Texas Administrative Code

(a) Voluntary removal. A mediator may request removal from the roster at any time. The mediator must submit the request under § 5.4251 of this title (relating to Requests and Submissions to the Department). (b) Removal by department. The department may, in its sole discretion, re…

(a) Applicability. This section applies when the parties are unable to agree on a mediator and a party requests the department to select a mediator. (b) Notice. The department will notify at least five mediators of possible inclusion on a mediator selection panel. (c) Factors. Wh…

(a) Conflicts. A mediator must disclose to both parties any conflicts of interest. Conflicts of interest are listed in § 5.4232 of this title (relating to Mediation Process - Mediator Qualifications and Conflicts of Interest). The mediator must disclose the conflicts of interest …

(a) Applicability. The following mediator obligations apply when the department selects a mediator, under § 5.4235 of this title (relating to Mediation Process - Mediator Selection by Department). (b) Notices. No later than the seventh day after receiving notice of selection to m…

(a) Mediation explanation. At the same time the association requests mediation, the association must give the claimant a notice explaining the mediation process. (b) Representative. The association must send an authorized representative to participate in the mediation. The associ…

(a) Participation. The claimant must participate in the mediation. A claimant who participates in mediation must know the facts of the dispute and must be authorized to make an agreement to resolve the claim. The claimant must come prepared to present any relevant documents, such…

(a) One-half per party. Each party must pay one-half of all reasonable and necessary costs incurred or charged in connection with the mediation, including: (1) mediator's fee; (2) mediator's travel costs; (3) cost of renting space for the mediation; and (4) food or beverages prov…

(a) Deadline. Mediation must be completed by the 60th day after the association notifies the claimant that the association is requesting mediation, unless the deadline is extended. If the association does not ask the department to select a mediator before the 60-day deadline, or …

(a) Items submitted under this section must be submitted in writing to the chief clerk, Texas Department of Insurance. They may be: (1) hand delivered; (2) mailed; or (3) sent in a manner that is otherwise acceptable to the department. (b) The date of the item will be the date th…

(a) Objections. A party or appraiser may object to an umpire or a mediator as follows: (1) for good cause: (A) no later than the third day after the party or appraiser receives the selection panel, based on the information provided with the selection panel, or based on other info…

The department may contract with one or more entities to administer the umpire roster, the mediator roster, or any of the department's or the commissioner's functions in this division. Notes 28 Tex. Admin. Code § 5.4253 The provisions of this §5.4253 adopted to be effective Febru…

(a) The expert panel must have a minimum of three and a maximum of seven members. (b) The commissioner or the commissioner's designee must appoint one member as the presiding officer of the expert panel. (c) Panel members may be individuals, firms, institutions, or governmental b…

(a) A member of the expert panel must have expertise in one or more of the following areas: (1) geography of the Texas seacoast territory; (2) meteorology of the Texas seacoast territory; (3) the scientific basis for determining the extent to which property damage is caused by wi…

(a) Potential conflicts. An applicant or member of the expert panel may have a conflict of interest if the applicant or member of the expert panel: (1) is an employee or a contractor of the association; (2) has a relative within one of the degrees of relationship described by Gov…

(a) The commissioner or the commissioner's designee must, in his or her sole discretion, select the members of the expert panel. (b) When selecting a member of the expert panel, the commissioner or the commissioner's designee may consider: (1) the applicant's education, experienc…

(a) A member of the expert panel must serve for a term set by the contract described in § 5.4268 of this title (relating to Contracting, Compensation, and Expenses), except as provided in subsections (b) and (c) of this section. (b) At any time: (1) the commissioner or the commis…

The commissioner or the commissioner's designee may, in his or her sole discretion, remove an expert panel member for: (1) alleged dishonest, incompetent, fraudulent, or unethical behavior; (2) alleged failure to respond promptly and completely to requests from the department, wh…

(a) The expert panel must develop methods or models for determining the extent to which a loss to insurable property, as defined in Insurance Code § 2210.004 , may be or was incurred as a result of wind, waves, tidal surges, or rising waters not caused by waves or surges in the c…

(a) On request. The expert panel must meet at the request of the department or the presiding officer. (b) Public meetings. (1) Purpose. The purposes of an expert panel public meeting are: (A) to inform the public about the progress of the expert panel's work; (B) for the public t…

(a) Each panel member must enter into a contract with the association for services and payment. (b) To be effective, a panel member's contract with the association must be approved by the commissioner or the commissioner's designee. (c) A contract may not set a term that exceeds …

The following terms, when used in connection with this division and Insurance Code Chapter 2210, Subchapter O, mean the following: (1) Association--The Texas Windstorm Insurance Association. (2) Assumption reinsurance agreement--A written agreement between the association and an …

(a) Policy forms and endorsements offered by insurers for voluntary market and assumption reinsurance programs under § 5.4306 or § 5.4307 of this title must be approved by the department. This section does not apply to the remaining term of a novated policy. (b) Insurance Code Ch…

As used in Insurance Code Chapter 2210, Subchapter O, and this division, a policy provides generally comparable coverage if the policy provides the same basic coverage(s) as the assumed association policy, including the endorsements included in the assumed association policy. For…

