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Texas Insurance Code - INS § 2210.059. Claims Practices Audit

Current as of January 01, 2024 | Updated by Findlaw Staff

(a) The commissioner, in the manner and at the time the commissioner determines to be necessary, shall conduct a random audit of claim files concerning claims the bases of which are damage to insured property caused by a particular storm to:

(1) determine whether the association is adequately and properly documenting claims decisions in each claim file;  and

(2) ensure that each claim is being handled appropriately, including being handled in accordance with the terms of the policy under which the claim is filed.

(b) The department shall conduct an audit required under this section as soon as possible to ensure the quality of the process with which the association is handling claims described by Subsection (a).

(c) If, following an audit conducted under this section, the commissioner determines that the association is not adequately and properly documenting claims decisions or that claims described by Subsection (a) are not otherwise being handled appropriately, the commissioner shall:

(1) notify the board of directors of that determination;  and

(2) identify the manner in which the association should correct any deficiencies identified by the commissioner and issue an order to that effect.

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Cite this article: FindLaw.com - Texas Insurance Code - INS § 2210.059. Claims Practices Audit - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-2210-059/

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