Table of Contents. Title 37 INSURANCE. Part I. Risk Management. Subpart 1. Insurance and Related Matters

Table of Contents Title 37 INSURANCE Part I. Risk Management Subpart 1. Insurance and Related Matters Chapter 1. Underwriting...1 101. Underwriting...1 Chapter 3. Auditing and Statistics...1 301. Auditing and Statistics...1 Chapter 5. Billing...2 501. Billing and Collection of Insurance Premiums...2 Chapter 7. Reporting of Claims...2 701. Reporting of Property Damage Claims...2 703. Reporting of Boiler and Machinery Claims...3 705. Reporting of Comprehensive General Liability Claims...3 707. Reporting of Worker's Compensation and Maritime Claims...4 709. Reporting of State Automobile Liability and Physical Damage Claims...4 711. Reporting of Aviation Claims...5 713. Reporting of Wet Marine Claims (Over 26 Feet)...6 715. Reporting of Bond and Crime Claims...6 717. Reporting of Medical Malpractice Liability Claims...7 719. Reporting of Road and Bridge Hazard Claims (Department of Transportation and Development)...7 721. Claims Unit Contacts...8 Chapter 9. Risk Analysis and Loss Prevention...8 901. Risk Analysis and Loss Prevention...8 Chapter 11. Law Enforcement Officers' and Firemen's Survivor Benefit Review Board...9 1101. Survivors Benefits...9 Subpart 2. Worker's Compensation Fee Schedule Chapter 25. Fees...11 2501. Fee Schedule...11 Part III. Patients' Compensation Fund Oversight Board Chapter 1. General Provisions...13 101. Scope...13 103. Source and Authority...13 105. Patients' Compensation Fund: Description...13 107. Purpose and Objective of Rules; Construction, Application...13 109. General Definitions...13 111. Interpretive Definitions...14 113. Severability...15 i Louisiana Administrative Code September 2006

Table of Contents Chapter 3. Organization, Functions, and Delegations of Authority...15 301. Board Organization...15 303. Executive Director of the Patients' Compensation Fund Oversight Board...15 305. Fund Property...16 307. Expenses of Administration and Defense...16 Chapter 5. Enrollment with the Fund...16 501. Scope of Chapter...16 503. Basic Qualifications for Enrollment...17 505. Financial Responsibility: Insurance...17 507. Financial Responsibility: Self-Insurance...18 509. Financial Responsibility: Self-Insurance Trusts...19 511. Coverage: Partnerships and Professional Corporations...21 513. Enrollment Procedure...21 515. Certification of Enrollment...22 517. Expiration, Renewal of Enrollment...22 Chapter 7. Surcharges...22 701. PCF Consulting Actuary...22 703. Annual Actuarial Study...23 705. Risk Rating...23 707. Rate Applications, Filings; Notice of Rates...24 709. Interim, Emergency Rate Filings...24 711. Payment of Surcharges: Insurers...24 713. Payment of Surcharges: Self-Insureds...24 715. Amount of Surcharges; Form of Coverage; Conversions...25 Chapter 9. Scope of Coverage...26 901. Effective Date...26 903. Term of Enrollment...26 905. Scope of Coverage: Insureds...26 907. Scope of Coverage: Self-Insureds...26 909. Scope of Coverage: Self-Insurance Trusts...26 Chapter 11. Reporting...27 1101. Reporting of Claims, Reserves, Proposed Settlement...27 1103. Claims Experience Reporting: Insurers, Institutions and Self-Insured...27 1105. Noncompliance; Failure to Report...27 1107. Confidentiality...28 Chapter 13. Fund Data Collection, Maintenance; Accounting and Reporting...28 1301. Fund Data Collection, Maintenance...28 1303. Fund Accounting...28 1305. Annual Budget...28 1307. Appropriation Request...28 1309. Periodic Reports...28 1311. Annual Report...28 Chapter 14. Medical Review Panels...29 1401. Procedure...29 1403. Malpractice Complaint...29 1405. Attorney Chairman...29 Chapter 15. Defense of the Fund...29 1501. Claims Defense...29 1503. Claims Accounting...30 1505. Claim Reserves...30 Louisiana Administrative Code September 2006 ii

Table of Contents 1507. Settlement of Claims...30 1509. Privileged Communications, Records...30 Chapter 17. Transitional Rules...30 1701. Continuing Enrollment of Self-Insureds...30 1703. Continuing Enrollment of Self-Insurance Trusts...30 Chapter 19. Future Medical Care and Related Benefits...31 1901. Scope of Chapter...31 1903. Definitions...31 1905. Obligation of the Fund...31 1907. Claims for Future Medical Care and Related Benefits...31 1909. Attorneys; Medical Experts; Architects; Adjusters...31 1911. Examinations; Notice Requirements...32 1913. Choice of Health Care Provider...32 1915. Psychological /Psychiatric Treatment and Counseling...32 1917. Nursing Care; Sitter Care...33 1919. Treatment Protocol...33 1921. Vehicles...33 1923. Ancillary Cost; Mileage...34 1925. Modifications/Renovations to Patient's Residence...34 1927. Testimony; Communications...34 1929. Fees and Costs...35 1931. Attorney Fees...35 Part VII. Motor Vehicles Chapter 1. Insurance...37 Subchapter A. Self Insurance...37 101. Certificates of Self Insurance...37 Subchapter B. Compulsory Motor Vehicle Liability Security...37 123. Maintenance of Compulsory Motor Vehicle Liability Security...37 129. Compulsory Insurance Hardship License...39 Part IX. Agricultural Commodities Chapter 1. Self-Insurance Fund...41 101. Definitions...41 103. The Fund...41 105. Purpose...41 107. Fees...41 109. Insurance Coverage...42 111. Claim Provisions...42 113. Appeal Procedure...43 115. Subrogation...43 117. Limit of Self-Insurance Fund...43 121. Participation in the Self-Insurance Fund...43 123. Prohibited Acts: Criminal Penalties...43 125. Validity of Rules...44 127. Pending Litigation; Stay of Claims...44 iii Louisiana Administrative Code September 2006

