28 Tex. Admin. Code § 3.6102 - Claims Reserves

(a) The insurer shall set up adequate reserves for claims on credit life and credit accident and health insurance, in addition to the policy reserves already described in § 3.6101 of this subchapter (relating to Policy Reserves). Claim reserves for single premium credit accident and health insurance contracts issued on or after January 1, 2009, must comply with the claim reserve requirements in § 3.7002 of this chapter (relating to Claim Reserves). Claim reserves for all other credit accident and health insurance contracts and credit life insurance contracts shall be based upon appropriate consideration for liability under each of the following categories:

(1) the liability on claims which are known to be due and already payable, but which have not yet been paid;

(2) the additional reserve on claims for ongoing and now continuing disability benefits which have already been reported, and on which future payment will be due during the continuance of this disability;

(3) the liability on claims which are incurred and benefits now due but not yet reported, but which will be payable when they are reported;

(4) the reserve on claims for disability benefits which are incurred but not yet reported, and on which future payments will be due during the continuance of this disability.

(b) The company may rely upon credible experience developed by its own claim experience, industry-wide experience, or any other available source which produces an adequate reserve for the liability described under subsection (a) of this section.

Notes

28 Tex. Admin. Code § 3.6102

The provisions of this §3.6102 adopted to be effective October 1, 1980, 5 TexReg 2772; amended to be effective January 26, 2010, 35 TexReg 485