Updated 11/16/2021 - Return to Index
SB 1367 (87th Legislature, Regular Session, 2021) may exempt from filing your commercial forms or rates/rules.
For more information, see Bulletin
B-0022-021 or contact .
Refer to Property & Casualty Filings Made Easy for required documentation.
Forms
Filing StandardsReview requirementsReferenceComments
Policy Forms and Endorsements| §2301.001(2), Insurance Code
| Policy forms and endorsements may not be unjust, unfair, inequitable, misleading or deceptive.
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Prior Approval| Chapter 2301, Insurance Code
| An insurance policy form or endorsement may not be delivered or issued for delivery in this state unless the form has been filed with and approved by the commissioner. Each filing shall be made not later than the 60th day before the date of any use or delivery for use.
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Large Risk Exemption| §2301.004, Insurance Code
| Policy forms for use with large risks are exempt from filing for prior approval if the forms are to be used with a "large risk." "Large Risk" is defined as an insured that has total insured property values of $5 million or more; an insured that has total annual gross revenues of $10 million or more; or an insured that has a total premium of $25,000 or more for property insurance, $25,000 or more for general liability insurance, or $50,000 or more for multiperil insurance.
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Disapproval of Forms; Withdrawal of Approval| §2301.007, Insurance Code
| The commissioner may disapprove a form filed under §2301.006 or withdraw approval of a form if the form (1) violates any law, including a rule adopted under the Texas Insurance Code, or (2) contains a provision or has a title or heading that is unjust or deceptive, encourages misrepresentation, or violates public policy.
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Applications|
| Not Required to be Filed For Approval Unless Being Made a Part of the Policy
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ArbitrationReview requirementsReferenceComments
Arbitration| Chapter 2301, Insurance Code
| Language used in arbitration agreements is to be consistent with that of the policy: to wit, don't use the word "parties" when you actually mean insured(s) and insurer. Binding arbitration is okay. Arbitration agreements may be mandatory. Arbitration must be held in Texas for Texas policyholders unless mutually agree on an alternate. In general, arbitration language cannot be unjust, misleading or deceptive.
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Cancellation & NonrenewalReview requirementsReferenceComments
Cancellation & Nonrenewal of Certain Liability Insurance Coverage| §§551.051-551.055 and
§551.004, Insurance Code
| Cancellation and nonrenewal of certain liability insurance policies.
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Elected Officials| §§551.151 & 551.152, Insurance Code
| An insurer may not cancel or refuse to renew an insurance policy based solely on the fact that the policyholder is an elected official.
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Insured's Right to Cancel| Chapter 2301, Insurance Code
| Insurance company cannot limit or restrict the insured's right to cancel a policy.
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Voiding Coverage| Chapter 705, Insurance Code
| "Void Coverage" language must comply with Chapter 705, Subchapter A, and the misrepresentation must be material.
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Choice of LawReview requirementsReferenceComments
Texas Laws Govern Policies| Article 21.42, Insurance Code
| Texas must be choice if filing contains choice of law provision.
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Claims Made PoliciesReview requirementsReferenceComments
Disclosure Required| Chapter 2301, Insurance Code
| If the policy is a claims made policy a disclosure to that effect must be prominently displayed on either or both the declaration sheet or the first page of the policy. The disclosure must be plainly readable bold type.
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30-Day Extended Reporting Period Required| Chapter 2301, Insurance Code
| The insured must be given at least an automatic 30-day extended reporting period to report claims becoming known too late to report before the end of the policy period.
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Policy Provision Required| Chapter 2301, Insurance Code
| A policy provision advising the insureds of a right to purchase an extended reporting endorsement. The policy must give the insured a minimum of thirty days to purchase the extended reporting endorsement and the term of the extended reporting period must be at least one year.
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Providing Certain Claims Information On Request| §§542.101-542.104, Insurance Code; and Commissioner's Bulletin No. B-0043-05
| If a policy form or endorsement contains language addressing the request or furnishing of claims information, it would need to comply with the applicable statute(s).
