Texas Register, Volume 11, Number 2, Pages 81-106, January 7, 1986 Page: 86
81-106 p. ; 28 cm.View a full description of this periodical.
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These amendment to 5.2004(aX4)(C) is
necessary for the fair and efficient con-
duct of the operations of the Joint Under-
writing Association. The association pro-
vides a residual market for medical pro-
fessional liability insurance in this state,
and the institutional and individual health
care providers who are members of the
association as well as the general public
require a fiscally sound and well admin-
istered association. The Immediate adop-
tion of an amendment to 5.2004(a)(4)(C)
is required to that end. The danger to the
financial stability of the association
without the immediate adoption of this
amendment creates an imminent peril to
the public welfare and requires that the
amendment be adopted or, an emergen-
cy basis.
These emergency amendments are
adopted under authority of the Insurance
Code, Article 21.49-3, 3(c). That article
provides for the preparation of the plan
of operation for the Joint Underwriting
Association and for amendments thereto
under the approval of or at the direction
of the State Board of Insurance.
5.2003. Members and Policyholders Par-
ticipation in the Texas Medical Liability In-
surance Underwriting Association.
(a)-(b) (No change.)
(c) Policyholder's stabilization re-
serve fund. The Act, 4A, creates the pol-
icyholder's stabilization reserve fund and
provides that this fund shall be administered
as provided in the Act and these sections
and that the advisory directors shall be
chosen as provided in these sections.
(1) (No change.)
(2) Policyholder's stabilization re-
serve fund charge. The proportionate pol-
icyholder's stabilization reserve fund charge
shall be based on the total annual written
premium for all coverages provided by the
association to the policyholder. The policy-
holder's stabilization reserve fund charges
shall not be refundable if the policy is
canceled after the 90th day of the coverage.
If canceled within the 90th day of coverage,
the earned charge will be based on the same
earned percentage charged for the insurance
premium [any portion of the coverage
premium that are the basis for the charge].
The policyholder's stablization reserve fund
charge shall apply to all new and renewal
policies effective on and after January 1,
1978.
(3) (No change.)
(d)-(j) (No change.)
5.2004. 'Medical Liability Insurance.
(a) The policy.
(1)-(3) (No change.)
(4) Special provisions.
(A)-(B) (No change.)
(C) Policies of excess medical li-
ability insurance written by the association
shall:
(i)-(ii) (No change.)
(iii) not be issued in those cases
where the net retention at risk by the primarycarrier is less than $100,000 [$25,0001 per oc-
currence or less than $300,000 [$75,000) ag-
gregate per annum;
(iv) (No change.)
(v) terminate automatically in
the event [if] the underlying primary policy
of medical liability insurance is not main-
tained for any reason, except exhaustion by
payment of a loss or losses. If the aggregate
underlying primary medical liability insur-
ance is exhausted by payment of a loss or
losses occurring during the policy period,
the insurance provided by the excess policy
shall apply in the same manner as if the
underlying primary insurance was in full
force and effect; [over which it is written
is canceled, expires, limits are exhausted, or
otherwise terminates.]
(vi) not be accepted for a hos-
pital or other institutional health care pro-
vider if the applicant does not provide evi-
dence that all physicians, surgeons, podia-
trists, dentists, pharmacists, or chiroprac-
tors with staff privileges are insured for
their individual medical (professional) li-
ability with limits of liability of at least
$100,000 per occurrence and $300,000 ag-
gregate per annum; and
(vii) not be accepted for phy-
sicians, surgeons, podiatrists, dentists, phar-
macists, or chiropractors who employ other
physicians, surgeons, podiatrists, dentists,
pharmacists, or chiropractors if the appli-
cant does not provide evidence that all em-
ployed physicians, surgeons, podiatrists,
dentists, pharmacists, or chiropractors who
are eligible to obtain coverage from the as-
sociation are insured for their individual
medical (professionall) liability with limits
of liability of at least $100,000 per occur-
rence and $300,000 aggregate per annum.
(D) No hospital or other institu-
tional health care provider or physician, sur-
geons, podiatrists, dentists, pharmacists, or
chiropractors that have employed physi-
cians, surgeons, podiatrists, dentists, phar-
macists, or chiropractors can be accepted
for coverage in the association without evi-
dence that all physicians, surgeons, podia-
trists, dentists, pharmacists, or chiroprac-
tors with staff privileges or employed by the
applicant are insured for their individual
medical (professional) liability with limits
of at least $100,000 per occurrence and
$300,000 aggregate per annum.
(5) (No change.)
(b) (No change.)
(c) Cancellation, nonrenewal, and
notice.
(1) Cancellation by the association.
The association may not cancel a policy of
insurance issued under these sections except
for:
(A)-(F) (No change.)
(G) noncompliance with reason-
able loss control or risk management engi-
neering recommendation in accordance with
subsection (b)(4)(A)(vi) of this section.
Upon cancellation of a policy of insurance
by the association, the association shall re-fund to the insured the unearned portion
of any paid premium and, if canceled withis
the 90th day of coverage, the unearned por-
tion of the paid pF licyholder's stabilization
reserve fund charge on a pro rata basis pro-
vided all assessments and policyholder's
stabilization reserve fund charges earned
have been fully paid; otherwise, only that
portion of unearned premium over any un-
paid assessment and policyholder's stabliza-
tion reserve fund charge [charges] will be
refunded. Policyholder assessments and
policyholder's stabilization reserve fund
charges are fully earned upon payment;
therefore, except as provided in the Act, or
S.2003(c)(2), of this title (relating to
Members and Policyholder's Participation
in the Texas Medical Liability Insurance
Underwriting Association) no portion is
refundable.
(2) Cancellation by the insured. A
policy of insurance may be canceled at any
time. [(A)] by the insured upon written re-
quest for cancellation of the policy; [(B)]
by an insurance premium finance company
in accordance with the provisions contained
in the Insurance Code, Article 24.17, in
which case the association shall efund the
unearned portion of any paid premium and
If canceled within the 90th day of coverage,
the unearned portion of the paid policy-
holder's stabilization reserve fund charge,
according to the approved short rate table,
provided all assessments and policyholder's
stabilization reserve fund charges earned
have been fully paid; otherwise, only that
portion of the unearned premium over any
unpaid assessment and policyholder's sta-
bilization reserve fund charge will be re-
funded. Policyholder assessments and pol-
icyholder's stabilization reserve fund
charges are fully earned upon payment;
therefore, except as provided in the Act, or
5.2003(c)(2), of this title (relating to Mem-
bers and Policyholder's Participation in the
Texas Medical Liability Insurance Under-
writing Association) no portion is
refundable.
(3)-(4) (No change.)
(d)-(e) (No change.)
Issued in Austin, Texas, on December 30, 1985.
TRD-8512324 James W. Norman
State Board of
Insurance
Effective date: January 1, 1986
Expiration date: May 1, 1986
For further information, please call
(512) 463-6327.
* j * *11~~~~~~~~~~~ Teg8 aur ,196TxsRgse
11 TexReg 86 January 7, 1986
Texas Register 4P
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Texas. Secretary of State. Texas Register, Volume 11, Number 2, Pages 81-106, January 7, 1986, periodical, January 7, 1986; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth243750/m1/8/: accessed April 30, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.