reglab/statecodes huggingface dataset:
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2328. Eligibility; application

RS 22:2328 - Eligibility; application
A.(1) Any person having an insurable interest in insurable property is entitled to apply to the governing committee of the plan, directly or through a representative, for such coverage and for an inspection of the property. Every such application shall be submitted on forms prescribed by the governing committee of the plan and approved by the commissioner of insurance, which application shall contain a statement as to whether or not there are any unpaid premiums due from the applicant for fire insurance on the property.
(2) The term "insurable interest" as used in this Subsection shall be deemed to include any lawful and substantial economic interest in the safety or preservation of property from loss, destruction, or pecuniary damage.
B. If the governing committee of the plan determines that the property is insurable and that there is no unpaid premium due from the applicant for prior insurance on the property, the governing committee of the plan upon receipt of the premium, or such portion thereof as is prescribed in the plan, shall cause to be issued a policy of essential property insurance for a term of one year. Any policy issued pursuant to the provisions of this Section shall be renewed annually, upon payment of premium due, so long as the property meets the definition of "insurable property" as set forth in R.S. 22:2322(4).
C. If the governing committee of the plan, for any reason, denies an application and refuses to cause to be issued an insurance policy on insurable property to any applicant or takes no action on an application within the time prescribed in the plan, such applicant may appeal to the commissioner of insurance and, after reviewing the facts, he may direct the governing committee of the plan to issue or cause to be issued an insurance policy to the applicant. In carrying out its duties pursuant to this Section, the commissioner of insurance may request and the governing committee of the plan shall provide any information the commissioner deems necessary to a determination concerning the reasons for the denial or delay of the application.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §§1 and 4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.7 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2329. Participants shall cede insurance to the plan

RS 22:2329 - Participants shall cede insurance to the plan
Any participant in the plan shall cede to the plan one hundred percent of the essential property insurance written pursuant to and on the terms and conditions set forth in the plan.
Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.8 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2330. Rates, rating plans, and rate rules applicable

RS 22:2330 - Rates, rating plans, and rate rules applicable
The rates, rating plans, and rating rules applicable to the insurance written pursuant to the plan shall be those approved by the commissioner of insurance; however, such rates may include rules for classification of risks insured hereunder and rate modifications thereof.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.9 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2331. Appeal to the commissioner; appeal to the court from the commissioner

RS 22:2331 - Appeal to the commissioner; appeal to the court from the commissioner
Any person insured pursuant to R.S. 22:2322 through 2334 or his representative, or any affected insurer, who may be aggrieved by an act, ruling, or decision of the governing committee of the plan may, within thirty days after such ruling, appeal to the commissioner. All persons or insureds aggrieved by any order or decision of the commissioner may demand a hearing in accordance with Chapter 12 of this Title, R.S. 22:2191 et seq.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §1, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.10 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 185, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2332. Reports of inspection

RS 22:2332 - Reports of inspection
All reports of inspection performed by or on behalf of the governing committee of the plan shall be made available to the participants in the plan and the commissioner of insurance. An applicant or his representative shall be entitled to a copy of any inspection report on property in which the applicant has an insurable interest.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.11 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2333. Immunity from liability

RS 22:2333 - Immunity from liability
There shall be no liability on the part of and no cause of action of any nature shall arise against the commissioner of insurance or any of his staff, or against the governing committee of the plan or anyone acting on its behalf, or against any servicing carrier or carriers of the plan, or against any participating insurer, for any inspections made hereunder or any statements made in good faith by them in any reports or communications concerning risks submitted to the governing committee of the plan or at any administrative hearings conducted in connection therewith under the provisions of this Code.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.12 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2334. Annual report

