Louisiana Administrative Code
Title 37 - INSURANCE
Part XIII - Regulations
Chapter 153 - Regulation 107-Homeowner and Fire/Commercial Insurance Policy Disclosure Forms
Section XIII-15313 - Appendices
Current through Register Vol. 50, No. 3, March 20, 2024
A. Appendix A
Important Information Required by the Louisiana Department of Insurance
Fire Insurance Policy Coverage Disclosure Summary (other than Homeowners)
Or Commercial Insurance Policy Coverage Disclosure Summary This form is promulgated pursuant to La. R.S. 22:1319
THIS IS ONLY A SUMMARY OF YOUR COVERAGE AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGES OR ANY OTHER PROVISIONS CONTAINED IN YOUR POLICY. INSURANCE IS A CONTRACT. THE LANGUAGE IN YOUR POLICY CONTROLS YOUR LEGAL RIGHTS AND OBLIGATIONS.
**READ YOUR INSURANCE POLICY FOR COMPLETE POLICY TERMS AND CONDITIONS**
COVERAGE(S) FOR WHICH PREMIUM WAS PAID (La. R.S. 22:1319(B)(1))
[INSERT PROPERTY COVERAGES]
Deductibles (La. R.S. 22:1319(B)(3))
This policy sets forth certain deductibles that will be applied to claims for damages. When applicable, a deductible will be subtracted from your total claim and you will be paid the balance subject to applicable coverage limits.
You may be able to reduce your premium by increasing your deductible. Contact your producer (agent) or insurer for details.
NOTICE: This policy [does/does not] set forth a separate deductible for covered losses caused by [hurricane; wind; named storm] as defined in the policy.
Separate Deductible Examples-Hurricane, Wind or Named Storm Damage.
If applicable, the following illustrates how a separate deductible applying to hurricane, wind or named storm damage is applied under your policy:
The insurer shall comply with La. R.S. 22:1319 B(3) by selecting either option A or B below:
The following assumes no co-insurance penalty and a 2% hurricane, wind, or named storm deductible. The amounts of loss to the damaged property are $50,000 (building) and $20,000 (business personal property).
|
Limits of insurance on building.................. |
$ 100,000 |
|
Total amount of building loss......................... |
$ 50,000 |
|
Less 2% deductible ($100,000 X .02) ...................... |
$ 2,000 |
|
Net payment to insured for building loss.................. |
$ 48,000 |
|
Limits of insurance on the business personal property......................... |
$ 50,000 |
|
Total amount of business personal property loss......................... |
$ 20,000 |
|
Less 2% deductible ($50,000 X .02) ......................... |
$ 1,000 |
|
Net payment to insured for business personal property loss......................... |
$ 19,000 |
|
Total net payment to insured for building and business personal property loss ($48,000 + $19,000)......................... |
$ 67,000 |
TO SEE EXACTLY HOW YOUR SEPARATE HURRICANE, WIND OR NAMED STORM DEDUCTIBLE WILL APPLY, PLEASE REFER TO YOUR POLICY.
Limitations or Exclusions under this Policy (La. R.S. 22:1319(B)(2))
FLOOD-Flood damage [is/is not] covered, regardless of how caused, when flood is the peril that causes the loss. Flood water includes, but is not limited to, storm surge, waves, tidal water, overflow of a body of water, whether driven by wind or not.
Flood Insurance may be available through the National Flood Insurance Program (NFIP). NFIP flood insurance may provide coverage for damage to your dwelling or building and/or contents subject to the coverage limits and terms of the policy.
Excess Flood Insurance may be available under a separate policy, from this or another insurer, if the amount of the primary flood insurance is not enough to cover the value of your property.
You may contact your producer (agent) or insurer for more information on the NFIP and excess flood insurance.
MOLD-Damage caused solely by mold [is/is not] covered under this policy.
**FOR ALL OTHER LIMITATIONS OR EXCLUSIONS REFER TO YOUR POLICY FOR COMPLETE DETAILS ON TERMS AND PROVISIONS**
B. Appendix B
Important Information Required by the Louisiana Department of Insurance
Homeowners Insurance Policy Coverage Disclosure Summary
This form is promulgated pursuant to La. R.S. 22:1332(B)(1)-(6) and (8)
THIS IS ONLY A SUMMARY OF YOUR COVERAGE AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGES OR ANY OTHER PROVISIONS CONTAINED IN YOUR POLICY. INSURANCE IS A CONTRACT. THE LANGUAGE IN YOUR POLICY CONTROLS YOUR LEGAL RIGHTS AND OBLIGATIONS.
