Tex. Ins. Code Section 1251.103
Incontestability of Policy


(a)

A group accident and health insurance policy must provide that:

(1)

the validity of the policy may not be contested after the policy has been in force for two years after its date of issue; and

(2)

in the absence of fraud, a statement made by any individual covered by the policy relating to the individual’s insurability may not be used in contesting the validity of the insurance with respect to which the statement was made:

(A)

after the insurance has been in force before the contest for two years during the individual’s lifetime; and

(B)

unless the statement is contained in a written instrument signed by the individual making the statement.

(b)

Subsection (a)(1) does not apply to a contest based on nonpayment of premiums.

(c)

The provisions required by this section do not preclude the assertion at any time of a defense based on:

(1)

a provision in the policy that relates to eligibility for coverage;

(2)

a provision in a group accident and health insurance policy or disability insurance policy that relates to overinsurance;

(3)

a provision in a disability policy that relates to the relation of earnings to insurance; or

(4)

another similar provision in a group accident and health insurance policy or disability insurance policy that limits the amounts of recovery from all sources to not more than 100 percent of the total actual losses or expenses incurred.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Source: Section 1251.103 — Incontestability of Policy, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1251.­htm#1251.­103 (accessed Jun. 5, 2024).

1251.001
Definitions
1251.002
Certain Group Health Insurance Authorized
1251.003
Certain Blanket Health Insurance Authorized
1251.004
Certain Payments by Insurers Prohibited
1251.005
Payment of Benefits
1251.006
Policy May Not Specify Service Provider
1251.007
Exceptions
1251.008
Rules
1251.051
Employers
1251.052
Associations
1251.053
Funds Established by Employers, Labor Unions, or Associations
1251.054
Eligibility for Group Life Insurance
1251.055
Fund for Former Employees and Members
1251.056
Other Groups
1251.101
Required Provisions
1251.102
Payment of Premiums
1251.103
Incontestability of Policy
1251.104
Entire Contract
1251.105
Statement Made by Policyholder or Insured
1251.106
Distinction Based on Marital Status Prohibited
1251.107
Evidence of Insurability
1251.108
Exclusion or Limitation of Coverage for Preexisting Conditions
1251.109
Adjustment of Premiums or Benefits if Age of Insured Is Misstated
1251.110
Deadline for Notice of Claim
1251.111
Claim Forms
1251.112
Deadline for Claim
1251.113
Prompt Payment of Benefits Required
1251.114
Payment of Benefits
1251.115
Right to Conduct Physical Examination or Autopsy
1251.116
Legal or Equitable Actions
1251.117
Continuation or Conversion of Coverage
1251.151
Coverage for Certain Grandchildren
1251.152
Optional Coverage for Spouses and Dependents
1251.153
Optional Continuation of Dependents’ Benefits on Death of Insured
1251.154
Coverage for Adopted Children
1251.201
Certificate of Insurance
1251.202
Notice Regarding Certain Employer Health Benefit Plans
1251.251
Continuation of Group Coverage Required
1251.252
Eligibility for Continuation of Group Coverage
1251.253
Request for Continuation of Group Coverage
1251.254
Payment of Contributions
1251.255
Termination of Continued Coverage
1251.256
Conversion of Group Policy
1251.257
Premium for Converted Policy
1251.258
Benefits Under Converted Policy
1251.259
Termination of Converted Policy
1251.260
Notice of Continuation and Conversion Privileges
1251.301
Continuation of Group Coverage
1251.302
Eligibility for Continued Coverage
1251.303
Physical Examination Not Required
1251.304
Scope of Coverage
1251.305
Amount of Premium
1251.306
Payment of Premiums
1251.307
Notice of Continuation Option
1251.308
Notice of Severance of Family Relationship
1251.309
Continuation of Certain Coverages
1251.310
Termination of Continued Coverage
1251.351
Common Carrier or Motor Vehicle Rental or Leasing Company
1251.352
Employers
1251.353
Educational Institutions
1251.354
Religious, Charitable, Recreational, Educational, or Civic Organization
1251.355
Sports Team or Camp
1251.356
Governmental or Volunteer Emergency Services Organization
1251.357
Newspaper or Other Publisher
1251.358
Association
1251.359
Coverage for Other Risks
1251.401
Individual Application and Certificate Not Required
1251.402
Liability of Policyholder Not Affected
1251.451
Applicability of Certain Laws to Out-of-state Group Accident and Health Insurance Coverage

Accessed:
Jun. 5, 2024

§ 1251.103’s source at texas​.gov