|
|
|
A BILL TO BE ENTITLED
|
|
AN ACT
|
|
relating to dispute resolution for certain claims arising under |
|
insurance policies issued by the Fair Access to Insurance |
|
Requirements (FAIR) Plan Association; authorizing fees. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. Section 2211.003, Insurance Code, is amended by |
|
adding Subsection (c) to read as follows: |
|
(c) Subsection (a) does not apply to a person who is |
|
required to resolve a dispute under Subchapter D-1. |
|
SECTION 2. Subchapter A, Chapter 2211, Insurance Code, is |
|
amended by adding Sections 2211.004 and 2211.005 to read as |
|
follows: |
|
Sec. 2211.004. CERTAIN CONDUCT IN DISPUTE RESOLUTION |
|
PROHIBITED. (a) For purposes of this section, "presiding officer" |
|
includes a judge, mediator, arbitrator, appraiser, or panel member. |
|
(b) If a person insured under this chapter is assigned to |
|
act as presiding officer to preside over or resolve a dispute |
|
involving the association and another person insured under this |
|
chapter, the presiding officer shall, not later than the seventh |
|
day after the date of assignment, give written notice to the |
|
association and to each other party to the dispute, or the |
|
association's or other party's attorney, that the presiding officer |
|
is insured under this chapter. |
|
(c) In a proceeding with respect to which the commissioner |
|
has authority to designate the presiding officer, the association |
|
or other party that receives notice under Subsection (b) may file |
|
with the commissioner a written objection to the assignment of the |
|
presiding officer to the dispute. The written objection must |
|
contain the factual basis on which the association or other party |
|
objects to the assignment. |
|
(d) The commissioner shall assign a different presiding |
|
officer to the dispute if, after reviewing the objection filed |
|
under Subsection (c), the commissioner determines that the |
|
presiding officer originally assigned to the dispute has a direct |
|
financial or personal interest in the outcome of the dispute. |
|
(e) The association or other party must file an objection |
|
under Subsection (c) not later than the earlier of: |
|
(1) the seventh day after the date the association or |
|
other party receives actual notice that the presiding officer is |
|
insured under this chapter; or |
|
(2) the seventh day before the date of the first |
|
proceeding concerning the dispute. |
|
(f) The commissioner may, on a showing of good cause, extend |
|
the deadline to file an objection under Subsection (e). |
|
Sec. 2211.005. APPLICABILITY OF CERTAIN OTHER LAW. (a) A |
|
person may not bring a private action against the association, |
|
including a claim against an agent or representative of the |
|
association, under Chapter 541 or 542. Notwithstanding any other |
|
provision of this code or this chapter, a class action under |
|
Subchapter F, Chapter 541, or under Rule 42, Texas Rules of Civil |
|
Procedure, may be brought against the association only by the |
|
attorney general at the request of the department. |
|
(b) Chapter 542 does not apply to the processing and |
|
settlement of claims by the association. |
|
SECTION 3. Subchapter D, Chapter 2211, Insurance Code, is |
|
amended by adding Sections 2211.158 and 2211.159 to read as |
|
follows: |
|
Sec. 2211.158. REQUIRED POLICY PROVISIONS: DEADLINE FOR |
|
FILING CLAIM; NOTICE CONCERNING RESOLUTION OF CERTAIN DISPUTES. |
|
(a) An insurance policy issued by the association must: |
|
(1) require an insured to file a claim under the policy |
|
not later than the first anniversary of the date on which the damage |
|
to property that is the basis of the claim occurs; and |
|
(2) contain, in boldface type, a conspicuous notice |
|
concerning the resolution of disputes under the policy, including: |
|
(A) the processes and deadlines for appraisal |
|
under Section 2211.174 and alternative dispute resolution under |
|
Section 2211.175; |
|
(B) the binding effect of appraisal under Section |
|
2211.174; and |
|
(C) the necessity of complying with the |
|
requirements of Subchapter D-1 to seek relief, including judicial |
|
relief. |
|
(b) The commissioner, on a showing of good cause by a person |
|
insured under this chapter, may extend the one-year period |
|
described by Subsection (a)(1) for a period not to exceed 180 days. |
|
Sec. 2211.159. VOLUNTARY ARBITRATION OF CERTAIN COVERAGE |
|
AND CLAIM DISPUTES. (a) A person insured under this chapter may |
|
elect to purchase a binding arbitration endorsement in a form |