**READ YOUR INSURANCE POLICY FOR COMPLETE POLICY TERMS AND CONDITIONS**
COVERAGE(S) FOR WHICH PREMIUM WAS PAID (La. R.S. 22:1332(B)(1))
[INSERT PERSONAL PROPERTY COVERAGES]
Example:
Coverage A Dwelling
Coverage B Other Structures
Coverage C Personal Property
Coverage D Loss of Use
Coverage E Personal Liability
Coverage F Medical Payments
Deductibles (La. R.S. 22:1332(B)(5) and (6))
This policy sets forth certain deductibles that will be applied to claims for damages. When applicable, a deductible will be subtracted from your total claim and you will be paid the balance subject to applicable coverage limits.
You may be able to reduce your premium by increasing your deductible. Contact your producer (agent) or insurer for details.
NOTICE: This policy [does/does not] set forth a separate deductible for covered losses caused by [hurricane; wind; named storm] as defined in the policy.
Separate Deductible Example-Hurricane, Wind or Named Storm Damage.
If applicable, the following illustrates how a separate deductible applying to hurricane, wind or named storm damage is applied under your policy:
The insurer shall comply with La. R.S. 22:1332(B)(6) by selecting and inserting either option A or B below:
If the total insured value of the dwelling or Coverage A is $200,000 and you have a 2% hurricane, wind, or named storm deductible, then your hurricane, wind or named storm deductible would be $200,000.00 X .02 = $4,000.00.
|
Losses: |
|
|
Coverage A - Dwelling $15,000 |
|
|
Coverage B - Other Structures |
$ 2,500 |
|
Coverage C - Personal Property |
$ 3,000 |
|
Coverage D - Loss of Use |
$ 2,000 |
|
Total amount of all losses |
$22,500 |
|
Less 2% hurricane, storm deductible wind or named |
$ 4,000 |
|
Net payment to insured |
$18,500 |
TO SEE EXACTLY HOW YOUR SEPARATE HURRICANE, WIND OR NAMED STORM DEDUCTIBLE WILL APPLY, PLEASE REFER TO YOUR POLICY.
Limitations or Exclusions under this Policy (La. R.S. 22:1332(B)(2))
FLOOD-Flood damage [is/is not] covered, regardless of how caused, when flood is the peril that causes the loss. Flood water includes but is not limited to storm surge, waves, tidal water, overflow of a body of water, whether driven by wind or not.
Flood Insurance may be available through the National Flood Insurance Program (NFIP). NFIP flood insurance may provide coverage for damage to your dwelling and/or contents subject to the coverage limits and terms of the policy.
Excess Flood Insurance may be available under a separate policy from this or another insurer if the amount of the primary flood insurance is not enough to cover the value of your property.
You may contact your producer (agent) or insurer for more information on the NFIP and excess flood insurance.
MOLD-Damage caused solely by mold [is/is not] covered under this policy.
**FOR ALL OTHER LIMITATIONS OR EXCLUSIONS REFER TO YOUR POLICY FOR COMPLETE DETAILS ON TERMS AND PROVISIONS**
Claim Filing Process (La. R.S. 22:1332(B)(3))
There may be time limitations for filing a claim and filing of a satisfactory proof of loss. There may also be time limitations for repairing and replacing damaged property that could cause you to not recover the replacement cost for the insured loss of your property, if applicable.
Payment of Claims (La. R.S. 22:1332(B)(3))
Depending on the terms of the insurance policy, some losses may be based on actual cash value (ACV) and other losses based on replacement cost (RC).
ACV is the amount needed to repair or replace the damaged or destroyed property, minus the depreciation.
RC involves the initial payment of actual cash value (ACV) of a loss, and the subsequent payment of the additional amount that is actually and necessarily expended to repair or replace the damaged or destroyed property.
**Refer to your policy for the terms and conditions describing how a particular loss is to be paid.
Payment and Adjustment of Claims (La. R.S. 22:1332(B)(4))
Pursuant to La. R.S. 22:1892 and 22:1973, except in the case of catastrophic loss, the insurer shall initiate loss adjustment of a property damage claim and/or a claim for reasonable medical expenses within fourteen (14) days after notification of loss by the claimant.
