Tex. Ins. Code Section 1204.252
Preconditions for Payment; Exceptions


(a)

In accordance with the terms of the policy and this subchapter, an insurer or group hospital service corporation may be required to pay benefits under a group accident and health insurance policy to a person who is not a group member and who complies with:

(1)

Section 1204.251 (Payment to Conservator Other than Group Member);

(2)

the insurer’s or group hospital service corporation’s claim application procedures; and

(3)

department rules.

(b)

Any requirement imposed on a possessory or managing conservator of a child under this subchapter does not apply with regard to:

(1)

an unpaid medical bill for which an assignment of benefits has been exercised, whether in accordance with policy provisions or otherwise; or

(2)

a claim presented by a group member for which the group member paid any portion of a medical bill that is covered under the policy’s terms.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Source: Section 1204.252 — Preconditions for Payment; Exceptions, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1204.­htm#1204.­252 (accessed Jun. 5, 2024).

Accessed:
Jun. 5, 2024

§ 1204.252’s source at texas​.gov