|
prescribed by the commissioner. A person who elects to purchase an |
|
endorsement under this section must arbitrate a dispute involving |
|
an act, ruling, or decision of the association relating to the |
|
payment of, the amount of, or the denial of the claim. |
|
(b) An arbitration under this section shall be conducted in |
|
the manner and under rules and deadlines prescribed by the |
|
commissioner by rule. |
|
(c) The association may offer a person insured under this |
|
chapter an actuarially justified premium discount on a policy |
|
issued by the association if the person elects to purchase a binding |
|
arbitration endorsement under this section. The premium discount |
|
may not exceed 10 percent of the premium for the policy, before the |
|
application of the discount. |
|
(d) The commissioner shall adopt rules necessary to |
|
implement and enforce this section, including rules defining |
|
"actuarially justified" for the purposes of this section. |
|
SECTION 4. Chapter 2211, Insurance Code, is amended by |
|
adding Subchapter D-1 to read as follows: |
|
SUBCHAPTER D-1. CLAIMS: SETTLEMENT AND DISPUTE RESOLUTION |
|
Sec. 2211.171. DEFINITIONS. In this subchapter: |
|
(1) "Association policy" means an insurance policy |
|
issued by the association. |
|
(2) "Claim" means a request for payment under an |
|
association policy. The term also includes any other claim against |
|
the association, or an agent or representative of the association, |
|
relating to an insured loss, under any theory or cause of action of |
|
any kind, regardless of the theory under which the claim is |
|
asserted, the cause of action brought, or the type of damages |
|
sought. |
|
(3) "Claimant" means a person who makes a claim. |
|
Sec. 2211.172. EXCLUSIVE REMEDIES AND LIMITATION ON AWARD. |
|
(a) This subchapter provides the exclusive remedies for a claim |
|
against the association, including an agent or representative of |
|
the association. |
|
(b) Subject to Section 2211.176, the association may not be |
|
held liable for any amount other than covered losses payable under |
|
the terms of the association policy. |
|
(c) The association, or an agent or representative of the |
|
association, may not be held liable for damages under Chapter 17, |
|
Business & Commerce Code, or, except as otherwise specifically |
|
provided by this chapter, under any provision of any law providing |
|
for additional damages, exemplary damages, or a penalty. |
|
Sec. 2211.173. FILING OF CLAIM; CLAIM PROCESSING. (a) |
|
Subject to Section 2211.158(b), an insured must file a claim under |
|
an association policy not later than the first anniversary of the |
|
date on which the damage to property that is the basis of the claim |
|
occurs. |
|
(b) The claimant may submit written materials, comments, |
|
documents, records, and other information to the association |
|
relating to the claim. If the claimant fails to submit information |
|
in the claimant's possession that is necessary for the association |
|
to determine whether to accept or reject the claim, the association |
|
may, not later than the 30th day after the date the claim is filed, |
|
request in writing the necessary information from the claimant. |
|
(c) The association shall, on request, provide a claimant |
|
reasonable access to all information relevant to the determination |
|
of the association concerning the claim. The claimant may copy the |
|
information at the claimant's own cost or may request the |
|
association to provide a copy of all or part of the information to |
|
the claimant. The association may charge a claimant the actual cost |
|
incurred by the association in providing a copy of information |
|
under this section, excluding any amount for labor involved in |
|
making any information or copy of information available to a |
|
claimant. |
|
(d) Unless the applicable 60-day period described by this |
|
subsection is extended by the commissioner under Section 2211.180, |
|
not later than the later of the 60th day after the date the |
|
association receives a claim or the 60th day after the date the |
|
association receives information requested under Subsection (b), |
|
the association shall provide the claimant, in writing, |
|
notification that: |
|
(1) the association has accepted coverage for the |
|
claim in full; |
|
(2) the association has accepted coverage for the |
|
claim in part and has denied coverage for the claim in part; or |
|
(3) the association has denied coverage for the claim |
|
in full. |
|
(e) In a notice provided under Subsection (d)(1), the |
