1 | 1 | | 84R28798 AJA-F |
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2 | 2 | | By: Taylor of Galveston, et al. S.B. No. 1628 |
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3 | 3 | | (Smithee) |
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4 | 4 | | Substitute the following for S.B. No. 1628: No. |
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5 | 5 | | |
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6 | 6 | | |
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7 | 7 | | A BILL TO BE ENTITLED |
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8 | 8 | | AN ACT |
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9 | 9 | | relating to insurance claims and certain prohibited acts and |
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10 | 10 | | practices in or in relation to the business of insurance. |
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11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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12 | 12 | | SECTION 1. Section 541.151, Insurance Code, is amended to |
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13 | 13 | | read as follows: |
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14 | 14 | | Sec. 541.151. PRIVATE ACTION FOR ACTUAL DAMAGES AUTHORIZED. |
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15 | 15 | | Except as provided by Section 541.1511, a [A] person who sustains |
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16 | 16 | | actual damages may bring an action against another person for those |
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17 | 17 | | damages caused by the other person engaging in an act or practice: |
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18 | 18 | | (1) defined by Subchapter B to be an unfair method of |
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19 | 19 | | competition or an unfair or deceptive act or practice in the |
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20 | 20 | | business of insurance; or |
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21 | 21 | | (2) specifically enumerated in Section 17.46(b), |
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22 | 22 | | Business & Commerce Code, as an unlawful deceptive trade practice |
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23 | 23 | | if the person bringing the action shows that the person relied on |
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24 | 24 | | the act or practice to the person's detriment. |
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25 | 25 | | SECTION 2. Subchapter D, Chapter 541, Insurance Code, is |
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26 | 26 | | amended by adding Section 541.1511 to read as follows: |
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27 | 27 | | Sec. 541.1511. ACTION RELATING TO CERTAIN CLAIMS FOR |
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28 | 28 | | PROPERTY DAMAGE: INSURER ELECTION FOR LEGAL RESPONSIBILITY FOR |
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29 | 29 | | ACTIONS OF AGENTS AND EMPLOYEES. (a) This section applies only to |
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30 | 30 | | an action brought by an insured relating to or arising from a claim |
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31 | 31 | | for damage to or loss of real property or tangible personal property |
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32 | 32 | | made under an insurance policy providing coverage for damage to or |
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33 | 33 | | loss of real property. |
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34 | 34 | | (b) Except as provided by Subsection (d), an insured seeking |
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35 | 35 | | damages in an action to which this section applies may not file or |
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36 | 36 | | maintain an action under this subchapter against an employee, |
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37 | 37 | | agent, representative, or adjuster issuing policies, handling |
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38 | 38 | | claims, or performing other acts on behalf of an insurer, and any |
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39 | 39 | | such action shall be immediately dismissed, if: |
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40 | 40 | | (1) the employee, agent, representative, or adjuster |
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41 | 41 | | was not named in a notice given under Section 541.1541; or |
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42 | 42 | | (2) not later than the 30th day after the date the |
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43 | 43 | | notice given under Section 541.1541 is received, the insurer agrees |
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44 | 44 | | in a document provided to the insured to be liable for any act or |
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45 | 45 | | omission of the employee, agent, representative, or adjuster |
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46 | 46 | | related to or arising out of the insured's claim. |
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47 | 47 | | (c) A dismissal under Subsection (b)(1) or an agreement |
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48 | 48 | | under Subsection (b)(2) does not limit the insurer's liability and |
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49 | 49 | | does not limit the insurer's vicarious liability for any act or |
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50 | 50 | | omission of the employee, agent, representative, or adjuster |
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51 | 51 | | related to or arising out of the insured's claim. |
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52 | 52 | | (d) An insured may file and maintain an action described by |
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53 | 53 | | Subsection (b) if the insured shows and the court finds that the |
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54 | 54 | | insured cannot reasonably expect to secure complete relief unless |
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55 | 55 | | the employee, agent, representative, or adjuster is made a party to |
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56 | 56 | | the action. |
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57 | 57 | | SECTION 3. The heading to Section 541.152, Insurance Code, |
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58 | 58 | | is amended to read as follows: |
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59 | 59 | | Sec. 541.152. ACTUAL DAMAGES, ATTORNEY'S FEES, AND OTHER |
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60 | 60 | | RELIEF. |
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61 | 61 | | SECTION 4. The heading to Section 541.154, Insurance Code, |
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62 | 62 | | is amended to read as follows: |
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63 | 63 | | Sec. 541.154. PRIOR NOTICE OF ACTION OTHER THAN ACTION |
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64 | 64 | | RELATING TO CLAIM FOR PROPERTY DAMAGE. |
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65 | 65 | | SECTION 5. Section 541.154(a), Insurance Code, is amended |
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66 | 66 | | to read as follows: |
