Appeal to the State Board of Insurance

If the insured physician or health care provider is not satisfied with a decision under the procedures established in §5.1501 and §5.1502 of this title (relating to Procedure for Reconsideration and Grievance and Hearing Procedures), the insured may appeal to the State Board of Insurance for a review of the rate or premium and request a determination of whether the rate or premium being charged complies with criteria of the Insurance Code, Article 5.15-1, §3.

(1) Any insured who wishes to appeal the final decision of the insurer under these rules shall file, with the chief clerk of the State Board of Insurance, a written notice of intent to appeal, which includes a copy of the final decision of the insurer.

(2) The appeal shall be filed within 30 days after receipt by the insured of the final decision of the insurer.

(3) The insured shall certify that a copy of the written notice of intent to appeal has been sent by certified mail to the insurer.

(4) The appeal will be conducted in accordance with the contested case provisions of the Administrative Procedure and Texas Register Act (Texas Civil Statutes, Article 6252-13a, §§13-17).

(5) The decision of the State Board of Insurance will be final and may not be appealed.

Source Note: The provisions of this §5.1503 adopted to be effective September 19, 1990, 15 TexReg 5137.