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 3.3055 - Standards for Probationary or Waiting Period Provision

Universal Citation: 28 TX Admin Code § 3.3055

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

A probationary or waiting period, if one is specified in the policy, is that period of time commencing with the date a person is initially insured under the policy to the date the coverage or coverages of the policy shall become effective as to such person.

(1) A probationary or waiting period shall not apply to any loss resulting from accidental injuries as defined in the policy; however, a policy may specify a probationary or waiting period for coverage of sickness which shall not exceed 30 days except as follows:

(A) for pregnancy, childbirth, miscarriage, or complications of pregnancy, the probationary or waiting period when expressed in terms of the inception of the pregnancy shall be no more than 30 days;

(B) six months for losses resulting from hernia, disorder of reproductive organs, varicose veins, hemorrhoids, appendix, tonsils, adenoids, and gall bladder;

(C) 120 days for coverages under specified disease insurance.

(2) The limitations set out in this section do not apply to benefits for dental or vision care.

(3) Probationary waiting periods do not affect limitations for pre-existing conditions.

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