Table of Contents Part XI. Rules Chapter 1. Rule Number 3A Advertisement of Medicare Supplement Insurance...45 101. Purpose...45 103. Applicability...45 105. Definitions...46 107. Method of Disclosure of Required Information...47 109. Form and Content of Advertisements...47 111. Advertisements of Benefits, Losses Covered, or Premiums Payable...47 113. Necessity for Disclosing Policy Provisions Relating to Renewability, Cancellability, and Termination...48 115. Testimonials or Endorsements by Third Parties...48 117. Use of Statistics...49 119. Disparaging Comparisons and Statements...49 121. Jurisdictional Licensing and Status of Insurer...49 123. Identity of Insurer...50 125. Group or Quasi-Group Implications...50 127. Introductory, Initial or Special Offers...50 129. Statements about an Insurer...51 131. Enforcement Procedures...51 133. Severability Provision...51 135. Effective Date...51 137. Interpretive Guidelines for Rules Governing Advertisements of Medicare Supplement Insurance...52 Chapter 3. Rule Number 4 Interlocal Risk Management Agency...56 301. Purpose...56 303. Applicability...56 305. Definitions...56 307. Requirements Necessary to Obtain a Certificate of Authority as an Interlocal Risk Management Agency...57 309. Filing of Reports...58 311. Solvency or Risk Management Agencies; Trustee Responsibilities...58 313. Interlocal Risk Management Self-Insurance Funds; Advance Premium Discounts; Surplus Distribution; Deficit...59 315. Aggregate Excess Insurance, Interlocal Risk Management Agency; Self-Insurance...59 317. Servicing Interlocal Risk Management Agencies; Application; Requirements; Noncompliance...60 319. Penalty for Non-Compliance...60 321. Severability...60 Chapter 5. Rule Number 9 Pre-Licensing Insurance Education Advisory Council...61 501. Purpose...61 503. Applicability and Scope...61 505. Effective Date...61 507. Course Requirements...61 509. Provider Requirements...62 511. Instructor Qualifications...62 513. Training Facility Requirements...63 515. Licensing Procedure of Applicant...63 517. Course Completion...63 519. Fees...63 Louisiana Administrative Code September 2006 iv

Table of Contents 521. Complaints...63 523. Violations...63 525. Expiration Date...64 Chapter 7. Rule Number 10 Continuing Education...64 701. Purpose...64 703. Basic Requirements...64 705. Applicability...64 707. Insurance Education Advisory Council...65 709. Program Requirements...65 711. Provider Requirements...67 713. Instruction Requirements...68 715. Training Facility Requirements...68 717. Rule 10.10. Measurement of Credit...68 719. Controls and Reporting...69 721. Program Review Disciplinary Action...70 723. Rule 10.13 Credit for Individual Study Programs...70 725. Credit for Service as Instructor...71 727. Effective Date...71 729. Separability...71 731. Periodic Review...71 733. Appendix 1 Request for Program/Course Approval...72 735. Appendix 2 Continuing Education Provider Training Schedule...73 737. Appendix 3 Continuing Education Provider Application...73 739. Appendix 4 Continuing Education Instructor Application...73 741. Appendix 5 Continuing Education Certificate...73 743. Appendix 6 Continuing Education Statement...74 745. Appendix 7 Administrative and Reporting Requirements Survey...74 Chapter 9. Rule Number 12 Transmission of Forms and Documents...74 901. Transmission of Forms and Documents Filed with the Department of Insurance...74 Chapter 11. Rule Number 1 Rules of Practice and Procedure before the Commissioner of Insurance...75 1101. Definitions...75 1103. Commencement of Hearings...75 1105. Petitions, Complaints or Orders...75 1107. Notice...75 1109. Service of Notice...75 1111. Proof of Service...75 1113. Answer or Appearance...76 1115. Leave to Intervene Necessary...76 1117. Docket...76 1119. Default in Answering or Appearing...76 1121. Subpoenas...76 1123. Prehearing Conference...76 1125. Hearing...77 1127. Order of Procedure at Hearing...77 1129. Witnesses to be Sworn...77 1131. Rules of Pleading and Evidence...77 1133. Attorneys...77 1135. Stenographic Record of Hearing...78 1137. Depositions...78 1139. Decision, Findings of Fact and Conclusions of Law and Order...78 v Louisiana Administrative Code September 2006

Table of Contents 1141. Rehearings...78 1143. Appeals to the District Court...78 1145. Transcript in Case on Appeal...79 1147. Amendment of Rules...79 1149. Exclusions...79 1151. Declaratory Orders and Rulings, Judicial Review...79 1153. Forms...79 1155. Supersedes All Prior Rules...79 Chapter 13. Rule Number 3 Advertisements of Accident and Sickness Insurance...79 1301. Purpose...79 1303. Applicability...79 1305. Definitions...80 1307. Method of Disclosure of Required Information...80 1309. Form and Content of Advertisements...80 1311. Advertisements of Benefits Payable, Losses Covered or Premiums Payable...80 1313. Necessity for Disclosing Policy Provisions Relating to Renewability, Cancellability and Termination...82 1315. Testimonials or Endorsements by Third Parties...82 1317. Use of Statistics...82 1319. Identification of Plan or Number of Policies...82 1321. Disparaging Comparisons and Statements...83 1323. Jurisdictional Licensing and Status of Insurer...83 1325. Identity of Insurer...83 1327. Group or Quasi-Group Implications...83 1329. Introductory, Initial or Special Offers...83 1331. Statements about an Insurer...84 1333. Enforcement Procedures...84 1335. Severability Provision...84 1337. Effective Date...84 Chapter 15. Rule Number 5 Unfair Trade Practices...85 1501. Purpose...85 1503. Applicability...85 1505. Definitions...85 1507. Rule...85 Chapter 17. Rule Number 6 Vehicle Mechanical Breakdown Insurer...85 1701. Purpose...85 1703. Applicability...85 1705. Definitions...85 1707. Qualifications...86 1709. Reserves...86 1711. Reports...86 1713. Penalty for Non-Compliance...87 1715. Severability...87 Chapter 19. Rule Number 7 Legal Expense Insurers...87 1901. Purpose...87 1903. Applicability...87 1905. Definitions...87 1907. Exemptions...87 1909. Qualifications as Insurer Required...88 1911. Licensing of Agents Required...88 Louisiana Administrative Code September 2006 vi

