Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 57 - Regulation 14-Limiting Exclusions in Industrial Policies, Restricting Payments for Death Caused in Specified Manner
Section XIII-5701 - Payment of Death or Funeral Benefits
Universal Citation: LA Admin Code XIII-5701
Current through Register Vol. 50, No. 9, September 20, 2024
A. All Domestic Insurance Companies
1. If your industrial life insurance or
funeral benefit policies contain provisions which exclude or limit the payment
of death or funeral benefits because death is caused in any specified manner,
or occurs while the insured has a specified status, except those listed below,
then it will be necessary that you amend such policies before they are
issued.
2. Provisions excluding or
restricting coverage in the event of death occurring:
a. as a result of war, declared or
undeclared, under conditions specified in the policy;
b. while in:
i. the military, naval or air forces of any
country at war, declared or undeclared;
ii. any ambulance, medical, hospital, or
civilian non-combatants unit serving with such forces, either while serving
with or within six months after termination of service in such forces or
units;
c. as a result of
self-destruction, while sane or insane, within two years from the date of issue
of the policy;
d. as a result of
aviation under conditions specified in the policy;
e. within two years from date of issue of the
policy as a result of a specified hazardous occupation or occupations, or while
the insured is residing in a specified foreign country or countries.
3. In the event of death to which
there is an exclusion or restriction pursuant to
§5701. A.2 a, b, c, d,
or e of this provision, the insurer shall pay an amount not less than the
reserve on the policy, together with the reserve for any paid-up additions
thereto and any dividends standing to the credit of the policy, less any
indebtedness to the insurer on the policy, including interest due or
accrued.
4. In the event of death
as to which there is an exclusion or restriction pursuant to Subparagraph (b)
of Paragraph (3)(B), the insurer shall pay the greater of:
a. the amount specified in the preceding
paragraph; or
b. the amount of the
gross premiums charged on the policy less dividends paid in cash or used in the
payment of premiums thereon and less any indebtedness to the insurer on the
policy, including interest due or accrued.
5. None of the provisions of
§5701. A.5 shall apply
to policies issued under Sections 253 E, nor to any accidental benefits in the
event such death by accident or accidental means included in a life
policy.
B. Senate Committee Amendment Number 3
1. The
Legislative intent of this Amendment, as evidenced by Industry and Committee
hearings, was that it should apply only to the two immediately preceding
unnumbered paragraphs so that a reduction not to exceed the percentages of the
reserve, computed in accordance with Part 5 of the Code, could continue to be
taken on funeral policies. Note reference to Sections 162. E.
AUTHORITY NOTE: Promulgated in accordance with R.S. 22:259.
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