Tex. Ins. Code § 1301.103 · Subchapter C. PROMPT PAYMENT OF CLAIMS
DEADLINE FOR ACTION ON CLEAN CLAIMS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
Except as provided by Sections 1301.104 and 1301.1054, not later than the 45th day after the date an insurer receives a clean claim from a preferred provider in a nonelectronic format or the 30th day after the date an insurer receives a clean claim from a preferred provider that is electronically submitted, the insurer shall make a determination of whether the claim is payable and:
(1) if the insurer determines the entire claim is payable, pay the total amount of the claim in accordance with the contract between the preferred provider and the insurer;
(2) if the insurer determines a portion of the claim is payable, pay the portion of the claim that is not in dispute and notify the preferred provider in writing why the remaining portion of the claim will not be paid; or
(3) if the insurer determines that the claim is not payable, notify the preferred provider in writing why the claim will not be paid.
Notes and commentary — not statutory text
History
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.
Acts 2011, 82nd Leg., R.S., Ch. 798 (H.B. 2292), Sec. 8, eff. September 1, 2011.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1301.htm
- Text hash
- sha256 92e99d166510e97d84ca4dc97c90f2fc782ae99a36607abf8af5e1349b45b2b6
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Cited by 4 provisions
Provisions in this library whose text cites Tex. Ins. Code § 1301.103. Each shows the citation as that text prints it.
Insurance Code
- Tex. Ins. Code § 1301.1053DEADLINES NOT EXTENDED.Printed as Section 1301.103 or 1301.104
- Tex. Ins. Code § 1301.1054REQUESTS FOR ADDITIONAL INFORMATION.Printed as Section 1301.103 or 1301.104
- Tex. Ins. Code § 1301.134COORDINATION OF PAYMENT.Printed as Section 1301.103 or 1301.104
- Tex. Ins. Code § 1301.137VIOLATION OF CLAIMS PAYMENT REQUIREMENTS; PENALTY.Printed as Section 1301.103, 1301.104, or 1301.105
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.