82R20567 TRH-F
 
  By: Carona, et al. S.B. No. 425
 
  (Hancock)
 
  Substitute the following for S.B. No. 425:  No.
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to property and casualty certificates of insurance and
  approval of property and casualty certificate of insurance forms by
  the Texas Department of Insurance; providing penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle A, Title 10, Insurance Code, is amended
  by adding Chapter 1811 to read as follows:
  CHAPTER 1811.  CERTIFICATES OF PROPERTY AND CASUALTY INSURANCE
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 1811.001.  DEFINITIONS. In this chapter:
               (1)  "Agent" means a person required to hold a license
  as a property and casualty agent or surplus lines agent.
               (2)  "Certificate holder" means a person, other than a
  policyholder:
                     (A)  who is designated on a certificate of
  insurance as a certificate holder; or
                     (B)  to whom a certificate of insurance has been
  issued by an insurer or agent at the request of the policyholder.
               (3)  "Certificate of insurance" means a document,
  instrument, or record, including an electronic record, no matter
  how titled or described, that is executed by an insurer or agent and
  issued to a third person not a party to the subject insurance
  contract, as a statement or summary of property or casualty
  insurance coverage. The term does not include an insurance binder
  or policy form.
               (4)  "Electronic record" has the meaning assigned by
  Section 322.002, Business & Commerce Code.
               (5)  "Insurance" means an insurance contract for
  property or casualty insurance.
               (6)  "Insurer" means a company or insurance carrier
  that is engaged in the business of making property or casualty
  insurance contracts. The term includes:
                     (A)  a stock fire or casualty insurance company;
                     (B)  a mutual fire or casualty insurance company;
                     (C)  a Mexican casualty insurance company;
                     (D)  a Lloyd's plan;
                     (E)  a reciprocal or interinsurance exchange;
                     (F)  a county mutual insurance company;
                     (G)  a farm mutual insurance company;
                     (H)  a risk retention group;
                     (I)  the Medical Liability Insurance Joint
  Underwriting Association under Chapter 2203;
                     (J)  the Texas Windstorm Insurance Association
  under Chapter 2210;
                     (K)  the FAIR Plan Association under Chapter 2211;
                     (L)  an eligible surplus lines insurer; and
                     (M)  any other insurer authorized to write
  property or casualty insurance in this state.
               (7)  "Lender" has the meaning assigned by Section
  549.001.
               (8)  "Person" means:
                     (A)  an individual; or
                     (B)  a partnership, corporation, limited
  liability company, association, trust, or other legal entity,
  including an insurer or a political subdivision or agency of this
  state.
               (9)  "Policyholder" means a person who has contracted
  with a property or casualty insurer for insurance coverage.
               (10)  "Record" has the meaning assigned by Section
  322.002, Business & Commerce Code.
         Sec. 1811.002.  APPLICABILITY. (a) This chapter applies to
  a certificate holder, policyholder, insurer, or agent with regard
  to a certificate of insurance issued on property or casualty
  operations or a risk located in this state, regardless of where the
  certificate holder, policyholder, insurer, or agent is located.
         (b)  This chapter may not be construed to apply to:
               (1)  a statement, summary, or evidence of property
  insurance required by a lender in a lending transaction involving:
                     (A)  a mortgage;
                     (B)  a lien;
                     (C)  a deed of trust; or
                     (D)  any other security interest in real or
  personal property as security for a loan;
               (2)  a certificate issued under:
                     (A)  a group or individual policy for:
                           (i)  life insurance;
                           (ii)  credit insurance;
                           (iii)  accident and health insurance;
                           (iv)  long-term care benefit insurance; or
                           (v)  Medicare supplement insurance; or
                     (B)  an annuity contract; or
               (3)  standard proof of motor vehicle liability
  insurance under Section 601.081, Transportation Code.
         Sec. 1811.003.  RULES. The commissioner may adopt rules as
  necessary or proper to accomplish the purposes of this chapter.
