What is the deadline to file a health insurance claim for this?

Health insuranceDeadlinesTexasChecked Nov 6, 2026

From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-06 · Source: Texas Insurance Code · Chapter 1201 · § 1201.211(a) (Policy Provision: Notice of Claim) View original ↗

In short

Written notice of a claim is due before the 21st day after the loss.
Written proof of loss is due before the 91st day after the loss.
If proof truly wasn't possible in time, you get up to one more year.

What this means

Send written notice before the 21st day after the loss [1]. Send proof of loss before the 91st day [2]. If you truly could not send proof in time, the law gives you up to one more year [2].

These dates are for an individual accident and health policy; this chapter does not reach a blanket or group policy except where it says otherwise [3], so a group or employer plan may set different windows.

Your next step

Send written notice before the 21st day after the illness or injury [1]. Then send proof of loss before the 91st day [2]. Has a deadline already passed? Then write down why you could not send it in time. The statute protects a late filing when it was not reasonably possible to be on time [2].

Check it yourself

Check how your plan is sold. Is it an individual policy? Then Sections 1201.211 and 1201.213 apply. Is it a blanket or group plan from work? Then this chapter leaves it out except where it says otherwise [3] — read the claim-filing part of the plan document instead.

Where this comes from (3)

[1] Texas Insurance Code · Chapter 1201 · § 1201.211(a) (Policy Provision: Notice of Claim) · checked 2026-11-06
Notice of Claim: A written notice of claim must be given to the insurer before the 21st day after the date of the occurrence or beginning of any loss covered by the policy, or as soon after that date as is reasonably possible.
[2] Texas Insurance Code · Chapter 1201 · § 1201.213 (Policy Provision: Proof of Loss) · checked 2026-11-06
For a claim for any other loss, a written proof of loss must be provided to the insurer at the insurer's designated office before the 91st day after the date of the loss. Failure to provide the proof within the required time does not invalidate or reduce any claim if it was not reasonably possible to give proof within the required time. In that case, the proof must be provided as soon as reasonably possible but not l…
[3] Texas Insurance Code · Chapter 1201 · § 1201.003(a), (b), (d)(6) (Applicability of Chapter) · checked 2026-11-06
This chapter applies only to an accident and health insurance policy delivered or issued for delivery in this state. (b) Except as otherwise provided by this chapter, this chapter applies only to an individual accident and health insurance policy delivered or issued for delivery by: (1) a life, health, and accident insurance company … (8) a nonprofit hospital, medical, or dental service corporation, including a corpo…

How we found this

We matched your question to 3 official sources, quoted the exact lines, and re-checked each quote against its source on 2026-11-06.

What we don’t know yet

Your own plan or notice may say something different. If your letter cites another rule, send it and we will look again.

Every answer is checked against the official rule it quotes.

Information only — not legal advice. Your plan, insurer or agency decides.

This answer quotes the official sources listed above, with the date we checked them. Your own policy, notice and state rules control. We are not your lawyer or your insurer. We don’t file, argue or negotiate claims for you — you send any letter or form yourself.

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