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67 | 67 | | (a) Except as provided by Section 541.1541, a [A] person |
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68 | 68 | | seeking damages in an action against another person under this |
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69 | 69 | | subchapter must provide written notice to the other person not |
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70 | 70 | | later than the 61st day before the date the action is filed. |
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71 | 71 | | SECTION 6. Subchapter D, Chapter 541, Insurance Code, is |
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72 | 72 | | amended by adding Section 541.1541 to read as follows: |
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73 | 73 | | Sec. 541.1541. PRIOR NOTICE OF ACTION RELATING TO CERTAIN |
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74 | 74 | | CLAIMS FOR PROPERTY DAMAGE. (a) This section applies only to an |
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75 | 75 | | action brought by an insured relating to or arising from a claim for |
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76 | 76 | | damage to or loss of real property or tangible personal property |
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77 | 77 | | made under an insurance policy providing coverage for damage to or |
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78 | 78 | | loss of real property. |
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79 | 79 | | (b) An insured seeking damages in an action to which this |
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80 | 80 | | section applies must provide written notice complying with this |
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81 | 81 | | section to all potential defendants not later than the 61st day |
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82 | 82 | | before the date the action is filed. |
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83 | 83 | | (c) The notice required by this section must state: |
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84 | 84 | | (1) the specific damage items and the amount alleged |
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85 | 85 | | to be owed by the insurer under the insurance policy; |
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86 | 86 | | (2) the amount of the actual damages, other damages, |
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87 | 87 | | interest, and expenses, specifically stated for each item, that the |
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88 | 88 | | insured alleges are owed by the insurer; |
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89 | 89 | | (3) the amount of attorney's fees the insured |
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90 | 90 | | reasonably has incurred as of the date the notice is given in |
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91 | 91 | | asserting the claim against the insurer; |
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92 | 92 | | (4) an amount that includes the amounts described by |
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93 | 93 | | Subdivisions (1) through (3) that the insured will accept in full |
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94 | 94 | | and final satisfaction of the claim; and |
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95 | 95 | | (5) the name of every person to whom notice is given |
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96 | 96 | | under this section and a brief description of each person's |
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97 | 97 | | relationship to the insured's claim. |
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98 | 98 | | (d) If the amount sought by the insured in the action |
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99 | 99 | | involves a claim for damage items not previously submitted to the |
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100 | 100 | | insurer, not later than the 15th day after the date notice under |
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101 | 101 | | this section is provided to an insurer, the insurer may request that |
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102 | 102 | | the insured provide copies of reports, estimates, photographs, and |
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103 | 103 | | other items reasonably supporting the insured's additional damage |
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104 | 104 | | items. If a request is made in accordance with this subsection, the |
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105 | 105 | | insured must provide the requested information before filing an |
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106 | 106 | | action to which this section applies. |
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107 | 107 | | (e) A presuit notice under this section is not required if |
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108 | 108 | | giving notice is impracticable because the action: |
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109 | 109 | | (1) must be filed to prevent the statute of |
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110 | 110 | | limitations from expiring; or |
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111 | 111 | | (2) is asserted as a counterclaim. |
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112 | 112 | | SECTION 7. Section 541.155, Insurance Code, is amended to |
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113 | 113 | | read as follows: |
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114 | 114 | | Sec. 541.155. ABATEMENT. (a) A person against whom an |
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115 | 115 | | action under this subchapter is pending who does not receive [the] |
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116 | 116 | | notice or requested information as required by Section 541.154 or |
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117 | 117 | | 541.1541 may file a plea in abatement not later than the 30th day |
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118 | 118 | | after the date the person files an original answer in the court in |
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119 | 119 | | which the action is pending. |
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120 | 120 | | (b) The court shall abate the action if, after a hearing, |
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121 | 121 | | the court finds that the person is entitled to an abatement because |
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122 | 122 | | the claimant did not provide [the] notice or requested information |
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123 | 123 | | as required by Section 541.154 or 541.1541. |
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124 | 124 | | (c) An action is automatically abated without a court order |
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125 | 125 | | beginning on the 11th day after the date a plea in abatement is |
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126 | 126 | | filed if the plea: |
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127 | 127 | | (1) is verified and alleges that the person against |
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128 | 128 | | whom the action is pending did not receive [the] notice or requested |
