Sec. 1701.055. DISAPPROVAL OF FORM OR WITHDRAWAL OF APPROVAL OR EXEMPTION. (a) Except as provided by Subsection (d), the commissioner may disapprove or, after notice and hearing, withdraw approval of a form if the form:
(1) violates this code, a rule of the commissioner, or any other law; or
(2) contains a provision, title, or heading that is unjust, encourages misrepresentation, or is deceptive.
(b) A form filed under this chapter that contains a coordination of benefits provision may not be approved for use in this state unless the form provides for the order of benefits determination for insured dependent children. An order of benefits determination provision may not be approved if the provision:
(1) violates this code, a rule of the commissioner, or any other law; or
(2) contains a provision, title, or heading that is unjust, encourages misrepresentation, or is deceptive.
(c) If necessary to accomplish the purpose of Subsection (b), the commissioner may adopt a policy provision and order the inclusion of that provision in a document subject to that subsection.
(d) If a form has been on file with the department for at least 180 days and has previously been affirmatively approved by the commissioner, been considered approved under this chapter, or been exempted from the approval requirements under this chapter, the commissioner may withdraw the approval or exemption only if:
(1) the form violates this code or a rule adopted under this code; or
(2) the commissioner finds proof of gross misrepresentation or fraud to a policyholder.
(e) An order of the commissioner disapproving or withdrawing approval for a form must state the grounds for the disapproval or withdrawal of approval and describe in adequate detail the changes that are necessary to obtain approval.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 5, eff. April 1, 2005.
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