RS 22:2334 - Annual report
The governing committee of the plan or its designee shall file in the office of the commissioner of insurance on or before September first of each year a statement which shall summarize the transactions, conditions, operations, and affairs of the plan during the preceding fiscal year ending June thirtieth. Such statement shall contain such matters and information as are prescribed by the commissioner and shall be in such form as is required by him. The commissioner may at any time require the governing committee of the plan to furnish to him any additional information with respect to its transactions or any other matter which the commissioner deems to be material to assist him in evaluating the operation and experience of the plan.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.13 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2335. Examination of plan

RS 22:2335 - Examination of plan
The commissioner of insurance may from time to time examine the plan when he deems it to be prudent and in undertaking such examination he may hold a public hearing. The expense of such examination shall be borne and paid by the plan participants who shall share the expenses ratably in accordance with their respective participation for the year under examination.
Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.14 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2336. Louisiana Joint Reinsurance Plan (FAIR Plan); definitions

RS 22:2336 - Louisiana Joint Reinsurance Plan (FAIR Plan); definitions
As used in R.S. 22:2336 through 2347, unless the context otherwise requires:
(1) "Designated area" means all of that area of the state designated in the plan on file with the commissioner of insurance and designated as FAIR (Fair Access to Insurance Requirements) Plan area.
(2) "Essential property insurance" means any of the following coverages against direct loss to property as defined by the plan approved by the commissioner of insurance:
(a) Fire, with or without extended coverage and vandalism and malicious mischief.
(b) Windstorm and hail without fire, but only with respect to dwellings and commercial properties on a monoline basis.
(c) Homeowners.
(3) "Governing committee" means that group which is referred to in R.S. 22:2338 and, where appropriate, any designee of the governing committee.
(4) "Insurable property" means real and tangible personal property at a fixed location in a designated area of Louisiana when such property is in an insurable condition and basic property insurance is not obtainable in the normal market.
(5) "Net direct premiums" means gross direct premiums, excluding reinsurance assumed and ceded, written on property in this state for fire and allied lines and, if provided in the plan, homeowners' insurance, including premium components of all multiperil policies and homeowners' policies, less return premiums, dividends paid or credited to policyholders, or the unused or unabsorbed portions of premium deposits. In no event shall premiums on industrial fire insurance policies be considered as net direct premiums.
(6) "Plan" means the document setting the rules of operation approved or promulgated by the commissioner of insurance relative to the Louisiana Joint Reinsurance Plan.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.15 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 326, §1, eff. Jan. 1, 2010.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2337. Louisiana Joint Reinsurance Plan; immunity from liability; commissioner of insurance

RS 22:2337 - Louisiana Joint Reinsurance Plan; immunity from liability; commissioner of insurance
A. The Louisiana Joint Reinsurance Plan is hereby continued and reestablished and all insurers authorized to write and engage in writing property insurance within Louisiana on a direct basis are required to be participants in the plan.
B. The commissioner of insurance is hereby authorized to issue rules and regulations for the purpose of carrying out the provisions of R.S. 22:2336 through 2347.
C. There shall be no liability on the part of and no cause of action of any nature shall arise against the commissioner of insurance or any of his staff, or against the governing committee of the Louisiana Joint Reinsurance Plan or anyone acting on its behalf, or against any servicing carrier or carriers, or against any participating insurer, for any inspections made hereunder or any statements made in good faith by them in any reports or communications concerning risks submitted to the governing committee of the plan or at any administrative hearings conducted in connection therewith under the provisions of R.S. 22:2336 through 2347.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.16 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2338. Powers and duties of the governing committee

RS 22:2338 - Powers and duties of the governing committee
The governing committee shall, pursuant to the provisions of this Part and the plan, and with respect to essential property insurance on insurable property, have the power on behalf of the participants:
(1) To cause to be issued policies of insurance having inception dates of and prior to December 31, 2003, to applicants.
(2) To assume reinsurance from the participants.
(3) To cede reinsurance to the participants and to purchase reinsurance on behalf of the participants.
(4) To service or cause to be serviced all policies issued having inception dates on or prior to December 31, 2003, and after all claims arising under said policies have been resolved and the business of the Louisiana Joint Reinsurance Plan (FAIR Plan) with respect to such policies has been concluded, to notify the commissioner of insurance, and thereafter dissolve as a committee.
Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.17 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2339. Board of directors of plan

