SECTION 5.9406. Eligibility for Referral

(a) Eligibility requirements. The following requirements must be met to be eligible to apply for a referral through the MAP:

(1) the residential risk must be located in a designated underserved area;

(2) the property must be insurable as provided in subsection (b) of this section; and

(3) the applicant must present written documentation as specified in subsection (e) of this section that the applicant has been unable to obtain residential property insurance.

(b) Insurable property. To be insurable as required in subsection (a)(2) of this section, the property must meet the following requirements:

(1) the general physical condition of the dwelling, manufactured home, or other private structure indicates good maintenance and there is no unrepaired previous damage; and

(2) good housekeeping is maintained throughout the residence premises.

(c) Certification of insurability. The requirement of insurable property as specified in subsection (b) of this section is met if the property has been inspected under the Voluntary Inspection Program and the residential property condition evaluation report and the certificate of insurability has been issued on the residential risk, pursuant to the Insurance Code, Article 5.33B. An evaluation report and a voluntary inspection certificate are not required to apply for referral through the MAP.

(d) Prohibited factors. The following factors shall not be used to deny application to the MAP or to determine eligibility for referral through the MAP:

(1) the value of the dwelling, manufactured home, or other private structure;

(2) the age of the dwelling, manufactured home, or other private structure;

(3) the geographic location of the dwelling, manufactured home, or other private structure located in a designated underserved area; or

(4) the condition of surrounding premises.

(e) Documentation of cancellation, non-renewal, or declination. An originating agent, acting on behalf of an applicant to the MAP, shall submit current written documentation as provided in this subsection with the application to the MAP. If the Department completes the application on behalf of the applicant, the Department shall either obtain from the applicant current written documentation as provided in this subsection or shall obtain contact information from the applicant to enable the Department to obtain written documentation as provided in this subsection. Such written documentation shall be dated within the one-year period which immediately precedes the date of application to the MAP. Photocopies or facsimile copies of original documents shall be acceptable.

(1) Canceled or non-renewed residential property insurance. If the applicant's residential property insurance has been canceled or non-renewed within the one-year period immediately preceding the date of application to the MAP, the following documents must be attached to the application:

(A) a copy of the notice of cancellation or non-renewal, and

(B) documentation of at least one other attempt, as provided in paragraph (3) of this subsection, to obtain residential property insurance from a licensed insurer that is unaffiliated with the insurer who issued the notice of cancellation or non-renewal.

(2) No previous residential property insurance. If the applicant did not have residential property insurance in the one-year period immediately preceding the date of application to the MAP, the applicant must attach to the application documentation of attempts, as provided in paragraph (3) of this subsection, to obtain residential property insurance from two or more licensed unaffiliated insurers.

(3) Attempts to obtain residential property insurance. The documentation of the attempt or attempts to obtain residential property insurance from a licensed insurer must be addressed to the applicant and relate to the property proposed to be insured. The following documents satisfy the documentation requirements in paragraphs (1)(B) and (2) of this subsection:

(A) a current letter or letters of declination of residential property insurance from a licensed insurer or insurers;

(B) a current letter or letters of non-eligibility for residential property insurance issued by a licensed local recording agent or by a salaried representative for an insurer whose plan of operation does not contemplate the use of local recording agents, both of whom may also be the originating agent. The agent or salaried representative must represent at least one licensed insurer actually writing residential property insurance in this state. The letter or letters of non-eligibility shall be on a form promulgated by the Commissioner for this purpose which states that based on known underwriting guidelines the agent or salaried representative is unable to place the residential risk with a licensed insurer available to that agent or salaried representative. The agent or salaried representative shall indicate on the form whether the letter of non-eligibility applies to one or two unaffiliated licensed insurers.

(f) Ineligible applicants.

(1) Fraudulent claims. Individuals who have had previous residential property insurance canceled or non-renewed for submission of a fraudulent claim are not eligible to apply for referral through the MAP.

(2) Cancellation for non-payment of premium for coverage obtained through the MAP. An applicant is not eligible to apply to the MAP again for the same risk if the insurer cancels coverage obtained through the MAP for non-payment of premium.

(g) Re-submission. An originating agent or the Department may re-submit an application to the MAP if the applicant satisfies all of the eligibility requirements of MAP on the date of re-submission.

Source Note: The provisions of this §5.9406 adopted to be effective October 1, 1996, 21 TexReg 8715; transferred effective April 16, 1999, 24 TexReg 3092; amended to be effective June 26, 2000, 25 TexReg 6144