28 TAC § 21.2009. Submission and Payment of Claims

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Texas Administrative Code › Title 28 INSURANCE › Part 1 TEXAS DEPARTMENT OF INSURANCE › Chapter 21 TRADE PRACTICES › 28 TAC § 21.2009

This text was captured on Aug 14, 2026. It is a snapshot, not a live feed, so check the official code before relying on it.

Text

(a) An insurer shall not require the approval of the insured or enrollee parent for the submission of claims for covered services or for the appeal of a denial of any benefit by a custodial parent, a health care provider, a child over 18 years of age, or a state agency that has been assigned medical support rights.

(b) An insurer shall not refuse or fail to make payments on covered claims directly to the custodial parent, health care provider, child over 18 years of age, or state agency submitting the claim, in accordance with the terms of the policy. Nothing in this section shall require an insurer to make duplicate payments on covered claims.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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28 TAC § 21.2009. Submission and Payment of Claims · 28 Tex. Admin. Code § 21.2009 | Frix