Louisiana Department of Insurance Office of Consumer Advocay
Volume 2, Issue 6
JUNE 2011

Community Housing and Resource Fair
6/4/2011
First Pilgrims Baptist Church 1228 Arts Street
New Orleans, LA
10:00 a.m. - 2:00 p.m.

Cortana Kiwanis Club Weekly Meeting
6/9/2011
Picadilly Cafeteria
3232 S. Sherwood Forest Blvd.
Baton Rouge, LA
7:30 a.m.

District 10 Councilwoman Tara Wicker Town Meeting
6/14/2011
Baton Rouge Gallery
1515 Dalrymple Drive
Baton Rouge, LA
5:30 p.m.

South Baton Rouge Kiwanis Club Weekly Meeting
6/15/2011
D’Jons Restaurant
5255 Florida Blvd.
Baton Rouge, LA
12 p.m.

BOEMRE Personal Wellness Expo
6/22/2011
1201 Elmwood Park Blvd.
New Orleans, LA
9:00 a.m. - 1:00 p.m.

Foundation for Louisiana
6/25/2011
Dillard University - Professional Building
2601 Gentilly Blvd.
New Orleans, LA
9:00 a.m. - 1:00 p.m.

Emergency Prep/Business Continuity Conference
6/28/2011
Hammond, LA
8:30 a.m. - 12:30 p.m.

Emergency Prep/Business Continuity Conference
6/29/2011
Mandeville/Slidell
8:30 a.m. - 12:30 p.m.

Foundation for Louisiana
6/29/2011
Dillard University - Professional Building
2601 Gentilly Blvd.
New Orleans, LA
9:00 a.m. - 1:00 p.m.

For speaking engagements scheduled after the release of the newsletter or for more detailed information about engagements listed in the newsletter, visit our web site at www.ldi.la.gov. Click on the Events tab found in the center of the home page.

To view previous newsletters, click on Consumer Advocacy under Consumers; then click on Consumer Advocacy Newsletters.

To find out if Consumer Advocacy will be in your area or to request a speaker for your organization or group, call (225) 219-0619 or e-mail
consumeradvocacy@ldi.la.gov

If you no longer wish to receive this newsletter please e-mail the following address with "REMOVE" in the subject line.
consumeradvocacy@ldi.la.gov

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What can the Department of Insurance do for you?

The Louisiana Department of Insurance (LDI) is the state agency that regulates the insurance industry.  The LDI was created by the Louisiana Legislature and is currently headed by Commissioner James J. Donelon. 

To answer the question, “What can the Louisiana Department of Insurance do for you?” we will first discuss the three key performers in the insurance industry, consumers, insurance companies and producers/adjusters.

Consumers
LDI protects the insurance consumers of Louisiana by making sure the insurance companies, producers and adjusters comply with state insurance laws.  LDI educates consumers regarding their rights and the insurance laws of Louisiana by participating in or by hosting community events, radio and television briefings and annual conferences.  Consumers are encouraged to contact LDI if they have a problem or question that can’t be resolved with their insurance producer or company.  A consumer can also contact LDI to obtain the insurance rating, telephone number and claim filing address of a particular insurance company.  If a consumer believes that his/her policyholder Bill of Rights has been violated or the behavior of an insurance company or producer is unethical or fraudulent, he/she is encouraged to file a complaint with LDI. LDI will investigate the complaint thoroughly and expeditiously. While the complaint is being investigated, the complainant will be kept abreast of the findings.

Insurance Companies

LDI encourages new companies to conduct business in Louisiana to keep the insurance market competitive, stable and financially sound.  LDI also continuously monitors the performance of companies, producers and adjusters currently participating in the Louisiana insurance industry.  All companies and producers must maintain a market conduct that is consistent with Louisiana laws and industry standards. LDI requires that an insurance company be financially solvent and show a high standard of performance.

Every insurance company that operates in Louisiana must be licensed with LDI. Each company, producer, and adjuster is assigned a license number by LDI. If you are not familiar with a representative or a company you are considering doing business with, contact LDI to verify their license status.  Prior to contacting LDI, it would be helpful for you to ask the company or representative for their LDI license number.