In the case of catastrophic loss, the insurer shall initiate loss adjustment of a property damage claim within thirty (30) days after notification of loss by the claimant unless the Commissioner of Insurance promulgates a rule to extend the time period for initiating a loss adjustment for damages arising from a presidentially declared emergency or disaster or a gubernatorially declared emergency or disaster for up to an additional thirty (30) days. Thereafter, one additional extension of the period of time for initiating a loss adjustment may be allowed by the Commissioner of Insurance if approved by the Senate Committee on Insurance and the House Committee on Insurance.
All insurers shall make a written offer to settle any property damage claim, including a third-party claim, within thirty (30) days after the receipt of satisfactory proof of loss of that claim.
Failure to make such payment within thirty (30) days after receipt of such satisfactory written proofs and demand thereof or failure to make a written offer to settle any property damage claim, including a third-party claim, within thirty (30) days after receipt of a satisfactory proof of loss of that claim may result in a late penalty against the insurer in addition to the payment of the claim.
If the insurer is found to be arbitrary, capricious, or without probable cause in settling any property damage claim, the insurer must pay the insured, in addition to the amount of the loss, fifty percent (50%) damages on the amount found to be due from the insurer to the insured, or one thousand dollars ($1,000.00), whichever is greater, as well as attorney fees and costs, if applicable.
Reduction in Premium for Improvements or Modifications to Property (La. R.S. 22:1332(B)(8))
Certain improvements or modifications to your property, such as adding storm shutters, modifying the roof design, and improving the roof covering, may reduce your premium. Contact your insurance producer or insurer for complete details on qualifying improvements or modifications. For further guidance and assistance, see Regulation 94-Premium Adjustments for Compliance with Building Codes and Damage Mitigation, found at LAC 37:XIII.Chapter 127.
C. Appendix C
Important Information Required by the Louisiana Department of Insurance
Homeowners Insurance Policy Coverage Disclosure Summary
This form is promulgated pursuant to La. R.S. 22:1332 (B) (1)-(8)
THIS IS ONLY A SUMMARY OF YOUR COVERAGE AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGES OR ANY OTHER PROVISIONS CONTAINED IN YOUR POLICY. INSURANCE IS A CONTRACT. THE LANGUAGE IN YOUR POLICY CONTROLS YOUR LEGAL RIGHTS AND OBLIGATIONS.
**READ YOUR INSURANCE POLICY FOR COMPLETE POLICY TERMS AND CONDITIONS**
COVERAGE(S) FOR WHICH PREMIUM WAS PAID (La. R.S. 22:1332(B)(1))
[INSERT PERSONAL PROPERTY COVERAGES]
Example:
Coverage A Dwelling
Coverage B Other Structures
Coverage C Personal Property
Coverage D Loss of Use
Coverage E Personal Liability
Coverage F Medical Payments
Deductibles (La. R.S. 22:1332(B)(5), (6) and (7))
This policy sets forth certain deductibles that will be applied to claims for damages. When applicable, a deductible will be subtracted from your total claim and you will be paid the balance subject to applicable coverage limits.
You may be able to reduce your premium by increasing your deductible. Contact your producer (agent) or insurer for details.
If you file a claim that does not exceed the policy deductible and that does not result in a payment either to you or on your behalf, that claim may be used to increase the cost of your policys premium in the future or as part of the basis for cancellation of your policy.
NOTICE: This policy [does/does not] set forth a separate deductible for covered losses caused by [hurricane; wind; named storm] as defined in the policy.
Separate Deductible Example-Hurricane, Wind or Named Storm Damage.
If applicable, the following illustrates how a separate deductible applying to hurricane, wind or named storm damage is applied under your policy:
The insurer shall comply with La. R.S. 22:1332 B(6) by selecting and inserting either option A or B below:
If the total insured value of the dwelling or Coverage A is $200,000.00 and you have a 2% hurricane, wind, or named storm deductible, then your hurricane, wind or named storm deductible would be $200,000.00 X .02 = $4,000.00.
