Tex. Insurance Code § 751.208
This is the official text of Tex. Insurance Code § 751.208, part of Texas’s Insurance Code — regulates insurance companies and the policies they sell.
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§ 751.208. ASSESSMENT OF COSTS OF EXAMINATION.
Official statutory text
(a) Subject to Subsection (d), if the reasonable and necessary cost of a market conduct examination is to be assessed against the affected insurer, fees for that cost must be consistent with those otherwise authorized by law. The fees must be itemized and bills for the fees must be provided to the insurer on a monthly basis for review prior to submission for payment.
(b) The commissioner shall actively manage and oversee examination costs, including costs associated with the use of department examiners and with retaining qualified contract examiners necessary to perform an on-site examination. To the extent the commissioner retains outside assistance, the commissioner shall adopt by rule written protocols that:
(1) clearly identify the types of functions to be subject to outsourcing;
(2) provide specific time lines for completion of the outsourced review;
(3) require disclosure of recommendations made by contract examiners;
(4) establish and use a dispute resolution or arbitration mechanism to resolve conflicts with insurers regarding examination fees; and
(5) require disclosure of the terms of contracts entered into with outside consultants, and specifically terms regarding the fees or hourly rates that may be charged by those consultants.
(c) The commissioner must review and affirmatively endorse detailed billings made by a qualified contract examiner before the detailed billings are sent to the insurer.
(d) An insurer may not be required to provide reimbursement for examiner fees under Subsection (a), whether those fees are incurred by market conduct surveillance personnel or qualified contract examiners, to the extent that those fees exceed the fees prescribed in the market conduct examiners handbook and any successor documents to that handbook, unless the commissioner demonstrates that the fees prescribed in the handbook are inadequate under the circumstances of the examination.
(b) The commissioner shall actively manage and oversee examination costs, including costs associated with the use of department examiners and with retaining qualified contract examiners necessary to perform an on-site examination. To the extent the commissioner retains outside assistance, the commissioner shall adopt by rule written protocols that:
(1) clearly identify the types of functions to be subject to outsourcing;
(2) provide specific time lines for completion of the outsourced review;
(3) require disclosure of recommendations made by contract examiners;
(4) establish and use a dispute resolution or arbitration mechanism to resolve conflicts with insurers regarding examination fees; and
(5) require disclosure of the terms of contracts entered into with outside consultants, and specifically terms regarding the fees or hourly rates that may be charged by those consultants.
(c) The commissioner must review and affirmatively endorse detailed billings made by a qualified contract examiner before the detailed billings are sent to the insurer.
(d) An insurer may not be required to provide reimbursement for examiner fees under Subsection (a), whether those fees are incurred by market conduct surveillance personnel or qualified contract examiners, to the extent that those fees exceed the fees prescribed in the market conduct examiners handbook and any successor documents to that handbook, unless the commissioner demonstrates that the fees prescribed in the handbook are inadequate under the circumstances of the examination.
Status: in_force · Read it on the official government site
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