|
association must inform the claimant of the amount of loss the |
|
association will pay and of the time limit to demand appraisal under |
|
Section 2211.174. |
|
(f) In a notice provided under Subsection (d)(2) or (3), the |
|
association must inform the claimant of, as applicable: |
|
(1) the portion of the loss for which the association |
|
accepts coverage and the amount of loss the association will pay; |
|
(2) the portion of the loss for which the association |
|
denies coverage and a detailed summary of the manner in which the |
|
association determined not to accept coverage for that portion of |
|
the claim; and |
|
(3) the time limit to: |
|
(A) demand appraisal under Section 2211.174 of |
|
the portion of the loss for which the association accepts coverage; |
|
and |
|
(B) provide notice of intent to bring an action |
|
as required by Section 2211.175. |
|
(g) In addition to a notice provided under Subsection (d)(2) |
|
or (3), the association shall provide a claimant with a form on |
|
which the claimant may provide the association notice of intent to |
|
bring an action as required by Section 2211.175. |
|
Sec. 2211.1731. PAYMENT OF CLAIM. (a) Except as provided |
|
by Subsection (b), if the association notifies a claimant under |
|
Section 2211.173(d)(1) or (2) that the association has accepted |
|
coverage for a claim in full or has accepted coverage for a claim in |
|
part, the association shall pay the accepted claim or accepted |
|
portion of the claim not later than the 10th day after the date |
|
notice is made. |
|
(b) If payment of the accepted claim or accepted portion of |
|
the claim is conditioned on the performance of an act by the |
|
claimant, the association shall pay the claim not later than the |
|
10th day after the date the act is performed. |
|
Sec. 2211.174. DISPUTES CONCERNING AMOUNT OF ACCEPTED |
|
COVERAGE. (a) If the association accepts coverage for a claim in |
|
full and a claimant disputes only the amount of loss the association |
|
will pay for the claim, or if the association accepts coverage for a |
|
claim in part and a claimant disputes the amount of loss the |
|
association will pay for the accepted portion of the claim, the |
|
claimant may request from the association a detailed summary of the |
|
manner in which the association determined the amount of loss the |
|
association will pay. |
|
(b) If a claimant disputes the amount of loss the |
|
association will pay for a claim or a portion of a claim, the |
|
claimant, not later than the 60th day after the date the claimant |
|
receives the notice described by Section 2211.173(d)(1) or (2), may |
|
demand appraisal in accordance with the terms of the association |
|
policy. |
|
(c) If a claimant, on a showing of good cause and not later |
|
than the 15th day after the expiration of the 60-day period |
|
described by Subsection (b), requests in writing that the 60-day |
|
period be extended, the association may grant an additional 30-day |
|
period in which the claimant may demand appraisal. |
|
(d) If a claimant demands appraisal under this section: |
|
(1) the appraisal must be conducted as provided by the |
|
association policy; and |
|
(2) the claimant and the association are responsible |
|
in equal shares for paying any costs incurred or charged in |
|
connection with the appraisal, including a fee charged under |
|
Subsection (e). |
|
(e) If a claimant demands appraisal under this section and |
|
the appraiser retained by the claimant and the appraiser retained |
|
by the association are able to agree on an appraisal umpire to |
|
participate in the resolution of the dispute, the appraisal umpire |
|
is the umpire chosen by the two appraisers. If the appraiser |
|
retained by the claimant and the appraiser retained by the |
|
association are unable to agree on an appraisal umpire to |
|
participate in the resolution of the dispute, the commissioner |
|
shall select an appraisal umpire from a roster of qualified umpires |
|
maintained by the department. The department may: |
|
(1) require appraisers to register with the department |
|
as a condition of being placed on the roster; and |
|
(2) charge a reasonable registration fee to defray the |
|
cost incurred by the department in maintaining the roster and the |
|
commissioner in selecting an appraisal umpire under this |
|
subsection. |
|
(f) Except as provided by Subsection (g), the appraisal |
|
decision is binding on the claimant and the association as to the |
|
amount of loss the association will pay for a fully accepted claim |