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Claims SettlementReview requirementsReferenceComments
Prompt Payment of Claims| §§542.051 - 542.061, Insurance Code
| Prompt payment of claims. (1st Party Coverage - "Pay to," "indemnify," or "reimburse" the insured. Not "pay on behalf of.")
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Notice of Settlement of Liability Claims| §§542.151 - 542.154, Insurance Code
| Notice of settlement of claim under casualty insurance policy. EXCEPTION - This article does not apply to a casualty policy that requires the insured's consent to settlement of a claim against the insured; or to fidelity, surety, or guaranty bonds.
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Contractual Limitations Period - Suits| §16.070, Civil Practice & Remedies
| Except as provided by Subsection (b), a person may not enter a stipulation, contract, or agreement that purports to limit the time in which to bring suit on the stipulation, contract, or agreement to a period shorter than two years. A stipulation, contract, or agreement that establishes a limitations period that is shorter than two years is void in this state. The Texas Third Court of Appeals issued an opinion that acknowledges that the language providing 2 years and 1 day from the date
the cause of action first accrues satisfies the statutory requirement of §16.070, Civil Practices and Remedy Code. (www.search.txcourts.gov/Case.aspx?cn=03-08-00408-CV) Case #03-08-00408-CV
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Notice Requirements| §16.071, Civil Practice & Remedies
| A contract stipulation that requires a claimant to give notice of a claim for damages as a condition precedent to the right to sue on the contract is not valid unless the stipulation is reasonable. A stipulation that requires notification within less than 90 days is void.
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Coverage IssuesReview requirementsReferenceComments
Anti-Stacking Provisions| Chapter 2301, Insurance Code
| - "Other insurance" clauses or similar provisions should not contain "anti-stacking" or "non-cumulation" language that excludes or limits coverage in other separate but applicable policies that are issued by the same company, affiliated companies, or by other unaffiliated companies.
- It is permissible to state whether the coverage in one policy is primary or excess over other applicable policies, or to coordinate limits in proportion to total limits available in applicable
policies.
- TDI will consider for approval anti-stacking language if:
- the anti-stacking provision is limited to the same "occurrence" and the other coverages are in the same policy or package issued by the same company.
OR - the anti-stacking provision is on a separate endorsement, is limited to the same "occurrence," and
- the company issued the policy for different operations or locations, and intended that only one policy limit apply to prevent unintended
duplication of coverage for which no premium has been paid, and the applicable operations and locations are scheduled on the endorsement; or
- the company or affiliated companies issued separate policies and the applicable policies are scheduled on the endorsement.
- Before TDI can approve anti-stacking language, the company must provide appropriate rate consideration and rate analysis. A "rate analysis" is the company's actuarial justification for the rate
consideration given, or not given, for use of the exclusion or limitation. This would include the reasons for the amount of any rate credit or the justification for the position that no rate credit is given.
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Employment Practices Liability Insurance Policies| Chapter 2301, Insurance Code
| Must provide coverage for sexual harassment, discrimination and wrongful termination.
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Examination Under OathChapter 2301, Insurance Code
§151.001(a)(7), Family Code
| If policy language requires examination under oath, the provision must also state that a parent or guardian may be present during any examination of a minor.
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Professional Liability Added To Commercial General Liability Policy| Chapter 2301, Insurance Code
| If Professional Liability Endorsement is attached to Commercial General Liability Policy, endorsement should match type of coverage of the form (i.e. ... occurrence, claims made).
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Tie-In Sales| Chapter 1806, Insurance Code & 6/1/78 Board Letter
| Tie-in sales may violate state law.
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ExclusionsReview requirementsReferenceComments
Abuse, Physical Abuse or Molestation Exclusions| Chapter 2301, Insurance Code
| Definition of "abuse" in abuse, physical abuse, or molestation exclusion must be included. Must include wording, "For purposes of this endorsement, abuse means an act which is committed with the intent to cause harm".