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129 | 129 | | information as required by Section 541.154 or 541.1541; and |
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130 | 130 | | (2) is not controverted by an affidavit filed by the |
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131 | 131 | | claimant before the 11th day after the date the plea in abatement is |
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132 | 132 | | filed. |
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133 | 133 | | (d) An abatement under this section continues until the 60th |
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134 | 134 | | day after the date notice or requested information is provided in |
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135 | 135 | | compliance with Section 541.154 or 541.1541. |
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136 | 136 | | (e) This section does not apply if Section 541.154(c) or |
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137 | 137 | | 541.1541(e) applies. |
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138 | 138 | | SECTION 8. Subchapter B, Chapter 542, Insurance Code, is |
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139 | 139 | | amended by adding Section 542.0595 to read as follows: |
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140 | 140 | | Sec. 542.0595. PRIOR NOTICE OF ACTION RELATING TO CERTAIN |
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141 | 141 | | CLAIMS FOR PROPERTY DAMAGE; ABATEMENT. (a) An insured may not |
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142 | 142 | | bring suit under Section 542.060 in connection with a claim for |
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143 | 143 | | damage to or loss of real property or tangible personal property |
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144 | 144 | | made under an insurance policy providing coverage for damage to or |
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145 | 145 | | loss of real property unless the insured has provided written |
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146 | 146 | | notice to the insurer with respect to the claim in accordance with |
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147 | 147 | | Section 541.1541 and any information requested by the insurer in |
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148 | 148 | | accordance with that section. |
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149 | 149 | | (b) A suit under Section 542.060 for which notice is |
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150 | 150 | | required by this section is subject to abatement to the same extent |
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151 | 151 | | and in the same manner provided by Section 541.155 for an action |
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152 | 152 | | under Subchapter D, Chapter 541. |
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153 | 153 | | SECTION 9. Section 542.060, Insurance Code, is amended to |
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154 | 154 | | read as follows: |
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155 | 155 | | Sec. 542.060. LIABILITY FOR VIOLATION OF SUBCHAPTER. |
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156 | 156 | | (a) If an insurer that is liable for a claim under an insurance |
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157 | 157 | | policy is not in compliance with this subchapter, the insurer is |
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158 | 158 | | liable to pay the holder of the policy or the beneficiary making the |
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159 | 159 | | claim under the policy, in addition to the amount of the claim, |
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160 | 160 | | interest on the unpaid amount of the claim at the rate of 18 percent |
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161 | 161 | | a year as damages, together with reasonable attorney's fees. |
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162 | 162 | | (a-1) In determining the amount of attorney's fees awarded |
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163 | 163 | | under Subsection (a), the trier of fact shall consider: |
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164 | 164 | | (1) the time and labor required, the novelty and |
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165 | 165 | | difficulty of the questions involved, and the skill requisite to |
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166 | 166 | | perform the legal service properly; |
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167 | 167 | | (2) the likelihood, if apparent to the claimant, that |
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168 | 168 | | the acceptance of the particular employment will preclude other |
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169 | 169 | | employment by the attorney; |
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170 | 170 | | (3) the fee customarily charged in the locality for |
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171 | 171 | | similar legal services; |
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172 | 172 | | (4) the amount involved and the results obtained; |
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173 | 173 | | (5) the time limitations imposed by the claimant or by |
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174 | 174 | | the circumstances; |
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175 | 175 | | (6) the nature and length of the professional |
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176 | 176 | | relationship with the claimant; |
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177 | 177 | | (7) the experience, reputation, and ability of the |
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178 | 178 | | attorney performing the services; and |
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179 | 179 | | (8) whether the fee is fixed or contingent on results |
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180 | 180 | | obtained or uncertainty of collection before the legal services |
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181 | 181 | | have been rendered. |
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182 | 182 | | (b) If a suit is filed, interest and [the] attorney's fees |
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183 | 183 | | payable under this section shall be taxed as part of the costs in |
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184 | 184 | | the case. |
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185 | 185 | | (c) The liability for interest and attorney's fees provided |
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186 | 186 | | by this section is the exclusive remedy for a violation of this |
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187 | 187 | | subchapter. This section is not intended to affect a right or |
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188 | 188 | | remedy provided by Chapter 541 or any other law outside this |
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189 | 189 | | subchapter. |
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190 | 190 | | (d) If a claim for a loss has been paid by the insurer and a |
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191 | 191 | | suit under this section arises out of a supplemental claim for that |
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192 | 192 | | loss, interest awarded under this section on the supplemental claim |