|
or the accepted portion of a partially accepted claim and is not |
|
appealable or otherwise reviewable. A claimant that does not |
|
demand appraisal before the expiration of the periods described by |
|
Subsections (b) and (c) waives the claimant's right to contest the |
|
association's determination of the amount of loss the association |
|
will pay with reference to a fully accepted claim or the accepted |
|
portion of a partially accepted claim. |
|
(g) A claimant or the association may, not later than the |
|
second anniversary of the date of an appraisal decision, file an |
|
action in a district court in the county in which the loss that is |
|
the subject of the appraisal occurred to vacate the appraisal |
|
decision and begin a new appraisal process if: |
|
(1) the appraisal decision was obtained by corruption, |
|
fraud, or other undue means; |
|
(2) the rights of the claimant or the association were |
|
prejudiced by: |
|
(A) evident partiality by an appraisal umpire; |
|
(B) corruption in an appraiser or appraisal |
|
umpire; or |
|
(C) misconduct or wilful misbehavior of an |
|
appraiser or appraisal umpire; or |
|
(3) an appraiser or appraisal umpire: |
|
(A) exceeded the appraiser's or appraisal |
|
umpire's powers; |
|
(B) refused to postpone the appraisal after a |
|
showing of sufficient cause for the postponement; |
|
(C) refused to consider evidence material to the |
|
claim; or |
|
(D) conducted the appraisal in a manner that |
|
substantially prejudiced the rights of the claimant or the |
|
association. |
|
(h) Except as provided by Subsection (g), a claimant may not |
|
bring an action against the association with reference to a claim |
|
for which the association has accepted coverage in full. |
|
Sec. 2211.175. DISPUTES CONCERNING DENIED COVERAGE. (a) |
|
If the association denies coverage for a claim in part or in full |
|
and the claimant disputes that determination, the claimant, not |
|
later than the expiration of the limitations period described by |
|
Section 2211.177(a) but after the date the claimant receives the |
|
notice described by Section 2211.173(d)(2) or (3), must provide the |
|
association with notice that the claimant intends to bring an |
|
action against the association concerning the partial or full |
|
denial of the claim. A claimant that does not provide notice of |
|
intent to bring an action before the expiration of the period |
|
described by this subsection waives the claimant's right to contest |
|
the association's partial or full denial of coverage and is barred |
|
from bringing an action against the association concerning the |
|
denial of coverage. |
|
(b) If a claimant provides notice of intent to bring an |
|
action under Subsection (a), the association may require the |
|
claimant, as a prerequisite to filing the action against the |
|
association, to submit the dispute to alternative dispute |
|
resolution by mediation or moderated settlement conference, as |
|
provided by Chapter 154, Civil Practice and Remedies Code. |
|
(c) The association must request alternative dispute |
|
resolution of a dispute described by Subsection (b) not later than |
|
the 60th day after the date the association receives from the |
|
claimant notice of intent to bring an action. |
|
(d) Alternative dispute resolution under this section must |
|
be completed not later than the 60th day after the date a request |
|
for alternative dispute resolution is made under Subsection (c). |
|
The 60-day period described by this subsection may be extended by |
|
the commissioner in accordance with Section 2211.180 or by the |
|
association and a claimant by mutual consent. |
|
(e) If the claimant is not satisfied after completion of |
|
alternative dispute resolution, or if alternative dispute |
|
resolution is not completed before the expiration of the 60-day |
|
period described by Subsection (d) or any extension under that |
|
subsection, the claimant may bring an action against the |
|
association in a district court in the county in which the loss that |
|
is the subject of the coverage denial occurred. An action brought |
|
under this subsection shall be presided over by a judge appointed by |
|
the judicial panel on multidistrict litigation designated under |
|
Section 74.161, Government Code. A judge appointed under this |
|
section must be an active judge, as defined by Section 74.041, |
|
Government Code, who is a resident of the county in which the loss |
|
that is the basis of the disputed denied coverage occurred or of a |
|
