kind, or plan of the credit

insurance coverage or premium payment system and regardless of

whether the credit insurance is charged to or paid for by the

debtor directly or indirectly.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.005. RULES. After notice and a hearing, the

commissioner may adopt rules to implement this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.006. FILING FEE. (a) The department shall set and

collect a fee for a form or schedule filed under this chapter in

an amount not to exceed $200.

(b) Fees collected under this section shall be deposited in the

Texas Department of Insurance operating account.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.007. GAIN OR ADVANTAGE FROM INSURANCE NOT PROHIBITED

CHARGE. (a) The premium or cost of credit life insurance or

credit accident and health insurance authorized under this

chapter is not considered to be interest, a charge,

consideration, or an amount in excess of permitted charges in

connection with the underlying credit transaction.

(b) Any benefit, return, or other gain or advantage to the

creditor arising out of the sale or provision of the insurance

under this chapter is not a violation of any law of this state.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER B. FORMS

Sec. 1153.051. FILING OF FORM. (a) An insurer shall file with

the commissioner the form of each policy, certificate of

insurance, notice of proposed insurance, application for

insurance, endorsement, and rider to which this chapter applies

that is delivered or issued for delivery in this state.

(b) If a group policy of credit life insurance or credit

accident and health insurance is delivered in another state, the

insurer is required to file only the group certificate and notice

of proposed insurance delivered or issued for delivery in this

state, as specified in Section 1153.052.

(c) The commissioner shall approve a certificate filed under

Subsection (b) if it conforms with the requirements provided by

Section 1153.052 and if the schedule of premium rates applicable

to the insurance evidenced by that certificate or notice does not

exceed the presumptive premium rate established by the

commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.052. REQUIREMENTS RELATING TO INSURANCE POLICY OR

CERTIFICATE. (a) A policy or certificate of credit life

insurance or credit accident and health insurance must:

(1) specify:

(A) the name and home office address of the insurer;

(B) the name of each debtor;

(C) in the case of a certificate under a group policy, the

identity, by name or otherwise, of each insured;

(D) the full amount of premium or the total identifiable

insurance charge, if any, to the debtor, separately for credit

life insurance and credit accident and health insurance; and

(E) each exception or limitation to or restriction on the

coverage;

(2) describe the coverage, including the amount and term of the

coverage; and

(3) state that the benefits are to be paid to the creditor to

reduce or extinguish the unpaid amount of the debt and that any

amount of benefits that exceeds the unpaid debt is to be paid to

a beneficiary, other than the creditor, named by the debtor or to

the debtor's estate.

(b) The requirements of this section are in addition to the

other requirements of law.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.053. DISAPPROVAL OF FORM. (a) Not later than the

60th day after the date an insurer files a form under Section

1153.051, the commissioner shall disapprove the form if:

(1) the benefits provided are not reasonable in relation to the

premium charge; or

(2) the form contains a provision that:

(A) is unjust, unfair, inequitable, misleading, or deceptive;

(B) encourages misrepresentation of the coverage; or

(C) is contrary to this code or a rule adopted under this code.

(b) The commissioner shall specify in the notice of disapproval

of a form the reason for the disapproval and state that, if the

insurer delivers to the commissioner a written request for a

hearing on the disapproval of the form, the hearing will be

granted not later than the 20th day after the date of the

request.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.054. WITHDRAWAL OF APPROVAL OF FORM. The commissioner

may hold a hearing on the withdrawal of the approval of a form

not earlier than the 21st day after the date written notice of

the hearing is given to the insurer who submitted the form. The

notice of the hearing must state the reason for the proposed

withdrawal of approval. At any time after the hearing, the

commissioner may withdraw approval of the form for any ground

provided by Section 1153.053(a).

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.055. PROHIBITIONS RELATING TO ISSUANCE OR USE OF FORM.

(a) A policy, certificate of insurance, notice of proposed

insurance, application for insurance, endorsement, or rider to

which this chapter applies may not be issued or used before the

61st day after the date the form is filed with the commissioner

under Section 1153.051, unless the commissioner gives prior

written approval of the issuance or use of the form.

(b) An insurer who is notified by the commissioner that a form

is disapproved may not issue or use that form.

(c) After the effective date of the withdrawal of the approval

of a form under Section 1153.054, the insurer may not issue or

use that form.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER C. RATES

Sec. 1153.101. FILING OF SCHEDULE OF RATES. An insurer shall

file with the commissioner each schedule of premium rates

relating to a document required to be filed under Section

1153.051.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.102. REVISION OF SCHEDULE OF RATES. (a) An insurer

may revise its schedules of premium rates for various classes of

business.

(b) The insurer shall file the revised schedules and classes of

business with the commissioner.

