Tex. Insurance Code § 1204.252
This is the official text of Tex. Insurance Code § 1204.252, part of Texas’s Insurance Code — regulates insurance companies and the policies they sell.
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§ 1204.252. PRECONDITIONS FOR PAYMENT; EXCEPTIONS.
Official statutory text
(a) In accordance with the terms of the policy and this subchapter, an insurer or group hospital service corporation may be required to pay benefits under a group accident and health insurance policy to a person who is not a group member and who complies with:
(1) Section 1204.251;
(2) the insurer's or group hospital service corporation's claim application procedures; and
(3) department rules.
(b) Any requirement imposed on a possessory or managing conservator of a child under this subchapter does not apply with regard to:
(1) an unpaid medical bill for which an assignment of benefits has been exercised, whether in accordance with policy provisions or otherwise; or
(2) a claim presented by a group member for which the group member paid any portion of a medical bill that is covered under the policy's terms.
(1) Section 1204.251;
(2) the insurer's or group hospital service corporation's claim application procedures; and
(3) department rules.
(b) Any requirement imposed on a possessory or managing conservator of a child under this subchapter does not apply with regard to:
(1) an unpaid medical bill for which an assignment of benefits has been exercised, whether in accordance with policy provisions or otherwise; or
(2) a claim presented by a group member for which the group member paid any portion of a medical bill that is covered under the policy's terms.
Status: in_force · Read it on the official government site
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