Texas Department of Insurance

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Life Health Credit Insurance Forms Listing

This is one of several pages linking to a central repository of forms used by TDI customers. Use the search or Forms by Type links on the Forms Home Page or scan through our form listings.

 

Credit Insurance
TDI Form NumberDescriptionFile FormatLanguage
LHL064 Life/Health Earned Premiums Credit Life Insurance
Collect data		 PDFEnglish
LHL065 Life/Health Actuarial Reserve Certification Form
Collect data		 PDFEnglish
LHL066 Life/Health Inventory Information Form Presumptive Rates
Collect data		 PDFEnglish
LHL069 Life/Health Inventory Information Form Deviated Rates
Collect data		 PDFEnglish
LHL071 Life/Health Affidavit of Validity of Experience Data Form
Collect data		 PDFEnglish
LHL072 Life/Health Earned Premiums Credit Disability Insurance
Collect data		 PDFEnglish
LHL073 Life/Health Reconciliation to State Page Credit Life
Collect data		 PDFEnglish
LHL074 Life/Health Reconciliation to State Page Credit Disability
Collect data		 PDFEnglish
LHL235 Life/Health Credit Insurance Deviation Request Form
Deviation request form ( CI-DRF )		 PDFEnglish
LHL387 Credit Life and Credit Accident and Health Insurance Presumptive Premium Rates
Checklist		 PDFEnglish
LHL620 Credit Data Call Acknowledgment Receipt
Credit Data Call Acknowledgment Receipt for Years 2006, 2007 and 2008		 PDFEnglish
LHL621 INDIVIDUAL AND GROUP CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE
Credit Life and Credit Accident and Health Checklist		 PDFEnglish
Additional Credit Insurance Information
TDI Form Number Description File Format
  Credit Insurance Credit Life and Accident & Health Presumptive Rates
for ยง3.5206, proceed to page 84 of the document		 PDF
  Notice Relating to Presumptive Premium Rates
These self extracting files include (3) in MS Excel format and (2) in MS Access format		 ZIP

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