Sections
Chapter 1351 Home Health Services 1351.001 – 1351.009
Chapter 1352 Brain Injury 1352.001 – 1352.008
Chapter 1353 Immunization or Vaccination Protocols Under Managed Care Plans 1353.001 – 1353.002
Chapter 1354 Eligibility for Benefits for Alzheimer’s Disease 1354.001 – 1354.002
Chapter 1355 Benefits for Certain Mental Disorders 1355.001 – 1355.258
Chapter 1356 Mammography and Other Breast Imaging 1356.001 – 1356.005
Chapter 1357 Mastectomy 1357.001 – 1357.057
Chapter 1358 Diabetes 1358.001 – 1358.104
Chapter 1359 Formulas for Individuals With Phenylketonuria or Other Heritable Diseases 1359.001 – 1359.003
Chapter 1360 Diagnosis and Treatment Affecting Temporomandibular Joint 1360.001 – 1360.005
Chapter 1361 Detection and Prevention of Osteoporosis 1361.001 – 1361.003
Chapter 1362 Certain Tests for Detection of Prostate Cancer 1362.001 – 1362.005
Chapter 1363 Certain Tests for Detection of Colorectal Cancer 1363.001 – 1363.005
Chapter 1364 Coverage Provisions Relating to Hiv, Aids, or Hiv-Related Illnesses 1364.001 – 1364.101
Chapter 1365 Loss or Impairment of Speech or Hearing 1365.001 – 1365.004
Chapter 1366 Benefits Related to Fertility and Childbirth 1366.001 – 1366.059
Chapter 1367 Coverage of Children 1367.001 – 1367.253
Chapter 1368 Availability of Chemical Dependency Coverage 1368.001 – 1368.008
Chapter 1369 Benefits Related to Prescription Drugs and Devices and Related Services 1369.001 – 1369.555
Chapter 1370 Certain Tests for Detection of Human Papillomavirus, Ovarian Cancer, and Cervical Cancer 1370.001 – 1370.004
Chapter 1371 Coverage for Certain Prosthetic Devices, Orthotic Devices, and Related Services 1371.001 – 1371.005
Chapter 1376 Certain Tests for Early Detection of Cardiovascular Disease 1376.001 – 1376.003
Chapter 1377 Coverage for Certain Amino Acid-Based Elemental Formulas 1377.001 – 1377.052
Chapter 1379 Coverage for Routine Patient Care Costs for Enrollees Participating in Certain Clinical Trials 1379.001 – 1379.055
Chapter 1425 Application of Subtitle to Certain Coverage 1425.001 – 1425.052

Terms Used In Texas Insurance Code > Title 8 > Subtitle E - Benefits Payable Under Health Coverages

  • Act: means a bodily movement, whether voluntary or involuntary, and includes speech. See Texas Penal Code 1.07
  • Actor: means a person whose criminal responsibility is in issue in a criminal action. See Texas Penal Code 1.07
  • Agency: includes authority, board, bureau, commission, committee, council, department, district, division, and office. See Texas Penal Code 1.07
  • Alcoholic beverage: has the meaning assigned by Section Texas Penal Code 1.07
  • Allegation: something that someone says happened.
  • Amortization: Paying off a loan by regular installments.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Another: means a person other than the actor. See Texas Penal Code 1.07
  • Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
  • Arrest: Taking physical custody of a person by lawful authority.
  • Association: means a government or governmental subdivision or agency, trust, partnership, or two or more persons having a joint or common economic interest. See Texas Penal Code 1.07
  • Bailiff: a court officer who enforces the rules of behavior in courtrooms.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Benefit: means anything reasonably regarded as economic gain or advantage, including benefit to any other person in whose welfare the beneficiary is interested. See Texas Penal Code 1.07
  • Bodily injury: means physical pain, illness, or any impairment of physical condition. See Texas Penal Code 1.07
  • Case law: The law as laid down in cases that have been decided in the decisions of the courts.
  • Chambers: A judge's office.
  • Civil commitment facility: means a facility owned, leased, or operated by the state, or by a vendor under contract with the state, that houses only persons who have been civilly committed as sexually violent predators under Chapter Texas Penal Code 1.07
  • Claims: includes :
    (1) liabilities of a decedent that survive the decedent's death, including taxes, regardless of whether the liabilities arise in contract or tort or otherwise;
    (2) funeral expenses;
    (3) the expense of a tombstone;
    (4) expenses of administration;
    (5) estate and inheritance taxes; and
    (6) debts due such estates. See Texas Estates Code 22.005
  • Coercion: means a threat, however communicated:
    (A) to commit an offense;
    (B) to inflict bodily injury in the future on the person threatened or another;
    (C) to accuse a person of any offense;
    (D) to expose a person to hatred, contempt, or ridicule;
    (E) to harm the credit or business repute of any person; or
    (F) to take or withhold action as a public servant, or to cause a public servant to take or withhold action. See Texas Penal Code 1.07
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Concurrent resolution: A legislative measure, designated "S. Con. Res." and numbered consecutively upon introduction, generally employed to address the sentiments of both chambers, to deal with issues or matters affecting both houses, such as a concurrent budget resolution, or to create a temporary joint committee. Concurrent resolutions are not submitted to the President/Governor and thus do not have the force of law.
