The state regulatory body that oversees workers’ compensation and authorizes medical treatment is the Texas Workers’ Compensation Commission. This agency maintains the official roster of physicians who are approved to treat workers’ compensation injuries, ensuring they meet credentialing and billing rules under the system’s guidelines. Firms or employers may offer their own panels of preferred doctors, but the legally recognized list—used to determine who may bill the workers’ comp system—comes from the Commission. Doctors not on that roster generally cannot bill for workers’ compensation treatment except in specific exceptions, such as emergencies.

The key idea is that premium surcharges are meant to reflect an insurer’s loss experience on individual policies, not broad events that affect many policyholders at once. Losses from natural causes fall into that latter category because they’re typically large, widespread catastrophes that aren’t tied to a single insured’s risk profile. Including them in the surcharge would unfairly raise rates for many customers and would be funded through separate catastrophe mechanisms or pools rather than the normal premium calculation for an individual policy. So, losses from natural causes are explicitly excluded from the premium surcharge calculation. Losses that were filed and not paid by the insurer aren’t typically excluded for this purpose, and excluding all losses would defeat the purpose of the surcharge. Liability losses are part of an insured’s risk profile and are normally included in the calculation.

Optional coverages must be affirmatively chosen by the insured. If the policyholder writes a rejection of Loss of Income and Rehabilitation coverage, that coverage isn’t automatically included again when the policy is reinstated or renewed. The insurer is not required to provide that particular coverage in any reinstated or renewed policy; the insured would need to elect it again in writing if they want it to be included. In other words, a prior written rejection stays effective for future terms unless the insured reaffirms the desire to add the coverage. The insurer may offer other options, but there’s no obligation to include Loss of Income and Rehabilitation automatically.

In Texas, the system rests on requiring licensing to perform insurance activities and enforcing penalties for anyone who operates without that license. This protects consumers by ensuring only qualified, regulated individuals can sell or negotiate insurance, and it gives regulators the tools—such as fines, cease-and-desist orders, and other penalties—to stop unlicensed practice. The other options aren’t accurate because licensing isn’t granted only after a claim, there is formal regulation of licensing, and there are no tax breaks that promote unlicensed activity.