Table of Contents 1913. Compliance Required...88 1915. Penalty for Non-Compliance...88 1917. Severability...88 Chapter 21. Rule Number 8 A New Annuity Mortality Table for Use in Determining Reserve Liabilities for Annuities...88 2100. Authority...88 2101. Purpose...88 2103. Definitions...88 2105. Individual Annuity for Pure Endowment Contracts...89 2107. Group Annuity or Pure Endowment Contracts...89 2108. Application of the 1994 GAR Table...89 2109. Separability...89 2111. Effective Date...89 Chapter 23. Rule 13 Special Assessment to Pay the Cost of Investigation, Enforcement, and Prosecution of Insurance Fraud...89 2301. Purposes...89 2303. Fee Assessment...90 2305. Limitations on the Fee Assessment...90 2307. Allocation of the Fee Assessment...90 2309. Payment of the Fee Assessment...90 2311. Sunset...90 Chapter 25. Rule 14 Records Management...90 2501. Records Management; General...90 Part XIII. Regulations Chapter 1. Regulation 31 Holding Company...91 101. Purpose...91 103. Severability Clause...91 105. Definitions...91 107. Subsidiaries of Domestic Insurers...91 109. Acquisition of Control Statement Filing...91 111. Amendments to Form A...91 113. Acquisition of Section 1004.A(l)(2) Insurers...91 115. Annual Registration of Insurers Statement Filing...92 117. Summary of Registration Statement Filing...92 119. Amendments to Form B...92 121. Alternative and Consolidated Registrations...92 123. Disclaimers and Termination of Registration...92 125. Extraordinary Dividends and Other Distributions...92 127. Adequacy of Surplus...93 129. Transactions Subject to Prior Notice Notice Filing...93 131. Instructions for Forms A, B, C, and D...93 133. Form A Acquisition of Control or Merger with a Domestic Insurer...95 135. Form B Annual Registration Statement...97 137. Form C Registration Statement Summary...99 139. Form D Prior Notice of a Transaction...100 Chapter 3. Regulation 32 Group Coordination of Benefits...101 301. Purpose and Applicability...101 303. Definitions...101 vii Louisiana Administrative Code September 2006

Table of Contents 305. Use of Model COB Contract Provision...103 307. Rules for Coordination of Benefits...104 309. Procedure to be Followed by Secondary Plan...105 311. Notice to Covered Persons...105 313. Miscellaneous Provisions...105 315. Effective Date; Existing Contracts...106 317. Appendix A Model COB Contract Provisions Coordination of This Group Contract's Benefits with Other Benefits...106 319. Appendix B Consumer Explanatory Booklet Coordination of Benefits...109 Chapter 5. Regulation 33 Medicare Supplement Insurance Minimum Standards...110 501. Purpose...110 502. Applicability and Scope...110 503. Definitions...110 504. Policy Definitions and Terms...112 505. Policy Provisions...112 506. Premium Increase Requirements...113 507. Rate Increases Requirements...113 510. Minimum Benefit Standards for Policies or Certificates Issued for Delivery Prior to July 20, 1992...113 515. Benefit Standards for Policies or Certificates Issued or Delivered on or after July 20, 1992 114 520. Standard Medicare Supplement Benefit Plans...118 525. Medicare Select Policies and Certificates...119 530. Open Enrollment...122 535. Guaranteed Issue for Eligible Persons...122 540. Standards for Claims Payment...124 545. Loss Ratio Standards and Refund or Credit of Premium...125 550. Filing and Approval of Policies and Certificates and Premium Rates...127 555. Permitted Compensation Arrangements...128 560. Required Disclosure Provisions...128 565. Requirements for Application Forms and Replacement Coverage...147 570. Filing Requirements for Advertising...149 575. Standards for Marketing...149 580. Appropriateness of Recommended Purchase and Excessive Insurance...150 585. Reporting of Multiple Policies...150 590. Prohibition against Preexisting Conditions, Waiting Periods, Elimination Periods and Probationary Periods in Replacement Policies or Certificates...150 595. Severability...150 596. Appendix A Calculation Forms...151 597. Appendix B Medicare Supplement Policies Reporting Form...153 598. Appendix C Disclosure Statements...153 599. Effective Date...157 Chapter 7. Regulation 39 Statement of Actuarial Opinion...157 701. Purpose...157 703. Applicability and Scope...157 705. Definitions...157 707. Content...158 709. Exemptions...158 Louisiana Administrative Code September 2006 viii

Table of Contents Chapter 9. Regulation 40 Summary Document and Disclaimer and Notice of Noncoverage...158 901. Purpose...158 903. Applicability and Scope...159 905. Form and Content...159 907. Exhibit A Summary of the Louisiana Life and Health Insurance Guaranty Association Act and Notice Concerning Coverage Limitations and Exclusions...159 909. Exhibit B Notice of Noncoverage...160 Chapter 11. Regulation 42 Group Self-Insurance Funds...160 1101. Definitions...160 1103. Application to Create a Group Self-Insurance Fund...161 1105. Conditions for Retaining the Self-Insurance Privilege...161 1107. Financial and Actuarial Reports for Group Self-Insurance Funds...162 1109. Excess Insurance Requirements for Group Self-Insurance Funds...162 1111. Indemnity Agreement...163 1113. Rates and Reporting of Rates...163 1115. Authorized Investments for Group Self-Insurance Funds...164 1117. Premium Audit...164 1119. Board of Trustees...164 1121. Group Membership; Termination, Liability...164 1123. Service Companies...165 1125. Licensing of Agents...165 1127. Deficits and Insolvencies...165 1129. Review of Rate Determination...165 1131. Cease and Desist Orders...166 1133. Revocation of Certificate of Authority...166 1135. Examinations...166 Chapter 13. Regulation 43 Companies in Hazardous Financial Condition...166 1301. Purpose...166 1303. Definitions...166 1305. Standards...166 1307. Commissioner's Authority...167 Chapter 15. Regulation 44 Accelerated Benefits...168 1501. Purpose...168 1503. Definitions...168 1505. Type of Product...168 1507. Assignee/Beneficiary...168 1509. Criteria for Payment...168 1511. Disclosures...169 1513. Effective Date of the Accelerated Benefits...169 1515. Waiver of Premiums...169 1517. Discrimination...170 1519. Actuarial Standards...170 1521. Actuarial Disclosure and Reserves...170 1523. Filing Requirement...171 Chapter 17. Regulation 45 Filing of Affirmative Action Plans...171 1701. Purpose...171 1703. Applicability and Scope...171 1705. Content and Procedure...171 1707. Effective Date...171 ix Louisiana Administrative Code September 2006

