(a) Establishment. The Texas Department of Insurance
(department) establishes the Coastal Outreach and Assistance Services
Team (COAST) Program to provide information and educational programs
to assist persons insured under Chapter 2210 of the Insurance Code
with the claim processes prescribed under Subchapter L-1, Chapter
2210 of the Insurance Code.
(b) Administration. The COAST Program is administratively
attached to the department and will be administered by the department.
(c) Staffing. The COAST Program will include an ombudsman
familiar with the claim processes prescribed under Subchapter L-1,
Chapter 2210, of the Insurance Code, as well as sufficient staff to
support its purpose. If a catastrophic event occurs, the COAST Program
may expand as necessary to support the increased number of policyholders
requiring assistance.
(d) Funding. The COAST Program will be funded by the
Texas Windstorm Insurance Association (the Association).
(1) Annual budget.
(A) The funding year shall be from May 1 of each year
to April 30 of the following year.
(B) Not later than March 1 of each year, the department
shall prepare and submit to the Commissioner of Insurance (commissioner)
a budget for the COAST Program, including approval of all expenditures
incurred to administer and operate the COAST Program. The department
may include ongoing ombudsman activities related to a prior catastrophic
event in the annual budget request. The commissioner will adopt or
modify and adopt the budget not later than April 1 of each year.
(C) Not later than May 1 of each year, the Association
shall transfer the budgeted amount adopted by the commissioner to
the department for the COAST Program.
(2) Amended budget.
(A) Not later than 60 days after a catastrophic event,
the department shall:
(i) prepare and submit an amended budget to the commissioner
for approval, including staffing requirements and expenditures necessary
to administer and operate the COAST Program; and
(ii) report to the commissioner the number of claimants
eligible for COAST Program services.
(B) The commissioner may modify the amended budget
before adopting it.
(C) Within 30 days after the commissioner adopts the
amended budget, the Association must transfer the additional money
required by the amended budget to the department for the COAST Program.
(3) Return of unexpended funds. Not later than April
30 of each year, the department must return to the Association any
unexpended funds that the COAST Program received from the Association
in the previous year.
(e) Services.
(1) The COAST Program may provide to persons insured
under Chapter 2210 of the Insurance Code information and educational
programs through means the COAST Program determines to be necessary
and appropriate. Possible means include:
(A) informational materials;
(B) toll-free telephone numbers;
(C) public meetings;
(D) outreach centers;
(E) the Internet; and
(F) other reasonable means.
(2) The COAST Program shall prepare and make available
to each person insured under Chapter 2210 of the Insurance Code information
describing the functions of the COAST Program.
(f) Notice Requirement. The Association must provide
each person insured by the Association on or after November 27, 2011,
notice of the operation of the COAST Program. The Association shall
fulfill this requirement by complying with paragraphs (1), (2), and
(3) of this subsection.
(1) The Association must include the notices set forth
in subsection (g)(1) and (2) of this section with each policy delivered,
issued for delivery, renewed, or otherwise processed by the Association.
Notwithstanding §1.601(a)(3) of this title (relating to Notice
of Toll-Free Telephone Numbers and Information and Complaint Procedures),
the Association must fulfill this requirement by printing the notice
on a separate piece of paper to be included with the policy or by
incorporating the notice into the Important Notice required to be
attached to the policy under §1.601 of this title.
(2) The Association must include the notice set forth
in subsection (g)(1) of this section with each written communication
acknowledging receipt of a claim. The Association must fulfill this
requirement by printing the notice on a separate piece of paper to
be included with the communication acknowledging receipt of a claim
or by incorporating the notice into the acknowledgement.
(3) The Association must include the notice set forth
in subsection (g)(1) of this section with each written communication
accepting or denying coverage of a claim, in whole or in part, that
is required to be provided to the claimant under the Insurance Code §2210.573(d).
The Association must fulfill this requirement by printing the notice
on a separate piece of paper to be included with the acceptance or
denial communication or by incorporating the notice into the acceptance
or denial document.
(g) Notice. The notice required by subsection (f) of
this section must include the following text and be in at least 10
point type.
(1) "The Texas Department of Insurance has established
the Coastal Outreach and Assistance Services Team (COAST) Program
to assist consumers with understanding the TWIA claim process. To
obtain assistance from the COAST Program, please refer to the COAST
Program website at www.tdi.texas.gov/COAST; email ConsumerProtection@tdi.state.tx.us;
call toll-free 1-855-352-6278; or write to COAST Program - MC 111-1A,
Texas Department of Insurance, PO Box 149104, Austin, TX 78714-9104."
(2) "El Departamento de Seguros de Texas ha establecido
el Programa de Alcance Comunitario y Servicios de Asistencia para
el Área Costera (Coastal Outreach and Assistance Services Team
(COAST) Program, por su nombre y siglas en inglés) para ayudar
a los consumidores a entender el proceso de las reclamaciones de TWIA.
Para obtener ayuda del Programa COAST, visite el sitio Web del Programa
COAST en www.tdi.texas.gov/COAST; por medio de correo electrónico
a ConsumerProtection@tdi.state.tx.us; o llame gratis al 1-855-352-6278;
o escriba al Programa COAST - MC 111-1A, Texas Department of Insurance,
PO Box 149104, Austin, TX 78714-9104."
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