Texas Administrative Code

If any provision of these sections or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the sections and the application of such provision to other persons or circumstances shall not be affected thereby. Notes 28 Tex. Adm…

For each plan of insurance with separate rates for smokers and nonsmokers, an insurer may: (1) use composite mortality tables to determine minimum reserve liabilities and minimum cash surrender values and amounts of paid-up nonforfeiture benefits or benefits under any extended te…

(a) For any policy of insurance delivered or issued for delivery in this state after the operative date of former Insurance Code Article 3.44a, §8 (recodified in Insurance Code Chapter 1105, Subchapter B, §§1105.051 - 1105.057), for that policy form and before January 1, 1989, at…

The following words and terms, when used in these sections, shall have the following meanings, unless the context clearly indicates otherwise. (1) 1958 CET Table--That mortality table developed by the Society of Actuaries Special Committee on New Mortality Tables, incorporated in…

The purpose of these sections is to permit the use of mortality tables that reflect differences in mortality between smokers and nonsmokers in determining minimum reserve liabilities and minimum cash surrender values and amounts of paid-up nonforfeiture benefits or benefits under…

Each filing must include an explanation of the purpose and use of the forms, rates, advertising, networks, or other information contained in the filing within the general information section of the filing that includes: (1) how the contents of the filing will be used (for example…

The 2001 CSO Mortality Table shall be used for purposes of this subchapter pursuant to the requirements of §§ 3.9101 - 3.9106 of this title (relating to 2001 CSO Mortality Table). Notes 28 Tex. Admin. Code § 3.1307 The provisions of this §3.1307 adopted to be effective April 14, …

If any provision of these sections or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the provisions of this subchapter and the application of such provisions to other persons or circumstances shall not be affected ther…

It is not a violation of Insurance Code § 541.057 for an insurer to issue the same kind of policy of life insurance on both a sex-distinct and sex-neutral basis, as permitted by this subchapter. Notes 28 Tex. Admin. Code § 3.1305 The provisions of this §3.1304 adopted to be effec…

(a) In determining minimum cash surrender value and amounts of paid-up nonforfeiture benefits for any policy of insurance on either a male or a female insured on a form of insurance with separate rates for smokers and nonsmokers delivered or issued for delivery in this state afte…

(a) For any policy of insurance on the life of either a male or female insured, delivered, or issued for delivery in this state after the operative date of former Insurance Code Article 3.44a, §8 (recodified in Insurance Code Chapter 1105, Subchapter B, §§1105.051 - 1105.057), an…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) 1980 CET Table--That mortality table consisting of separate rates of mortality for male and female lives, developed by the Society o…

The purpose of these sections is to permit individual life insurance policies to provide the same cash values and paid up nonforfeiture benefits to both men and women. (No change in minimum valuation standards is implied by these sections. For example, the reserve held for any po…

(a) For a form filing identified under §3.1(1) of this of this title (relating to Applicability and Scope), a fee of $100 is required, subject to the following exceptions: (1) a fee of $50 is required for an exempt form filing that is made under Insurance Code Chapter 1701, conce…

Renewable term policies may specify rates for renewal terms in dollars and cents, by reference to rates in use by the company on the original issue date or by reference to the rates in use by the company on the renewal date. If such rates are specified by reference to the rates i…

(a) Any policy which contains a title, heading, or other indication of its provisions which is misleading will be disapproved. For example, a title, heading, etc., will be misleading if it contradicts the provisions of the policy. A life insurance policy may not be described or r…

Sections 3.101 - 3.128 of this title (relating to Individual Life Insurance Policy Form Checklist and Affirmative Requirements) apply to the review of ordinary life insurance policies and are not applicable to annuity contracts. Any contract which provides death benefits in exces…

(a) The policy may contain provisions under which the company will accept advance payments of premiums; but in no event may the company undertake to accept deposits which would exceed the maximum amount required to pay all future premiums which will become due under the policy, i…

(a) Any provision by which the insurer undertakes to pay specific amounts will be treated as definite contract benefits and valued in accordance with Insurance Code § 841.253 . (b) Any policy which contains a provision promising to pay "dividends" from specified sources must clea…

There is no prohibition against a provision which permits the assignment of the policy benefits or proceeds. However, policies which make provision for dividends, coupon accumulations, or other guaranteed returns, and which also contain provision for the assignment of these funds…

Any life insurance policy which is a tontine policy or which contains a tontine provision will be disapproved. Provisions by which dividends during the participating period are not allocated or paid annually are prohibited as being within the tontine principle unless the policyho…

(a) If the policy provides that proceeds may be paid in installments, it must contain a representative table showing the amounts of such installments. (b) If the settlement options provision indicates that modes of payment other than monthly may be available, then the amount of s…

Inclusion of a discretionary clause in any form to which this subchapter applies is prohibited. Notes 28 Tex. Admin. Code § 3.1203 The provisions of this §3.1203 adopted to be effective December 23, 2010, 35 TexReg 11259

