SECTION 5.4241. Mediation Process - Deadlines and Extensions

(a) Deadline. Mediation must be completed by the 60th day after the association notifies the claimant that the association is requesting mediation, unless the deadline is extended. If the association does not ask the department to select a mediator before the 60-day deadline, or any extension of that deadline, the association waives its right to require mediation under Insurance Code §2210.575 and this division.

(b) Good cause. This section defines "good cause" for the purpose of extending the deadlines related to mediation. In this section, "good cause" means objective facts beyond a party's or mediator's control that reasonably caused or may cause the party or mediator to fail to meet a deadline related to mediation.

(c) Extensions.

(1) The association and the claimant may agree to extend the 60-day deadline for mediation in subsection (a) of this section.

(2) For good cause, the Commissioner may extend any deadline related to mediation, except the deadline for the mediator to notify the parties that the mediator is insured by the association, under §5.4236 of this title (relating to Mediation Process - Mediator Obligations).

(3) The Commissioner may extend deadlines for a single claim or a group of claims.

(d) Lawsuit. If mediation is not complete by the 60-day deadline or an extension, the claimant may file suit.

(e) Request for extension. To request the Commissioner to extend a deadline, a party or mediator must send the request in writing to the department, under §5.4251 of this title (relating to Requests and Submissions to the Department). The request must explain the good cause for the extension. Good cause includes military deployment of the claimant.

(f) Extension limit. The extension of deadlines under Insurance Code §2210.575(c); the extension of deadlines under §5.4231(b) and §5.4235(f) of this title (relating to Mediation Process and Mediation Process - Mediator Selection by the Department); and the extension of any other deadlines under Insurance Code Chapter 2210, Subchapter L-1 that apply only to the association may not exceed 120 days in the aggregate for claims arising from the same occurrence. For purposes of Insurance Code §2210.581(b), all other deadlines related to mediation--including those for mediators--are considered applicable to both the claimant and the association and are not subject to an extension limit.

Source Note: The provisions of this §5.4241 adopted to be effective February 14, 2013, 38 TexReg 653; amended to be effective December 31, 2019, 44 TexReg 8314