Table of Contents Chapter 19. Regulation 46 Long-Term Care Insurance...171 1901. Purpose...171 1903. Applicability and Scope...171 1905. Definitions...172 1907. Policy Definitions...172 1909. Policy Practices and Provisions...173 1911. Unintentional Lapse...175 1913. Required Disclosure Provisions...176 1915. Required Disclosure of Rating Practices to Consumers...176 1917. Initial Filing Requirements...177 1919. Requirements to Offer Inflation Protection...178 1921. Prohibition against Post-Claim Underwriting (former 1915)...179 1923. Minimum Standards for Home Health and Community Care Benefits in Long-Term Care Insurance Policies (former 1917)...179 1925. Requirements for Application Forms and Replacement Coverage (former 1921)...180 1927. Reporting Requirements (former 1923)...181 1929. Licensing (former 1925)...182 1931. Discretionary Powers of Commissioner (former 1927)...182 1933. Reserve Standards (former 1929)...182 1935. Loss Ratio (former 1931)...183 1937. Premium Rate Schedule Increases...183 1939. Filing Requirement (former 1933)...186 1941. Filing Requirements for Advertising (former 1935)...186 1943. Standards for Marketing (former 1937)...186 1945. Suitability (former 1939)...187 1947. Prohibition against Pre-Existing Conditions and Probationary Periods in Replacement Policies or Certificates (former 1941)...188 1949. Nonforfeiture Benefit Requirement (former 1943)...188 1951. Standards for Benefit Triggers (former 1945)...190 1953. Additional Standards for Benefit Triggers for Qualified Long-Term Care Insurance Contracts (former 1947)...190 1955. Standard Format Outline of Coverage (former 1949)...191 1957. Requirement to Deliver Shopper's Guide (former 1951)...193 1959. Penalties (former 1953)...193 1961. Appendices (former 1955)...193 Chapter 21. Regulation 47 Actuarial Opinion and Memorandum Regulation...197 2101. Purpose...197 2103. Authority...197 2105. Scope...197 2107. Definitions...197 2109. General Requirements...198 2111. Statement of Actuarial Opinion Based on an Asset Adequacy Analysis...199 2113. Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary...202 Chapter 23. Regulation 48 Standardized Claims Forms...204 2301. Purpose...204 2303. Definitions...204 2305. Applicability and Scope...205 2307. Requirements for Use of HCFA Form 1500...205 2309. Requirements for Use of HCFA Approved Form UB92...205 Louisiana Administrative Code September 2006 x

Table of Contents 2311. Requirements for Use of J512 Form...206 2313. General Provisions...206 Chapter 25. Regulation 49 Billing Audit Guidelines...206 2501. Purpose...206 2503. Applicability and Scope...206 2505. Definitions...207 2507. Qualifications of Auditors and Audit Coordinators...207 2509. Notification of Audit...207 2511. Provider Audit Coordinators...208 2513. Conditions and Scheduling of Audits...208 2515. Confidentiality and Authorizations...209 2517. Documentation...209 2519. Fees and Payments...209 Chapter 27. Regulation 51 Individual Health Insurance Rating Requirements...210 2701. Purpose...210 2703. Applicability and Scope...210 2705. Definitions...210 2707. Restrictions on Premium Rates...211 2709. General Provisions...211 Chapter 29. Regulation 52 Small Group Health Insurance Rating Requirements...211 2901. Purpose...211 2903. Applicability and Scope...211 2905. Definitions...211 2907. Restrictions on Premium Rates...212 2909. General Provisions...213 Chapter 31. Regulation 53 Basic Health Insurance Plan Pilot Program...213 3101. Purposes...213 3103. Applicability and Scope...213 3105. Definitions...213 3107. Pilot Plan in General...214 3109. Pilot Plan Authorized Carrier...215 3111. Application Process...215 3113. Authorization of Pilot Plan...215 3115. Revocation of an Authorized Carrier's Authority...216 3117. Evaluation and Reporting Requirements...216 3119. Premium Taxes...216 3121. Guaranty Association...217 3123. Health Insurance Agents...217 3125. Eligibility...217 3127. Benefits...217 3129. Hospital Services...217 3131. Emergency Room Benefits...218 3133. Provider Services...218 3135. Limitations...219 3137. Exclusions...219 3139. Outpatient Prescription Rider...220 3141. Premium Maximums, Method for Calculating...220 3143. Payment of Benefits...221 3145. General Provisions...221 3147. Termination of Coverage...221 xi Louisiana Administrative Code September 2006

Table of Contents Chapter 33. Regulation 55 Life Insurance Illustrations...221 3301. Purpose...221 3303. Applicability and Scope...221 3305. Definitions...222 3307. Policies to Be Illustrated...223 3309. General Rules and Prohibitions...223 3311. Standards for Basic Illustrations...224 3313. Standards for Supplemental Illustrations...225 3315. Delivery of Illustrations and Record Retention...225 3317. Annual Report; Notice to Policy Owners...226 3319. Annual Certifications...227 3321. Severability...227 3323. Effective Date...228 Chapter 35. Regulation 56 Credit for Reinsurance...228 3501. Purpose...228 3503. Severability...228 3505. Credit for Reinsurance Reinsurer Authorized in this State...228 3507. Credit for Reinsurance Accredited Reinsurer...228 3509. Credit for Reinsurance Reinsurer Maintaining Trust Funds...228 3511. Credit for Reinsurance Required by Law...230 3513. Reduction from Liability for Reinsurance Ceded to an Unauthorized Assuming Insurer...230 3515. Trust Agreements Qualified under 3513....230 3517. Letters of Credit Qualified under 3513...233 3519. Other Security...234 3521. Reinsurance Contract...234 3523. Agreements Requiring Approval...234 3525. Contracts Affected...235 Chapter 37. Regulation 57 Life and Health Reinsurance Agreements...235 3701. Preamble...235 3703. Scope...235 3705. Accounting Requirements...236 3707. Written Agreements...237 3709. Existing Agreements...238 3711. Effective Date...238 Chapter 39. Regulation 58 Viatical Settlements...238 3901. Purposes...238 3903. Applicability and Scope...238 3905. Definitions...238 3907. License Requirements for Viatical Settlement Providers...239 3909. License Requirements for Viatical Settlement Brokers...239 3911. Approval of Viatical Settlement Contract...239 3913. Reporting Requirements...240 3915. Standards for Evaluation of Reasonable Payments...240 3917. General Rules...240 Chapter 41. Regulation 60 Advertising of Life Insurance...241 4101. Purpose...241 4103. Definitions...241 4105. Applicability...242 4107. Form and Content of Advertisements...242 4109. Disclosure Requirements...242 Louisiana Administrative Code September 2006 xii

