No. JM-1154 (1990).
|Case Date:||April 12, 1990|
Texas Attorney General Opinions 1990. No. JM-1154 (1990). April 12, 1990Opinion No. JM-1154Mattox Opinion No. JM-1154Office of the Attorney General State of TexasHonorable Juan J. Hinojosa Chairman Local and Consent Calendars Committee Texas House of Representatives P.O. Box 2910 Austin, Texas 78768-2910Opinion No. JM-1154Re: Waiver of insurance deductible under section 27.02 of the Business and Commerce Code (RQ-1843) Dear Representative Hinojosa: You ask about the interpretation of section 27.02 of the Business and Commerce Code, which was added by the 71st Legislature. Acts 1989, 71st Leg., ch. 898, at 3925. Section 27.02 provides: (a) A person who sells goods or services commits an offense if: (1) the person advertises or promises to provide the good or service and to pay: (A) all or part of any applicable insurance deductible; or (B) a rebate in an amount equal to all or part of any applicable insurance deductible; (2) the good or service is paid for by the consumer from proceeds of a property or casualty insurance policy; and (3) the person knowingly charges an amount for the good or service that exceeds the usual and customary charge by the person for the good or service by an amount equal to or greater than all or part of the applicable insurance deductible paid by the person to an insurer on behalf of an insured or remitted to an insured by the person as a rebate. (b) A person who is insured under a property or casualty insurance policy commits an offense if the person: (1) submits a claim under the policy based on charges that are in violation of Subsection (a) of this section; or (2) knowingly allows a claim in violation of Subsection (a) of this section to be submitted, unless the person promptly notifies the insurer of the excessive charges. (c) An offense under this section is a Class A misdemeanor. You ask whether a person who advertises or promises to provide a good or service and "waives the deductible" violates section 27.02(a). We understand you to be asking about an advertisement or promise to engage in the following transaction: A person providing a good or service would submit a bill directly to an insurer and then accept the portion of the bill paid by the insurer as satisfaction for the entire claim. In other words, the person providing the good or service would not seek payment of the unpaid...
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