Updated 11/16/2021 - Return to Index
Refer to Property & Casualty Filings Made Easy for required documentation.
Forms
| Review requirements | Reference | Comments |
|---|---|---|
| Prior Approval for Non-Standard Endorsements | §2052.002, Insurance Code | Policy form and standard endorsements are adopted by the Commissioner. Insurance companies must get prior approval in order to use a non-standard endorsement or a non-standard form. |
| Review requirements | Reference | Comments |
|---|---|---|
| 30-day Notice of Cancellation & Nonrenewal | §406.008, Labor Code | Policyholder must receive at least 30 days notice of cancellation or nonrenewal sent by certified mail if policy is cancelled for any reason other than the reasons set forth under the 10-day notice requirement. |
| 10-day Notice of Cancellation & Nonrenewal | §406.008, Labor Code | Policyholder must receive at least 10 days notice of cancellation or non-renewal, sent by certified mail, if policy is cancelled for one of these reasons: (1) fraud in obtaining coverage; (2) misrepresentation of payroll used in calculating premium; (3) failure to pay premium when due; (4) an increase in the hazard of the policyholder that would cause the rates to increase; (5) a determination made by the Commissioner that continuation of the policy would place the insurer in violation of the law or would be hazardous to the interest of subscribers, creditors or the general public. |
| Review requirements | Reference | Comments |
|---|---|---|
| Policy Language Promulgated by Commissioner | §2052.002, Insurance Code | Form WC 00 00 00 A and WC 00 00 01 (Information Page) adopted by the Commissioner and is required to be used for all Texas workers' compensation policies. Specimen copies of the standard policy are not required to be filed for approval. Insurance companies are required to use the policy language as adopted by the Commissioner. |
| Endorsements / Forms (Standard) | §2052.002, Insurance Code | The standard WC policy, endorsements and forms are published in NCCI's Forms Manual. Insurance companies are required to use these forms as adopted by the Commissioner. |
| Endorsements / Forms (Non-Standard) | §2052.002, Insurance Code | Insurance companies must file for prior approval any WC endorsement to be used on a Texas workers' compensation policy that is not one of the standard endorsements adopted by the Commissioner. |
| Endorsements / Negotiated Deductible | Chapter 2053, Subchapter E and §2052.002, Insurance Code | Insurance companies desiring to write workers' compensation policies with negotiated deductibles must file an endorsement for approval as no standard endorsement is adopted. The terms of the company specific endorsement cannot be in conflict with the Texas Miscellaneous rules set forth in NCCI's Basic Manual with Texas Exceptions. Negotiated deductibles cannot be written until notice of TDI approval is received by the insurance company. |
| Review requirements | Reference | Comments |
|---|---|---|
 Political Affiliation and Expression |
Chapter 544, Subchapter M, Insurance Code | Except as provided by Section 544.603, a person may not refuse to insure or provide coverage to an individual, refuse to continue to insure or provide coverage to an individual, limit the amount, extent, or kind of coverage available for an individual, or charge an individual a rate that is different from the rate charged to other individuals for the same coverage because of the individual's political affiliation or expression. |
| Review requirements | Reference | Comments |
|---|---|---|
| Notice of Policyholder Complaint Procedures | §521.005, Insurance Code | A brief written notice of suggested procedure to be followed by the policyholder in the event of a dispute concerning a policyholder's claim or premium. |
| Toll-Free Information & Complaint Number | §§521.051 - 521.056, Insurance Code | Toll-Free number for the Texas Department of Insurance. |
| Insurer's Toll-Free Information & Complaint Number | §§521.101 - 521.103, Insurance Code | Insurer's requirement to maintain toll-free number to provide information concerning policies issued by the insurer and to accept complaints from policyholder. Article contains an exception for insurers whose gross initial premium receipts collected in this state are less than $2 million a year or to an insurer with regard to fidelity, surety, or guaranty bonds. |
| Notice of Toll-Free Telephone Numbers and Information & Complaint Procedures | 28 TAC §1.601 & §1.602, Texas Administrative Code and Commissioner’s Order 3952 | To satisfy requirements for §521.005, §§521.051 - 521.056, and §§521.101 - 521.103 noted above. |
Manual rules
| Review requirements | Reference | Comments |
|---|---|---|
| Promulgated | Article 5.96, Insurance Code | Insurance company specific rules are not accepted for workers' compensation in Texas. NCCI's Basic Manual with Texas Exceptions, as adopted by the Commissioner, contains rules that pertain to policy issuance, premium determination, and the uniform classification system. NCCI's Experience Rating Plan with Texas Exceptions contains the uniform experience rating plan. The Texas section of NCCI's Forms Manual contains the standard policy, endorsements and forms. |
Rates
| Review requirements | Reference | Comments |
|---|---|---|
| Rates - File and Use | Chapter 2053, Subchapter A & §2053.051, Insurance Code | Rates may not be excessive, inadequate or unfairly discriminatory. Insurance companies must either adopt the workers' compensation classification relativities as adopted by the Commissioner or must file their own rates. In addition, insurance companies must file any deviation to be applied to the relativities and/or rates along with justification for the deviation. The relativity and/or rate after deviation is applied becomes the filed rate to be charged in writing Texas workers' compensation insurance. |
| Schedule Rating Plan - File and Use | Chapter 2053, Subchapter A & §2053.051, Insurance Code | Insurance companies must file the range of percentages that will be given in schedule rating debts or credits. In addition, the insurance companies must file criteria and applicable percentage to be considered for each category used to determine the amount of schedule rating for policyholders. |
| Review requirements | Reference | Comments |
|---|---|---|
| Experience Rating Plan | §2053.052, Insurance Code | Insurance companies are required to use the experience rating plan adopted by the Commissioner. The law requires that TDI adopt a uniform experience rating plan. |
| Retrospective Rating Plan | Article 5.77, Insurance Code | Insurance companies are required to use the retrospective rating plan adopted by the Commissioner, unless approval has been given by the Commissioner for another plan to be used. |
Fees
| Review requirements | Reference | Comments |
|---|---|---|
| Fees for Paper Checks Prohibited | §116.002, Business and Commerce Code | An insurer or agent may not charge a fee for issuing payment via a paper check. |