Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 28. INSURANCE |
PART 1. TEXAS DEPARTMENT OF INSURANCE |
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES |
SUBCHAPTER S. MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES |
SECTION 3.3008. Policy Definitions of Accident, Accidental Injury, Injury
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(a) These terms shall be defined to employ "result" language and may not include words which establish an accidental means test. Except for accidental death or dismemberment, said definitions may not include words such as "external, violent, visible wounds" or similar words of description or characterization and may not be more restrictive than the following: Injury or injuries for which benefits are provided means accidental bodily injuries sustained by an insured person which are the direct cause of the loss independent of disease, bodily infirmity, or any other cause and occurs while the policy is in force. (b) Such definition may exclude, unless prohibited by law, injuries for which benefits are provided under any workmen's compensation, employer's liability or similar statute or injuries occurring while the insured person is engaged in any activity pertaining to any trade, business, employment, or occupation for wage or profit. Source Note: The provisions of this §3.3008 adopted to be effective January 26, 1977, 2 TexReg 159.