  • Conduct: means an act or omission and its accompanying mental state. See Texas Penal Code 1.07
  • Consent: means assent in fact, whether express or apparent. See Texas Penal Code 1.07
  • Controlled substance: has the meaning assigned by Section Texas Penal Code 1.07
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporate fiduciary: means a financial institution, as defined by Section Texas Estates Code 22.006
  • Correctional facility: means a place designated by law for the confinement of a person arrested for, charged with, or convicted of a criminal offense. See Texas Penal Code 1.07
  • Court: means and includes:
    (1) a county court in the exercise of its probate jurisdiction;
    (2) a court created by statute and authorized to exercise original probate jurisdiction; and
    (3) a district court exercising original probate jurisdiction in a contested matter. See Texas Estates Code 22.007
  • Dangerous drug: has the meaning assigned by Section Texas Penal Code 1.07
  • Deadly weapon: means :
    (A) a firearm or anything manifestly designed, made, or adapted for the purpose of inflicting death or serious bodily injury; or
    (B) anything that in the manner of its use or intended use is capable of causing death or serious bodily injury. See Texas Penal Code 1.07
  • Death: includes , for an individual who is an unborn child, the failure to be born alive. See Texas Penal Code 1.07
  • Decedent: A deceased person.
  • Devisee: includes a legatee. See Texas Estates Code 22.009
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Distributee: means a person who is entitled to a part of the estate of a decedent under a lawful will or the statutes of descent and distribution. See Texas Estates Code 22.010
  • Donee: The recipient of a gift.
  • Effective consent: includes consent by a person legally authorized to act for the owner. See Texas Penal Code 1.07
  • Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) Source: OCC
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Estate: means a decedent's property, as that property:
    (1) exists originally and as the property changes in form by sale, reinvestment, or otherwise;
    (2) is augmented by any accretions and other additions to the property, including any property to be distributed to the decedent's representative by the trustee of a trust that terminates on the decedent's death, and substitutions for the property; and
    (3) is diminished by any decreases in or distributions from the property. See Texas Estates Code 22.012
  • Executor: A male person named in a will to carry out the decedent
  • Exempt property: means the property in a decedent's estate that is exempt from execution or forced sale by the constitution or laws of this state, and any allowance paid instead of that property. See Texas Estates Code 22.013
  • Felony: means an offense so designated by law or punishable by death or confinement in a penitentiary. See Texas Penal Code 1.07
  • Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. Source: OCC
  • Forgery: The fraudulent signing or alteration of another's name to an instrument such as a deed, mortgage, or check. The intent of the forgery is to deceive or defraud. Source: OCC
  • Garnishment: Generally, garnishment is a court proceeding in which a creditor asks a court to order a third party who owes money to the debtor or otherwise holds assets belonging to the debtor to turn over to the creditor any of the debtor
  • Government: means :
    (A) the state;
    (B) a county, municipality, or political subdivision of the state; or
    (C) any branch or agency of the state, a county, municipality, or political subdivision. See Texas Penal Code 1.07
  • Grand jury: agreement providing that a lender will delay exercising its rights (in the case of a mortgage,
  • Grantor: The person who establishes a trust and places property into it.
  • Harm: means anything reasonably regarded as loss, disadvantage, or injury, including harm to another person in whose welfare the person affected is interested. See Texas Penal Code 1.07
  • Heir: means a person who is entitled under the statutes of descent and distribution to a part of the estate of a decedent who dies intestate. See Texas Estates Code 22.015
  • Independent executor: means the personal representative of an estate under independent administration as provided by Chapter Texas Estates Code 22.017
  • Individual: means a human being who is alive, including an unborn child at every stage of gestation from fertilization until birth. See Texas Penal Code 1.07
  • Inter vivos: Transfer of property from one living person to another living person.
  • Intestate: Dying without leaving a will.
  • Judge: means the presiding judge of any court having original jurisdiction over probate proceedings, regardless of whether the court is:
    (1) a county court in the exercise of its probate jurisdiction;
    (2) a court created by statute and authorized to exercise probate jurisdiction; or
    (3) a district court exercising probate jurisdiction in a contested matter. See Texas Estates Code 22.019
  • Law: means the constitution or a statute of this state or of the United States, a written opinion of a court of record, a municipal ordinance, an order of a county commissioners court, or a rule authorized by and lawfully adopted under a statute. See Texas Penal Code 1.07
  • Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
  • lien: include :
    (1) a deed of trust;
    (2) a vendor's lien, a mechanic's, materialman's, or laborer's lien, an attachment or garnishment lien, and a federal or state tax lien;
    (3) a chattel mortgage;
    (4) a judgment; and
    (5) a pledge by hypothecation. See Texas Estates Code 22.024
  • Life estate: A property interest limited in duration to the life of the individual holding the interest (life tenant).
