CHAPTER 554. BURDEN OF PROOF AND PLEADING - Texas Statutes

INSURANCE CODE

TITLE 5. PROTECTION OF CONSUMER INTERESTS

SUBTITLE C. DECEPTIVE, UNFAIR, AND PROHIBITED PRACTICES

CHAPTER 554. BURDEN OF PROOF AND PLEADING

Sec. 554.001. APPLICABILITY OF CHAPTER. This chapter applies to

each insurer or health maintenance organization engaged in the

business of insurance or the business of a health maintenance

organization in this state, regardless of form and however

organized, including:

(1) a stock life, health, or accident insurance company;

(2) a mutual life, health, or accident insurance company;

(3) a stock fire or casualty insurance company;

(4) a mutual fire or casualty insurance company;

(5) a Mexican casualty insurance company;

(6) a Lloyd's plan;

(7) a reciprocal or interinsurance exchange;

(8) a fraternal benefit society;

(9) a title insurance company;

(10) an attorney's title insurance company;

(11) a stipulated premium company;

(12) a nonprofit legal services corporation;

(13) a statewide mutual assessment company;

(14) a local mutual aid association;

(15) a local mutual burial association;

(16) an association exempt under Section 887.102;

(17) a nonprofit hospital, medical, or dental service

corporation, including a corporation subject to Chapter 842;

(18) a county mutual insurance company;

(19) a farm mutual insurance company; and

(20) an insurer or health maintenance organization engaged in

the business of insurance or the business of a health maintenance

organization in this state that does not hold a certificate of

authority issued by the department or is not otherwise authorized

to engage in business in this state.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1,

2005.

Sec. 554.002. BURDEN OF PROOF AND PLEADING. In a suit to

recover under an insurance or health maintenance organization

contract, the insurer or health maintenance organization has the

burden of proof as to any avoidance or affirmative defense that

the Texas Rules of Civil Procedure require to be affirmatively

pleaded. Language of exclusion in the contract or an exception to

coverage claimed by the insurer or health maintenance

organization constitutes an avoidance or an affirmative defense.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1,

2005.