Sec. 1201.003. APPLICABILITY OF CHAPTER. (a) This chapter applies only to an accident and health insurance policy delivered or issued for delivery in this state.
(b) Except as otherwise provided by this chapter, this chapter applies only to an individual accident and health insurance policy delivered or issued for delivery by:
(1) a life, health, and accident insurance company;
(2) a mutual insurance company, including:
(A) a mutual life insurance company; and
(B) a mutual assessment life insurance company;
(3) a local mutual aid association;
(4) a mutual or natural premium life or casualty insurance company;
(5) a general casualty company;
(6) a Lloyd's plan;
(7) a reciprocal or interinsurance exchange;
(8) a nonprofit hospital, medical, or dental service corporation, including a corporation operating under Chapter 842; or
(9) another insurer required by law to be authorized by the department.
(c) This chapter applies to an accident and health insurance policy issued by a stipulated premium company subject to Chapter 884.
(d) This chapter does not apply to:
(1) any society, company, or other insurer whose activities are exempt by statute from the control of the department and that is entitled by statute to a certificate from the department that shows the entity's exempt status;
(2) a credit accident and health insurance policy issued under Chapter 1153;
(3) a workers' compensation insurance policy;
(4) a liability insurance policy, with or without supplementary expense coverage;
(5) a reinsurance policy or contract;
(6) a blanket or group insurance policy, except as otherwise provided by this chapter; or
(7) a life insurance endowment or annuity contract or a contract supplemental to a life insurance endowment or annuity contract if the contract or supplemental contract contains only provisions relating to accident and health insurance that:
(A) provide additional benefits in case of accidental death, accidental dismemberment, or accidental loss of sight; or
(B) operate to:
(i) safeguard the contract or supplemental contract against lapse; or
(ii) give a special surrender value, a special benefit, or an annuity if the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract.
(e) Subchapters C and D do not apply to a conversion policy issued under a contractual conversion privilege under a group accident and health insurance policy.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
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