Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 9 - Regulation 40-Summary Document and Disclaimer and Notice of Noncoverage › Section XIII-907 - Exhibit A-Summary of the Louisiana Life and Health Insurance Guaranty Association Act and Notice Concerning Coverage Limitations and Exclusions

Current through Register Vol. 50, No. 6, June 20, 2024
A. Residents of
				Louisiana who purchase life insurance, annuities, or health insurance should
				know that the insurance companies licensed in this state to write these types
				of insurance are required by law to be members of LLHIGA. The purpose of LLHIGA
				is to assure that policyholders will be protected, within limits, in the
				unlikely event that a member insurer becomes financially unable to meet its
				obligations. If this happens, LLHIGA will assess its other member insurance
				companies for the money to pay the claims of insured persons who live in this
				state, and in some cases, to keep coverage in force. However, the valuable
				extra protection provided by these insurers through LLHIGA is limited. As noted
				in the disclaimer below, this protection is not a substitute for consumers'
				care in selecting companies that are well-managed and financially
				stable.
B. Except as provided in
				R.S.
				22:2098(D), when an insurer
				delivers a policy or contract described in
				R.S.
				22:2083(B)(1), then prior to
				or at the time of delivery, the disclaimer notice described in
				R.S.
				22:2098(C) and approved by
				the commissioner, shall be given separately to the policy or contract holder:
Disclaimer
The Louisiana Life and Health Insurance Guaranty Association
				  provides coverage of claims under some types of policies if the insurer becomes
				  impaired or insolvent. COVERAGE MAY NOT BE AVAILABLE FOR YOUR POLICY. Even if
				  coverage is provided, there are significant limits and exclusions. Coverage is
				  generally conditioned upon residence in this state. Other conditions may also
				  preclude coverage.
Insurance companies and insurance agents are prohibited by
				  law from using the existence of the association or its coverage to sell you an
				  insurance policy.
You should not rely on the availability of coverage under the
				  Louisiana Life and Health Insurance Guaranty Association when selecting an
				  insurer.
The Louisiana Life and Health Insurance Guaranty Association
				  or the Department of Insurance will respond to any questions you may have which
				  are not answered by this document.
LLHIGA
Department of Insurance
P.O. Drawer 44126
P. O. Box 94214
Baton Rouge, LA 70804
Baton Rouge, LA 70804-9214
C.
				The state law that provides for this safety-net coverage is called the
				Louisiana Life and Health Insurance Guaranty Association Law (the law), and is
				set forth at
				R.S.
				22:2081 et seq. The following is a brief
				summary of this law's coverages, exclusions and limits. This summary does not
				cover all provisions of the law; nor does it in any way change any person's
				rights or obligations under the law or the rights or obligations of
				LLHIGA.
D. Generally, individuals
				will be protected by the Life and Health Insurance Guaranty Association if they
				live in this state and hold a direct non-group life, health, or annuity policy
				or contract, a certificate under a direct group policy or contract for a
				supplemental contract to any of these, or an unallocated annuity contract,
				issued by an insurer authorized to conduct business in Louisiana. The
				beneficiaries, payees or assignees of insured persons may also be protected as
				well even if they live in another state unless they are afforded coverage by
				the guaranty association of another state, or other circumstances described
				under the law are applicable.
E.
				Exclusions from Coverage
1. A person who
				holds a direct non-group life, health, or annuity policy or contract, a
				certificate under a direct group policy or contract for a supplemental contract
				to any of these, or an unallocated annuity contract is not protected by LLHIGA
				if:
a. he is eligible for protection under
				the laws of another state (This may occur when the insolvent insurer was
				incorporated in another state whose guaranty association protects insureds who
				live outside that state.);
b. the
				insurer was not authorized to do business in this state;
c. his policy was issued by a profit or
				nonprofit hospital or medical service organization, an HMO, a fraternal benefit
				society, a mandatory state pooling plan, a mutual assessment company or similar
				plan in which the policyholder is subject to future assessments, an insurance
				exchange, an organization that issues charitable gift annuities as is defined
				in
				R.S.
				22:952(A)(3), or any entity
				similar to any of these.