Table of Contents 4111. Identity of Insurer...245 4113. Jurisdictional Licensing and Status of Insurer...246 4115. Statements about the Insurer...246 4117. Enforcement Procedures...246 4119. Conflict with Other Rules...246 4121. Severability...246 4123. Effective Date...247 Chapter 45. Regulation 63 Prohibitions on the Use of Medical Information and Genetic Test Results...247 4501. Purpose...247 4503. Authority...247 4505. Definitions...247 4507. Applicability and Scope...248 4509. Prohibitions on the Use of Pregnancy Test Results...248 4511. Requirements for Release of Genetic Test and Related Medical Information...248 4513. Prohibitions on the Use of Medical Information and Genetic Test Results...249 4515. General Provisions...249 Chapter 47. Regulation 64 Vehicle Mechanical Breakdown Insurers Cancellation Provisions...250 4701. Purpose...250 4703. Authority...250 4705. Applicability and Scope...250 4707. Cancellation Standards...250 4709. Failure to Comply...250 4711. Severability...251 4713. Effective Date...251 Chapter 49. Regulation 65 Bail Bond Licensing Requirements/Bounty Hunter...251 4901. Purpose...251 4903. Definitions...251 4905. Bail Recovery Agent License Requirements for Louisiana...251 4907. Bail Recovery Persons License Requirement from Other States...251 4909. Out of State Bail Enforcement Procedure and Notification Requirements...252 4911. In State Bail Enforcement Procedure and Notification Requirement...252 4913. Prohibited Acts...252 4915. Enforcement of Regulation...252 4917. Effective Date...252 Chapter 51. Regulation 66 Requirements for Officers, Directors, and Trustees of Domestic Regulated Entities...253 5101. Purpose...253 5103. Definitions...253 5105. Review of Officers, Directors and Trustees by Commissioner Required...253 5107. Procedure for Requesting Letter of No Objection from Commissioner...253 5109. Conditions for Refusal of Letter of No Objection...254 5111. Waiver of Submission of Biographical Information...254 5113. Scope and Limitations...254 Chapter 53. Regulation 62 Managed Care Contracting Requirements...254 5301. Purpose...254 5303. Definitions...254 5305. Applicability and Scope...255 5307. Provider Contracting Requirements...256 5309. Requirements for Inclusion of Rural Hospitals...256 xiii Louisiana Administrative Code September 2006

Table of Contents 5311. Requirements for Inclusion of Physicians Practicing in Qualifying Rural Hospitals...257 5313. General Provisions...257 Chapter 55. Regulation 9 Deferred Payment of Fire Premiums in Connection with the Term Rule...258 5501. Payment of Fire Premiums...258 Chapter 57. Regulation 14 Limiting Exclusions in Industrial Policies, Restricting Payments for Death Caused in Specified Manner...258 5701. Payment of Death or Funeral Benefits...258 5703. Rider or Endorsement...259 Chapter 60. Regulation 74 Payment of Health Coverage Claims...259 6001. Purpose...259 6003. Applicability and Scope...259 6005. Claim Payments Definitions...260 6007. Nonelectronic Claim Submission Standards...261 6009. Electronic Claim Submission Standards...261 6011. Thirty-Day Payment Standard...261 6013. Claim Handling Procedures...261 6015. Limitations on Claim Filing and Audits...262 6017. Effective Date...262 Chapter 61. Regulation 16 Investment by Insurers of Part of Premium Paid, Return Guaranteed...262 6101. Policy Directive Number Three to Insurance Companies...262 Chapter 62. Regulation 77 Medical Necessity Review Organizations...262 6201. Purpose...262 6203. Definitions...263 6205. Authorization or Licensure as an MNRO...265 6207. Procedure for Application to Act as an MNRO...265 6211. Expiration and Renewal of License for Entities other than Health Insurance Issuers...266 6213. Scope and Content of Medical Necessity Determination Process...266 6215. Medical Necessity Review Organization Operational Requirements...267 6217. Procedures for Making Medical Necessity Determinations...267 6219. Informal Reconsideration...268 6221. Appeals of Adverse Determinations; Standard Appeals...269 6223. Second Level Review...269 6225. Request for External Review...270 6227. Standard External Review...270 6229. Expedited Appeals...271 6231. Expedited External Review of Urgent Care Requests...271 6233. Binding Nature of External Review Decisions...272 6235. Minimum Qualifications for Independent Review Organizations...272 6237. External Review Register...273 6239. Emergency Services...273 6241. Confidentiality Requirements...274 6243. Severability...274 6245. Effective Date...274 Chapter 63. Regulation 17 Reinstatement of Policies...274 6301. Policy Directive Number Four to Non-Profit Funeral Associations...274 Chapter 65. Regulation 18 Non-Profit Funeral Service Associations, Reinstatement of Lapsed Policies...274 6501. Policy Directive Number Five to Non-Profit Funeral Service Associations...274 Louisiana Administrative Code September 2006 xiv

Table of Contents Chapter 67. Regulation 19 Inclusion of Burial Plots, Vaults, etc., as Part of Funeral Service-Change in Reserve Basis...275 6701. Policy Directive Number Six to All Insurance Issuing Funeral Policies...275 Chapter 69. Regulation 21 Special Policies and Provisions: Prohibitions, Regulations, and Disclosure Requirements...275 6901. Policy Directive Number Seven to All Companies Authorized to Write Life Insurance in the State of Louisiana...275 Chapter 71. Regulation 24 Proxies, Consents and Authorizations of Domestic Stock Insurers...277 7101. Application of Regulation...277 7103. Proxies, Consents and Authorizations...277 7105. Disclosure of Equivalent Information...277 7107. Definitions...277 7109. Information to Be Furnished to Security Holders...277 7111. Requirements as to Proxy...278 7113. Material Required to be Filed...278 7115. Proposals of Stockholders...279 7117. False or Misleading Statements...279 7119. Prohibition of Certain Solicitations...279 7121. Special Provisions Applicable to Election Contest...279 7123. Schedule A Information Required in Proxy Statement...280 7125. Schedule B Information to Be Included in Statements Filed by or on Behalf of a Participant (other than the insurer) in a Proxy Solicitation in an Election Contest...283 Chapter 73. Regulation 25 Sale of Stock to Public; Stock Options...284 7301. Sale of Stock; Stock Options...284 Chapter 75. Regulation 27 Insider Trading of Equity Securities of a Domestic Stock Insurance Company...284 Subchapter A. General Application...284 7501. Definitions...284 7503. Transactions Exempted from the Operation of Section 1526 of the Act...285 Subchapter B. Regulations under Section 1525 of the Act...285 7509. Filing of Statements...285 7511. Ownership of More than 10 Percent of an Equity Security...285 7513. Disclaimer of Beneficial Ownership...285 7515. Exemptions from Sections 1525 and 1526 of the Act...286 7517. Exemption from the Act of Securities Purchased or Sold by Odd-Lot Dealers...286 7519. Certain Transactions Subject to Section 1525 of the Act...286 7521. Ownership of Securities Held in Trust...286 7523. Exemption for Small Transactions...287 7525. Exemption from Section 1526 of the Act of Transactions which Need Not Be Reported under Section 1525...287 Subchapter C. Regulations under Section 1526 of the Act...287 7531. Exemption from Section 1526 of Certain Transactions Effected in Connection with a Distribution...287 7533. Exemption from Section 1526 of Acquisitions of Shares of Stock and Stock Options under Certain Stock Bonus, Stock Option or Similar Plans...288 7535. Exemption from Section 1526 of Certain Transactions in which Securities Are Received by Redeeming other Securities...289 7537. Exemption of Long-Term Profits Incident to Sales within Six Months of the Exercise of an Option...289 xv Louisiana Administrative Code September 2006