(a) A limited service agreement is an agreement between an insurer or its managing general agent and the agent of record on an association policy being acquired or assumed by the insurer, and which provides that the agent continue to provide service to the policyholder as authori…

(a) The association must: (1) create an electronic information repository containing the information listed in § 5.4309 of this title; and (2) update the electronic information repository with current policy data through the prior month-end not later than the 15th day of the curr…

(a) Except as provided in § 5.4307 of this title, the association and an insurer must submit to the department for approval any depopulation program that encourages the transfer of association policies to insurers through the voluntary market. The submission must include all nece…

(a) An insurer and the association must submit to the department the written assumption reinsurance program, including the assumption reinsurance agreement and all necessary documents, including notices and policy forms evidencing generally comparable coverage and premiums, to al…

The association may not enter into a voluntary market depopulation program or assumption reinsurance agreement that would violate Insurance Code § 2210.616 . The association must demonstrate compliance with the section in each filing under § 5.4306 or § 5.4307 of this title. Note…

The association must make the following information available through the electronic information repository: (1) Policy Expiration Date; (2) Policy ID; (3) Policy Holder Name; (4) Mailing Address; (5) Item Number; (6) Item Description; (7) Premium; (8) Structure Coverage Amount; …

(a) Persons must submit the following information when applying to TDI for a certificate of compliance for a completed improvement on a structure: (1) a statement from a professional engineer licensed by the Texas Board of Professional Engineers and Land Surveyors that affirms th…

The items listed in this section do not require an inspection for compliance with the windstorm and hail insurance coverage through the Texas Windstorm Insurance Association provided that any repairs, replacements, or procedures are made with like kind and quality materials, fast…

(a) "Supporting evidence" includes: (1) product evaluations; (2) installation instructions from the manufacturer for the product; (3) test data; (4) written evidence from inspections--for example, an inspection report; (5) photographs; (6) video recording; (7) plans, either as-bu…

(a) Purpose. The purpose of this section is to specify the procedures for the Commissioner of Insurance to appoint temporary qualified inspectors for a specified limited period to conduct inspections for windstorm and hail insurance pursuant to the Insurance Code Article 21.49 §6…

This section describes the procedure for the certification of ongoing improvements to certain components inspected by TDI-employed inspectors. (1) Eligible components. (A) TDI-employed inspectors may inspect on certain alterations and repairs (including reroofs) on components suc…

(a) Experience and education. An appointed qualified inspector must display demonstrable experience and education related to windstorm design. (b) Appointed qualified inspector application. To apply for appointment as a qualified inspector, an applicant must provide TDI with: (1)…

(a) Appointment term. An appointed qualified inspector's first appointment will be for a term of two years plus the length of time between the first appointment and the earliest date by which the appointed qualified inspector must renew his or her Texas Board of Professional Engi…

(a) No deemed appointment. The commissioner must affirmatively appoint an applicant before the appointment is effective. No applicant will be deemed appointed. (b) Denial. The commissioner may deny an application or a renewal application because: (1) the application is incomplete…

An appointed qualified inspector must: (1) maintain a current license with the Texas Board of Professional Engineers; (2) notify TDI in writing not later than 30 days after a change in the appointed qualified inspector's: (A) legal name; (B) mailing address; (C) telephone number;…

(a) Appointed qualified inspector accountability. An appointed qualified inspector is solely accountable for inspections performed under the appointed qualified inspector's name. (b) Failure to comply. An appointed qualified inspector is strictly accountable for any failure to co…

This section describes the procedure for the certification of ongoing improvements inspected by appointed qualified inspectors. (1) Eligible structures. An appointed qualified inspector or a designated representative of an appointed qualified inspector may only inspect an ongoing…

(a) To verify that a design of an ongoing improvement complies with the applicable building code under the plan of operation, an appointed qualified inspector must review design documents sealed by the engineer of record for the ongoing improvement, including design criteria, win…

(a) An appointed qualified inspector or a designated representative under the appointed qualified inspector's supervision must prepare a written inspection report for each inspection. Except as provided in subsection (b) of this section, all inspection reports must include the fo…

(a) On request from TDI, an appointed qualified inspector must provide information and evidence necessary to substantiate the appointed qualified inspector's verification that an ongoing improvement complies with the wind load requirements of the applicable building code. (b) The…

(a) Inspection oversight. An appointed qualified inspector is subject to TDI's regulatory authority, which includes oversight inspections conducted by TDI. TDI oversees all aspects of the inspection and notification of compliance of ongoing improvements by an appointed qualified …

(a) Purpose. The purpose of this section is: (1) to specify, pursuant to Article 21.49, §8E of the Insurance Code, the percentage of rate reduction which must be applied to windstorm and hail insurance policies issued by the Texas Windstorm Insurance Association for new residenti…

(a) The department shall post on the department's website and with the Texas Secretary of State notice of the Texas Windstorm Insurance Association's (Association) annual rate filing under the Insurance Code § 2210.352 , other than a filing under the Insurance Code § 2210.352(a-1…

(a) The Texas Windstorm Insurance Association (TWIA) board of directors must comply with Insurance Code § 2210.3512 in all votes on proposed rate filings. (b) TWIA must comply with Insurance Code § 2210.453(f) in all purchases of reinsurance under §2210.453. (c) This section is p…