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193 | 193 | | begins to accrue on the 60th day after the date the insurer receives |
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194 | 194 | | notice of the supplemental claim. |
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195 | 195 | | SECTION 10. Subtitle A, Title 10, Insurance Code, is |
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196 | 196 | | amended by adding Chapter 1808 to read as follows: |
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197 | 197 | | CHAPTER 1808. CERTAIN CLAIMS FOR PROPERTY DAMAGE |
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198 | 198 | | Sec. 1808.001. DEFINITION. In this chapter, "claim for |
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199 | 199 | | property damage" means a claim to which this chapter applies. |
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200 | 200 | | Sec. 1808.002. APPLICABILITY OF CHAPTER. This chapter |
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201 | 201 | | applies only to a first party claim for damage to or loss of real |
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202 | 202 | | property or tangible personal property made under an insurance |
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203 | 203 | | policy: |
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204 | 204 | | (1) providing coverage for damage to or loss of real |
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205 | 205 | | property; and |
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206 | 206 | | (2) issued by: |
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207 | 207 | | (A) any insurer authorized to write property |
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208 | 208 | | insurance in this state, including: |
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209 | 209 | | (i) an insurance company; |
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210 | 210 | | (ii) a reciprocal or interinsurance |
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211 | 211 | | exchange; |
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212 | 212 | | (iii) a mutual insurance company; |
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213 | 213 | | (iv) a capital stock insurance company; |
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214 | 214 | | (v) a county mutual insurance company; |
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215 | 215 | | (vi) a farm mutual insurance company; or |
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216 | 216 | | (vii) a Lloyd's plan; |
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217 | 217 | | (B) an eligible surplus lines insurer; or |
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218 | 218 | | (C) the FAIR Plan Association. |
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219 | 219 | | Sec. 1808.003. CLAIM FILING PERIOD. (a) Subject to |
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220 | 220 | | Subsection (b), failure to provide notice of a claim for property |
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221 | 221 | | damage by the second anniversary of the date on which the damage to |
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222 | 222 | | or loss of property that is the basis of the claim occurs is an |
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223 | 223 | | absolute bar to recovery on the claim. |
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224 | 224 | | (b) Recovery on a claim for property damage is not barred if |
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225 | 225 | | in an action to recover on the claim the trier of fact determines |
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226 | 226 | | the claimant had good cause not to provide notice of the claim in |
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227 | 227 | | the time prescribed by Subsection (a). |
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228 | 228 | | (c) For the purposes of Subsection (b), "good cause" |
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229 | 229 | | includes military deployment. |
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230 | 230 | | (d) Except as provided by this subsection, nothing in this |
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231 | 231 | | section precludes an insurer from raising any defense available |
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232 | 232 | | under the terms of its policy relating to prompt notice or that is |
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233 | 233 | | otherwise available under the law. If an insurer raises a defense |
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234 | 234 | | based on the fact that notice of claim was not made in accordance |
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235 | 235 | | with the policy terms, the defense applies only on a showing and to |
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236 | 236 | | the extent that the insurer was prejudiced by notice not being made |
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237 | 237 | | in accordance with the policy terms. |
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238 | 238 | | Sec. 1808.004. APPRAISAL STANDARDS. (a) The commissioner |
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239 | 239 | | by rule shall adopt standards for minimum fairness for provisions |
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240 | 240 | | in insurance policies described by Section 1808.002 that provide an |
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241 | 241 | | appraisal process for claims for property damage. |
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242 | 242 | | (b) Standards adopted under this section must: |
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243 | 243 | | (1) take into consideration the expense involved in |
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244 | 244 | | submitting a claim to the appraisal process; and |
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245 | 245 | | (2) provide for a process that: |
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246 | 246 | | (A) is not unnecessarily complicated; and |
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247 | 247 | | (B) is designed to yield a prompt and fair |
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248 | 248 | | resolution of the disputed matter. |
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249 | 249 | | Sec. 1808.005. APPROVAL OF APPRAISAL PROVISIONS. (a) An |
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250 | 250 | | insurer described by Section 1808.002 may submit to the |
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251 | 251 | | commissioner for purposes of Section 1808.006 any policy form used |
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252 | 252 | | or proposed to be used by the insurer to write insurance policies |
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253 | 253 | | described by Section 1808.002 that contains provisions that provide |
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254 | 254 | | an appraisal process for claims for property damage. |
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255 | 255 | | (b) If the commissioner determines the appraisal provisions |
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256 | 256 | | in a policy form submitted under this section comply with the |
