Sec. 1204.252. PRECONDITIONS FOR PAYMENT; EXCEPTIONS. (a) In accordance with the terms of the policy and this subchapter, an insurer or group hospital service corporation may be required to pay benefits under a group accident and health insurance policy to a person who is not a group member and who complies with:
(1) Section 1204.251;
(2) the insurer's or group hospital service corporation's claim application procedures; and
(3) department rules.
(b) Any requirement imposed on a possessory or managing conservator of a child under this subchapter does not apply with regard to:
(1) an unpaid medical bill for which an assignment of benefits has been exercised, whether in accordance with policy provisions or otherwise; or
(2) a claim presented by a group member for which the group member paid any portion of a medical bill that is covered under the policy's terms.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Section: Previous 1204.002 1204.051 1204.052 1204.053 1204.054 1204.055 1204.101 1204.102 1204.151 1204.152 1204.153 1204.154 1204.201 1204.251 1204.252Last modified: September 28, 2016