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A BILL TO BE ENTITLED
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AN ACT
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relating to a misleading representation or misrepresentation in an |
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explanation of benefits provided by a health benefit plan issuer or |
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administrator. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 541.051, Insurance Code, is amended to |
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read as follows: |
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Sec. 541.051. MISREPRESENTATION REGARDING POLICY OR |
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INSURER. It is an unfair method of competition or an unfair or |
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deceptive act or practice in the business of insurance to: |
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(1) make, issue, or circulate or cause to be made, |
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issued, or circulated an estimate, illustration, circular, or |
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statement misrepresenting with respect to a policy issued or to be |
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issued: |
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(A) the terms of the policy; |
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(B) the benefits or advantages promised by the |
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policy; or |
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(C) the dividends or share of surplus to be |
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received on the policy; |
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(2) make a false or misleading statement regarding the |
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dividends or share of surplus previously paid on a similar policy; |
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(3) make a misleading representation or |
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misrepresentation regarding: |
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(A) the financial condition of an insurer; or |
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(B) the legal reserve system on which a life |
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insurer operates; |
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(4) use a name or title of a policy or class of |
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policies that misrepresents the true nature of the policy or class |
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of policies; [or] |
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(5) make a misrepresentation to a policyholder insured |
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by any insurer for the purpose of inducing or that tends to induce |
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the policyholder to allow an existing policy to lapse or to forfeit |
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or surrender the policy; or |
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(6) make a misleading representation or |
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misrepresentation in an explanation of benefits provided by a |
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health insurer or other health benefit plan issuer or a third-party |
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administrator of a health benefit plan to an individual covered |
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under the plan. |
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SECTION 2. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2017. |