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257 | 257 | | minimum standards adopted by the commissioner under Section |
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258 | 258 | | 1808.004, the commissioner shall approve the appraisal provisions |
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259 | 259 | | for purposes of Section 1808.006. |
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260 | 260 | | Sec. 1808.006. LIABILITY LIMITATIONS. (a) Except as |
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261 | 261 | | provided by this section, an insurer is not liable in any private |
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262 | 262 | | cause of action under Chapter 541 or 542 relating to or arising from |
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263 | 263 | | a claim for property damage if: |
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264 | 264 | | (1) the policy under which the claim is made contains |
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265 | 265 | | appraisal provisions: |
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266 | 266 | | (A) approved by the commissioner under Section |
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267 | 267 | | 1808.005; or |
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268 | 268 | | (B) substantially similar to provisions approved |
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269 | 269 | | by the commissioner under that section; |
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270 | 270 | | (2) the insurer: |
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271 | 271 | | (A) timely accepts the insured's demand for |
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272 | 272 | | appraisal; or |
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273 | 273 | | (B) makes a demand for appraisal not later than |
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274 | 274 | | the 30th day after the later of the date the insurer receives the |
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275 | 275 | | notice of the claim required by Section 541.1541 or 542.0595, as |
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276 | 276 | | applicable, or the date the insurer receives information related to |
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277 | 277 | | the claim timely requested by the insurer in accordance with |
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278 | 278 | | Section 541.1541 for purposes of that section or Section 542.0595, |
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279 | 279 | | as applicable, including notice or requested information received |
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280 | 280 | | after an abatement of an action under Section 541.155 or 542.0595; |
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281 | 281 | | and |
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282 | 282 | | (3) the insurer: |
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283 | 283 | | (A) participates in the appraisal process in good |
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284 | 284 | | faith; and |
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285 | 285 | | (B) pays or tenders, not later than the 15th day |
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286 | 286 | | after the date the insurer receives the appraisal award: |
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287 | 287 | | (i) the full amount of the appraisal award, |
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288 | 288 | | less the amount of any deductible or previous payment on the claim; |
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289 | 289 | | and |
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290 | 290 | | (ii) interest on the amount paid under |
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291 | 291 | | Subparagraph (i) at the rate of 12 percent annually. |
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292 | 292 | | (b) For purposes of this section, if there is a dispute as to |
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293 | 293 | | whether the insurer is to pay actual cash value or replacement cost, |
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294 | 294 | | the insurer must pay or tender an amount under Section (a)(3)(B) |
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295 | 295 | | that is based on the replacement cost. |
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296 | 296 | | (c) Interest to be paid under Subsection (a) accrues |
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297 | 297 | | beginning on the later of: |
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298 | 298 | | (1) the fifth business day after the latest date on |
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299 | 299 | | which the insurer is required to provide notice of acceptance or |
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300 | 300 | | rejection of the relevant claim under Section 542.056; or |
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301 | 301 | | (2) if payment of the relevant claim or part of the |
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302 | 302 | | relevant claim is conditioned on the performance of an act by the |
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303 | 303 | | claimant, the fifth business day after the date the act is |
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304 | 304 | | performed. |
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305 | 305 | | SECTION 11. Section 4102.051(a), Insurance Code, is amended |
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306 | 306 | | to read as follows: |
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307 | 307 | | (a) A person may not act as a public insurance adjuster in |
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308 | 308 | | this state or hold himself or herself out to be a public insurance |
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309 | 309 | | adjuster in this state unless the person holds a license [or |
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310 | 310 | | certificate] issued by the commissioner under Section 4102.053 |
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311 | 311 | | or[,] 4102.054[, or 4102.069]. |
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312 | 312 | | SECTION 12. Sections 4102.066(a) and (b), Insurance Code, |
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313 | 313 | | are amended to read as follows: |
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314 | 314 | | (a) The commissioner shall collect in advance the following |
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315 | 315 | | nonrefundable fees: |
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316 | 316 | | (1) for a public insurance adjuster license, an |
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317 | 317 | | application fee in an amount to be determined by rule by the |
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318 | 318 | | commissioner; |
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319 | 319 | | (2) for a nonresident public insurance adjuster |
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320 | 320 | | license, an application fee in an amount to be determined by rule by |
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321 | 321 | | the commissioner; and |
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322 | 322 | | (3) for each public insurance adjuster examination, a |
