Donelon Issues Emergency Rule 39 Providing Mid-Term Audit of Admitted Policies
Commissioner Jim Donelon issued Emergency Rule 39 to address the statewide public health emergency declared by Governor John Bel Edwards for the state of Louisiana as the result of the imminent threat posed to Louisiana citizens by COVID-19.
"The continued impact of the stay at home order has shuttered many businesses across Louisiana," said Donelon. "This action provides a procedure whereby commercial insureds in our state can make a demand of their admitted insurers to allow for a mid-term self-audit in order to document if there has been a change in their exposure basis to appropriately and immediately adjust their premium in accordance with their new risk."
This action is done in consideration of the record number of layoffs and business closures amid the ongoing COVID-19 event. It addresses the need for small businesses to access available cash flow in an effort to keep or restart their business operations. This will also afford employees the chance to resume their previous work and provide for themselves and their families.
In summary, Emergency Rule 39:
- Provides a Louisiana commercial insured with the right to demand that their admitted insurer consent to the insured conducting a mid-term self-audit of the insurance policy.
- Defines the procedures that will control the actions of those admitted insurers who have provided commercial coverage with policies rated using an auditable exposure basis, including but not limited to, payroll, sales, enrollment, attendance, occupancy rates, square footage or any other basis.
- Allows any admitted insurer who is required to consent to their insured conducting a mid-term self-audit the opportunity to conduct its own physical audit of an applicable insurance policy at any time during the policy term or at the end of the policy term as provided in the policy terms and conditions.
- If the mid-term self-audit establishes that the premium charged at the initiation of the policy is now in excess of what the premium would be based on the current rating variables, it requires the admitted insurer to adjust the premium immediately but in no event less than 10 days from the completion and submission of the mid-term self-audit, and to refund any over-payment to the insured.
The full text of Emergency Rule 39 can be found here.
Donelon Issues Emergency Rule 40 - Moratorium on Policy Cancellations/Non-Renewals for Louisiana Policyholders
Commissioner Jim Donelon issued Emergency Rule 40 to address the statewide public health emergency declared by Governor John Bel Edwards for the state of Louisiana as a result of the imminent threat posed to Louisiana citizens by COVID-19.
“The ongoing impact of the stay at home order has touched households and businesses throughout Louisiana and this order provides Louisiana policyholders a moratorium on policy cancellations and non-renewal by their insurers,” said Donelon. “However, I do want to stress that nothing in this order absolves consumers or businesses of their ultimate responsibility for payment of premiums.”
Emergency Rule 40 in summary:
- Defines the insurance carriers and the kinds of insurance coverage governed by this order as well as the Louisiana policyholders entitled to the benefits and protections of this rule.
- Suspends cancellation, non-renewal and non-reinstatement by insurers, or premium finance companies acting on behalf of insurers retroactively to the start of this emergency period. Additionally, this rule clarifies that no policy can be canceled or non-renewed because of a claim that is filed during this emergency.
- Policies may continue to be canceled for fraud and material misrepresentation or upon written request by the consumer.
- Insureds remain obligated to pay all premiums. Any property and casualty claim during this period are subject to a premium offset prior to payment. Health and accident claims related to a delinquent policy may be pended during the moratorium and will be paid in accordance with procedures established therein.
- Emergency Rule 40 does not apply to new policies issued after the effective date of the rule.
The full text of Emergency Rule 40 can be found here [mailstats.ldi.la.gov].
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