§ 542.006. Periodic Reporting Requirement
542.006. Periodic Reporting Requirement
(a) In this section, “claim” means a written claim filed by a resident of this state with an insurer engaging in business in this state.
(b) If, based on complaints of unfair claim settlement practices under this subchapter, the department finds that an insurer should be subjected to closer supervision with respect to the insurer's claim settlement practices, the department may require the insurer to file periodic reports at intervals the department determines necessary.
(c) The department shall devise a statistical plan for the periodic reports required under Subsection (b). The plan must contain at a minimum:
(1) the following claims information for the preceding 12 months or from the date of the insurer's last periodic report, whichever period is shorter:
(A) the total number of claims filed, including for each individual claim:
(i) the original amount filed for by the insured; and
(ii) the classification by line of insurance;
(B) the total number of claims denied;
(C) the total number of claims settled, including for each individual claim:
(i) the original amount filed for by the insured;
(ii) the amount settled; and
(iii) the classification by line of insurance; and
(D) the total number of claims for which suits have been instituted against the insurer, including for each individual claim:
(i) the original amount filed for by the insured;
(ii) the amount of final adjudication;
(iii) the reason for the suit; and
(iv) the classification by line of insurance; and
(2) the information required to be maintained by the insurer under Section 542.005.
(d) If at any time the department determines that the requirement to file a periodic report is no longer necessary to accomplish the objectives of this subchapter, the department may rescind the reporting requirement.