Table of Contents 7539. Exemption from Section 1526 of Certain Acquisitions and Dispositions of Securities Pursuant to Merger or Consolidations...290 7541. Exemption from Section Two of Certain Securities Received upon Surrender of Similar Equity Securities...290 7543. Exemption from Section Two of Certain Transactions Involving an Exchange of Similar Securities...291 Subchapter D. Regulations under Section 1527 of the Act...291 7549. Exemption of Certain Securities from Section 1527 of the Act...291 7551. Exemption from Section 1527 of the Act of Certain Transactions Effected in Connection with a Distribution...291 7553. Exemption from Section 1527 of the Act of Sales of Securities to be Acquired...291 Subchapter E. Regulation under Section 1529 of the Act...292 7559. Arbitrage Transactions under Section 1529 of the Act...292 7561. Form A...292 7563. Form B...293 Chapter 77. Regulation 28 Variable Contract Regulation...296 7700. Authority...296 7701. Definition...296 7703. Qualification of Insurance Companies to Issue Variable Contracts...296 7705. Separate Account or Separate Accounts...296 7707. Filing of Contracts...297 7709. Contracts Providing for Variable Benefits...297 7711. Required Reports...298 7713. Foreign Companies...298 7715. Licensing of Agents and Other Persons...298 Chapter 79. Regulation 29 Correlated Sales of Life Insurance and Equity Products...299 7901. Purpose...299 7903. Applicability...299 7905. Statement of Policy...299 7907. Responsibility of Company and Agent...299 7909. Tie-In Sales...299 7911. Written Proposal...299 7913. Contents of Proposal...300 7915. Statement to Be Separate...300 7917. Maintenance of File by Company...300 7919. Effective Date...300 Chapter 81. Regulation 30 Certificates of Insurance Coverage...300 8101. Certificates of Insurance...300 Chapter 83. Regulation 35 Variable Life Insurance Model Regulation...301 8301. Definitions...301 8303. Qualification of Insurer to Issue Variable Life Insurance...302 8305. Insurance Policy Requirements...303 8307. Reserve Liabilities for Variable Life Insurance...306 8309. Separate Accounts...307 8311. Information Furnished to Applicants...309 8313. Applications...310 8315. Reports to Policyholders...310 8317. Foreign Companies...310 8319. Life Insurance...310 8321. Severability...311 Louisiana Administrative Code September 2006 xvi

Table of Contents Chapter 85. Regulation 36 Universal Life Insurance Model Regulation...311 8501. Purpose...311 8503. Definitions...311 8505. Scope...312 8507. Valuation...312 8509. Nonforfeiture...313 8511. Mandatory Policy Provisions...315 8513. Disclosure Requirements...315 8515. Periodic Disclosure to Policyowner...316 8517. Interest-Indexed Universal Life Insurance Policies...316 Chapter 87. Regulation 69 Year 2000 Exclusions...317 Subchapter A. General Provisions...317 8701. Authority...317 8703. Purpose...317 8705. Scope and Applicability...317 8707. Severability...318 8709. Definitions...318 8711. Forms Approval...318 Subchapter B. Admitted Insurers...318 8713. Underwriting Standards...318 8715. Monitoring of Market Conduct...319 8717. Representations and Warranties...319 8719. Notice...319 8721. Exemptions...320 Subchapter C. Surplus Lines Insurers...320 8723. Mandatory Policyholder Notice...320 8725. Claims Notice...320 8727. Issuance of Notices...321 Subchapter D. Administrative Actions...321 8729. Hearings...321 8731. Penalties...321 Chapter 89. Regulation 70 Replacement of Life Insurance and Annuities...321 8901. Purpose...321 8903. Definitions...321 8905. Exemptions...322 8907. Duties of Producers...323 8909. Duties of Insurers that Use Producers...324 8911. Duties of Replacing Insurers that Use Producers...324 8913. Duties of the Existing Insurer...325 8915. Duties of Insurers with Respect to Direct Response Solicitations...325 8917. Violations and Penalties...326 8919. Effective Date...326 8921. Appendix A Replacement Notice...326 8923. Appendix B Replacement Notice...327 8925. Appendix C Replacement Notice...328 Chapter 90. Regulation 72 Commercial Lines Insurance Policy Form Deregulation...329 9001. Authority...329 9003. Purpose...329 9005. Scope and Applicability...329 9007. Severability...329 xvii Louisiana Administrative Code September 2006

Table of Contents 9009. Definitions...329 9011. Types of Coverage Exempt from Filing and Approval...330 9013. Special Commercial Entities...330 9015. Disclosure Requirements and Certification Form...330 9017. Requirements for Maintaining Records...331 9019. Exempt Policy Forms...331 9021. Penalties for Failure to Comply...331 Chapter 91. Regulation 68 Patient Rights under Health Insurance Coverage in Louisiana...331 9101. Purpose...331 9103. Definitions...332 9105. Applicability and Scope...332 9107. Patient Rights under Policies or Plans of Health Insurance Coverage...332 9109. Patient Responsibilities...335 Chapter 93. Regulation 80 Commercial Lines Insurance Rate Deregulation...335 9301. Authority...335 9303. Purpose...335 9305. Scope and Applicability...336 9307. Severability...336 9309. Definitions...336 9311. Types of Insurance Exempt from Rate Filing and Approval Process...336 9313. Exempt Rates...336 9315. Noncompetitive Market; Public Notice and Hearing...337 9317. Disciplinary Hearings; Fines...337 9319. Effective Date...337 Chapter 95. Regulation 81 Military Personnel Automobile Liability Insurance Premium Discount and Insurer Premium Tax Credit Program...337 9501. Authority...337 9503. Purpose...337 9505. Scope and Applicability...338 9507. Severability...338 9509. Definitions...338 9511. Premium Discount; Proof of Eligibility...338 9513. Requests for Tax Credit; Documentation; Dispute Resolution...339 9515. Recordkeeping; Annual Report...340 9517. Overpayments; Collection Proceedings; Fines and Hearings...340 9519. Louisiana Application for Military Discount Appendix...341 9521. Effective Date; Implementation...342 Chapter 99. Regulation 76 Privacy of Consumer...342 Subchapter A. General Provisions...342 9901. Authority...342 9903. Purpose...342 9905. Scope and Applicability...342 9907. Rule of Construction...342 9909. Definitions...342 Subchapter B. Privacy and Opt Out Notices for Financial Information...346 9911. Initial Privacy Notice to Consumers Required...346 9913. Annual Privacy Notice to Customers Required...347 9915. Information to be Included in Privacy Notices...348 9917. Form of Opt Out Notice to Consumers and Opt Out Methods...349 9919. Revised Privacy Notices...351 Louisiana Administrative Code September 2006 xviii

