Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES
Section 3.3008 - Policy Definitions of Accident, Accidental Injury, Injury

Universal Citation: 28 TX Admin Code § 3.3008

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

(a) These terms shall be defined to employ "result" language and may not include words which establish an accidental means test. Except for accidental death or dismemberment, said definitions may not include words such as "external, violent, visible wounds" or similar words of description or characterization and may not be more restrictive than the following: Injury or injuries for which benefits are provided means accidental bodily injuries sustained by an insured person which are the direct cause of the loss independent of disease, bodily infirmity, or any other cause and occurs while the policy is in force.

(b) Such definition may exclude, unless prohibited by law, injuries for which benefits are provided under any workmen's compensation, employer's liability or similar statute or injuries occurring while the insured person is engaged in any activity pertaining to any trade, business, employment, or occupation for wage or profit.

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