Procedure for Reconsideration

Each insurer covered by the Insurance Code, Article 5.15-1, shall adopt a procedure for reconsideration of the rate or premium charged a physician or health care provider, as defined in §2 of said article, for professional liability insurance coverage. The procedure so adopted must:

(1) afford any insured physician or health care provider the opportunity to file a written grievance with, or request a hearing before, officers or employees of the insurer who have responsibility for determining rates and premiums to be charged for professional liability insurance;

(2) require that the insurer reconsider the rate or premium of the insured physician or health care provider;

(3) require the insurer to provide a written explanation of the rate or premium being charged; and

(4) provide that the insurer shall file a copy of any grievance or request for hearing, together with the insurer's response thereto, with the Professional Liability Division of the State Board of Insurance.

Source Note: The provisions of this §5.1501 adopted to be effective September 19, 1990, 15 TexReg 5137.