Table of Contents 9921. Delivery...351 Subchapter C. Limits on Disclosures of Financial Information...352 9923. Limits on Disclosure of Nonpublic Personal Financial Information to Nonaffiliated Third Parties...352 9925. Limits on Re-Disclosure and Reuse of Nonpublic Personal Financial Information...352 9927. Limits on Sharing Account Number Information for Marketing Purposes...353 Subchapter D. Exceptions to Limits on Disclosures of Financial Information...354 9929. Exception to Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Service Providers and Joint Marketing...354 9931. Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Processing and Servicing Transactions...354 9933. Other Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information...355 Subchapter E. Additional Provisions...355 9945. Protection of Existing Requirements...355 9947. Nondiscrimination...355 9949. Violations and Penalties...356 9951. Severability...356 9953. Effective Date...356 9955. Appendix A Sample Clauses...356 Chapter 101. Regulation 78 Policy Form Filing Requirements...358 10101. Purpose...358 10103. Authority...358 10105. Applicability and Scope; Severability...358 10107. Filing and Review of Health Insurance Policy Forms and Related Matters...358 10109. Filing and Review of Life and Annuity Insurance Policy Forms and Related Matters...363 10113. Filing and Review of Property and Casualty Insurance Policy Forms and Related Matters...368 10115. Penalties...373 10117. Effective Date...373 Chapter 103. Regulation 79 Limited Licensing for Motor Vehicle Rental Companies...373 10301. Purpose...373 10303. Definitions...373 10305. Issuance of Limited License in General...374 10307. Limited Licensing; Application, Supplements, Requirements...374 10309. Renewals...375 10311. Limitations of License...375 10313. Insurance Charges...375 10315. Penalties for Violations...375 10317. Applicability...376 10319. Severability...376 Chapter 105. Regulation Number 83 Domestic Insurer's Use of Custodial Agreements and the Use of Clearing Corporations...376 10501. Definitions...376 10503. Custody Agreement; Requirements...377 10505. Deposit with Affiliates; Requirements...378 10507. Custodian Affidavit Form A...378 10509. Custodian Affidavit Form B...379 10511. Custodian Affidavit Form C...379 xix Louisiana Administrative Code September 2006

Table of Contents Chapter 107. Regulation Number 84 Recognition and Use of the 2001 CSO Mortality Table in Determining Minimum Reserve Liabilities and Nonforfeiture Benefits...380 10701. Authority...380 10703. Purpose...380 10705. Definitions...380 10707. 2001 CSO Mortality Table...380 10709. Conditions...380 10711. Applicability of the 2001 CSO Mortality Table to Regulation 85...381 10713. Gender-Blended Tables...381 10715. Separability...382 10717. Effective Date...382 Chapter 109. Regulation Number 85 Valuation of Life Insurance Policies...382 10901. Purpose...382 10903. Authority...382 10905. Applicability...382 10907. Definitions...383 10909. General Calculation Requirements for Basic Reserves and Premium Deficiency Reserves...384 10911. Calculation of Minimum Valuation Standard for Policies with Guaranteed Nonlevel Gross Premiums or Guaranteed Nonlevel Benefits (Other than Universal Life Policies)...385 10913. Calculation of Minimum Valuation Standard for Flexible Premium and Fixed Premium Universal Life Insurance Policies that Contain Provisions Resulting in the Ability of a Policy Owner to Keep a Policy in Force over a Secondary Guarantee Period...388 10915. Select Mortality Factors Appendix...388 10917. Effective Date...400 Chapter 111. Regulation 86 Dependent Coverage of Newborn Children in the Group and Individual Market...400 11101. Authority...400 11103. Purpose...400 11105. Applicability and Scope...400 11107. Definitions...400 11109. Enrollment Notification Procedures for a Qualifying Newborn Child...401 11111. Procedures for a Non-Qualifying Newborn Child...402 11113. Timely Payment of Claims...402 11115. Sanctions...402 11117. Severability...402 11119. Effective Date...402 Chapter 113. Regulation 88 Standardization of Health Benefits and Compliance Requirements for LaChoice...402 11301. Purpose...402 11303. Applicability and Scope...403 11305. Eligibility, Benefits and Underwriting Criteria...403 11307. Participation Requirement...403 11309. Underwriting Criteria for Health Insurance Issuer...403 11311. Criteria for Public Subsidy...404 11313. Enforcement Provisions...404 Louisiana Administrative Code September 2006 xx

Table of Contents 11315. Financial Statement Requirements...404 11317. Discontinuation of Product Type...404 11319. Severability...404 xxi Louisiana Administrative Code September 2006