         Sec. 1811.004.  FILING FEE. (a) The department may collect a
  fee in an amount determined by the commissioner for the filing of a
  new or amended certificate of insurance form under this chapter.
         (b)  The fee may not exceed $100.
         (c)  A fee collected under this section shall be deposited to
  the credit of the Texas Department of Insurance operating account.
  [Sections 1811.005-1811.050 reserved for expansion]
  SUBCHAPTER B. PROHIBITED ACTS AND PRACTICES
         Sec. 1811.051.  ALTERING, AMENDING, OR EXTENDING THE TERMS
  OF AN INSURANCE POLICY; CONTRACTUAL RIGHTS OF CERTIFICATE HOLDER.  
  (a)  A property or casualty insurer or agent may not issue a
  certificate of insurance or any other type of document purporting
  to be a certificate of insurance if the certificate or document
  alters, amends, or extends the coverage or terms and conditions
  provided by the insurance policy referenced on the certificate or
  document.
         (b)  A certificate of insurance or any other type of document
  may not convey a contractual right to a certificate holder.
         Sec. 1811.052.  USE OF APPROVED CERTIFICATE OF INSURANCE
  FORMS. (a)  An insurer or an agent may not issue a certificate of
  insurance unless the form of the certificate:
               (1)  has been filed with and approved by the department
  under Section 1811.101; or
               (2)  is a standard form deemed approved by the
  department under Section 1811.103.
         (b)  A person may not execute, issue, or require the issuance
  of a certificate of insurance for risks located in this state,
  unless the certificate of insurance form has been filed with and
  approved by the department.
         Sec. 1811.053.  ALTERATION OR MODIFICATION OF APPROVED
  CERTIFICATE OF INSURANCE FORMS. A person may not alter or modify a
  certificate of insurance form approved under Section 1811.101
  unless the alteration or modification is approved by the
  department.
         Sec. 1811.054.  ISSUANCE OF FALSE OR MISLEADING CERTIFICATE
  OF INSURANCE. A person may not require the issuance of a
  certificate of insurance from an insurer, agent, or policyholder
  that contains any false or misleading information concerning the
  policy of insurance to which the certificate refers.
         Sec. 1811.055.  REQUEST FOR DOCUMENTS IN LIEU OF CERTIFICATE
  OF INSURANCE. A person may not require an agent or insurer, either
  in addition to or in lieu of a certificate of insurance, to issue
  any other document or correspondence, instrument, or record,
  including an electronic record, that is inconsistent with this
  chapter.
         Sec. 1811.056.  USE OF DISAPPROVED CERTIFICATE OF INSURANCE
  FORMS. A person who receives written notice under Section 1811.102
  that a certificate of insurance form filed under this chapter has
  been disapproved by the commissioner shall immediately stop using
  the form.
  [Sections 1811.057-1811.100 reserved for expansion]
  SUBCHAPTER C. CERTIFICATE OF INSURANCE FORMS
         Sec. 1811.101.  FILING AND APPROVAL OF FORMS. (a) Except as
  provided by Subsection (b), an insurer or agent may not deliver or
  issue for delivery in this state a certificate of insurance unless
  the certificate's form:
               (1)  has been filed with and approved by the
  commissioner; and
               (2)  contains the phrase "for information purposes
  only" or similar language.
         (b)  If a certificate of insurance form does not contain the
  language required by Subsection (a)(2), the commissioner may
  approve the form if the form states:
               (1)  that the certificate of insurance does not confer
  any rights or obligations other than the rights and obligations
  conveyed by the policy referenced on the form; and
               (2)  that the terms of the policy control over the terms
  of the certificate of insurance.
         (c)  A filed form is approved at the expiration of 60 days
  after the date the form is filed unless the commissioner by order
  approves or disapproves the form during the 60-day period beginning
  the date the form is filed.  The commissioner's approval of a filed
  form constitutes a waiver of any unexpired portion of the 60-day
  period.