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323 | 323 | | fee in an amount to be determined by rule by the commissioner[; and |
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324 | 324 | | [(4) for a public insurance adjuster trainee |
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325 | 325 | | certificate under Section 4102.069, a registration fee in an amount |
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326 | 326 | | to be determined by rule by the commissioner]. |
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327 | 327 | | (b) The amount of the fee for the renewal of a license [or a |
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328 | 328 | | certificate] issued under this chapter shall be determined by rule |
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329 | 329 | | by the commissioner. |
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330 | 330 | | SECTION 13. Section 4102.103, Insurance Code, is amended by |
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331 | 331 | | adding Subsection (d) to read as follows: |
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332 | 332 | | (d) A license holder may not enter into a contract with an |
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333 | 333 | | insured and collect a commission as provided by Section 4102.104 |
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334 | 334 | | without the intent to actually perform the services customarily |
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335 | 335 | | provided by a licensed public insurance adjuster for the insured. |
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336 | 336 | | SECTION 14. Section 4102.104(d), Insurance Code, is amended |
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337 | 337 | | to read as follows: |
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338 | 338 | | (d) A public insurance adjuster may not accept any payment |
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339 | 339 | | that violates the provisions of this section [Subsection (c)]. |
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340 | 340 | | SECTION 15. Section 4102.158, Insurance Code, is amended by |
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341 | 341 | | amending Subsection (a) and adding Subsections (d), (e), and (f) to |
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342 | 342 | | read as follows: |
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343 | 343 | | (a) A license holder may not: |
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344 | 344 | | (1) participate directly or indirectly in the |
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345 | 345 | | reconstruction, repair, or restoration of damaged property that is |
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346 | 346 | | the subject of a claim adjusted by the license holder; or |
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347 | 347 | | (2) engage in any other activities that may reasonably |
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348 | 348 | | be construed as presenting a conflict of interest, including |
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349 | 349 | | soliciting or accepting any remuneration from, [or] having a |
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350 | 350 | | financial interest in, or deriving any direct or indirect financial |
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351 | 351 | | benefit from, any salvage firm, repair firm, construction firm, or |
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352 | 352 | | other firm that obtains business in connection with any claim the |
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353 | 353 | | license holder has a contract or agreement to adjust. |
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354 | 354 | | (d) A license holder may not directly or indirectly solicit, |
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355 | 355 | | as described by Chapter 38, Penal Code, employment for an attorney |
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356 | 356 | | or enter into a contract with an insured for the primary purpose of |
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357 | 357 | | referring an insured to an attorney and without the intent to |
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358 | 358 | | actually perform the services customarily provided by a licensed |
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359 | 359 | | public insurance adjuster. This section may not be construed to |
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360 | 360 | | prohibit a license holder from recommending a particular attorney |
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361 | 361 | | to an insured. |
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362 | 362 | | (e) A license holder may not act on behalf of an attorney in |
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363 | 363 | | having an insured sign an attorney representation agreement. |
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364 | 364 | | (f) A license holder must become familiar with and at all |
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365 | 365 | | times act in conformance with the criminal barratry statute set |
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366 | 366 | | forth in Section 38.12, Penal Code. |
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367 | 367 | | SECTION 16. Section 4102.160, Insurance Code, is amended to |
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368 | 368 | | read as follows: |
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369 | 369 | | Sec. 4102.160. CERTAIN PAYMENTS PROHIBITED. A license |
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370 | 370 | | holder may not: |
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371 | 371 | | (1) advance money to any potential client or insured; |
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372 | 372 | | or |
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373 | 373 | | (2) pay, allow, or give, or offer to pay, allow, or |
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374 | 374 | | give, directly or indirectly, to a person who is not a licensed |
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375 | 375 | | public insurance adjuster a fee, commission, or other valuable |
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376 | 376 | | consideration for the referral of an insured to the public |
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377 | 377 | | insurance adjuster for purposes of [based on] the insured entering |
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378 | 378 | | into a contract with that public insurance adjuster or for any other |
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379 | 379 | | purpose[; or |
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380 | 380 | | [(3) otherwise offer to pay a fee, commission, or |
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381 | 381 | | other valuable consideration exceeding $100 to a person not |
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382 | 382 | | licensed as a public insurance adjuster for referring an insured to |
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383 | 383 | | the license holder]. |
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384 | 384 | | SECTION 17. Subchapter D, Chapter 4102, Insurance Code, is |
