Sec. 1251.103. INCONTESTABILITY OF POLICY  


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  • (a) A group accident and health insurance policy must provide that:

    (1) the validity of the policy may not be contested after the policy has been in force for two years after its date of issue; and

    (2) in the absence of fraud, a statement made by any individual covered by the policy relating to the individual's insurability may not be used in contesting the validity of the insurance with respect to which the statement was made:

    (A) after the insurance has been in force before the contest for two years during the individual's lifetime; and

    (B) unless the statement is contained in a written instrument signed by the individual making the statement.

    (b) Subsection (a)(1) does not apply to a contest based on nonpayment of premiums.

    (c) The provisions required by this section do not preclude the assertion at any time of a defense based on:

    (1) a provision in the policy that relates to eligibility for coverage;

    (2) a provision in a group accident and health insurance policy or disability insurance policy that relates to overinsurance;

    (3) a provision in a disability policy that relates to the relation of earnings to insurance; or

    (4) another similar provision in a group accident and health insurance policy or disability insurance policy that limits the amounts of recovery from all sources to not more than 100 percent of the total actual losses or expenses incurred.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.