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ENROLLED
ACT No. 322026 Regular Session
HOUSE BILL NO. 739
BY REPRESENTATIVE BERAULT
1 AN ACT
2 To amend and reenact R.S. 22:1921(D), 1924(B), 1925(B), 1961, 1962(introductory
3 paragraph), 1963, and 1968 and to enact R.S. 22:1962(G), relative to insurance
4 fraud; to define certain terms; to provide for the investigation of insurance fraud
5 matters; to provide for the powers of the commissioner with respect to insurance
6 fraud; to provide for effectiveness; and to provide for related matters.
7 Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 22:1921(D), 1924(B), 1925(B), 1961, 1962(introductory paragraph),
9 1963, and 1968 are hereby amended and reenacted and R.S. 22:1962(G) is hereby enacted
10 to read as follows:
11 §1921. Purpose and powers
12 * * *
13 D. If during the course of the investigation, the office of insurance fraud
14 determines that there may be a violation of criminal law, the office shall turn the
15 matter over to the Department of Justice; the Department of Public Safety and
16 Corrections, public safety services, office of state police; and any other appropriate
17 law enforcement or prosecutorial agency, for further investigation, enforcement, or
18 prosecution. However, with the consent of the law enforcement or prosecutorial
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1 agency, the office of insurance fraud may assist the law enforcement or prosecutorial
2 agency in its investigation.
3 * * *
4 §1924. Prohibited activities and sanctions
5 * * *
6 B. The Unless otherwise provided by law, the criminal provisions of this
7 Section shall be investigated, enforced, or prosecuted only by the proper law
8 enforcement and prosecutorial agencies.
9 * * *
10 §1925. Automobile insurance policies
11 * * *
12 B. The Unless otherwise provided by law, the criminal provisions of this
13 Section shall be investigated, enforced, or prosecuted only by the proper law
14 enforcement and prosecutorial agencies.
15 * * *
16 §1961. Purpose
17 The purpose of this Part is to regulate the trade practices and affairs of any
18 person engaged in the business of insurance, in accordance with the intent of
19 congress as expressed in Public Law 15-79th Congress*, by defining or providing
20 for the determination of all acts, methods, and practices which constitute unfair
21 methods of competition and unfair or deceptive acts and practices in this state, and
22 to prohibit the same.
23 §1962. Definitions
24 When used in this Part: For purposes of this Part, the following definitions
25 apply:
26 * * *
27 G.(1) "Business of insurance" means any of the following:
28 (a) An action concerning the sale, advertisement, or solicitation of a contract
29 or policy of insurance.
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1 (b) Aiding in the resolution of a claim or benefit under an insurance policy
2 involving an insurer or a person who acts on behalf of an insurer, directly or
3 indirectly, and an insured, claimant, or any person who acts on behalf of an insured
4 or claimant, directly or indirectly.
5 (2) "Business of insurance" does not mean an attorney actively providing
6 legal services on behalf of a client or a healthcare provider or its representative
7 assisting a patient with a prior authorization or appeal concerning the denial of
8 healthcare services provided by a duly licensed healthcare provider.
9 §1963. Unfair methods and unfair or deceptive acts and practices prohibited
10 No person shall engage in this state in any trade practice which is or act
11 affecting the business of insurance as defined in this Part to be an unfair method of
12 competition or an unfair or deceptive act or practice in the conduct of the business
13 of insurance, including unauthorized insurance as provided in R.S. 22:1902 et seq.
14 or the failure to maintain professional liability insurance, if such coverage is required
15 pursuant to R.S. 22:1570.1.
16 * * *
17 §1968. Notice of hearing
18 A. If the commissioner has reason to believe that any person licensed by the
19 department has been engaged or is engaging in this state in any unfair trade practice
20 as defined in this Code, whether or not defined in this Part, the commissioner shall
21 issue a notice of wrongful conduct to that person in accordance and compliance with
22 R.S. 49:977.3 describing the unfair trade practice and citing the law which is deemed
23 by the commissioner to be violated.
24 B. If the commissioner has reason to believe that any person not licensed by
25 the department has engaged or is engaging in the business of insurance in this state
26 and committed or is committing any unfair trade practice as defined in this Part, the
27 commissioner may issue a cease and desist order, issue a fine, or take any other
28 action against the person pursuant to R.S. 22:1961 et seq.
29 C. Any person not licensed by the commissioner who has been aggrieved by
30 any act, cease and desist order, fine, order, or any other action of the commissioner
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1 pursuant to R.S. 22:1961 et seq., may appeal in accordance with the provisions of
2 R.S. 22:2191 et seq.
3 D. The commissioner may promulgate and adopt rules in accordance with
4 the Administrative Procedure Act to provide means of electronic delivery of the
5 notice required in this Section.
6 Section 2. This Act shall become effective upon signature by the governor or, if not
7 signed by the governor, upon expiration of the time for bills to become law without signature
8 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
9 vetoed by the governor and subsequently approved by the legislature, this Act shall become
10 effective on the day following such approval.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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