county adjacent to the county in which that loss occurred. |
|
(f) If a claimant brings an action against the association |
|
concerning a partial or full denial of coverage, the court shall |
|
abate the action until the notice of intent to bring an action has |
|
been provided and, if requested by the association, the dispute has |
|
been submitted to alternative dispute resolution, in accordance |
|
with this section. |
|
(g) A moderated settlement conference under this section |
|
may be conducted by a panel consisting of one or more impartial |
|
third parties. |
|
(h) If the association requests mediation under this |
|
section, the claimant and the association are responsible in equal |
|
shares for paying any costs incurred or charged in connection with |
|
the mediation. |
|
(i) If the association requests mediation under this |
|
section, and the claimant and the association are able to agree on a |
|
mediator, the mediator is the mediator agreed to by the claimant and |
|
the association. If the claimant and the association are unable to |
|
agree on a mediator, the commissioner shall select a mediator from a |
|
roster of qualified mediators maintained by the department. The |
|
department may: |
|
(1) require mediators to register with the department |
|
as a condition of being placed on the roster; and |
|
(2) charge a reasonable registration fee to defray the |
|
cost incurred by the department in maintaining the roster and the |
|
commissioner in selecting a mediator under this subsection. |
|
(j) The commissioner shall establish rules to implement |
|
this section, including provisions for expediting alternative |
|
dispute resolution, facilitating the ability of a claimant to |
|
appear with or without counsel, establishing qualifications |
|
necessary for mediators to be placed on the roster maintained by the |
|
department under Subsection (i), and providing that formal rules of |
|
evidence shall not apply to the proceedings. |
|
Sec. 2211.176. ISSUES BROUGHT TO SUIT; LIMITATIONS ON |
|
RECOVERY. (a) The only issues a claimant may raise in an action |
|
brought against the association under Section 2211.175 are: |
|
(1) whether the association's denial of coverage was |
|
proper; and |
|
(2) the amount of the damages described by Subsection |
|
(b) to which the claimant is entitled, if any. |
|
(b) Except as provided by Subsections (c) and (d), a |
|
claimant that brings an action against the association under |
|
Section 2211.175 may recover only: |
|
(1) the covered loss payable under the terms of the |
|
association policy less, if applicable, the amount of loss already |
|
paid by the association for any portion of a covered loss for which |
|
the association accepted coverage; |
|
(2) prejudgment interest from the first day after the |
|
date specified in Section 2211.1731 by which the association was or |
|
would have been required to pay an accepted claim or the accepted |
|
portion of a claim, at the prejudgment interest rate provided by |
|
Subchapter B, Chapter 304, Finance Code; and |
|
(3) court costs and reasonable and necessary |
|
attorney's fees. |
|
(c) Nothing in this chapter, including Subsection (b), may |
|
be construed to limit the consequential damages, or the amount of |
|
consequential damages, that a claimant may recover under common law |
|
in an action against the association. |
|
(d) A claimant that brings an action against the association |
|
under Section 2211.175 may, in addition to the covered loss |
|
described by Subsection (b)(1) and any consequential damages |
|
recovered by the claimant under common law, recover damages in an |
|
amount not to exceed the aggregated amount of the covered loss |
|
described by Subsection (b)(1) and the consequential damages |
|
recovered under common law if the claimant proves by clear and |
|
convincing evidence that the association mishandled the claimant's |
|
claim to the claimant's detriment by intentionally: |
|
(1) failing to meet the deadlines or timelines |
|
established under this subchapter without good cause, including the |
|
applicable deadline established under Section 2211.1731 for |
|
payment of an accepted claim or the accepted portion of a claim; |
|
(2) failing to provide the notice required under |
|
Section 2211.173(d); |
|
(3) rejecting a claim without conducting a reasonable |
|
investigation with respect to the claim; or |
|
(4) denying coverage for a claim in part or in full if |
|
the association's liability has become reasonably clear as a result |
|
of the association's investigation with respect to the portion of |