(c) An insurer may not issue a credit life insurance policy or

credit accident and health insurance policy for which the premium

rate exceeds the rate determined by using the appropriate

schedule for that class of business that the insurer has on file

with the commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.103. PRESUMPTIVE PREMIUM RATE. (a) After notice and

a hearing, the commissioner by rule may adopt a presumptive

premium rate for various classes of business and terms of

coverage. An insurer that does not file a different rate under

Section 1153.105 or 1153.106 shall file the presumptive rate

adopted by the commissioner.

(b) Except as provided by this chapter, any hearing conducted or

order adopting a presumptive rate under this subchapter shall be

held in accordance with the rulemaking provisions of Chapter

2001, Government Code.

(c) In the commissioner's order adopting a presumptive rate, the

commissioner shall set forth findings and conclusions on all

material issues presented at the hearing.

(d) In determining the presumptive premium rate, the

commissioner shall consider any relevant data, including

reasonable acquisition costs, loss ratios, administrative

expenses, reserves, loss settlement expenses, the type or class

of business, the duration of various credit transactions, and

reasonable and adequate profits to the insurers.

(e) In determining the presumptive premium rate, the

commissioner may not set or limit the amount of compensation

actually paid by a company to an agent but may request from an

insurer or agent any relevant data relating to the presumptive

premium rate, including information relating to compensation paid

for the sale of credit insurance, expenses, losses, and profits.

An insurer or agent shall provide the requested information to

the commissioner in a timely manner.

(f) The commissioner may not adopt a presumptive premium rate

that is unjust, unreasonable, inadequate, confiscatory, or

excessive to the insureds, the insurers, or the agents.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(a),

eff. Sept. 1, 2003.

Sec. 1153.104. APPEAL OF PRESUMPTIVE RATE. Any person who is

aggrieved by any action of the commissioner taken in the setting

of a presumptive rate may, not later than the 30th day after the

date the commissioner adopts a presumptive rate order, file a

petition for judicial review in a district court in Travis

County. Judicial review under this section is governed by

Subchapter B, Chapter 2001, Government Code.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(a),

eff. Sept. 1, 2003.

Sec. 1153.105. RATE WITHIN CERTAIN PERCENTAGES OF PRESUMPTIVE

RATE. (a) An insurer electing to deviate from the presumptive

rate shall file with the commissioner the insurer's proposed rate

for credit life and credit accident and health insurance.

(b) On filing the rate with the commissioner, the insurer may

use the filed rate until the insurer elects to file a different

rate.

(c) Except as provided by Section 1153.106, an insurer may not

use a rate that is more than 30 percent higher or more than 30

percent lower than the presumptive rate.

(d) Except as provided by this subchapter, a rate that complies

with this section is valid and in compliance with the

requirements of this subchapter and other applicable law.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

Sec. 1153.106. RATE OUTSIDE CERTAIN PERCENTAGES OF PRESUMPTIVE

RATE. (a) An insurer may file with the commissioner a proposed

rate for credit life and credit accident and health insurance

that is more than 30 percent higher or more than 30 percent lower

than the presumptive rate adopted by the commissioner under this

subchapter.

(b) The commissioner may disapprove a rate filed under this

section on the ground that the rate is not actuarially justified.

(c) A rate filed under this section is considered approved and

the insurer may use the rate if the rate is not disapproved by

the commissioner before the 60th day after the date the insurer

filed the rate.

(d) A hearing under this section is a contested case hearing

conducted under Chapter 2001, Government Code. Judicial review of

any action of the commissioner under this section is governed by

Subchapter D, Chapter 36.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

Sec. 1153.107. RATE STANDARD. (a) A rate filed under this

subchapter is not excessive unless the rate 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 is applicable.

(b) A rate filed under this subchapter is not inadequate unless

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.

Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.304(b), eff.

Sept. 1, 2003.

SUBCHAPTER D. CREDIT INSURANCE REQUIREMENTS

Sec. 1153.151. FORMS OF CREDIT LIFE INSURANCE. Credit life

insurance may be issued only as:

(1) an individual policy of life insurance issued to a debtor on

a term plan; or

(2) a group policy of life insurance issued to a creditor on a

term plan providing insurance on the lives of debtors.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.152. FORMS OF CREDIT ACCIDENT AND HEALTH INSURANCE.