RS 22:2339 - Board of directors of plan
The governing committee of the plan shall be a board of directors which shall consist of seven representatives of participants in the plan.
Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.18 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2340. Functions of participants in the plan

RS 22:2340 - Functions of participants in the plan
A. All participants in the plan shall participate in the writings, expenses, profits, and losses in the proportion that the net direct premium of such participant written in this state during the preceding calendar years bears to the aggregate net direct premiums written in this state by all participants in the plan in the preceding calendar year as certified to the governing committee of the plan after review of annual statements, other reports, and other statistics necessary to provide the information herein required and which the commissioner of insurance is hereby authorized and empowered to obtain from any participant in the plan.
B. However, each participant shall be entitled to receive credit for essential property insurance voluntarily written in designated areas. The governing committee of the plan shall define the terms "essential property insurance" and "designated areas" for the purposes of this Section.
C. Any insurer who becomes authorized to engage in writing property insurance within Louisiana and who engages in writing property insurance within Louisiana shall become a participant in the plan on January first immediately following such authorization and writing, and the determination of such insurer's participation in the plan shall be made as of the date of such participation in the same manner as for all other participants in the plan.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.19 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2341. Plan

RS 22:2341 - Plan
A.(1) The plan as filed and approved by the commissioner of insurance shall continue. The plan shall set forth the number, qualifications, terms of office, and manner of election of the members of the governing committee. The plan may include the assessment procedures of all participants for expenses necessary to the operation; the establishment of necessary facilities; management of the plan; plan for assessment of participants to defray losses and expenses; underwriting standards; procedures for the acceptance and cession of reinsurance on behalf of the participants; procedures for determining the amounts of insurance to be provided to specific risks; procedures for processing applicants for insurance; and such other provisions as may be deemed necessary to carry out the purposes of R.S. 22:2336 through 2347.
(2) The plan shall be filed with the commissioner of insurance and the commissioner may, in his discretion, consult with the governing committee of the plan and may seek any further information which he deems necessary for a decision.
B. The governing committee of the plan may, subject to the approval of the commissioner of insurance, amend the plan at any time. The commissioner may review the plan at any time he deems prudent, but not less than once in each calendar year. After review of the plan, the commissioner may amend it after consultation with the governing committee of the plan, and upon certification to the governing committee of such amendment.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.20 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2342. Eligibility; application

RS 22:2342 - Eligibility; application
A. Any person having an insurable interest in insurable property is entitled to apply to the governing committee of the plan, directly or through a representative, for such coverage and for an inspection of the property. Every such application shall be submitted on forms prescribed by the governing committee of the plan and on file with the commissioner of insurance.
B. The term "insurable interest" as used in this Section shall be deemed to include any lawful and substantial economic interest in the safety and preservation of property from loss, destruction, or pecuniary damage.
C. If the governing committee of the plan determines that the property is insurable, the governing committee of the plan, upon receipt of the premium or such portion thereof as is prescribed in the plan, shall cause to be issued a policy of essential property insurance for a term not exceeding one year. Any policy issued pursuant to the provisions of this Section shall be renewed annually, upon payment of premium due, so long as the property meets the definition of "insurable property".
D. If the governing committee of the plan for any reason denies an application and refuses to cause to be issued an insurance policy on insurable property to any applicant, or takes no action on an application within the time prescribed in the plan, such applicant may appeal to the commissioner of insurance, and the commissioner, after reviewing the facts, may direct the governing committee of the plan to issue, or cause to be issued, an insurance policy to the applicant. In carrying out his duties pursuant to this Section, the commissioner of insurance may request and the governing committee of the plan shall provide any information which the commissioner deems necessary to a determination concerning the reason for the denial or delay of the application.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §§1 and 4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.21 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2343. Plan participants shall cede insurance

