Provisión sobre Formularios de Reclamación en Seguros de Salud

Sec. 1201.212. POLICY PROVISION: CLAIM FORMS. (a) Except as provided by Subsection (b), an individual accident and health insurance policy must contain the following provision: "Claim Forms: The insurer, on receipt of a notice of claim, will provide to the claimant the forms usually provided by the insurer for filing proof of loss. If the forms are not provided before the 16th day after the date of the notice, the claimant shall Statute text rendered on: - 1981 - 10/18/2024 INSURANCE CODE be considered to have complied with the requirements of this policy as to proof of loss on submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character, and the extent of the loss for which the claim is made." (b) The provision required by this section is not required to be contained in a policy issued by a corporation operating under Chapter 842. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.