|
Losses: |
|
|
Coverage A - Dwelling $15,000 |
|
|
Coverage B - Other Structures |
$ 2,500 |
|
Coverage C - Personal Property |
$ 3,000 |
|
Coverage D - Loss of Use |
$ 2,000 |
|
Total amount of all losses |
$22,500 |
|
Less 2% hurricane, wind deductible or named storm |
$ 4,000 |
|
Net payment to insured |
$18,500 |
TO SEE EXACTLY HOW YOUR SEPARATE HURRICANE, WIND OR NAMED STORM DEDUCTIBLE WILL APPLY, PLEASE REFER TO YOUR POLICY. Limitations or Exclusions under this Policy (La. R.S. 22:1332(B)(2))
FLOOD-Flood damage [is/is not] covered, regardless of how caused, when flood is the peril that causes the loss. Flood water includes but is not limited to storm surge, waves, tidal water, overflow of a body of water, whether driven by wind or not.
Flood Insurance may be available through the National Flood Insurance Program (NFIP). NFIP flood insurance may provide coverage for damage to your dwelling and/or contents subject to the coverage limits and terms of the policy.
Excess Flood Insurance may be available under a separate policy from this or another insurer if the amount of the primary flood insurance is not enough to cover the value of your property.
You may contact your producer (agent) or insurer for more information on the NFIP and excess flood insurance.
MOLD-Damage caused solely by mold [is/is not] covered under this policy.
**FOR ALL OTHER LIMITATIONS OR EXCLUSIONS REFER TO YOUR POLICY FOR COMPLETE DETAILS ON TERMS AND PROVISIONS**
Claim Filing Process (La. R.S. 22:1332(B)(3))
There may be time limitations for filing a claim and filing of a satisfactory proof of loss. There may also be time limitations for repairing and replacing damaged property that could cause you to not recover the replacement cost for the insured loss of your property, if applicable.
Payment of Claims (La. R.S. 22:1332(B)(3))
Depending on the terms of the insurance policy, some losses may be based on actual cash value (ACV) and other losses based on replacement cost (RC).
ACV is the amount needed to repair or replace the damaged or destroyed property, minus the depreciation.
RC involves the initial payment of actual cash value (ACV) of a loss, and the subsequent payment of the additional amount that is actually and necessarily expended to repair or replace the damaged or destroyed property.
** Refer to your policy for the terms and conditions describing how a particular loss is to be paid.
Payment and Adjustment of Claims (La. R.S. 22:1332(B)(4))
Pursuant to La. R.S. 22:1892 and 22:1973, except in the case of catastrophic loss, the insurer shall initiate loss adjustment of a property damage claim and/or a claim for reasonable medical expenses within fourteen (14) days after notification of loss by the claimant.
In the case of catastrophic loss, the insurer shall initiate loss adjustment of a property damage claim within thirty (30) days after notification of loss by the claimant unless the Commissioner of Insurance promulgates a rule to extend the time period for initiating a loss adjustment for damages arising from a presidentially declared emergency or disaster or a gubernatorially declared emergency or disaster for up to an additional thirty (30) days. Thereafter, one additional extension of the period of time for initiating a loss adjustment may be allowed by the Commissioner of Insurance if approved by the Senate Committee on Insurance and the House Committee on Insurance.
All insurers shall make a written offer to settle any property damage claim, including a third-party claim, within thirty (30) days after the receipt of satisfactory proof of loss of that claim.
Failure to make such payment within thirty (30) days after receipt of such satisfactory written proofs and demand thereof or failure to make a written offer to settle any property damage claim, including a third-party claim, within thirty (30) days after receipt of a satisfactory proof of loss of that claim may result in a late penalty against the insurer in addition to the payment of the claim.
If the insurer is found to be arbitrary, capricious, or without probable cause in settling any property damage claim, the insurer must pay the insured, in addition to the amount of the loss, fifty percent (50%) damages on the amount found to be due from the insurer to the insured, or one thousand dollars ($1,000.00), whichever is greater, as well as attorney fees and costs, if applicable.
Reduction in Premium for Improvements or Modifications to Property (La. R.S. 22:1332(B)(8))
Certain improvements or modifications to your property, such as adding storm shutters, modifying the roof design, and improving the roof covering, may reduce your premium. Contact your insurance producer or insurer for complete details on qualifying improvements or modifications. For further guidance and assistance, see Regulation 94-Premium Adjustments for Compliance with Building Codes and Damage Mitigation, found at LAC 37:XIII.Chapter 127.
AUTHORITY NOTE: Promulgated in accordance with R.S. 22:11, 22:1319 and 22:1332.
