Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 101 - Regulation 78-Policy Form Filing Requirements › Section XIII-10113 - Filing and Review of Property and Casualty Insurance Policy Forms and Related Matters

Current through Register Vol. 50, No. 6, June 20, 2024
A. Definitions.
				As used in this Section, the following terms shall have the meaning or
				definition as indicated herein.
Affirmative Approval
-department approval, as
				  a result of the department taking action, following compliance review of a
				  complete filing, or a filing pursuant to Subsection D hereof.
Basic Insurance Policy Form
-an insurance
				  contractual agreement delineating the terms, provisions and conditions of a
				  particular insurance product. It includes endorsements, and application forms
				  where written application is required and is to be attached to the policy or be
				  a part of the contract. It does not include policies, riders, or endorsements
				  designed, at the request of the individual policyholder, contract holder, or
				  certificate holder, to delineate insurance coverage upon a particular subject
				  or which relate to the manner of distribution of benefits or to the reservation
				  of rights and benefits under such policy.
Certification of Compliance
-certification by
				  an insurer, executed by an officer or authorized representative of the insurer
				  on a form prescribed by the department, that upon knowledge and belief a filing
				  is complete and in compliance with all applicable statutes, and rules and
				  regulations promulgated by the department. A certification of compliance must
				  be included with any filing for certified approval.
Certified Approval
-approval on the basis of
				  an expedited review by the department of a complete filing based upon the
				  inclusion of a statement of compliance and a certification of compliance,
				  executed by an officer or authorized representative of the filing insurer on
				  forms prescribed by the department. The department shall by directive determine
				  those specific types of coverage and particular types of contracts for which
				  the certified approval procedure is either required or available at the option
				  of the insurer.
Commissioner
-the commissioner of insurance
				  of the Louisiana Department of Insurance.
Complete Filing
-the filing of a single
				  insurance product, including any required filing fees; a basic insurance policy
				  form, application form to be attached to the policy or be a part of the
				  contract; all items required under Subsection C hereof, "General Filing
				  Requirements," and any other requirements as may be set forth in the applicable
				  statement of compliance.
Compliance Audit
-a retrospective review
				  conducted by the department of previously approved basic insurance policy forms
				  to determine compliance with applicable law.
Compliance Review
-department review of a
				  filing made pursuant to this Section to determine either that the filing is in
				  compliance with all applicable statutes, rules and regulations, or that the
				  filing should be disapproved for noncompliance.
Deemed Approval
-approval of a complete
				  filing based upon notice, as provided herein, made to the department by the
				  filing insurer, following expiration of the specific time periods as provided
				  herein, where affirmative approval has not been granted and the filing has not
				  been disapproved by the department.
Department
-the Louisiana Department of
				  Insurance.
Endorsement
-a written agreement attached to
				  an insurance product to add or subtract coverage, or otherwise modify the
				  product.
Filing Organization
-an entity authorized by
				  the Commissioner to act as an advisory or rating organization on behalf of its
				  members and subscribers.
Insurance Product
-a basic insurance policy
				  form delineating the terms, provisions and conditions of a specific type of
				  coverage under a particular type of contract, or a basic insurance policy form
				  which combines more than one line of business within one policy form at a
				  single premium.
Insurer
-every person engaged in the business
				  of making contracts of insurance, as further defined in
				  R.S.
				  22:46(10).
Method of Marketing
-marketing either through
				  independent or captive agents; telephone, electronic mail or direct mail
				  solicitation; groups, organizations, associations or trusts; and/or the
				  Internet.
Rate/Rule Approval
-a department notice
				  addressed to an insurer granting authorization to implement or revise rates
				  and/or rules on a specified date.
Required Filing Fee
-the fee assessed per
				  product or filing pursuant to state insurance law.
Rider
-an endorsement to an insurance product
				  that modifies clauses and provisions of the product, including adding or
				  excluding coverage.
Statement of Compliance
-a form prescribed by
				  the department detailing the requirements specific to a particular form of
				  coverage and contract type.
B. Filing Required
1. Pursuant to
				R.S.
				22:861(A), no basic
				insurance policy form, other than fidelity or surety bond forms, or application
				form where written application is required and is to be attached to the policy
				or be a part of the contract, or printed rider or endorsement form, shall be
				issued, delivered, or used in this state unless and until it has been filed
				with and approved by the commissioner. Every page of each such form including
				rider and endorsement forms filed with the department must be identified by a
				form number in the lower left corner of the page.
2. A filing description must accompany every
				filing, describing the items included in the filing, the insurance product for
				which the filing is being made, and the method of marketing to be used for the
				product For non-electronic paper filings, this description must be satisfied by
				the submission of a completed transmittal document.