TDI Outlines Expectations for Industry Regarding Hurricane Rita

September 22, 2005

As Hurricane Rita approaches the Texas coast, the Texas Department of Insurance issued several bulletins to the insurance industry. Bulletins are signed by the insurance commissioner and notify the industry of the department’s expectations regarding insurers’ conduct during the disaster and afterward.

Specifically, the bulletins address the following issues in light of the impending weather emergency:

1. Insurers should authorize payment to pharmacies for up to a ninety-day supply of any prescription medication.

2. Insurers should waive restrictions that require insureds to obtain preauthorization, referrals, notification of hospital admissions or medical necessity reviews.

3. Insurers should waive penalties and restrictions on insureds when insureds obtain necessary health and dental services out of network.

4. Insurers are authorized to use nonresident and emergency adjusters to handle claims.

5. Insurers must provide reasonable exceptions to use of credit information that is directly influenced by “temporary loss of employment” as a result of Hurricane Rita. Insurers should avoid placing additional burdens on victims or evacuees of Hurricane Rita and should accept verbal requests in lieu of written.

6. It is inappropriate for insurers to re-rate, cancel, nonrenew or refuse to provide coverage due to an individual’s status as a victim or evacuee of Hurricane Rita. It is unreasonable to change policyholders’ rating classifications or increase insurance rates solely because they are a victim or evacuee of Hurricane Rita.

7. Insurers should allow suspension of premium payments to allow for continuing insurance coverage.

8. Health insurers and HMOs should extend claims filing deadlines.

9. Insurers should authorize payments for necessary medical equipment, supplies and services.

The bulletins are available on the TDI Web site, Additional information about Hurricane Rita will be posted as it becomes available.

For assistance with insurance questions, call (800) 252-3439. For assistance with workers’ compensation issues, call (800) 372-7713.

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