RS 22:2343 - Plan participants shall cede insurance
All participants in the plan shall cede one hundred percent of the essential property insurance written pursuant to and on terms and conditions set forth in the plan.
Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.22 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2344. Rates, rating plans, and rate rules applicable

RS 22:2344 - Rates, rating plans, and rate rules applicable
Rates shall be in accordance with the rating plans approved by the commissioner of insurance for use by the Property Insurance Association of Louisiana; however, such rates may include rules for classification of risks insured hereunder and rate modifications hereof.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.23 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2345. Reports of inspection

RS 22:2345 - Reports of inspection
All reports of inspection performed by the governing committee of the plan shall be made available to the participants in the plan and the commissioner of insurance. An applicant or his representative shall be entitled to a copy of any inspection report on property in which the applicant has an insurable interest.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.24 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2346. Annual report

RS 22:2346 - Annual report
The governing committee of the plan shall file in the office of the commissioner of insurance each year a statement which shall summarize the transactions, conditions, operations, and affairs of the plan during the preceding fiscal year ending September thirtieth.
Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.25 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2347. Examination of plan

RS 22:2347 - Examination of plan
The commissioner of insurance may from time to time make an examination into the affairs of the plan when he deems it to be prudent and, in undertaking such examination, he may hold a public hearing. The expense of such examination shall be borne and paid by plan participants who shall share the expense ratably in accordance with their respective participation for the year under examination.
Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.26 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2361. Short title

RS 22:2361 - Short title
This Chapter shall be known as the "Insure Louisiana Incentive Program" and may be referred to as the "program".
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3301 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2362. Purposes; public purpose

RS 22:2362 - Purposes; public purpose
A. Louisiana currently is experiencing a crisis in the availability and affordability of insurance for residential and commercial properties. Louisiana property owners and their insurers sustained catastrophic losses in 2020 and 2021 from hurricanes Laura, Delta, Zeta, and Ida. As the result of their losses and their assessment of the risk of loss from future storms, many insurers have substantially reduced their participation in the voluntary market for residential and commercial property insurance. With fewer insurers in the voluntary market, competitive pressure on premium rates is reduced. Current underwriting practices have resulted in a substantial increase in the number of Louisiana property owners forced to obtain their property insurance coverage or their coverage for wind peril from Louisiana Citizens Property Insurance Corporation, the state insurer of last resort. Increased premiums and assessments make property insurance coverage unaffordable for some property owners, forcing them to sell or abandon their residential or commercial properties or preventing them from restoring storm-damaged properties, causing some residents to leave or fail to return to the state. The availability of property insurance at reasonable cost is essential to the economy of the state. Owners cannot invest in and lenders will not finance the construction and ownership of residential and commercial buildings without adequate property insurance protection. The state has a vital interest in fostering the availability of property insurance at reasonable cost.
B. The Insure Louisiana Incentive Program is adopted for the purpose of cooperative economic development and stability in Louisiana by encouraging additional insurers to participate in the voluntary property insurance market to increase the availability of property insurance, increase competitive pressure on insurance rates, and reduce the volume of business written by the Louisiana Citizens Property Insurance Corporation, thereby offering a less expensive alternative to its policyholders and reducing Louisiana Citizens Property Insurance Corporation's exposure to an increased deficit and future assessments.
C. The legislature hereby declares that assuring an adequate and affordable market for insurance for both residential and commercial properties in this state is essential to the economic viability of the state and its citizens, the assurance of an adequate and stable tax base for the state and its political subdivisions, and the health, welfare, and safety of its citizens. Accordingly, the establishment of the Insure Louisiana Incentive Program implemented through public-private partnerships is declared and demonstrated to be an essential public function and public purpose.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3302 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2363. Cooperative endeavors; grants; regulations