|
the claim that was denied. |
|
(e) For purposes of Subsection (d), "intentionally" means |
|
actual awareness of the facts surrounding the act or practice |
|
listed in Subsection (d)(1), (2), (3), or (4), coupled with the |
|
specific intent that the claimant suffer harm or damages as a result |
|
of the act or practice. Specific intent may be inferred from |
|
objective manifestations that the association acted intentionally |
|
or from facts that show that the association acted with flagrant |
|
disregard of the duty to avoid the acts or practices listed in |
|
Subsection (d)(1), (2), (3), or (4). |
|
Sec. 2211.177. LIMITATIONS PERIOD. (a) Notwithstanding |
|
any other law, a claimant that brings an action against the |
|
association under Section 2211.175 must bring the action not later |
|
than the second anniversary of the date on which the person receives |
|
a notice described by Section 2211.173(d)(2) or (3). |
|
(b) This section is a statute of repose and controls over |
|
any other applicable limitations period. |
|
Sec. 2211.178. CONSTRUCTION WITH OTHER LAW. (a) To the |
|
extent of any conflict between a provision of this subchapter and |
|
any other law, the provision of this subchapter prevails. |
|
(b) Notwithstanding any other law, the association may not |
|
bring an action against a claimant, for declaratory or other |
|
relief, before the 180th day after the date an appraisal under |
|
Section 2211.174, or alternative dispute resolution under Section |
|
2211.175, is completed. |
|
Sec. 2211.179. RULEMAKING. (a) The commissioner shall |
|
adopt rules regarding the provisions of this subchapter, including |
|
rules concerning: |
|
(1) qualifications and selection of appraisers for the |
|
appraisal procedure and mediators for the mediation process; |
|
(2) procedures and deadlines for the payment and |
|
handling of claims by the association as well as the procedures and |
|
deadlines for a review of a claim by the association; and |
|
(3) any other matters regarding the handling of claims |
|
that are not inconsistent with this subchapter. |
|
(b) All rules adopted by the commissioner under this section |
|
must promote the fairness of the process, protect the rights of |
|
aggrieved policyholders, and ensure that policyholders may |
|
participate in the claims review process without the necessity of |
|
engaging legal counsel. |
|
Sec. 2211.180. COMMISSIONER EXTENSION OF DEADLINES. (a) |
|
The commissioner, on a showing of good cause, may extend any |
|
deadline established under this subchapter. |
|
(b) For the purposes of Subsection (a), "good cause" |
|
includes military deployment. |
|
Sec. 2211.181. OMBUDSMAN PROGRAM. (a) The department |
|
shall establish an ombudsman program to provide information and |
|
educational programs to assist persons insured under this chapter |
|
with the claim processes under this subchapter. |
|
(b) Not later than March 1 of each year, the department |
|
shall prepare and submit to the commissioner a budget for the |
|
ombudsman program, including approval of all expenditures incurred |
|
in administering and operating the program. The commissioner shall |
|
adopt or modify and adopt the budget not later than April 1 of the |
|
year in which the budget is submitted. |
|
(c) Not later than May 1 of each year, the association shall |
|
transfer to the ombudsman program money in an amount equal to the |
|
amount of the budget adopted under Subsection (b). The ombudsman |
|
program, not later than April 30 of each year, shall return to the |
|
association any unexpended funds that the program received from the |
|
association in the previous year. |
|
(d) The department shall, not later than the 60th day after |
|
the date of a catastrophic event, as defined by the commissioner for |
|
the purposes of this subsection, prepare and submit an amended |
|
budget to the commissioner for approval and report to the |
|
commissioner the approximate number of claimants eligible for |
|
ombudsman services. The commissioner shall adopt rules as |
|
necessary to implement an amended budget submitted under this |
|
section, including rules regarding the transfer of additional money |
|
from the association to the program. |
|
(e) The ombudsman program may provide to persons insured |
|
under this chapter information and educational programs through: |
|
(1) informational materials; |
|
(2) toll-free telephone numbers; |
|
(3) public meetings; |
|
(4) outreach centers; |
|
(5) the Internet; and |
|
(6) other reasonable means. |
|