  • Minor: means a person younger than 18 years of age who:
    (1) has never been married; and
    (2) has not had the disabilities of minority removed for general purposes. See Texas Estates Code 22.022
  • Misdemeanor: means an offense so designated by law or punishable by fine, by confinement in jail, or by both fine and confinement in jail. See Texas Penal Code 1.07
  • Mortgagee: The person to whom property is mortgaged and who has loaned the money.
  • Mortgagor: The person who pledges property to a creditor as collateral for a loan and who receives the money.
  • Oath: includes affirmation. See Texas Government Code 311.005
  • Oath: A promise to tell the truth.
  • Omission: means failure to act. See Texas Penal Code 1.07
  • Owner: means a person who:
    (A) has title to the property, possession of the property, whether lawful or not, or a greater right to possession of the property than the actor; or
    (B) is a holder in due course of a negotiable instrument. See Texas Penal Code 1.07
  • Peace officer: means a person elected, employed, or appointed as a peace officer under Article Texas Penal Code 1.07
  • Penal institution: means a place designated by law for confinement of persons arrested for, charged with, or convicted of an offense. See Texas Penal Code 1.07
  • Person: includes a natural person and a corporation. See Texas Estates Code 22.027
  • Person: means an individual or a corporation, association, limited liability company, or other entity or organization governed by the Business Organizations Code. See Texas Penal Code 1.07
  • person interested: means :
    (1) an heir, devisee, spouse, creditor, or any other having a property right in or claim against an estate being administered; and
    (2) anyone interested in the welfare of an incapacitated person, including a minor. See Texas Estates Code 22.018
  • personal representative: include :
    (1) an executor and independent executor;
    (2) an administrator, independent administrator, and temporary administrator; and
    (3) a successor to an executor or administrator listed in Subdivision (1) or (2). See Texas Estates Code 22.031
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • Possession: means actual care, custody, control, or management. See Texas Penal Code 1.07
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
  • Probate: Proving a will
  • Public place: means any place to which the public or a substantial group of the public has access and includes, but is not limited to, streets, highways, and the common areas of schools, hospitals, apartment houses, office buildings, transport facilities, and shops. See Texas Penal Code 1.07
  • Public servant: means a person elected, selected, appointed, employed, or otherwise designated as one of the following, even if he has not yet qualified for office or assumed his duties:
    (A) an officer, employee, or agent of government;
    (B) a juror or grand juror; or
    (C) an arbitrator, referee, or other person who is authorized by law or private written agreement to hear or determine a cause or controversy; or
    (D) an attorney at law or notary public when participating in the performance of a governmental function; or
    (E) a candidate for nomination or election to public office; or
    (F) a person who is performing a governmental function under a claim of right although he is not legally qualified to do so. See Texas Penal Code 1.07
  • Real property: includes estates and interests in land, whether corporeal or incorporeal or legal or equitable. See Texas Estates Code 22.030
  • Reasonable belief: means a belief that would be held by an ordinary and prudent man in the same circumstances as the actor. See Texas Penal Code 1.07
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Right of survivorship: The ownership rights that result in the acquisition of title to property by reason of having survived other co-owners.
  • Rule: includes regulation. See Texas Penal Code 1.07
  • Serious bodily injury: means bodily injury that creates a substantial risk of death or that causes death, serious permanent disfigurement, or protracted loss or impairment of the function of any bodily member or organ. See Texas Penal Code 1.07
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Sole ownership: The type of property ownership in which one individual holds legal title to the property and has full control of it.
  • Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
  • Surety: includes a personal surety and a corporate surety. See Texas Estates Code 22.032
  • Tenancy in common: A type of property ownership in which two or more individuals have an undivided interest in property. At the death of one tenant in common, his (her) fractional percentage of ownership in the property passes to the decedent
  • Testate: To die leaving a will.
  • Testator: A male person who leaves a will at death.
  • Testify: Answer questions in court.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. Source: OCC
  • Uniform Commercial Code: A set of statutes enacted by the various states to provide consistency among the states' commercial laws. It includes negotiable instruments, sales, stock transfers, trust and warehouse receipts, and bills of lading. Source: OCC
  • Unlawful: means criminal or tortious or both and includes what would be criminal or tortious but for a defense not amounting to justification or privilege. See Texas Penal Code 1.07
  • Ward: means a person for whom a guardian has been appointed. See Texas Estates Code 22.033
  • Will: includes :
    (1) a codicil; and
    (2) a testamentary instrument that merely:
    (A) appoints an executor or guardian;
    (B) directs how property may not be disposed of; or
    (C) revokes another will. See Texas Estates Code 22.034