Credit accident and health insurance may be issued only as:

(1) an individual policy of accident and health insurance issued

to a debtor on a term plan;

(2) a disability benefit provision in an individual policy of

credit life insurance;

(3) a group policy of accident and health insurance issued to a

creditor on a term plan insuring debtors; or

(4) a disability benefit provision in a group policy of credit

life insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.153. EVIDENCE OF INSURANCE. Credit life insurance or

credit accident and health insurance shall be evidenced by an

individual policy or group certificate of insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.154. REQUIREMENTS FOR DELIVERY OR ISSUANCE OF CREDIT

INSURANCE POLICY. A policy of credit life insurance or credit

accident and health insurance that is delivered or issued for

delivery in this state may be delivered or issued for delivery

only by an insurer authorized to engage in the business of

insurance in this state and may be issued only through a holder

of a license issued by the commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.155. LIMITS ON AMOUNT OF CREDIT LIFE INSURANCE. (a)

The initial amount of credit life insurance on a debtor may not

exceed the total amount of debt repayable under the contract that

evidences the credit transaction.

(b) If the debt is repayable in substantially equal

installments, the amount of insurance may not at any time exceed

the greater of the scheduled or actual unpaid amount of the debt

under the contract.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.156. LIMITS ON AMOUNT OF CREDIT ACCIDENT AND HEALTH

INSURANCE. (a) The total amount of indemnity payable by credit

accident and health insurance may not exceed the total amount of

debt repayable under the contract that evidences the credit

transaction.

(b) The amount of a periodic indemnity payment may not exceed

the scheduled periodic installment payment on the debt.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.157. BEGINNING OF TERM OF CREDIT INSURANCE COVERAGE.

(a) Except as otherwise provided by this section, the term of

credit life insurance or credit accident and health insurance

begins, subject to acceptance by the insurer, on the date that

the debtor becomes obligated to the creditor.

(b) With respect to an obligation that exists when a group

policy takes effect, coverage begins on the later of the

effective date of the policy or the date of enrollment for

coverage under the policy.

(c) If evidence of insurability is required and is provided

after the 30th day after the date the debtor becomes obligated to

the creditor, the term of the insurance may begin on the date the

insurance company determines that the evidence is satisfactory.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.158. DELIVERY OF EVIDENCE OF INSURANCE TO DEBTOR. (a)

At the time a debt for which credit insurance is sold is

incurred:

(1) the individual policy or group certificate of insurance, as

appropriate, shall be delivered to the debtor; or

(2) a copy of the application for the policy or certificate of

insurance or a notice of proposed insurance that satisfies

Section 1153.159 shall be delivered to the debtor.

(b) If delivery to the debtor is made under Subsection (a)(2),

the insurer shall deliver the individual policy or group

certificate of insurance to the debtor on acceptance of the

insurance by the insurer and not later than the 45th day after

the date the debt is incurred.

(c) If the insurer named in the application or notice under

Subsection (a)(2) does not accept the risk, the debtor shall

receive a policy or certificate of insurance that specifies the

name and home office address of the substituted insurer and the

amount of the premium to be charged for the insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.159. REQUIREMENTS RELATING TO APPLICATION FOR

INSURANCE OR NOTICE OF PROPOSED INSURANCE. A copy of an

application for insurance or a notice of proposed insurance

delivered under Section 1153.158 must:

(1) be signed by the debtor;

(2) specify:

(A) the name and home office address of the insurer;

(B) the name of each debtor;

(C) the full amount of the premium or the total identifiable

insurance charge, if any, to be paid by the debtor, separately

for credit life insurance and credit accident and health

insurance; and

(D) the amount, term, and a brief description of the coverage to

be provided;

(3) refer exclusively to insurance coverage;

(4) be separate from the instrument or agreement for the loan or

sale or other credit statement of account, unless the information

required by this section is prominently set forth in that

instrument, agreement, or statement; and

(5) provide that on acceptance by the insurer, the insurance

becomes effective as provided by Section 1153.157.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.160. TERMINATION OF CREDIT INSURANCE. (a) The term

of credit life insurance or credit accident and health insurance

must end not later than the 15th day after the scheduled maturity

date of the debt unless the coverage after that date is without

additional cost to the debtor.

(b) If the debt is discharged by renewing or refinancing the

debt before the scheduled maturity date, the insurance in force

must terminate before new insurance may be issued in connection

with the renewed or refinanced debt.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.161. INSURANCE MAY BE PROVIDED BY DEBTOR. If credit

life insurance or credit accident and health insurance is

required as additional security for a debt, the debtor, on

request to the creditor, may provide the required amount of

insurance through:

(1) an existing insurance policy owned or controlled by the

debtor; or

(2) an insurance policy obtained from an insurer authorized to

engage in the business of insurance in this state.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER E. CHARGES, REFUNDS, ADJUSTMENTS, AND CLAIMS