RS 22:2363 - Cooperative endeavors; grants; regulations
A. The commissioner may implement the essential public purpose of this Chapter through public-private partnerships executed through cooperative endeavors with authorized insurers. Such endeavors may include matching capital fund grants under the provisions of this Chapter.
B. The commissioner may grant matching capital funds to qualified property insurers in accordance with the requirements of this Chapter from the fund. The commissioner shall promulgate rules and regulations in accordance with the Administrative Procedure Act, R.S. 49:950 et seq., governing the application process, award of grants, use of grant funds, reporting requirements, and other regulations to assure compliance with and to carry out the purposes of the program.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3303 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2012, No. 271, §1; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2364. Implementation; grant limitations

RS 22:2364 - Implementation; grant limitations
A. The commissioner shall promulgate rules and regulations to implement this program in accordance with the Administrative Procedure Act, R.S. 49:950 et seq.
B. When the program is ready for implementation, the commissioner shall issue a public invitation to insurers to submit grant applications. In the initial applications, the commissioner shall not allocate individual grants of less than two million dollars nor in excess of ten million dollars. In the initial allocation of grants, the commissioner shall allocate twenty percent of the total amount of funds available for grants to domestic insurers.
C. If all monies in the fund are not allocated in response to the first invitation for grant applications, the commissioner may issue a second invitation for grant applications. In the second invitation, the commissioner shall not allocate individual grants of less than two million dollars nor in excess of ten million dollars, but insurers who have been allocated a grant in response to the first invitation may apply for an additional grant up to the ten-million-dollar limit. If all monies in the fund are not allocated in response to the second invitation for grant applications, the commissioner may issue a third invitation for grant applications. In the third invitation, the commissioner shall not allocate individual grants of less than two million dollars nor in excess of ten million dollars, but insurers who have been allocated a grant in response to the first or second invitation may apply for an additional grant up to the ten-million-dollar limit.
D. Once the commissioner has finalized all responses for grant applications authorized under this Chapter, any unexpended and unencumbered monies in the fund and any matching capital fund grant funds that are not earned pursuant to R.S. 22:2370(A) shall revert to the state general fund.
E. The total amount of funds available for this program is the amount appropriated or otherwise made available to the fund by the legislature. If the amount requested in grant applications exceeds the amount of funds available, the commissioner shall have the discretion to prioritize and allocate funds among insurers considered eligible to participate in the program, considering the financial strength of each insurer and the potential for its business plan to improve the availability and affordability of property insurance in this state.
F. Prior to the award of any grant pursuant to the provisions of this Chapter, the grant shall be subject to the review and approval of the Joint Legislative Committee on the Budget. The use of grant funds and unexpended and unencumbered monies pursuant to the provisions of Subsection D of this Section shall not be subject to review and approval of the Joint Legislative Committee on the Budget.
Acts 2007, No. 447, §1, eff. July 11, 2007; Acts 2008, No. 390, §1, eff. June 21, 2008; Redesignated from R.S. 22:3304 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2008, No. 469, §1; Acts 2012, No. 271, §1; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2365. Minimum capital requirements

RS 22:2365 - Minimum capital requirements
A. Grants shall be made only to insurers who satisfy minimum capital requirements as specified in the rules and regulations promulgated by the commissioner, which shall include capital and surplus exceeding ten million dollars, stable financial condition as shown by a satisfactory risk-based capital level, and an adequate risk-based reinsurance program.
B. In no event shall matching fund grants exceed twenty percent of an insurer's capital and surplus.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3305 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2366. Satisfactory prior experience

RS 22:2366 - Satisfactory prior experience
As determined by the commissioner, grants shall be made only to insurers with satisfactory prior experience in writing property insurance or to new insurers whose management has satisfactory prior experience in property insurance.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3306 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2367. Authorized insurers

RS 22:2367 - Authorized insurers
Although a surplus lines insurer may apply for a grant, the insurer shall obtain a certificate of authority to do business in Louisiana before it may receive the grant funding. The commissioner may reallocate funds allocated to a surplus lines insurer if it does not apply on a timely basis, as specified in the regulations, or is not approved for a certificate of authority.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3307 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2368. Matching capital fund grants

