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


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:


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


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


department rules.


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


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


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 Dec. 2, 2023).

Dec. 2, 2023

§ 1204.252’s source at texas​.gov