This section defines “insurance service” and lists specific services and situations that are excluded from that definition.
Sec. 151.0039. "INSURANCE SERVICE". (a) Except as provided in Subsection (b), "insurance service" means insurance loss or damage appraisal, insurance inspection, insurance investigation, insurance actuarial analysis or research, insurance claims adjustment or claims processing, or insurance loss prevention service. (b) "Insurance service" does not include: (1) insurance coverage for which a premium is paid or commissions paid to insurance agents for the sale of insurance or annuities; (2) a service performed on behalf of an insured by a person licensed under Chapter 4102, Insurance Code; (3) a service performed by a certified public accountancy firm, if less than one percent of the firm's total revenue in the prior calendar year is from services in this state that would otherwise constitute insurance service under Subsection (a); (4) a service performed on behalf of a certified public accountancy firm by an owner of the firm or a member of the firm's affiliated group, if less than one percent of the owner's or member's total revenue in the prior calendar year is from services in this state that would otherwise constitute insurance service under Subsection (a); (5) a medical or dental billing service performed before the original submission of: (A) a medical or dental insurance claim related to health or dental coverage; or (B) a claim related to health or dental coverage made to a medical assistance program funded by the federal government, a state government, or both; or (6) a medical service, examination, or test required or authorized under Chapter 408, Labor Code, for the purpose of determining the appropriate level of benefits under that chapter. (c) In this section: (1) "Affiliated group" has the meaning assigned by Section 171.0001. (2) "Certified public accountancy firm" has the meaning assigned by Section 901.002, Occupations Code. (3) "Medical or dental billing service" means assigning codes for the preparation of a medical or dental claim, verifying medical or dental insurance eligibility, preparing a medical or dental claim form for filing, and filing a medical or dental claim. Added by Acts 1987, 70th Leg., 2nd C.S., ch. 5, art. 1, pt. 4, Sec. 6. Amended by: Acts 2015, 84th Leg., R.S., Ch. 748 (H.B. 1841), Sec. 1, eff. October 1, 2015. Acts 2017, 85th Leg., R.S., Ch. 68 (S.B. 1083), Sec. 1, eff. January 1, 2018. Acts 2021, 87th Leg., R.S., Ch. 1 (H.B. 1445), Sec. 1, eff. January 1, 2022. Acts 2021, 87th Leg., R.S., Ch. 1 (H.B. 1445), Sec. 2, eff. January 1, 2022. Acts 2023, 88th Leg., R.S., Ch. 1159 (S.B. 1122), Sec. 1, eff. June 18, 2023.