Producers & Adjusters
LDI producer licensing division is responsible for making sure that every insurance producer or adjuster has satisfied the requirements for licensure. Producers and adjusters are required to complete continuing education courses annually to renew their license. This process ensures that producers and adjusters of Louisiana are aware of recent changes in the insurance industry and are updated on current events and legislative changes.
If a consumer is searching for a producer or trying to verify which companies a producer is affiliated with, he/she can access the LDI Web site at www.ldi.state.la.us or call 1-800-259-5300.

There are four consumer protection offices/divisions within the Louisiana Department of Insurance.

Property & Casualty Compliance Division:  assists consumers with auto and property insurance questions. This division, most often referred to as Consumers Affairs, can also answer questions relating to workers' compensation and commercial insurance.

Office of Health Insurance including the Senior Health Insurance Information Program (SHIIP):  provides consumers assistance with questions regarding health insurance. SHIIP answers senior-related health insurance questions, provides Medicare counseling specific to the citizens of Louisiana, and participates in community presentations.

Division of Life & Annuities: assists consumers with questions about life insurance, long-term care insurance, and annuities.

Office of Consumer Advocacy: serves as an advocate for consumers requesting assistance and enforces the Policyholders Bill of Rights.

The following LDI phone numbers may be useful to you!

Louisiana Department of Insurance                         800-259-5300   or  225-342-0895
Property & Casualty                                              225-342-1258
Health Insurance                                                  225-219-4770
Life & Annuities                                                    225-342-1226
Producer Licensing                                               225-342-0860
Company Licensing                                               225-342-1251
Fraud Investigation                                               225-342-4956
Insurance Ratin g                                                 225-342-5203
Senior Health Insurance Information Program           225-342-5301
Consumer Advocacy                                              225-219-0619 

The Louisiana Department of Insurance is proud to serve the insurance consumers of Louisiana. Our staff is committed to public service and educational development.  Our aim is to provide excellent service to every individual who contacts LDI.  If you have an insurance question or concern, don’t hesitate to contact the Louisiana Department of Insurance.  

The Role and Function of the Office of Consumer Advocacy

The Office of Consumer Advocacy (OCA) was created by the Louisiana Legislature in 2007 after the abolishment of the Louisiana Insurance Rating Commission.  OCA was created to advocate on behalf of consumers with insurance inquiries and complaints and to bring awareness to the functions of the Department of Insurance.  OCA disseminates informational brochures to educate consumers regarding insurance issues.  OCA gives presentations statewide at legislative community meetings, civic organizations, agent group meetings, homebuyers' classes and colleges and universities.  Taking a proactive approach to insurance and helping consumers understand their insurance policies ensures that consumers are better equipped to file claims, prepare property inventory checklists, and to engage in open discussions with their producer regarding their insurance needs.

The staff of the Office of Consumer Advocacy works with the Louisiana Legislature to address consumer concerns and to promote awareness of changes in insurance laws.  OCA partners with the other divisions of the Department of Insurance to investigate complaints concerning products or services that it regulates.  In an effort to ensure that Louisiana’s marketing practices and policy form filings are comparable to national state filings, OCA researches and tracks insurance trends of other states.  OCA is charged with reporting violations of rules, regulations or laws of entities in violation to the appropriate official in the Department.  A major consumer protection that OCA must ensure compliance with is the Policyholder Bill of Rights.
           