Sec. 1153.201. MAXIMUM AMOUNT OF INSURANCE CHARGE TO DEBTOR. A

creditor may not charge a debtor for credit life or credit

accident and health insurance issued to the debtor an amount that

exceeds the amount of the premium that the insurer charges the

creditor for that insurance, as computed at the time the charge

to the debtor is determined.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.202. REFUND OF INSURANCE CHARGE ON TERMINATION OF DEBT

OR INSURANCE; FILING OF FORMULA. (a) Each individual policy or

group policy and group certificate must include a written notice

stating that:

(1) if the underlying debt or the insurance terminates before

the originally scheduled termination date of the insurance,

including the termination of a debt by renewing or refinancing

the debt, the debtor shall be entitled to a refund of unearned

premium; and

(2) in the event that the underlying debt or the insurance

terminates before the originally scheduled termination date of

the insurance, including the termination of a debt by renewing or

refinancing the debt, the person who is the holder of the

underlying debt instrument on the date the debt terminates shall,

no later than 60 days after the termination of the insurance,

provide notice to the insurer of the termination of the debt,

that includes the name and address of the insured and the payoff

date of the underlying debt.

(a-1) The refund of any amount of unearned premium paid by or

charged to the debtor for insurance shall be paid or credited

promptly to the person entitled to the refund no later than 30

days after receipt of the notice required to be sent to the

insurer under Subsection (a)(2).

(a-2) In any claim or action asserted by an insured against an

insurer for failure to refund any unearned premium in accordance

with this section, the insurer shall be entitled to indemnity

from a holder who failed to provide the notice required under

Subsection (a)(2).

(b) A refund is not required if the amount of the refund is less

than $3.

(c) The formula to be used in computing the refund of the amount

paid by or charged to the debtor for insurance if the underlying

debt or the insurance terminates before the scheduled maturity

date of the debt must be filed with and approved by the

commissioner.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

502, Sec. 1, eff. September 1, 2007.

Sec. 1153.203. CERTAIN REFUNDS OR ADJUSTMENTS REQUIRED. (a) If

the beginning of the term of insurance is delayed under Section

1153.157(c), the charge to the debtor for insurance shall be

adjusted or the appropriate amount shall be refunded to the

debtor.

(b) If insurance is substituted under Section 1153.158(c) and

the amount of premium for the substituted insurance is less than

the amount specified in the application or notice of proposed

insurance, the appropriate amount shall be refunded to the

debtor.

(c) If a creditor requires a debtor to make any payment for

credit life insurance or credit accident and health insurance and

an individual policy or group certificate of insurance is not

issued, the creditor shall:

(1) immediately give written notice to the debtor; and

(2) promptly make an appropriate credit to the debtor's account.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.204. CLAIM UNDER POLICY. (a) A claim for recovery

under a policy to which this chapter applies shall be reported

promptly to the insurer or the insurer's designated claim

representative.

(b) An insurer shall maintain adequate claim files.

(c) A claim shall be settled as soon as possible and in

accordance with the insurance contract.

(d) A claim shall be paid by a draft drawn on the insurer or by

check of the insurer to the order of the claimant to whom payment

of the claim is due under the policy or on direction of the

claimant to the person specified.

(e) A plan or arrangement may not be used to authorize an

individual, firm, or corporation, other than the insurer or the

insurer's designated claim representative, to settle or adjust a

claim. The creditor may not be designated as claim representative

for the insurer in settling or adjusting a claim. Notwithstanding

this subsection, a group policyholder, under an arrangement with

the group insurer, may draw drafts or checks in payment of claims

due to the group policyholder subject to audit and review by the

insurer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

SUBCHAPTER O. ENFORCEMENT OF CHAPTER; PENALTY

Sec. 1153.701. COMPLIANCE ORDER. (a) If, after written notice

to an insurer or other person who holds a license or other

authorization issued by the commissioner and a hearing, the

commissioner determines that a violation of this chapter or a

rule adopted under this chapter has occurred, the commissioner

shall issue the details of that determination and an order for

compliance by a specified date.

(b) An order issued under this section is binding on the insurer

or other person to whom it is issued on the date specified in the

order unless:

(1) the order is withdrawn by the commissioner before that date;

or

(2) the order is appealed under Subchapter D, Chapter 36.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.702. PENALTY. (a) An individual, firm, or

corporation who violates a final order issued under this chapter

is liable to the state in a civil action for a penalty of not

more than:

(1) $250; or

(2) $1,000, if the court finds the violation to be wilful.

(b) The penalty provided by this section is in addition to any

other penalty provided by law.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.

Sec. 1153.703. REVOCATION OR SUSPENSION OF AUTHORITY ON

VIOLATION OF ORDER. After notice and a hearing, the commissioner

may revoke or suspend the license or certificate of authority of

an individual, firm, or corporation that violates an order issued

under this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1,

2003.