SECTION 5.9409. Operations

(a) Application process.

(1) Applications will be accepted from a duly licensed local recording agent or from a salaried representative for an insurer whose plan of operation does not contemplate the use of local recording agents.

(2) Agents submitting applications to the MAP shall use the application form (TMAP-10) promulgated by the Department for use with the MAP, shall submit a completed application packet as specified in paragraph (4) of this subsection, and shall submit such applications to the Department's MAP Division.

(3) Applicants may apply directly to the MAP by contacting the Department to obtain the Department's assistance in completing the MAP application form (TMAP-10). Applicants applying directly to the MAP must meet the same eligibility requirements as provided in §5.9406 of this plan of operation.

(4) For applicants applying directly to the MAP, information will be requested by Department staff from the applicant based on the same information elements required in the MAP application form (TMAP-10) required of originating agents. Information relating to the originating agent will be marked "not applicable" or "N/A." In the applicant's signature box, the Department staff member will indicate "call received by TDI on (date)" with staff member's initials.

(5) The Department staff will assist applicants applying directly to the MAP as specified in subparagraphs (A)-(C) of this paragraph.

(A) The Department staff member will request ZIP code information to verify that the risk is located in a designated underserved area.

(B) The Department staff member will request documentation as specified in subsection (e) of §5.9406 to verify that the applicant has been unable to obtain residential property insurance within the one year period preceding the date of application to the MAP. If requested, the Department staff member will make a diligent effort to assist the applicant in obtaining the required documentation concerning the applicant's inability to obtain residential property insurance.

(C) Upon receipt of the documentation showing the applicant's inability to obtain residential property insurance, the Department staff member will determine if the applicant is eligible to participate in the MAP.

(6) A completed application packet shall consist of the following to be eligible for referral to participating insurers:

(A) a completed application form (TMAP-10) signed by both the applicant and the originating agent; or if an applicant applies directly to the Department, the application will be initialed and dated by the staff member assisting with the completion of the application as provided in paragraph (5) of this subsection.

(B) declination letter or letters or non-eligibility letter or letters as provided in §5.9406 of this plan of operation (also §5.9406 of this title (relating to Eligibility for Referral)); and

(C) cancellation or non-renewal notices as provided in §5.9406 of this plan of operation (also §5.9406 of this title (relating to Eligibility for Referral)).

(7) An application shall indicate if the applicant has a voluntary inspection property condition evaluation report and certificate of insurability, as specified in §5.9406 of this plan of operation (also §5.9406 of this title, relating to Eligibility for Referral). The applicant may provide a copy of the report and the certificate to the insurer at the time of the insurer's inspection of the residential risk.

(b) Application review. The Department's MAP Division shall perform the application review and referral as specified in this subsection and subsection (c) of this section.

(1) If the application is submitted by an originating agent, preliminary processing shall include review of the application for signatures of the applicant and originating agent, logging in of names and addresses of applicant and originating agent and notification of the originating agent in writing or via electronic means of the receipt of the application.

(2) If the applicant has applied directly to the MAP, preliminary processing shall include logging in name and address of the applicant.

(3) Applications, including the information on the residential risks proposed to be insured, shall be verified by the Department's MAP Division for compliance with the requirements specified in this section and in §5.9406 of this plan of operation (also §5.9406 of this title, relating to Eligibility for Referral).

(4) Applications submitted by an originating agent that are ineligible for referral through the MAP will be returned to the originating agent within 14 calendar days of receipt by the Department with written documentation stating the reason or reasons for the ineligibility. A copy of the notice of ineligibility shall be sent to the applicant.

(c) Referral of applications.

(1) Information from eligible MAP applications as specified in paragraph (2) of this subsection shall be faxed or provided electronically by the Department's MAP Division to all participating insurers for selection for purposes of issuing a quote.

(A) If a policy has not been issued within 90 days from the date the application is entered on the Department's MAP application data base, the Department's MAP Division shall notify the originating agent, if the application was submitted by an originating agent, or the applicant, if the applicant applied directly to the Department, in writing or via electronic means.

(B) The MAP application shall remain as an active MAP application available for selection and quoting by an insurer until a policy is issued but for no longer than one year from the date the application was either entered on the electronic bulletin board or entered on the MAP application database.

(C) If a policy has not been issued within one year from the date the application is entered on the MAP application database and faxed to participating insurers, the application shall be considered inactive, and the Department's MAP Division shall notify the applicant in writing and the originating agent in writing or via electronic means.

(2) The information provided to participating insurers shall include the following:

(A) originating agent's name, mailing address, telephone number, fax number, and agent's TDI identification number if submitted by an originating agent;

(B) name of applicant and co-applicant, mailing address, and phone number;

(C) applicant's military status;

(D) designated underserved area in which property to be insured is located, including location zip code, whether in Class 1 designated underserved area or Class 2 designated underserved area, and the county where the property is located;

(E) location of property to be insured, including if same as applicant's mailing address, and if not, street address and city;

(F) rating information:

(i) public protection classification code used;

(ii) type of construction;

(iii) policy form requested;

(iv) dwelling and personal property coverage amounts;

(v) deductible;

(vi) year built;

(vii) structure type;

(viii) usage type;

(ix) owner or tenant occupancy;

(G) availability of Voluntary Inspection Program certification.