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Fully Earned Premium/Retention of Minimum Earned PremiumReview requirementsReferenceComments
Fully Earned Premium / Retention of Minimum Earned Premium| Chapter 2251 &
Chapter 2301, Insurance Code and 28 TAC §5.9320, Texas Administrative Code
| TDI will consider approving fully earned premium only for risks with exposure during a period certain, such as special events and weather policies. TDI will consider approving minimum earned premium only if it is a nominal amount. The company must file appropriate rates associated with a minimum or fully earned premium.
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General Change EndorsementsReview requirementsReferenceComments
May Not Manuscript Coverage Once Approved| Chapter 2301, Insurance Code
| Coverage forms are prior approval. Change endorsements may be used to change insured address, etc. but may not be used to change, alter or "clarify" coverage in any way. Company must provide verification that the endorsement will not be used to change, alter, or clarify coverage.
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Rebating or DiscriminationReview requirementsReferenceComments
Rebating or Discrimination| Chapter 1806, Insurance Code
| Inducements prohibited.
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Political Affiliation and Expression | Chapter 544, Subchapter M, Insurance Code
| Except as provided by Section 544.603, a person may not refuse to insure or provide coverage to an individual, refuse to continue to insure or provide coverage to an individual, limit the amount, extent, or kind of coverage available for an individual, or charge an individual a rate that is different from the rate charged to other individuals for the same coverage because of the individual's political affiliation or expression.
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Toll Free InformationReview requirementsReferenceComments
Notice of Policyholder Complaint Procedures| §521.005, Insurance Code
| A brief written notice of suggested procedure to be followed by the policyholder in the event of a dispute concerning a policyholder's claim or premium.
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Toll-Free Information & Complaint Number| §§521.051 - 521.056, Insurance Code
| Toll-Free number for the Texas Department of Insurance.
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Insurer's Toll-Free Information & Complaint Number| §§521.101 - 521.103, Insurance Code
| Insurer's requirement to maintain toll-free number to provide information concerning policies issued by the insurer and to accept complaints from policyholder. Article contains an exception for insurers whose gross initial premium receipts collected in this state are less than $2 million a year or to an insurer with regard to fidelity, surety, or guaranty bonds.
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Notice of Toll-Free Telephone Numbers and Information & Complaint Procedures| 28 TAC §1.601 &
§1.602, Administrative Code and Commissioner’s Order 3952
| To satisfy requirements for §521.005, §§521.051 - 521.056, and §§521.101 - 521.103 noted above.
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Rates
Filing StandardsReview requirementsReferenceComments
File & Use| Chapter 2251, Insurance Code
| Each insurer shall file with the Commissioner all rates, supplementary rating information, and reasonable and pertinent supporting information for risks written in this state.
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Elimination of (a) Rates| Commissioner's Bulletin No. B-0022-95
| Chapter 2251 does not provide for the filing of rates on an individual basis. Each insurer shall file with the Commissioner all rates, supplementary rating information, and reasonable and pertinent supporting information for risks written in this state.
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Rules
Filing StandardsReview requirementsReferenceComments
File & Use| Chapter 2301 & Chapter 2251, Insurance Code
| Manual rules should reflect specific requirements for usage of policy forms, endorsements, and disclosures.
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Fees
Filing StandardsReview requirementsReferenceComments
Fees for Paper Checks Prohibited| §116.002, Business and Commerce Code
| An insurer or agent may not charge a fee for issuing payment via a paper check.
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Which entity approves the insurance policy forms used in Florida?
Individual short-term policy forms and rates must be filed and approved by the Florida Office of Insurance Regulation (OIR) prior to being marketed.
What document must be made part of the insurance policy?
According to the entire contract provision, what document must be made part of the insurance policy? Copy of the original application. What provision of a life insurance policy states the insurer's duty to pay benefits upon the death of the insured, and to whom the benefits will be paid? Consideration.
Which of the following is an agreement between an insured and an insurer?
The Insuring Agreement
This is a summary of the major promises of the insurance company and states what is covered. In the Insuring Agreement, the insurer agrees to do certain things such as paying losses for covered perils, providing certain services, or agreeing to defend the insured in a liability lawsuit.
What must a policy owner provide to the insurer for validation that a loss has occurred?
A Proof of Loss statement must be provided to an insurance company to show that a loss actually occurred. Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?