(a) A report filed under Article 5.01(a) of this code must include the information necessary to compute a Texas automobile experience modifier as provided by this code or a rule adopted by the State Board of Insurance. In reporting losses under Article 5.01(a) of this code, an insurer may include only the following as basic limits losses:
(1) indemnity losses, up to the basic limits for the losses;

Terms Used In Texas Insurance Code

  • Rule: includes regulation. See Texas Government Code 311.005
  • 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.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.

(2) losses based on payments for immediate medical or surgical treatment;
(3) fees paid to an attorney who is not an employee of the insurer, if the fees were for services rendered in the trial of an action arising under a covered claim;
(4) specific expenses incurred as a direct result of defending an action in connection with which the expense is claimed;
(5) specific expenses, other than claims adjustment expenses, incurred in connection with the settlement of a claim with respect to which the expense is claimed;
(6) all medical payments coverage; and
(7) personal injury protection coverage losses.
(b) In reporting its basic limits losses to the State Board of Insurance, each insurer shall disclose the specific nature of each loss expense claimed and shall show to the Board’s satisfaction that each specific expense claimed was necessary with respect to the specific risk involved.