SECTION 3.3073. Minimum Standards for Hospital Confinement Indemnity Coverage  


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  • (a) "Hospital Confinement Indemnity Coverage" is a policy of accident and sickness insurance which provides daily benefits for hospital confinement on an indemnity basis in an amount not less than $15 per day or $100 per week and not less than 31 days during any "one period of confinement" for each person insured under the policy. A one day or two day elimination period may be used when "one period of confinement" is not less than 31 days and not more than 364 days. A three day elimination period may be used when "one period of confinement" is 365 days or more. If a hospital confinement policy, whether styled as an indemnity policy or however styled, includes confinement for pregnancy within the scope of its coverage, then the minimum benefits payable for each covered pregnancy shall be the insured loss or expense up to an amount no less than 10 times the minimum daily benefit of the policy.

    (b) Hospital confinement indemnity coverage is not required to be guaranteed renewable in accordance with §3.3020 of this title (relating to Policy Definition of Guaranteed Renewable and Limited Guarantee of Renewability) and §3.3038 of this title (relating to Mandatory Guaranteed Renewability Provisions for Individual Hospital, Medical or Surgical Coverage; Exceptions) of this subchapter, provided that it meets the criteria for "excepted benefits" defined in relation to such coverage in §3.3002(b)(6)(B)(ii) of this title (relating to Definitions).

Source Note: The provisions of this §3.3073 adopted to be effective January 26, 1977, 2 TexReg 159; amended to be effective January 2, 1978, 3 TexReg 4943; amended to be effective December 22, 1997, 22 TexReg 12503.