RS 22:2368 - Matching capital fund grants
A. The insurer shall make a commitment of capital of not less than two million dollars to write property insurance in this state that complies with the requirements of R.S. 22:2369.
B. Matching capital fund grants authorized under this Chapter shall match the newly allocated insurer capital funds at a ratio of one dollar of state capital grant funds to one dollar of allocated insurer capital funds.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3308 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2370. Earned capital

RS 22:2370 - Earned capital
A. An insurer who receives a matching capital fund grant under the provisions of this Chapter shall earn the grant at the rate of twenty percent per year for each year in which the insurer maintains the net written premiums in compliance with the requirements of this Chapter, such that the insurer may earn the entire grant in five years.
B. If an insurer fails to comply with the requirements of this Chapter at the end of any year of the grant, the commissioner shall have the option of granting an extension, if the insurer shows promise of future compliance.
C. If the commissioner finds that an insurer has failed to comply with the statutory or regulatory requirements for the grant, the commissioner may declare the insurer in default. The insurer in default shall repay any matching capital fund grant funds that have not been earned under Subsection A of this Section, plus legal interest from the date of the commissioner's default declaration.
D. In the event of insolvency of an insurer, the Louisiana Insurance Guaranty Association shall have no obligation to repay matching capital fund grants.
Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3310 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2371. Insure Louisiana Incentive Fund

RS 22:2371 - Insure Louisiana Incentive Fund
There is hereby created in the state treasury as a special fund the Insure Louisiana Incentive Fund, referred to in this Chapter as the "fund". Monies appropriated or transferred to the fund shall be deposited by the state treasurer after compliance with the provisions of Article VII, Section 9(B) of the Constitution of Louisiana. Monies in the fund shall be invested in the same manner as monies in the state general fund and any interest earned on the investment of monies in the fund shall be credited to the fund. All unexpended and unencumbered monies in the fund at the end of the fiscal year shall remain in the fund. Monies in the fund shall be used by the department to provide grants pursuant to the provisions of this Chapter.
Acts 2022, No. 754, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2382. Louisiana compact commission official

RS 22:2382 - Louisiana compact commission official
Pursuant to the terms and conditions of this Part, the state of Louisiana seeks to join with other states and establish the Interstate Insurance Product Regulation Compact, and thus become a member of the Interstate Insurance Product Regulation Commission. The commissioner of insurance is hereby designated to serve as the representative of this state to the commission.
Acts 2008, No. 353, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2391. Purpose; short title

RS 22:2391 - Purpose; short title
A. This Chapter shall be known and may be cited as the "Internal Claims and Appeals Process and External Review Act".
B. The purpose of this Chapter is the following:
(1) To establish standards and criteria for the structure and operation of utilization review and benefit determination processes designed to facilitate ongoing assessment and management of health care services.
(2) To provide standards for the establishment and maintenance of procedures by health insurance issuers to assure that covered persons have the opportunity for the appropriate resolution of internal and external appeals, as defined in this Chapter.
(3) To provide uniform standards for the establishment and maintenance of an internal claims and appeals process and external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination, as defined in this Chapter.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2393. Applicability and scope

RS 22:2393 - Applicability and scope
A. This Chapter shall apply to any health insurance issuer that offers a health benefit plan as defined in this Chapter.
B. For purposes of claims related to a dental insurance policy, this Chapter shall apply only to external review or adverse determinations involving individual claims in excess of two hundred fifty dollars.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2021, No. 89, §1, eff. June 4, 2021.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2394. Licensure as a utilization review organization