         (d)  The commissioner may extend by not more than 10 days the
  60-day period described by Subsection (c) during which the
  commissioner may approve or disapprove a form filed by an insurer or
  agent.  The commissioner shall notify the insurer or agent of the
  extension before the expiration of the 60-day period.
         (e)  A filed form for which an extension has been granted
  under Subsection (d) is considered approved at the expiration of
  the extension period described by that subsection absent an earlier
  approval or disapproval of the form.
         (f)  A person may not use a form unless the form has been
  filed with and approved by the commissioner.
         Sec. 1811.102.  DISAPPROVAL OF FORMS; WITHDRAWAL OF
  APPROVAL.  (a)  The commissioner shall disapprove a form filed under
  Section 1811.101 or withdraw approval of a form if the form:
               (1)  contains a provision or has a title or heading that
  is misleading, is deceptive, or violates public policy;
               (2)  violates any state law, including a rule adopted
  under this code;
               (3)  requires an agent to provide certification of
  insurance coverage that is not available in the line or type of
  insurance coverage referenced on the form; or
               (4)  directly or indirectly requires the commissioner
  to make a coverage determination under a policy of insurance or
  insurance transaction.
         (b)  The commissioner may not disapprove a form filed under
  Section 1811.101 or withdraw approval of a form based solely on the
  fact that the form contains language described by Section
  1811.101(b).
         (c)  An order issued by the commissioner disapproving a form,
  or a notice of the commissioner's intention to withdraw approval of
  a form, must state the grounds for the disapproval or withdrawal of
  approval in sufficient detail to reasonably inform the person
  filing the form of those grounds and the changes to the form
  necessary to obtain approval.
         (d)  An order disapproving a form or withdrawing approval of
  a form takes effect on the date prescribed by the commissioner in
  the order.  The commissioner may not prescribe a date earlier than
  the 30th day after the effective date of the order, as prescribed by
  the commissioner.
         Sec. 1811.103.  STANDARD CERTIFICATE OF INSURANCE FORMS. A
  standard certificate of insurance form promulgated by the
  Association for Cooperative Operations Research and Development,
  the American Association of Insurance Services, or the Insurance
  Services Office (ISO) is deemed approved on the date the form is
  filed with the department. Notwithstanding this section, the
  commissioner may withdraw approval of a standard form under Section
  1811.102.
         Sec. 1811.104.  PUBLIC INSPECTION OF INFORMATION. A
  certificate of insurance form and any supporting information filed
  with the department under this subchapter is open to public
  inspection as of the date of the filing.
  [Sections 1811.105-1811.150 reserved for expansion]
  SUBCHAPTER D. EFFECT OF APPROVAL OF CERTIFICATE OF INSURANCE FORM
         Sec. 1811.151.  CONFIRMATION OF POLICY ISSUANCE. A
  certificate of insurance form that has been approved by the
  commissioner and properly executed and issued by a property and
  casualty insurer or an agent constitutes a confirmation that the
  referenced insurance policy has been issued or that coverage has
  been bound.  This section applies regardless of whether the face of
  the certificate includes the phrase "for information purposes only"
  or similar language.
         Sec. 1811.152.  CERTIFICATE OF INSURANCE NOT POLICY OF
  INSURANCE. A certificate of insurance is not a policy of insurance
  and does not amend, extend, or alter the coverage afforded by the
  referenced insurance policy.
         Sec. 1811.153.  RIGHTS CONFERRED BY CERTIFICATE OF
  INSURANCE. A certificate of insurance does not confer to a
  certificate holder new or additional rights beyond what the
  referenced policy or any executed endorsement of insurance
  provides.
         Sec. 1811.154.  REFERENCE TO OTHER CONTRACTS. A certificate
  of insurance may not contain a reference to a legal or insurance
  requirement contained in a contract other than the underlying
  contract of insurance, including a contract for construction or
  services.