Policyholder bill of rights (R.S. 22:41)
The following items exist in Louisiana statutes and shall serve as standards for a policyholder bill of rights and do not create additional causes of actions or further penalties not otherwise provided under Louisiana statutes:
(1)  Policyholders shall have the right to competitive pricing practices and marketing methods that enable them to determine the best value among comparable coverage in accordance with R.S. 22:1964.
(2)  Policyholders shall have the right to insurance advertising that is not false and other selling approaches that provide accurate and balanced information on the benefits and limitations of a policy in accordance with R.S. 22:1964.
(3)  Policyholders shall have the right to an insurance company that is financially stable.
(4)  Policyholders shall have the right to be treated fairly and be free from unfair or deceptive acts or practices in accordance with R.S. 22:1961 et seq.
(5)  Policyholders shall have the right to receive service from competent, honest insurance producers who will answer their questions promptly.
(6)  Policyholders shall have the right to receive the appropriate disclosure form as an insert in the front of the policy that complies with R.S. 22:1319 and 1332.
(7)  Policyholders shall have the right to balanced and positive regulation by the Department of Insurance.
(8)  Policyholders shall have the right to check the license status of an insurance company, producer, or adjuster.
(9)  Policyholders shall have the right to receive written notice of cancellation or nonrenewal at least thirty days prior to the effective date of the cancellation or nonrenewal, unless the cancellation or nonrenewal is for non-payment of premium. Policyholders shall have the right to protection from improper cancellation or nonrenewal in accordance with R.S. 22:1265 and 1333.
(10)  Policyholders shall have the right to receive in writing the reason for any cancellation or nonrenewal of coverage.  The written statement must provide an explanation for the cancellation or nonrenewal of coverage.
(11)  Policyholders shall have the right to cancel their policy and receive a refund of any unearned premium.  If a policy was funded by a premium finance company, the unearned premium will be returned to the premium finance company to pay toward the policyholder's financing loan.
(12)  Policyholders shall have the right to a written notification detailing any change in policy provisions at renewal.
(13)  Policyholders shall have the right to receive payment of the amount of any property damage claim, or a portion of the claim, due or a written offer to settle any property damage claim within thirty days after receipt of satisfactory proof of loss in accordance with R.S. 22:1892 and 1973.  If a claim is denied, policyholders shall have the right to receive a written explanation as to the reason for denial, in whole or in part, of any claim made under their policy of insurance.
(14)  Relative to first party property damage claims, policyholders shall have the right to request and receive from the insurance company any estimates, bids, plans, measurements, drawings, engineer reports, contractor reports, statements or documents that are not legally privileged that the insurance company prepared, had prepared, or used during its adjustment of a policyholder's claim. A company may keep confidential adjuster notes, logs, and any documents prepared in conjunction with a fraud investigation.
(15)  Policyholders shall have the right to file a complaint against any insurance company, producer, or adjuster with the Department of Insurance and to have that complaint investigated by the department.
(16)  Policyholders shall have the right to a readable policy, to receive a complete property insurance policy, and to request a duplicate or replacement policy as needed.
(17)  Policyholders shall have the right to the remedies provided for in R.S. 22:1892 if an insurer violates that Section in the handling of the claim.

EDITOR’S LETTER

School is out and summer is here!

The kids are out of school and summer activities are beginning.  Backyard barbeques, camping trips, pool parties and other fun outdoor activities will keep us busy until the new school year starts.  As we enjoy the good times with our families and friends, we must remember to be safe while having fun.  Injuries and damage to property can result when we are not careful and there may not be protection for certain injuries and damage under your insurance policy. 

Take the time to review your insurance policies before an accident happens.  Here are a few things to consider:

  • What liability protections and limits are available to you?  If you are hosting an event and someone gets hurt, you could be liable for injuries.
  • Is your pool covered or excluded under your property policy?
  • If you travel, is your personal property covered away from home?  If so, to what limit?
  • Do you need to purchase travel insurance to protect yourself from unforeseen circumstances that would cancel or postpone your travels?
  • Will your policy cover accidents when you engage in dangerous activities such as rock climbing, sky diving, race car driving, or bungee jumping?
  • Do you need prior authorization for medical treatment when you are out of your network area?
  • What are the co-payments and/or deductibles that apply for emergency room care?

Review your insurance policies.  Be careful and enjoy your summer!

Deputy Commissioner
Clarissa A. Preston, CIC, APIR

 

Office of Consumer AdvocacyP.O. Box 94214Baton Rouge, LA 70804-9214
(225) 219-0619 or (800)259-5300www.ldi.la.govconsumeradvocacy@ldi.la.gov