RS 22:2394 - Licensure as a utilization review organization
A. No health insurance issuer, or entity acting on behalf of, or agent of a health insurance issuer shall act as a utilization review organization unless authorized as such by the commissioner as provided in this Chapter.
B. Any other entity may apply for and be issued a license pursuant to this Chapter to act as a utilization review organization on behalf of a health insurance issuer.
C. An entity licensed as a utilization review organization shall notify the commissioner of any material change in fact or circumstance affecting its qualification for a license in this state within sixty days of the effective date of the change. The notice shall include any documentation that the commissioner may require. Changes in fact or circumstances shall include the following items:
(1) Changes in control as defined in R.S. 22:691.2.
(2) Amendments to the articles of incorporation.
(3) Changes in officers and directors.
(4) Merger or consolidation of the utilization or independent review organization with any other person or entity.
(5) Use of a trade name in this state.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2401. Requirements of federal laws and regulations; minimum requirements

RS 22:2401 - Requirements of federal laws and regulations; minimum requirements
Health insurance issuers shall implement effective processes for appeals of coverage determinations and claims. The processes shall comply with any applicable federal law or regulation. Under such processes, a health insurance issuer shall, at a minimum:
(1) Have in effect an internal claims appeal process.
(2) Provide notice to covered persons, in a culturally and linguistically appropriate manner, of available internal and external appeals processes and the availability of the office of consumer advocacy of the Department of Insurance to assist such persons with the appeals process.
(3) Allow covered persons, upon request and free of charge, to review and have copies of all documents relevant to the claim for benefits and to submit comments and documents relating to the claim, without regard to whether that information was submitted or considered in the initial benefit determination, and to receive continued coverage pending the outcome of the appeals process where required by applicable law or the plan document or policy.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2020, No. 36, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2432. Purpose and intent

RS 22:2432 - Purpose and intent
The purpose of this Part is to provide uniform standards for the establishment and maintenance of external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination, as defined in this Chapter.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2434. Request for external review

RS 22:2434 - Request for external review
A.(1) Except for a request for an expedited external review, all requests for external review shall be made in writing to the health insurance issuer.
(2) The commissioner may prescribe by regulation the form and content of external review requests required to be submitted pursuant to this Section.
B. A covered person or his authorized representative may make a request for an external review of an adverse determination or final adverse determination when such determination involves an issue of medical necessity, appropriateness, health care setting, level of care, effectiveness, or a rescission.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2439. Binding nature of external review decision

RS 22:2439 - Binding nature of external review decision
A. A standard or an expedited external review decision shall be binding on the health insurance issuer except to the extent the health insurance issuer has other remedies available under applicable federal or state law.
B. A standard or an expedited external review decision shall be binding on the covered person except to the extent the covered person has other remedies available under applicable federal or state law.
C. A covered person or his authorized representative may not file a subsequent request for a standard or expedited external review involving the same adverse determination or final adverse determination for which the covered person has already received a standard or expedited external review decision pursuant to this Part.
D. For any decision by an independent review organization in favor of the covered person, a health insurance issuer may only subsequently deny coverage of the services that were the subject of review if it is determined that the covered person was ineligible for coverage due to nonpayment of premiums or for suspected fraud or material misrepresentation of fact.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2022, No. 81, §1, eff. Jan. 1, 2023.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2440. Approval of independent review organizations

