Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter L - MEDICAL CHILD SUPPORT, UNFAIR PRACTICES
Section 21.2009 - Submission and Payment of Claims

Universal Citation: 28 TX Admin Code § 21.2009

Current through Reg. 50, No. 13; March 28, 2025

(a) An insurer shall not require the approval of the insured or enrollee parent for the submission of claims for covered services or for the appeal of a denial of any benefit by a custodial parent, a health care provider, a child over 18 years of age, or a state agency that has been assigned medical support rights.

(b) An insurer shall not refuse or fail to make payments on covered claims directly to the custodial parent, health care provider, child over 18 years of age, or state agency submitting the claim, in accordance with the terms of the policy. Nothing in this section shall require an insurer to make duplicate payments on covered claims.

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