For the purpose of this subchapter, a discretionary clause is a provision that: (1) purports or acts to bind the claimant to, or grant deference in subsequent proceedings to, adverse claim decisions or policy interpretations by the insurer or health maintenance organization; (2) …

(a) This subchapter applies to any form filed under the Insurance Code Chapters 1701 or 1271, including forms filed by Lloyd's plans and fraternal benefit societies. (b) Except as specified in subsections (c) and (d) of this section, this subchapter applies to forms offered, issu…

(a) The policy must not contain a provision by which it is issued or takes effect more than six months before the original application for the insurance was made, if thereby the insured would rate at an age younger than his age at the date when the application was made, according…

An issuer submitting a filing to the department must: (1) designate one person as the contact person for that filing; (2) provide the contact person's name, address, direct telephone number, and email address; (3) provide, for any filing submitted by anyone other than the issuer,…

The policy must not contain a provision limiting the time within which any action at law or in equity may be commenced to less than two years after the cause of action shall accrue. Notes 28 Tex. Admin. Code § 3.119 The provisions of this §3.119 adopted to be effective January 1,…

A conversion provision in a policy must comply with the following: (1) the conversion provision shall state the plan and face amount of the new policy; (2) the text of the provision shall state what premium rates will apply to the new policy; (3) the text of the provision shall d…

The following requirements apply to a contract of life insurance containing a preliminary term insurance rider: (1) a grace period must be allowed for payment of the first premium due on the principal policy; (2) the date of commencement of the preliminary term insurance, which i…

(a) The rider shall contain a statement requiring submission of an application signed by both the owner and the substitute insured. (b) The rider may require evidence of insurability of the substitute insured. (c) The following shall be clearly specified: (1) policy date; (2) fac…

(a) The application must contain a statement which discloses the deferred nature of the insurance and which reflects the amount of insurance in force during the deferred period. It may not state only the ultimate amount. (b) The brief description on the face page and filing back,…

(a) The rider must specify the effect on the rider of the death of the insured(s) under the base policy prior to the expiry date(s) of the rider. The following are acceptable: (1) the rider may terminate, in which case no incontestability provision is required; (2) the rider may …

(a) A family group life insurance policy is considered to be any life insurance policy, other than a regular joint life insurance policy, that grants benefits upon the death of each of the insured members of the family. This does not include individual policies with payor death b…

The policy must provide that settlement will be made upon receipt of or not later than two months after due proof of death of the insured and the right of the claimant to the proceeds. Notes 28 Tex. Admin. Code § 3.112 The provisions of this §3.112 adopted to be effective January…

(a) All policies which have nonforfeiture benefits must provide that if, in the event of default in premium payments, the value of the policy shall be applied for the purchase of other insurance, and if such insurance shall be in force and the original policy shall not have been …

A life insurance company may increase the amount of its reserve liabilities by changing the basis of computation as provided in Insurance Code § 425.067 . The insurer may establish a higher reserving basis by reporting an increase in reserve in Exhibit 5A of its annual statement.…

The policy must stipulate that the company may defer payment of cash surrender values for not more than six months after the application therefor is made. The six-month period may commence with the date of receipt of the request by the company, if the policy so provides. Notes 28…

(a) All filings and supporting documentation within the scope of this subchapter must be submitted through SERFF. (b) If the electronic system designated by the department experiences a system-wide outage for any reason, any applicable deemer date or due date for a company respon…

(a) Automatic premium loans do not constitute a stipulated form of insurance, and the automatic premium loan provision must not be classified as a nonforfeiture value. Provisions for automatic premium loans must be revocable at the option of the owner of the policy. (b) If the au…

(a) Nonforfeiture values are governed by Insurance Code Chapter 1105. (b) Occasionally, the cash value (because of the inclusion of accumulated dividends, coupon benefits, or other guaranteed returns) is more than sufficient to purchase the maximum amount of extended term insuran…

(a) A policy loan provision is not required in term insurance policies, nor in pure endowments issued or granted as original policies or in exchange for lapsed or surrendered policies. (b) Loans must be made available at any time while the policy is in force after premiums for th…

(a) The policy must provide that if the age of the insured has been understated, the amount payable under the policy shall be such as the premium paid would have purchased at the correct age. The word "misstated" may be used instead of "understated." (b) If more than one life is …

(a) The policy must provide that all statements made by the insured will, in the absence of fraud, be deemed representations and not warranties. The policy may provide that statements made on behalf of the insured will also, in the absence of fraud, be deemed representations and …

(a) The policy must provide that it will be incontestable not later than two years from its date as provided in Insurance Code § 1101.006 . If a reinstatement is contested for misrepresentation, then no representation other than one causing the reinstatement may be used to contes…

(a) The policy must provide that the policy, or policy and application, shall constitute the entire contract between the parties. Regardless of any statement to the contrary, the policy will be deemed incomplete if it attempts to incorporate by reference the provisions of any ins…

(a) The policy must provide for a grace period of at least one month for the payment of every premium after the first, during which period the policy shall remain in full force and effect. If the grace period is expressed in days, at least 31 days of grace must be granted. (b) Th…