Tex. Ins. Code Section 4152.208
Settlement of Claims

(a)

This section applies only to a contract entered into under Section 4152.201 (Contract Between Manager and Insurer) that permits a manager to settle claims on behalf of an insurer.

(b)

All claims must be reported to the insurer at least quarterly.

(c)

The manager shall send a copy of the claim file to the insurer at the insurer’s request or as soon as it is known that the claim:

(1)

has the potential to exceed the lesser of:

(A)

an amount determined by the commissioner; or

(B)

the limit set by the insurer;

(2)

involves a coverage dispute;

(3)

may exceed the manager’s claims settlement authority;

(4)

has been open for more than six months; or

(5)

has been closed by payment of the lesser of:

(A)

an amount determined by the commissioner; or

(B)

the limit set by the insurer.

(d)

A claim file is the joint property of the insurer and manager, except that on an order of liquidation of the insurer the file becomes the sole property of the insurer or the insurer’s estate. The manager is entitled to reasonable access to the claim file and may copy the file on a timely basis.

(e)

Any settlement authority granted to the manager may be terminated for cause on the insurer’s written notice by certified mail, return receipt requested, to the manager or on the termination of the contract. The insurer may suspend the settlement authority during any dispute regarding the cause of termination.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 7, eff. April 1, 2005.

Source: Section 4152.208 — Settlement of Claims, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­4152.­htm#4152.­208 (accessed Jun. 5, 2024).

4152.001
Definitions 4152.002
Classification as Commercially Domiciled Insurer 4152.003
Rights of Third Parties Not Affected 4152.004
Rules 4152.051
License Required 4152.052
Qualifications 4152.053
Application 4152.054
Service of Notice, Orders, and Process 4152.055
Fees 4152.056
License Issuance 4152.057
Persons Authorized to Act Under License 4152.058
Bond or Errors and Omissions Policy 4152.059
License Expiration and Renewal 4152.101
Examination by Commissioner 4152.102
Access to and Maintenance of Books, Bank Accounts, and Records 4152.103
Conduct of Examination 4152.104
Examination Expense 4152.151
Contract Between Broker and Insurer 4152.152
Placement of Reinsurance with Unauthorized Reinsurer 4152.153
Transaction Records 4152.154
Employment of Person by Insurer and Broker 4152.201
Contract Between Manager and Insurer 4152.202
Termination of Contract 4152.203
Accounting for Transactions 4152.204
Management of Money 4152.205
Transaction Records 4152.206
Contract Assignment Prohibited 4152.207
Compliance with Underwriting and Rating Standards of Insurer 4152.208
Settlement of Claims 4152.209
Payment of Interim Profits 4152.210
Audited Statement of Manager’s Financial Condition 4152.211
Disclosure of Relationships with Other Insurers 4152.212
Acts of Manager Considered Acts of Insurer 4152.213
Actuary’s Opinion on Adequacy of Loss Reserves 4152.214
Placement of Reinsurance with Unauthorized Reinsurer 4152.215
Prohibitions 4152.216
Employment of Person by Insurer and Manager 4152.251
Engagement of Services of Unlicensed Broker or Manager 4152.252
Audited Statement of Manager’s Financial Condition 4152.253
Review of Underwriting and Claims Processing Operations 4152.254
Authority for Retrocessional Contracts or Participation in Reinsurance Syndicates 4152.255
Notification of Termination of Manager’s Contract 4152.256
Appointment of Certain Persons to Board of Directors Prohibited 4152.301
Grounds for License Denial or Disciplinary Action 4152.302
Imposition of Sanctions
Green check means up to date. Up to date

Accessed:
Jun. 5, 2024

§ 4152.208’s source at texas​.gov