Tex. Ins. Code Section 4151.301
Grounds for Denial, Suspension, or Revocation of Certificate of Authority


The department may deny an application for a certificate of authority or discipline the holder of a certificate of authority under this subchapter if the department determines that the applicant or holder, individually, or through an officer, director, or shareholder:

(1)

has wilfully violated an insurance law of this state;

(2)

has intentionally made a material misstatement in the application for a certificate of authority;

(3)

has obtained or attempted to obtain a certificate of authority by fraud or misrepresentation;

(4)

has misappropriated, converted to the applicant’s or holder’s own use, or illegally withheld money belonging to:

(A)

an insurance carrier, as that term is defined by Section 401.011 (General Definitions), Labor Code;

(B)

an insurer, as that term is defined by Section 4001.003 (Definitions);

(C)

a health maintenance organization; or

(D)

an insured, enrollee, injured employee, or beneficiary;

(5)

has engaged in fraudulent or dishonest acts or practices;

(6)

has materially misrepresented the terms and conditions of an insurance policy, certificate, evidence of coverage, or contract;

(7)

has been convicted of a felony;

(8)

is in a financial condition, or is operating or conducting business in a manner, that would render further transaction of business in this state hazardous or injurious to insured persons or the public;

(9)

has failed to comply with any judgment rendered against the applicant or holder before the 60th day after the date on which the judgment becomes final;

(10)

has wilfully violated a commissioner rule;

(11)

has refused to be examined or to produce accounts, records, and files for examination as required by this chapter or commissioner rule;

(12)

at any time fails to meet a qualification for which issuance of the certificate of authority could have been denied had the failure then existed and been known to the commissioner;

(13)

has had a certificate of authority, license, or other authority issued by this state, another state, or the United States suspended or revoked; or

(14)

has failed to timely file the annual report required by Section 4151.205 (Annual Report).
Added by Acts 2007, 80th Leg., R.S., Ch. 1176 (H.B. 472), Sec. 1.21, eff. September 1, 2007.

Source: Section 4151.301 — Grounds for Denial, Suspension, or Revocation of Certificate of Authority, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­4151.­htm#4151.­301 (accessed Jun. 5, 2024).

4151.001
Definitions
4151.002
Exemptions
4151.003
Applicability of Other Provisions of Code
4151.004
Applicability to Certain Insurers and Health Maintenance Organizations
4151.005
Administrator Not Insurance Agent
4151.006
Rules
4151.0021
Applicability to Certain Processing Agents
4151.0022
Nonapplicability
4151.0031
Market Analysis
4151.0051
Referral to Adjuster by Administrator
4151.051
Certificate of Authority Required
4151.052
Application
4151.053
Approval of Application
4151.054
Denial of Application
4151.055
Fidelity Bond Required
4151.056
Duration of Certificate of Authority
4151.101
Written Agreement with Insurer or Plan Sponsor Required
4151.102
Contents of Written Agreement
4151.103
Retention of Written Agreement
4151.104
Notice of Use of Administrator’s Services
4151.105
Payments to Administrator
4151.106
Certain Funds Collected or Received by Administrator
4151.107
Delivery or Deposit of Certain Funds Received by Administrator
4151.108
Withdrawals from Fiduciary Account
4151.109
Payment of Claims from Fiduciary Account Prohibited
4151.110
Underwriting Standards
4151.111
Adjudication of Claims
4151.112
Maintenance of Books and Records
4151.113
Access to Books and Records
4151.114
Disposition of Books and Records on Termination of Written Agreement
4151.115
Confidentiality of Personal Information
4151.116
Advertising
4151.117
Compensation of Administrator
4151.151
Definition
4151.152
Identification Cards
4151.153
Disclosure of Certain Patient Information Prohibited
4151.154
Discount Health Care Programs
4151.201
Examination of Administrator
4151.202
Contents of Examination
4151.203
Cost of Examination
4151.204
Examination Under Oath
4151.205
Annual Report
4151.206
Fees
4151.210
Effect of Revocation of Other Certificates
4151.211
Restrictions on Acquisition of Ownership Interest
4151.212
Maintenance of Qualifications Required
4151.251
Definition
4151.252
Application
4151.253
Agreements Between Administrators and Carriers
4151.254
Agreements Between Administrators and Employers
4151.255
Administrator Compensation
4151.256
Large Deductible Policies
4151.257
Rules
4151.301
Grounds for Denial, Suspension, or Revocation of Certificate of Authority
4151.302
Remedies for Violation of Insurance Laws or Commissioner Rules
4151.303
Probated Suspension
4151.304
Hearing
4151.305
Application for Certificate of Authority After Denial or Revocation
4151.306
Disciplinary Proceeding for Conduct Committed Before Surrender or Forfeiture of Certificate
4151.307
Emergency Certificate Suspension
4151.308
General Administrative Sanctions
4151.309
Criminal Penalty
4151.1041
Referral by Insurer
4151.1042
Responsibilities of Insurer

Accessed:
Jun. 5, 2024

§ 4151.301’s source at texas​.gov