(d) Insurers' processing of selected applications.

(1) Application review and property inspection.

(A) An insurer may select MAP applications for review based on criteria contained on the application.

(B) Prior to issuing a quote or writing a policy, an insurer should underwrite the risk in accordance with the insurer's applicable underwriting procedures, including inspecting the property and obtaining the insurer's own application for insurance. An insurer shall evaluate each risk in accordance with the provisions set forth in §§5.9404 and 5.9405 of this plan of operation (also §5.9404 of this title, relating to Policy Forms and Types of Coverage, and §5.9405 of this title, relating to Rates).

(2) Determination of whether to issue premium quote.

(A) An insurer shall make its premium quote or indicate the insurer's refusal to quote within 30 days after selecting the application.

(B) If the insurer, however, has not quoted or refused to quote by the 30th day after selecting an application, the insurer shall be considered to have requested additional time and shall have an additional 15 days to quote or to refuse to quote. Within 45 days after selecting an application, the insurer shall notify the Department's MAP Division by mail or facsimile transmission that the insurer has quoted or has refused to quote.

(C) An insurer shall issue a premium quote as specified in paragraph (3) of this subsection.

(3) Issuance of premium quote. Insurers shall issue premium quotes in accordance with the following provisions:

(A) An insurer shall send its quote directly to the MAP applicant and simultaneously report the required information as specified in subparagraph (C) of this paragraph to the Department by mail or facsimile transmission.

(B) An insurer's quote shall be valid for at least 30 days after the date the quote is issued. Within 35 days after issuance of the quote, the insurer shall notify the Department's MAP Division by mail or facsimile transmission that the quote has been accepted or rejected by the applicant. If an applicant has not affirmatively rejected the quote by the thirty-first day after the quote is issued, the insurer shall notify the Department's MAP Division by mail or facsimile transmission that the quote has been rejected.

(C) An insurer's quote shall contain the following information:

(i) name and address of MAP applicant;

(ii) MAP application TDI reference number;

(iii) location of the residential risk to be insured;

(iv) insurer's name, mailing address, and phone number;

(v) type of policy being quoted;

(vi) the amount of premium due for the policy quoted, limits of liability, applicable deductible, and term of the policy;

(vii) issuance date and expiration date of the quote;

(viii) instructions for the applicant to contact the issuing agent to accept the offered quote;

(ix) issuing agent's name, mailing address, phone number, and fax number.

(4) Notification of issuance of policy. If the application was submitted by an originating agent, within five business days after the issuance date of the insurance policy, the insurer shall notify the Department by mail or facsimile transmission and the originating agent in writing or via electronic means that the insurance policy was issued. The notification shall include the policy number and the name, address, telephone number, and fax number of the issuing agent.

(5) Inactive application. An application shall be considered inactive upon acceptance of a quote by the applicant.

(e) MAP data collection and analysis.

(1) The Department shall provide quarterly data analysis reports to the Executive Committee to enable the Executive Committee to fully evaluate the operations of the MAP.

(2) Upon the Executive Committee's request, the Department shall provide additional data and analyses of data for purposes of review of the MAP or for other purposes related to the administration of the MAP as deemed appropriate by the Executive Committee.

(f) Educational initiatives.

(1) The Department may provide educational information to consumers, agents, and insurers through:

(A) the development and distribution of educational materials outlining the operation of the MAP;

(B) seminars and workshops;

(C) the print and electronic media, including public service announcements, press releases, TV and radio community programs, and local TV access stations.

(D) coordination of speaking and training programs with trade associations and consumer organizations; and

(E) use of the Internet System.

(2) Participating insurers may provide information to their appointed agents for distribution to consumers.

(3) Participating insurers may include a brief description of the MAP with any cancellation or non-renewal notice issued on residential property insurance located in a designated underserved area.

(g) Complaints procedures.

(1) Complaints relating to the operation of the MAP shall be received and processed by the Department's MAP Division.

(2) The complaints shall be handled in accordance with the Department's standard complaints handling procedures.

(3) Until final disposition of the complaint, the complainant shall be notified quarterly by the Department's MAP Division of the status of the complaint.

(4) The MAP Executive Committee shall be notified as part of its review and monitoring of the MAP of all complaints relating to the operation of the MAP.

Source Note: The provisions of this §5.9409 adopted to be effective October 1, 1996, 21 TexReg 8715; amended to be effective August 1, 1998, 23 TexReg 7587; transferred effective April 16, 1999, 24 TexReg 3092; amended to be effective June 26, 2000, 25 TexReg 6144