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385 | 385 | | amended by adding Section 4102.164 to read as follows: |
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386 | 386 | | Sec. 4102.164. ACCEPTANCE OF REFERRAL PAYMENTS PROHIBITED. |
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387 | 387 | | (a) A licensed public insurance adjuster may not accept a fee, |
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388 | 388 | | commission, or other valuable consideration of any nature, |
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389 | 389 | | regardless of form or amount, in exchange for the referral by a |
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390 | 390 | | licensed public insurance adjuster of an insured to any third-party |
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391 | 391 | | individual or firm, including but not limited to an attorney, |
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392 | 392 | | appraiser, umpire, construction company, contractor, or salvage |
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393 | 393 | | company. |
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394 | 394 | | (b) The commissioner shall adopt rules necessary to |
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395 | 395 | | implement and enforce this section. |
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396 | 396 | | SECTION 18. The heading to Section 27.02, Business & |
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397 | 397 | | Commerce Code, is amended to read as follows: |
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398 | 398 | | Sec. 27.02. CERTAIN OFFERS MADE AND INFORMATION PROVIDED IN |
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399 | 399 | | CONNECTION WITH INSURANCE CLAIMS [FOR EXCESSIVE CHARGES]. |
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400 | 400 | | SECTION 19. Section 27.02(a), Business & Commerce Code, is |
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401 | 401 | | amended to read as follows: |
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402 | 402 | | (a) A person who sells goods or services, including a |
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403 | 403 | | contractor, appraiser, estimator, or insurance restoration |
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404 | 404 | | contractor, commits an offense if, in connection with a claim for |
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405 | 405 | | property loss or damage under a property or casualty insurance |
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406 | 406 | | policy: |
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407 | 407 | | (1) the person advertises or promises to [provide the |
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408 | 408 | | good or service and to] pay, waive, absorb, rebate, subsidize, |
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409 | 409 | | credit, or otherwise cover for any reason[: |
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410 | 410 | | [(A)] all or part of any applicable insurance |
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411 | 411 | | deductible or other uninsured amount owed by an insured under the |
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412 | 412 | | terms of the policy; [or |
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413 | 413 | | [(B) a rebate in an amount equal to all or part of |
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414 | 414 | | any applicable insurance deductible;] |
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415 | 415 | | (2) [the good or service is paid for by the consumer |
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416 | 416 | | from proceeds of a property or casualty insurance policy; and |
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417 | 417 | | [(3)] the person knowingly provides or causes to be |
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418 | 418 | | provided to an insurer any estimate or other statement as to the |
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419 | 419 | | cost of repair for the good or service to be provided that has been |
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420 | 420 | | increased, inflated, or otherwise manipulated [charges an amount |
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421 | 421 | | for the good or service that exceeds the usual and customary charge |
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422 | 422 | | by the person for the good or service] by an amount equal to or |
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423 | 423 | | greater than all or part of the applicable insurance deductible or |
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424 | 424 | | other uninsured amount owed by an insured under the policy; or |
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425 | 425 | | (3) the person knowingly provides or causes to be |
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426 | 426 | | provided to an insurer any false information within any estimate, |
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427 | 427 | | bid, proposal, or other statement as to the scope of damage or cost |
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428 | 428 | | of repair for the good or service to be provided [paid by the person |
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429 | 429 | | to an insurer on behalf of an insured or remitted to an insured by |
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430 | 430 | | the person as a rebate]. |
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431 | 431 | | SECTION 20. Section 4102.069, Insurance Code, is repealed. |
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432 | 432 | | SECTION 21. (a) The Texas Department of Insurance shall |
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433 | 433 | | conduct a study to determine the effectiveness of the changes in law |
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434 | 434 | | made by this Act. The study must determine: |
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435 | 435 | | (1) whether the changes in law made the affected |
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436 | 436 | | insurance policies more affordable; |
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437 | 437 | | (2) whether the changes in law made the affected |
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438 | 438 | | insurance policies more available; |
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439 | 439 | | (3) whether the changes in law resulted in a change in |
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440 | 440 | | the percentage of home buyers who qualify for home loans; |
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441 | 441 | | (4) the effect of the changes in law on litigation; |
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442 | 442 | | (5) the effect of the changes in law on consumer |
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443 | 443 | | complaints; and |
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444 | 444 | | (6) the effect of the changes in law on policy |
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445 | 445 | | deductibles. |
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446 | 446 | | (b) The commissioner of insurance may request and obtain |
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447 | 447 | | data from insurers as necessary to perform the study required by |
