Tex. Ins. Code Section 1201.208
Policy Provision: Incontestability


(a)

Except as provided by Subsection (c), an individual accident and health insurance policy must contain the following provision:
"Time Limit on Certain Defenses: (a) After the second anniversary of the date this policy is issued, a misstatement, other than a fraudulent misstatement, made by the applicant in the application for the policy may not be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) beginning after that anniversary.
“(b) A claim for loss incurred or disability (as defined in the policy) beginning after the second anniversary of the date this policy is issued may not be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss existed before the effective date of coverage of this policy.”

(b)

Clause (a) of the provision required by Subsection (a) does not:

(1)

affect any legal requirement for avoidance of a policy or denial of a claim during the initial two-year period; or

(2)

limit the application of Section 1201.219 (Policy Provision: Change of Occupation), 1201.220 (Policy Provision: Misstatement of Age), or 1201.221 (Policy Provision: Excess Insurance) in a case of a misstatement regarding age, occupation, or other insurance.

(c)

For a policy that provides that the insured is entitled to continue the policy in force by the timely payment of premiums until the insured reaches at least 50 years of age or, if the policy was issued after the insured reached 44 years of age, until at least the fifth anniversary of the policy’s date of issuance, an insurer may use the following clause instead of Clause (a) of the provision required by Subsection (a):
“After this policy has been in force for a period of two years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestible as to the statements contained in the application.”

(d)

The provision provided by Subsection (c) must be under the caption “Incontestable.” An insurer that uses the provision may omit the parenthetical clause.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Source: Section 1201.208 — Policy Provision: Incontestability, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1201.­htm#1201.­208 (accessed Jun. 5, 2024).

1201.001
Definitions
1201.002
Purpose
1201.003
Applicability of Chapter
1201.004
Construction of Chapter
1201.005
References to Chapter
1201.006
Rulemaking Authority
1201.007
Notice and Hearing
1201.008
Judicial Review
1201.009
Nonconforming Policy
1201.010
Third-party Ownership of Policy
1201.011
Coverage for Premium Period with Limitations by Age or Date
1201.012
Defense of Claim
1201.013
Programs Promoting Disease Prevention, Wellness, and Health
1201.051
Entire Consideration
1201.052
Time of Effectiveness and Termination
1201.053
Persons Insured
1201.054
Appearance of Text
1201.055
Exceptions and Reductions of Indemnity
1201.056
Form Number
1201.057
Incorporation of or Reference to Other Documents
1201.058
Notification that Policy Is Returnable
1201.059
Termination of Coverage Based on Age of Child in Individual, Blanket, or Group Policy
1201.061
Coverage for Adopted Child
1201.062
Coverage for Certain Children in Individual or Group Policy or in Plan or Program
1201.063
Prohibition of Certain Criteria Relating to Child’s Coverage in Individual or Group Policy
1201.064
Coverage for Child of Spouse in Individual or Group Policy
1201.065
Age and School Enrollment Eligibility Criteria for Dependent Children in Individual or Group Policy
1201.101
Standards for Policy Provisions
1201.102
Prohibition of Policy Provisions
1201.103
Compliance with Minimum Standards for Benefits
1201.104
Minimum Standards for Benefits
1201.105
Minimum Standards for Benefits for Long-term Care in Individual, Group, or Blanket Policy
1201.106
Identification of Policies According to Coverage Provided
1201.107
Outline of Coverage Required
1201.108
Format and Content of Outline of Coverage
1201.109
Notice of Rate Increase for Major Medical Expense Insurance Policy
1201.151
Compliance with Subchapter
1201.152
Coverage Under Simplified Application Form
1201.154
Coverage for Certain Previously Covered Persons
1201.201
Policy Provisions Required
1201.202
Order of Required Policy Provisions
1201.203
Other Policy Provisions
1201.204
Policy Provisions Required by Other Jurisdiction
1201.205
Policy Provisions for Policy Delivered Outside This State
1201.206
Filing Procedure
1201.207
Policy Provision: Entirety of Contract
1201.208
Policy Provision: Incontestability
1201.209
Policy Provision: Grace Period
1201.210
Policy Provision: Reinstatement
1201.211
Policy Provision: Notice of Claim
1201.212
Policy Provision: Claim Forms
1201.213
Policy Provision: Proof of Loss
1201.214
Policy Provision: Time of Payment of Claims
1201.215
Policy Provision: Payment of Claims
1201.216
Policy Provision: Physical Examinations and Autopsy
1201.217
Policy Provision: Legal Actions
1201.218
Policy Provision: Change of Beneficiary
1201.219
Policy Provision: Change of Occupation
1201.220
Policy Provision: Misstatement of Age
1201.221
Policy Provision: Excess Insurance
1201.222
Policy Provision: Relation of Earnings to Insurance
1201.223
Policy Provision: Unpaid Premium
1201.224
Policy Provision: Cancellation
1201.225
Policy Provision: Conformity with State Statutes
1201.226
Policy Provision: Illegal Occupation
1201.271
Alteration of Policy Application
1201.272
False Statements
1201.273
Binding Statements
1201.274
Insurer’s Evidentiary Use of Application for Reinstatement or Renewal
1201.0601
Required Definitions: Specified Disease Policy
1201.701
Civil Penalty
1201.702
Action Against Certificate of Authority or License

Accessed:
Jun. 5, 2024

§ 1201.208’s source at texas​.gov