Sec. 463.252. IMPAIRED DOMESTIC, FOREIGN, OR ALIEN INSURER NOT PAYING CLAIMS. (a) This section applies only to a member insurer that:
(1) is an impaired domestic, foreign, or alien insurer; and
(2) is not timely paying claims.
(b) Subject to Subsection (d), the association shall:
(1) with respect to the insurer, take one or more actions that the association is authorized to take under Section 463.251 with respect to an impaired domestic insurer, subject to the conditions of that section; or
(2) provide substitute benefits instead of the insurer's contractual obligations as provided by Subsection (c).
(c) A policy or contract owner who claims emergency or hardship may petition for substitute benefits under standards the association proposes and the commissioner approves. Substitute benefits are available only for a health claim, periodic annuity benefit payment, death benefit, supplemental benefit, or cash withdrawal.
(d) The association is required to take action under this section only if:
(1) the laws of the insurer's state of domicile provide that, until all payments of or on account of the insurer's contractual obligations are made by all guaranty associations and all expenses of the associations and interest on those payments and expenses have been repaid to the associations or a plan of repayment by the insurer has been approved by the associations:
(A) the delinquency proceeding may not be dismissed;
(B) the insurer and the insurer's assets may not be returned to the control of the insurer's shareholders or private management; and
(C) the insurer may not solicit or accept new business or have any suspended or revoked certificate of authority restored;
(2) the insurer is a domestic insurer that has been placed under an order of rehabilitation by a court in this state; or
(3) the insurer is a foreign or alien insurer and:
(A) the insurer has been prohibited from soliciting or accepting new business in this state;
(B) the insurer's certificate of authority has been suspended or revoked in this state; and
(C) a petition for rehabilitation or liquidation has been filed in a court in the insurer's state of domicile by the insurance official of that state.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Section: Previous 463.201 463.202 463.203 463.204 463.205 463.206 463.251 463.252 463.253 463.254 463.255 463.256 463.257 463.258 463.259 NextLast modified: September 28, 2016