Title 37 INSURANCE Part I. Risk Management Subpart 1. Insurance and Related Matters Chapter 1. Underwriting 101. Underwriting A. All coverages which are self-insured by the Office of Risk Management are mandatory for all Louisiana state departments, agencies, boards, and commissions. B. If any department, agency, board, or commission requires or wishes to procure any insurance coverages which are not written through the Louisiana Self Insurance Program, request is to be made to the Office of Risk Management to procure said coverage. It is the responsibility of the department, agency, board, or commission to provide the underwriting information required to procure or underwrite the risk. C. All leases for real and movable property (including vehicles) which are entered into by any state department, agency, board, or commission are to be forwarded to the Office of Risk Management for review in compliance of insurance requirements. D. All inquiries regarding interpretation of insurance coverages are to be addressed to the underwriting unit and are to be in a written form. E. Boiler and machinery equipment at new locations are to be reported to the underwriting unit. F. Builder's risk projects are to be reported to the underwriting unit when the construction contract has been awarded or the "Notice to Proceed" has been issued. G. All newly constructed state-owned buildings are to be reported to the underwriting unit upon acceptance/completion. H. All newly acquired state-owned aircraft are to be reported to the underwriting unit immediately but in no event more than 30 days after acquisition. All newly leased or borrowed aircraft are to be reported to the underwriting unit immediately but in no event more than 30 days after possession or lease. I. Any newly acquired, constructed, leased, or borrowed airport or heliport facilities are to be reported to the underwriting unit before coverage will be effective. J. All newly acquired state-owned marine vessels which are over 26 feet in length are to be reported to the underwriting unit immediately but in no event more than 30 days after acquisition. All newly leased or borrowed marine vessels which are over 26 feet in length are to be reported to the underwriting unit immediately but in no event more than 30 days after possession or lease. K. Applications for new crime policies are to be submitted to the underwriting unit. Coverage does not become effective until the insurance company has accepted the new risk. L. All departments, agencies, boards, and commissions are to provide the name, address, telephone number, and job title of the following: 1. the department, agency, board, or commission head; 2. the person(s) to receive insurance premium billings; 3. the safety coordinator or person(s) responsible for loss prevention matters; 4. the person(s) responsible for handling and disposition of claims matters; 5. the person(s) responsible for reporting exposure information. 39:1527, et seq. HISTORICAL NOTE: Promulgated by the Office of the Governor, Division of Administration, Office of Risk Management, LR 13:19 (January 1987), amended LR 31:61 (January 2005), LR 32:1435 (August 2006). Chapter 3. Auditing and Statistics 301. Auditing and Statistics A. The exposure data requested by the Office of Risk Management (ORM) are to be submitted in a timely manner and in the form specified. The exposures may include, but are not limited to: 1. payroll; 2. maritime payroll; 3. number of board and commission members; 4. mileage of all licensed vehicles which are stateowned or leased, and all mileage on personal vehicles driven in the course and scope of state employment; 5. number of licensed vehicles; 6. acquisition or appraised value of property including, but not limited to, buildings, improvements, and inventory (includes contents, all equipment including mobile equipment and watercraft 26 feet and under), and boiler and machinery; 7. medical malpractice exposures including, but not limited to, patient days, clinic visits, emergency room visits, number of residents/ interns, and miscellaneous categories; 1 Louisiana Administrative Code September 2006

INSURANCE 8. number of employees, and miscellaneous or special classes not falling within these definitions as required. B. Billed units are to allocate premiums to subunits if required. It is not the ORM's responsibility to provide breakdowns at a lower level than the level to which premiums were budgeted or billed. C. The Office of Risk Management is to receive immediate written notification of the abolishment, transfer, and/or merger of any department, agency, board or commission. D. The state agencies are to provide or allow access to ORM representatives to records or information necessary to the effective operation of the risk management program. 39:1527, et seq. HISTORICAL NOTE: Promulgated by the Office of the Governor, Division of Administration, Office of Risk Management, LR 13:19 (January 1987), amended LR 15:85 (February 1989), LR 31:62 (January 2005), LR 32:1436 (August 2006). Chapter 5. Billing 501. Billing and Collection of Insurance Premiums A. After an agency receives a billing invoice from the Office of Risk Management for payment of insurance premiums, the agency is to render payment in full within 30 days from the billing date. B. Every agency shall timely pay premiums billed by the Office of Risk Management. In the event any agency fails to pay any premiums due the Office of Risk Management within 120 days of the effective date of the appropriated insurance coverages, the commissioner of administration may upon request by the Office of Risk Management draw a warrant against budgeted funds of any delinquent agency directing the treasurer to pay the Office of Risk Management for the unpaid premiums. If an agency is a non-depository agency, the commissioner of administration may direct the head of such agency to render payment of insurance premiums due and owing to the Office of Risk Management. C. All billing inquiries are to be directed to the Office of Risk Management, Accounting Unit, Accounts Receivable Section. 39:1527, et seq. HISTORICAL NOTE: Promulgated by the Office of the Governor, Division of Administration, Office of Risk Management, LR 13:20 (January 1987), amended LR 31:62 (January 2005), LR 32:1436 (August 2006). Chapter 7. Reporting of Claims 701. Reporting of Property Damage Claims A. All claims must be reported as soon as possible, but no later than the prescription period outlined in Book III, Title 24, Chapter 4 of the Louisiana Civil Code. In most cases, prescription periods are one year. ORM will pay only for covered losses reported before one year from the date of the accident or discovery date. Policy language clearly states "you must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim." Failure to report potential claims as soon as possible severely limits the ability of ORM to investigate the facts and may compromise the state's legal rights to subrogation from a responsible third party. B. The state of Louisiana provides insurance coverage for damage to state-owned property which includes damage to buildings and improvements, contents, inventories, mobile equipment, heating and air conditioning systems, and marine hulls 26 feet and under. C. All claims for damage to property owned by the state are to be reported to the Office of Risk Management's Property Claim Unit in writing. If a loss or claim is serious in nature, it is to be reported by telephone to the Office of Risk Management's Property Claim Unit. D. Claims are to be submitted, in writing, to the Office of Risk Management, P.O. Box 91106, Baton Rouge, LA 70821-9106. E. Information required to be submitted when a claim is reported to the Office of Risk Management's Property Claim Unit includes the following: 1. name of insured, location of property or unit; 2. date of loss; 3. description of loss; 4. location of item, state building ID/property control tag number; 5. size, model, and serial number of item, if applicable; 6. name of person reporting claim, listing job title, and telephone number; and 7. proof of ownership. F. After a loss has occurred, all property which has been damaged is to be protected against further damage and is to be made available for inspection by a claims adjuster assigned by the Office of Risk Management. G. If a loss occurs or a claim arises, the agency is not to assume any obligation or incur any expenses without authorization from the Office of Risk Management, but should act to protect property and minimize the loss. H. If repair or replacement is not accomplished within 36 months of the loss date; or, if approval is not obtained from the commissioner of administration to use the funds for some other purpose, or to extend the 36 month prescriptive period, the claim file will be closed. I. All lawsuits, demands, notices, summons, or other legal documents pertaining to a claim against a state agency are to be forwarded immediately to the Office of Risk Management, Property Claims Unit for further handling. J. Any objects and/or products which may have caused, contributed to, or which are suspective of causing an accident are to be retained and preserved as evidence. Louisiana Administrative Code September 2006 2