         Sec. 1811.155.  NOTICE. (a)  A person may have a legal right
  to notice of cancellation, nonrenewal, or material change or any
  similar notice concerning a policy of insurance only if:
               (1)  the person is named within the policy or an
  endorsement to the policy; and
               (2)  the policy or endorsement or a law, including a
  rule, of this state requires notice to be provided.
         (b)  A certificate of insurance may not alter the terms and
  conditions of the notice required by a policy of insurance or the
  law of this state.
         Sec. 1811.156.  CERTIFICATE OF INSURANCE ISSUED IN VIOLATION
  OF CHAPTER.  A certificate of insurance that is executed, issued, or
  required and that is in violation of this chapter is void and has no
  effect.
  [Sections 1811.157-1811.200 reserved for expansion]
  SUBCHAPTER E. ENFORCEMENT AND REMEDIES
         Sec. 1811.201.  POWERS OF COMMISSIONER. (a)  If the
  commissioner has reason to believe that an insurer or agent has
  violated or is threatening to violate this chapter or a rule adopted
  under this chapter, the commissioner may:
               (1)  issue a cease and desist order;
               (2)  seek an injunction under Section 1811.203;
               (3)  request that the attorney general recover a civil
  penalty under Section 1811.203;
               (4)  impose sanctions on the insurer or agent as
  provided by Chapter 82; or
               (5)  take any combination of those actions.
         (b)  This section does not prevent or limit any action by or
  remedy available to the commissioner under applicable law.
         Sec. 1811.202.  HEARING; NOTICE. (a)  The commissioner may
  hold a hearing on whether to issue a cease and desist order under
  Section 1811.201 if the commissioner has reason to believe that:
               (1)  an insurer or agent has violated or is threatening
  to violate this chapter or a rule adopted under this chapter; or
               (2)  an insurer or agent has engaged in or is
  threatening to engage in an unfair act related to a certificate of
  insurance.
         (b)  The commissioner shall serve on the insurer or agent a
  statement of charges and a notice of hearing in the form provided by
  Section 2001.052, Government Code.
         (c)  A hearing under this section is a contested case under
  Chapter 2001, Government Code.
         Sec. 1811.203.  CIVIL PENALTY; INJUNCTION.  (a)  A person,
  including an insurer or agent, who wilfully violates this chapter
  is subject to a civil penalty of not more than $1,000 for each
  violation.
         (b)  The commissioner may request that the attorney general
  institute a civil suit in a district court in Travis County for
  injunctive relief to restrain a person, including an insurer or
  agent, from continuing a violation or threat of violation of
  Subchapter B. On application for injunctive relief and a finding
  that a person, including an insurer or agent, is violating or
  threatening to violate Subchapter B, the district court shall grant
  the injunctive relief and issue an injunction without bond.
         (c)  On request by the commissioner, the attorney general
  shall institute and conduct a civil suit in the name of the state
  for injunctive relief, to recover a civil penalty, or for both
  injunctive relief and a civil penalty, as authorized under this
  subchapter.
         Sec. 1811.204.  INVESTIGATION OF COMPLAINTS. (a)  The
  commissioner may:
               (1)  investigate a complaint or allegation of specific
  violations by a person, including an insurer or agent, who has
  allegedly engaged in an act or practice prohibited by Subchapter B;
  and
               (2)  enforce the provisions of this chapter.
         (b)  If the commissioner has reason to believe that a person,
  including an insurer or agent, is performing an act in violation of
  Subchapter B, the person shall immediately provide to the
  commissioner, on written request of the commissioner, information
  relating to that act.
         SECTION 2.  The changes in law made by this Act apply only to
  a certificate of insurance issued on or after January 1, 2012. A
  certificate of insurance issued before January 1, 2012, is governed
  by the law in effect immediately before the effective date of this
  Act, and that law is continued in effect for that purpose.
         SECTION 3.  This Act takes effect September 1, 2011.