§ 22:1892.3 — Payment of claims; property policies; proof of loss statements

Louisiana § 22:1892.3

• Jurisdiction: Louisiana
• Title 22: Insurance

Text

§1892.3. Payment of claims; property policies; proof of loss statements
A. An insurer issuing any type of insurance policy, other than those specified in R.S.
22:1811 and 1821, and Chapter 10 of Title 23 of the Louisiana Revised Statutes of 1950,
may require the claimant to submit a proof of loss statement as a prerequisite to making
payment on the claim.
B. The insurer may require a proof of loss statement on a form consistent with and
limited to the form provided for in Subsection F of this Section; however, nothing in this
Section shall be construed to limit an insurer from utilizing a different font, format, or trade
dress than is used in this Section. Prior to requiring a proof of loss statement as a prerequisite
to making payment on a claim, the insurer shall file its proof of loss statement with the
commissioner and receive approval from the commissioner.
C. If an insurer requires submission of a proof of loss statement as a prerequisite to
making payment on a claim, the insurer shall provide the proof of loss statement form to the
claimant within ten business days of receiving the claim. The insurer shall also maintain the
proof of loss statement form on its website in a location easily accessible by claimants.
D. If an insurer requires submission of a proof of loss statement as a prerequisite to
making payment on a claim, the insurer's receipt of a completed proof of loss statement from
the claimant is the only means of constituting satisfactory proof of loss, as required by R.S.
22:1892 and 1892.2. Within ten business days of receipt of a proof of loss statement, the
insurer shall notify the claimant whether the proof of loss statement was complete or
incomplete.
E. The commissioner may promulgate and adopt rules and regulations in accordance
with the Administrative Procedure Act for the implementation and enforcement of this
Section.
F. The following form is a model proof of loss statement:
INSURANCE COMPANY:
POLICY NUMBER:
POLICY COVERAGE PERIOD:
From : _________________
To : _______________________
POLICYHOLDER NAME(S):
POLICY LIMITS:
INSURED’S CURRENT CONTACT INFORMATION:
Phone Number :
_______________________________________________________
Email Address :
_______________________________________________________
INSURANCE CLAIM
NUMBER:
DATE OF LOSS:
LOCATION OF LOSS ( physical address ):
TYPE OF PROPERTY ( dwelling, other structure, contents):
BRIEFLY IDENTIFY HOW YOUR LOSS OCCURRED ( fire, flood,
hurricane, or other windstorm event):
LEGAL OWNER(S) OF THE PROPERTY ON THE DATE OF LOSS,
INCLUDING MORTGAGEES (if any ):
ESTIMATED TOTAL COST OF REPAIR OR REPLACEMENT OF
PROPERTY CALCULATED TO DATE*
ARE THERE ANY OTHER INSURANCE POLICIES THAT COVER THIS
PROPERTY? Y or N (circle one)
If yes, please identify the name of the insurance company, policy number,
policy limits, and the amount of policy proceeds recovered to date for this loss
(if any).
I certify that the information provided in this Proof of Loss Form is true, correct, and current
to the best of my knowledge and belief. The loss(es) identified herein did not originate due
to any act, plan, or procurement on my part. Additionally, I have not taken nor consented to
any action designed to violate the conditions of my Policy or render it void. I further certify
that all material facts known to date have been provided to my Insurance Company, and I
have not artificially inflated any part or portion of my loss claim, concealed or
misrepresented the pre-loss condition of my property, or otherwise engaged in any deceptive
conduct with respect to my property loss claim.
The furnishing of this form or the preparation of proof by a representative of the above
insurance company is not a waiver of any of its rights.
Executed this ______ day of ______________________, 20__.
Signature: ___________________________________
INSURED
Signature: ___________________________________
INSURED
* Please note, this PROOF OF LOSS FORM does not preclude an insured from
submitting a supplemental loss claim if necessary. The amount identified in response to
the “ESTIMATED TOTAL COST OF REPAIR OR REPLACEMENT OF PROPERTY
CALCULATED TO DATE” inquiry is based solely upon the damages and losses
ascertained to date.
If you have any questions or concerns regarding your claim or the claims process, please
refer to the Louisiana Department of Insurance’s Catastrophe Claims Process Disclosure
Guide on the Louisiana Department of Insurance’s website.

Legislative History

Acts 2025, No. 500, §1.