RS 22:2440 - Approval of independent review organizations
A. The commissioner shall approve independent review organizations eligible to be assigned to conduct external reviews under this Part.
B. In order to be eligible for approval by the commissioner under this Section to conduct external reviews under this Part, an independent review organization shall:
(1) Except as otherwise provided in this Section, be accredited by a nationally recognized private accrediting entity that the commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum qualifications for independent review organizations provided for pursuant to R.S. 22:2441.
(2) Submit an application for approval in accordance with Subsection D of this Section along with the application fee specified in R.S. 22:821(B)(37). Such application shall also include a specified e-mail address to which external review information may be submitted.
C. The commissioner shall develop an application form for approving independent review organizations to conduct external reviews.
D.(1) Any independent review organization wishing to be approved to conduct external reviews under this Part shall submit the application form and include with the form all documentation and information necessary for the commissioner to determine if the independent review organization satisfies the minimum qualifications provided for by R.S. 22:2441.
(2)(a) Subject to Subparagraph (b) of this Paragraph, an independent review organization shall be eligible for approval under this Section only if it is accredited by a nationally recognized private accrediting entity that the commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum qualifications for independent review organizations provided for by R.S. 22:2441.
(b) The commissioner may approve independent review organizations that are not accredited by a nationally recognized private accrediting entity if there are no acceptable nationally recognized private accrediting entities providing independent review organization accreditation.
(3) The commissioner shall charge an application fee as specified in R.S. 22:821(B)(37) that independent review organizations shall submit to the commissioner with an application for approval.
E.(1) An approval shall remain effective unless the commissioner determines that the independent review organization is not satisfying the minimum qualifications provided for by R.S. 22:2441, or if the independent review organization gives notice of intent to cease operations.
(2) Whenever the commissioner determines that an independent review organization has lost its accreditation or no longer satisfies the minimum requirements established under R.S. 22:2441, the commissioner shall terminate the approval of the independent review organization.
F. Repealed by Acts 2017, No. 14, §2.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 14, §§1,2.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2442. Hold harmless for external review procedures

RS 22:2442 - Hold harmless for external review procedures
No independent review organization or clinical peer working on behalf of an independent review organization or an employee, agent, or contractor of an independent review organization shall be liable in damages to any person for any opinions rendered or acts or omissions performed within the scope of the organization's or person's duties under the law during or upon completion of an external review conducted pursuant to this Part, unless the opinion was rendered or act or omission was performed in bad faith or involved negligence or gross negligence.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2443. External review reporting requirements

RS 22:2443 - External review reporting requirements
A. An independent review organization assigned pursuant to R.S. 22:2436 through 2438 to conduct an external review shall maintain written records in the aggregate, by state, and by health insurance issuer on all requests for external review for which it conducted an external review during a calendar year and, upon request, submit an annual report to the commissioner.
B. The independent review organization shall retain the written records required pursuant to this Section for at least three years.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 14, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2444. Funding of external review

RS 22:2444 - Funding of external review
A. The health insurance issuer against which a request for a standard external review or an expedited external review is filed shall pay the cost of the independent review organization for conducting the external review, and no fee or other charge may be levied upon a covered person for any costs of an external review.
B.(1) The amount charged by the independent review organization as the cost to be paid by the health insurance issuer shall be a reasonable amount for the actual review performed. The independent review organization shall provide adequate documentation to the health insurance issuer justifying the amount charged.
(2) A health insurance issuer that believes that the amount charged for a review by an independent review organization is not reasonable may appeal those charges to the commissioner. In conducting the appeal, the commissioner shall review the amount charged, make a determination regarding the reasonableness of the amount charged, and, if warranted, may order an appropriate reduction. The commissioner may request additional information from the independent review organization, the health insurance issuer, or other independent review organizations or healthcare providers in making his determination.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 35, §1.
2023 Louisiana Laws › Revised Statutes › Title 22 - Insurance › §22:2445. Disclosure requirements

RS 22:2445 - Disclosure requirements
A.(1) Each health insurance issuer shall include a description of the external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage that it provides to covered persons.
(2) The description required by Paragraph (1) of this Subsection shall be in a format prescribed by the commissioner.
B. The description required by Subsection A of this Section shall include a statement that informs covered persons of their right to file a request for an external review of an adverse determination or final adverse determination with the health insurance issuer. The statement may explain that an external review is available when the adverse determination or final adverse determination involves an issue of medical necessity, appropriateness, health care setting, level of care, or effectiveness. The statement shall include the telephone number and address of the commissioner.
C. In addition to the requirements of Subsection B of this Section, the statement shall inform covered persons that, when filing a request for an external review, they will be required to authorize the release of any of their medical records that may be required to be reviewed for the purpose of reaching a decision on the external review.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015.