What Insurers Must Know About New La. Proof Of Loss Law
This article was republished in Law360.com.
The Louisiana Legislature recently passed H.B. 437, enacting Louisiana Revised Statutes, Title 22, Section 1892.3, in an attempt to clarify parties' respective obligations as they relate to proof of loss statements and corresponding payments under an insurance policy. The law went into effect on Aug. 1.
Under this new statute, any type of insurance policy — other than life, health and accident, and workers' compensation — may be written to require submission of a proof of loss statement as a condition precedent to payment under the policy.
Before any insurers attempt to condition payment on receipt of a proof of loss statement, they must ensure full compliance with the statutory requirements to avoid any confusion and late payments.
What was the law?
Prior to July 1, 2024, Louisiana's bad faith statutes required an insurer of a first-party loss to pay amounts due to its insured within 30 days after receipt of "satisfactory proofs of loss" — an undefined term.
If payment was untimely an insurer could be subject to statutory penalties and attorney fees and costs if the failure to timely pay was found to be "arbitrary, capricious, or without probable cause"; thus, the question of what qualified as "satisfactory proofs of loss" was the subject of much litigation.
In Louisiana Bag Co. Inc. v. Audubon Indemnity Co., the Louisiana Supreme Court held in 2008 that an insurer cannot condition payment upon the submission of a proof of loss form even if it is required by the policy. Rather, the court declared that "satisfactory proof of loss" broadly encompasses that which is sufficient to fully apprise the insurer of the insured's claims.
Following Louisiana Bag, Louisiana courts interpreted that ruling broadly to mean that no specific form is even required for an insurer to be in receipt of "satisfactory proof of loss."
One court, the Louisiana Court of Appeal, Third Circuit, even found in its 2023 decision in Guillory v. Louisiana Farm Bureau Casualty Insurance Co. that, in certain circumstances, an insurer could receive satisfactory proof of loss by way of an independent adjuster's inspection of an insured property. In that scenario, the insurer's 30-day payment obligation would commence from the date of the inspection and not upon receipt of a report or estimate from the independent adjuster as is common in the industry.