Texas Insurance Code Title 5, Chapter 542 - Processing And Settlement Of Claims

SUBCHAPTER A UNFAIR CLAIM SETTLEMENT PRACTICES

• Texas Section 542.001 - Short Title
  This subchapter may be cited as the Unfair Claim Settlement Practices Act. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1,
• Texas Section 542.002 - Applicability Of Subchapter
  This subchapter applies to the following insurers whether organized as a proprietorship, partnership, stock or mutual corporation, or unincorporated association: (1) a life, health, or...
• Texas Section 542.003 - Unfair Claim Settlement Practices Prohibited
  (a) An insurer engaging in business in this state may not engage in an unfair claim settlement practice. (b) Any of the following acts by...
• Texas Section 542.004 - Examination Of Tax Returns Prohibited
  (a) An insurer regulated under this code may not require a claimant, as a condition of settling a claim, to produce the claimant's federal income...
• Texas Section 542.005 - Record Of Complaints
  (a) In this section, "complaint" means any written communication primarily expressing a grievance. (b) An insurer shall maintain a complete record of all complaints received...
• Texas Section 542.006 - Periodic Reporting Requirement
  (a) In this section, "claim" means a written claim filed by a resident of this state with an insurer engaging in business in this state....
• Texas Section 542.007 - Comparison Of Certain Insurers To Minimum Standard Of Performance; Investigation
  (a) The department shall compile the information received from an insurer under Section 542.006 in a manner that enables the department to compare the insurer's...
• Texas Section 542.008 - Complaints Against Insurers; Investigation
  (a) The department shall establish a system for receiving and processing individual complaints alleging a violation of this subchapter by an insurer regardless of whether...
• Texas Section 542.009 - Review Of Investigation Results; Hearing
  (a) On receiving the results of an investigation instituted under Section 542.007 or 542.008, the department shall review those results considering the standards of this...
• Texas Section 542.010 - Cease And Desist Order; Enforcement
  (a) If the department determines that an insurer has violated this subchapter, the department shall issue a cease and desist order to the insurer directing...
• Texas Section 542.011 - Time Limit To Appeal
  An insurer affected by a ruling or order of the department under this subchapter may appeal the ruling or order, in accordance with Subchapter D,...
• Texas Section 542.012 - Attorney's Fees
  The department is entitled to reasonable attorney's fees if judicial action is necessary to enforce an order of the department under this subchapter. Added by...
• Texas Section 542.013 - Personnel
  The department may hire employees and examiners as needed to enforce this subchapter. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April...

SUBCHAPTER B PROMPT PAYMENT OF CLAIMS

• Texas Section 542.014 - Rules
  The commissioner shall adopt reasonable rules as necessary to implement and augment the purposes and provisions of this subchapter. Added by Acts 2003, 78th Leg.,...
• Texas Section 542.051 - Definitions
  In this subchapter: (1) "Business day" means a day other than a Saturday, Sunday, or holiday recognized by this state. (2) "Claim" means a first-party...
• Texas Section 542.052 - Applicability Of Subchapter
  This subchapter applies to any insurer authorized to engage in business as an insurance company or to provide insurance in this state, including: (1) a...
• Texas Section 542.053 - Exception
  (a) This subchapter does not apply to: (1) workers' compensation insurance; (2) mortgage guaranty insurance; (3) title insurance; (4) fidelity, surety, or guaranty bonds; (5)...
• Texas Section 542.054 - Liberal Construction
  This subchapter shall be liberally construed to promote the prompt payment of insurance claims. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff....
• Texas Section 542.055 - Receipt Of Notice Of Claim
  (a) Not later than the 15th day or, if the insurer is an eligible surplus lines insurer, the 30th business day after the date an...
• Texas Section 542.056 - Notice Of Acceptance Or Rejection Of Claim
  (a) Except as provided by Subsection (b) or (d), an insurer shall notify a claimant in writing of the acceptance or rejection of a claim...
• Texas Section 542.057 - Payment Of Claim
  (a) Except as otherwise provided by this section, if an insurer notifies a claimant under Section 542.056 that the insurer will pay a claim or...
• Texas Section 542.058 - Delay In Payment Of Claim
  (a) Except as otherwise provided, if an insurer, after receiving all items, statements, and forms reasonably requested and required under Section 542.055, delays payment of...
• Texas Section 542.059 - Extension Of Deadlines
  (a) A court may grant a request by a guaranty association for an extension of the periods under this subchapter on a showing of good...
• Texas Section 542.060 - Liability For Violation Of Subchapter
  (a) If an insurer that is liable for a claim under an insurance policy is not in compliance with this subchapter, the insurer is liable...

