28 Tex. Admin. Code § 3.3008 - Policy Definitions of Accident, Accidental Injury, Injury
(a) These terms shall be defined to employ
"result" language and may not include words which establish an accidental means
test. Except for accidental death or dismemberment, said definitions may not
include words such as "external, violent, visible wounds" or similar words of
description or characterization and may not be more restrictive than the
following: Injury or injuries for which benefits are provided means accidental
bodily injuries sustained by an insured person which are the direct cause of
the loss independent of disease, bodily infirmity, or any other cause and
occurs while the policy is in force.
(b) Such definition may exclude, unless
prohibited by law, injuries for which benefits are provided under any workmen's
compensation, employer's liability or similar statute or injuries occurring
while the insured person is engaged in any activity pertaining to any trade,
business, employment, or occupation for wage or profit.
Notes
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