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448 | 448 | | this section. |
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449 | 449 | | (c) Not later than November 1, 2018, the Texas Department of |
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450 | 450 | | Insurance shall submit a written report detailing the findings made |
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451 | 451 | | by the department under this section to the lieutenant governor, |
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452 | 452 | | speaker of the house of representatives, and members of the |
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453 | 453 | | legislature. |
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454 | 454 | | (d) This section expires January 1, 2019. |
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455 | 455 | | SECTION 22. Chapter 541, Insurance Code, as amended by this |
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456 | 456 | | Act, applies only to conduct that occurs on or after the effective |
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457 | 457 | | date of this Act. Conduct that occurs before the effective date of |
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458 | 458 | | this Act is governed by the law as it existed immediately before the |
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459 | 459 | | effective date of this Act, and that law is continued in effect for |
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460 | 460 | | that purpose. |
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461 | 461 | | SECTION 23. Subchapter B, Chapter 542, Insurance Code, as |
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462 | 462 | | amended by this Act, applies only to a claim for which notice of |
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463 | 463 | | claim is provided to an insurer on or after the effective date of |
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464 | 464 | | this Act. A claim for which notice of claim is provided to an |
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465 | 465 | | insurer before the effective date of this Act is governed by the law |
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466 | 466 | | as it existed immediately before the effective date of this Act, and |
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467 | 467 | | that law is continued in effect for that purpose. |
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468 | 468 | | SECTION 24. Chapter 1808, Insurance Code, as added by this |
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469 | 469 | | Act, applies only to a claim under an insurance policy delivered, |
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470 | 470 | | issued for delivery, or renewed on or after January 1, 2016. A |
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471 | 471 | | claim under a policy delivered, issued for delivery, or renewed |
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472 | 472 | | before January 1, 2016, is governed by the law as it existed |
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473 | 473 | | immediately before the effective date of this Act, and that law is |
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474 | 474 | | continued in effect for that purpose. |
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475 | 475 | | SECTION 25. The repeal by this Act of Section 4102.069, |
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476 | 476 | | Insurance Code, does not affect the authority of a person to act |
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477 | 477 | | under a temporary certificate issued by the Texas Department of |
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478 | 478 | | Insurance under that section before the effective date of this Act. |
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479 | 479 | | SECTION 26. Sections 4102.103(d) and 4102.158(d), |
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480 | 480 | | Insurance Code, as added by this Act, apply only to a contract |
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481 | 481 | | entered into or solicitation made on or after the effective date of |
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482 | 482 | | this Act. |
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483 | 483 | | SECTION 27. (a) Except as provided by this section, |
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484 | 484 | | Section 4102.104, Insurance Code, as amended by this Act, applies |
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485 | 485 | | only to payment for a service performed on or after the effective |
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486 | 486 | | date of this Act. |
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487 | 487 | | (b) Payment for a service performed before the effective |
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488 | 488 | | date of this Act or performed after the effective date of this Act |
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489 | 489 | | under a contract entered into before the effective date of this Act |
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490 | 490 | | is governed by the law as it existed immediately before the |
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491 | 491 | | effective date of this Act, and that law is continued in effect for |
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492 | 492 | | that purpose. |
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493 | 493 | | SECTION 28. Section 4102.160, Insurance Code, as amended by |
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494 | 494 | | this Act, and Section 4102.164, Insurance Code, as added by this |
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495 | 495 | | Act, apply only to a referral made on or after the effective date of |
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496 | 496 | | this Act. A referral made before the effective date of this Act is |
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497 | 497 | | governed by the law as it existed immediately before the effective |
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498 | 498 | | date of this Act, and that law is continued in effect for that |
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499 | 499 | | purpose. |
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500 | 500 | | SECTION 29. The changes in law made by this Act apply only |
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501 | 501 | | to an offense committed on or after the effective date of this Act. |
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502 | 502 | | An offense committed before the effective date of this Act is |
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503 | 503 | | governed by the law in effect when the offense was committed, and |
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504 | 504 | | the former law is continued in effect for that purpose. For |
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505 | 505 | | purposes of this section, an offense was committed before the |
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506 | 506 | | effective date of this Act if any element of the offense occurred |
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507 | 507 | | before that date. |
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508 | 508 | | SECTION 30. This Act takes effect September 1, 2015. |
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