SUBCHAPTER C PROVIDING CERTAIN CLAIMS INFORMATION ON REQUEST

• Texas Section 542.061 - Remedies Not Exclusive
  The remedies provided by this subchapter are in addition to any other remedy or procedure provided by law or at common law. Added by Acts...
• Texas Section 542.101 - Request By Named Insured Under Liability Insurance Policy
  (a) In this section, "liability insurance" means: (1) general liability insurance; (2) professional liability insurance, including medical professional liability insurance; (3) commercial automobile liability insurance;...
• Texas Section 542.102 - Request By Policyholder Under Property And Casualty Insurance Policy
  (a) On written request of a policyholder, an insurer that writes property and casualty insurance in this state shall provide the policyholder with a list...
• Texas Section 542.103 - Deadline For Providing Requested Information
  (a) An insurer shall provide the information requested under this subchapter in writing not later than the 30th day after the date the insurer receives...

SUBCHAPTER C-1 REQUEST FOR CLAIMS INFORMATION BY CERTAIN OFFICIALS

• Texas Section 542.104 - Rules
  The commissioner may by rule prescribe forms for requesting information and for providing requested information under this subchapter. Added by Acts 2003, 78th Leg., ch....

SUBCHAPTER D NOTICE OF SETTLEMENT OF CLAIM UNDER CASUALTY INSURANCE POLICY

• Texas Section 542.131 - Request By Certain Officials Engaged In Criminal Investigation
  (a) This section applies only to a claim for a burglary or robbery loss or a death claim seeking life insurance proceeds that is filed...
• Texas Section 542.151 - Applicability Of Subchapter
  This subchapter applies only to the settlement of a claim under a casualty insurance policy that is delivered, issued for delivery, or renewed in this...
• Texas Section 542.152 - Exception
  This subchapter does not apply to: (1) a casualty insurance policy that requires the insured's consent to settle a claim against the insured; (2) fidelity,...
• Texas Section 542.153 - Notice Required
  (a) Not later than the 10th day after the date an initial offer to settle a claim against a named insured under a casualty insurance...

SUBCHAPTER E RECOVERY OF DEDUCTIBLE FROM THIRD PARTIES UNDER CERTAIN AUTOMOBILE INSURANCE POLICIES

• Texas Section 542.154 - Rules
  The commissioner may adopt rules to implement this subchapter. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.
• Texas Section 542.201 - Purpose
  This subchapter is intended to encourage insurers to take appropriate and necessary steps to collect from third parties or the insurers of the third parties....
• Texas Section 542.202 - Definition
  In this subchapter, "action" includes taking various actions such as reasonable and diligent collection efforts, mediation, arbitration, and litigation against a responsible third party or...
• Texas Section 542.203 - Applicability Of Subchapter
  This subchapter applies to any insurer that delivers, issues for delivery, or renews in this state a private passenger automobile insurance policy, including a reciprocal...
• Texas Section 542.204 - Action To Recover Deductible
  (a) Notwithstanding any other provision of this code and except as provided by Subsection (b), if an insurer is liable to an insured for a...

SUBCHAPTER F WATER DAMAGE CLAIMS

• Texas Section 542.205 - Enforcement; Rules
  The commissioner may enforce this subchapter and adopt and enforce reasonable rules necessary to accomplish the purposes of this subchapter. Added by Acts 2003, 78th...
• Texas Section 542.251 - Purposes
  The purposes of this subchapter are to: (1) provide for the prompt, efficient, and effective handling and processing of water damage claims filed under residential...
• Texas Section 542.252 - Applicability Of Subchapter
  This subchapter applies to any insurer that handles or processes water damage claims filed under residential property insurance policies. Added by Acts 2005, 79th Leg.,...

SUBCHAPTER G INSURER'S RECOVERY FROM UNINSURED THIRD PARTY

• Texas Section 542.253 - Rules
  (a) The commissioner may adopt rules that identify the types of water damage claims that require more prompt, efficient, and effective processing and handling than...
• Texas Section 542.301 - Applicability Of Subchapter
  This subchapter applies to any insurer that delivers, issues for delivery, or renews a private passenger automobile insurance policy in this state, including a county...
• Texas Section 542.302 - Recovery In Suit Or Other Action
  An insurer that brings suit or takes other action described by Section 542.202 against a responsible third party relating to a loss that is covered...

Last modified: September 28, 2016