(f) The ombudsman program is administratively attached to |
|
the department. The department shall provide the staff, services, |
|
and facilities necessary for the ombudsman program to operate, |
|
including: |
|
(1) administrative assistance and service, including |
|
budget planning and purchasing; |
|
(2) personnel services; |
|
(3) office space; and |
|
(4) computer equipment and support. |
|
(g) The ombudsman program shall prepare and make available |
|
to each person insured under this chapter information describing |
|
the functions of the ombudsman program. |
|
(h) The association, in the manner prescribed by the |
|
commissioner by rule, shall notify each person insured under this |
|
chapter concerning the operation of the ombudsman program. |
|
(i) The commissioner may adopt rules as necessary to |
|
implement this section. |
|
SECTION 5. (a) Except as otherwise specifically provided |
|
by this section, this Act applies only to an insurance policy that |
|
is delivered, issued for delivery, or renewed by the Fair Access to |
|
Insurance Requirements Plan Association on or after the 60th day |
|
after the effective date of this Act. An insurance policy that is |
|
delivered, issued for delivery, or renewed by the Fair Access to |
|
Insurance Requirements Plan Association before the 60th day after |
|
the effective date of this Act is governed by the law as it existed |
|
immediately before the effective date of this Act, and that law is |
|
continued in effect for that purpose. |
|
(b) The deadline to file a claim under an insurance policy |
|
delivered, issued for delivery, or renewed before the 60th day |
|
after the effective date of this Act by the Fair Access to Insurance |
|
Requirements Plan Association is governed by the law as it existed |
|
immediately before the effective date of this Act, and that law is |
|
continued in effect for that purpose. |
|
(c) If a person insured by the Fair Access to Insurance |
|
Requirements Plan Association disputes the amount the association |
|
will pay for a partially or fully accepted claim filed by the |
|
person, Section 2211.174, Insurance Code, as added by this Act, |
|
applies only if the insurance policy under which the claim is filed |
|
is delivered, issued for delivery, or renewed on or after the 60th |
|
day after the effective date of this Act. |
|
(d) If a person insured by the Fair Access to Insurance |
|
Requirements Plan Association disputes the amount the association |
|
will pay for a partially or fully accepted claim filed by the person |
|
and the insurance policy under which the claim is filed is |
|
delivered, issued for delivery, or renewed before the 60th day |
|
after the effective date of this Act: |
|
(1) Section 2211.174, Insurance Code, as added by this |
|
Act, does not apply to the resolution of the dispute; and |
|
(2) notwithstanding any other provision of this Act, |
|
the claimant must attempt to resolve the dispute through any |
|
appraisal process contained in the association policy under which |
|
the claim is filed before an action may be brought against the Fair |
|
Access to Insurance Requirements Plan Association concerning the |
|
claim. |
|
(e) The person insured by the Fair Access to Insurance |
|
Requirements Plan Association and the association may agree that an |
|
appraisal conducted under Subsection (d)(2) of this section is |
|
binding on the parties. |
|
(f) An action brought against the association concerning a |
|
claim described by Subsection (d) of this section shall be abated |
|
until the appraisal process under Subsection (d)(2) of this section |
|
is completed. |
|
(g) Notwithstanding Sections 2211.175 and 2211.176, |
|
Insurance Code, as added by this Act, Subsection (b) of this |
|
section, or any other provision of this Act, Sections 2211.176(b), |
|
(c), (d), and (e), Insurance Code, apply to any cause of action that |
|
accrues against the Fair Access to Insurance Requirements Plan |
|
Association on or after the effective date of this Act and the basis |
|
of which is a claim filed under an insurance policy that is |
|
delivered, issued for delivery, or renewed by the association, |
|
regardless of the date on which the policy was delivered, issued for |
|
delivery, or renewed. |
|
SECTION 6. This Act takes effect immediately if it receives |
|
a vote of two-thirds of all the members elected to each house, as |
|
provided by Section 39, Article III, Texas Constitution. If this |
|
Act does not receive the vote necessary for immediate effect, this |
|
Act takes effect September 1, 2017. |