By: Davis of Dallas H.B. No. 4277
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of the consumer complaint review
panel by the State Office of Administrative Hearings to conduct
certain insurance appeals.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 2003, Government Code, is amended by
adding Subchapter E to read as follows:
SUBCHAPTER E. INSURANCE APPEALS
Sec. 2003.151. DEFINITIONS. In this subchapter:
(1) "Department" means the Texas Department of
Insurance.
(2) "Panel" means the consumer complaint review panel
established under this subchapter.
Sec. 2003.152. CONSUMER COMPLAINT REVIEW PANEL. (a) The
office shall establish a consumer complaint review panel to conduct
an appeal from the complaint resolution program established under
Chapter 521, Insurance Code, of a policyholder complaint:
(1) that is denied by the department;
(2) that is determined to be without merit by the
department; or
(3) for which the department did not confirm receipt
of the complaint.
(b) Except as provided by this subchapter, an appeal under
this section is a contested case under Chapter 2001.
Sec. 2003.152. TIMELINESS OF APPEAL. (a) The panel shall
conduct all appeals under this subchapter in a timely manner.
(b) The panel shall use every reasonable means to expedite
an appeal under this subchapter when the policyholder or department
provides good cause that the panel expedite the appeal.
Sec. 2003.153. CONFIDENTIALITY OF INFORMATION. (a) The
panel shall keep information that identifies a policyholder who
participates in an appeal under this subchapter confidential,
including the policyholder's name and medical condition, if
applicable.
(b) The provision of information to the panel that is
confidential under any law does not affect the confidentiality of
the information, and the panel shall maintain that confidentiality.
(c) An appeal conducted under this subchapter is
confidential and not open to the public.
Sec. 2003.154. DECISION. The panel shall determine whether
an appeal conducted under this subchapter has merit and if so,
remand the case to the department for resolution.
Sec. 2003.155. RULES. The commissioner of insurance may
adopt rules necessary to implement this subchapter.
SECTION 2. Not later than January 1, 2020, the State
Office
of Administrative Hearings shall establish the consumer complaint
review panel under Section 2003.152, Government Code, as added by
this Act.
SECTION 3. This Act takes effect September 1, 2019.