Tex.
Ins. Code Section 1201.152
Coverage Under Simplified Application Form
(a)
Notwithstanding Clause (b) of the provision required by Section 1201.208 (Policy Provision: Incontestability)(a), an individual accident and health insurance policy must cover any loss that occurs after 12 months from a preexisting condition if the insurer uses a simplified application form that does not include a question concerning the applicant’s health history or medical treatment history.(b)
This section applies regardless of whether the simplified application form includes a question regarding the applicant’s health at the time of application.(c)
This section does not require an insurer to cover a loss from a condition that the policy specifically excludes from coverage.(b)
Notwithstanding Subsection (a), the commissioner may authorize a policy provision that excludes coverage for a preexisting condition for a period of not more than one year if the commissioner determines that the provision would serve the public interest.(c)
This section does not require an insurer to provide coverage for a loss from a preexisting condition specifically excluded from coverage by name or specific description in an exclusion endorsement or rider that is effective on the date of the loss.
Source:
Section 1201.152 — Coverage Under Simplified Application Form, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1201.htm#1201.152 (accessed Jun. 5, 2024).
