Texas Insurance Code 4152.208 – Settlement of Claims
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(a) This section applies only to a contract entered into under Section 4152.201 that permits a manager to settle claims on behalf of an insurer.
(b) All claims must be reported to the insurer at least quarterly.
Terms Used In Texas Insurance Code 4152.208
- Contract: A legal written agreement that becomes binding when signed.
- Property: means real and personal property. See Texas Government Code 311.005
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
- Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005
(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.