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Louisiana Insurance Bad Faith Questions & Answers
1 Answer | Asked in Insurance Bad Faith for Louisiana on
Q: BCBS Insurance exclusions for TMJ - denied the authorization for a surgery that is medically necessary - RS 22:1055

There is a document put out by BCBS Louisiana Policy #00583 that details when the surgery should be covered for TMJ due to medical necessity and BCBS is still denying it... what are my rights?

What can I do?

Tim Akpinar
Tim Akpinar answered on Oct 13, 2021

A Louisiana attorney could answer best, but your question remains open for three weeks. If the surgery pre-authorization you're talking about has provisions for appeal, you could discuss with your oral surgeon what an appeal would entail. At the very least, they would probably need to present... Read more »

1 Answer | Asked in Insurance Bad Faith for Louisiana on
Q: With the revised statute 9:2800.17 does that also apply to hail damaged vehicles?
Randy Bryan Ligh
Randy Bryan Ligh answered on Oct 12, 2021

That is a good question. I am inclined to say that unless you can show the the damage caused by the hail was due to the negligence of a 3rd party, then there is no recovery for diminution in value claim. Another way to look at this is that if you are making the claim against your own insurance... Read more »

1 Answer | Asked in Insurance Bad Faith for Louisiana on
Q: Is there treble damages against insurance companies in the state of Louisiana if so what is the civil statue
Randy Bryan Ligh
Randy Bryan Ligh answered on Oct 6, 2021

I think more information is needed to properly answer this. That said, I would not say there are treble damages available, however, depending on the circumstances, an insurance company can be found liable for attorney's fees, penalties and interest for bad faith actions---two statutes which... Read more »

1 Answer | Asked in Insurance Bad Faith and Insurance Defense for Louisiana on
Q: Is it normal for an insurance company to ask for the death certificate of someone you share a name with?

My mom and aunt share a name and birthday, different years, she claims her insurance was canceled in 2018 because they thought she was my mom who died in 2016. Her insurance Risa asking for my moms death certificate to reinstate her . I assumed her ssn would be enough .

Ellen Cronin Badeaux
Ellen Cronin Badeaux answered on May 5, 2021

No, asking for death cert is normal.

1 Answer | Asked in Criminal Law and Insurance Bad Faith for Louisiana on
Q: What constitutes burglary in Louisiana? Does there need to be evidence of forced entry to prove burglary?

I have been told that I have burglary coverage, but not theft coverage and that is why they cannot honor my claim. The "theft" occurred inside my locked door to my apartment bedroom. The representative told me because there is no proof of forced entry into my room it is therefore, theft... Read more »

Ellen Cronin Badeaux
Ellen Cronin Badeaux answered on Mar 25, 2021

Burglary can be of a "dwelling" not a "room". But it does not require forced entry, only unauthorized entry.

1 Answer | Asked in Insurance Bad Faith for Louisiana on
Q: Can my home ins. company legally deny claim for roof damage from a hurricane by saying “we don’t cover wear & tear”?

3 roofers have said I need roof replaced. Two insurance company’s contract inspectors have told my roofer that it needs replacement but co still denies my claim.

Ellen Cronin Badeaux
Ellen Cronin Badeaux answered on Jan 28, 2021

Get written estimates for roof replacement. Make sure that estimates state: "due to hurricane damage". Send certified letter, return receipt requested, or fax, with estimate to insurance company.

2 Answers | Asked in Insurance Bad Faith and Car Accidents for Louisiana on
Q: In an hit and run when accused has left the scene of the crime who is responsible for the damage?

The person who hit my car gave fake information to the officers and had no insurance. They have no license either.

Ellen Cronin Badeaux
Ellen Cronin Badeaux answered on Dec 4, 2019

That's what your UM insurance is for, unless it was a minor or using an insured driver's vehicle.

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2 Answers | Asked in Personal Injury and Insurance Bad Faith for Louisiana on
Q: Just had my forma pauperis statis accepted on a suit for over 100000 do i ask for hearing to obtain evidence now

How do i file for trial

Douglas Lee Bryan
Douglas Lee Bryan answered on Jun 3, 2019

You should consult with an attorney to represent you.

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1 Answer | Asked in Insurance Bad Faith for Louisiana on
Q: How long does a insurance company has to pay on replacement cost claims after the receipts are turned in?

I submitted them on the June 21,2018 and again on the July 25, 2018 because they claim they were to light. Never had a problem before .

Ellen Cronin Badeaux
Ellen Cronin Badeaux answered on Aug 3, 2018

Is this your insurance company or the other driver's company?

1 Answer | Asked in Consumer Law, Contracts, Personal Injury and Insurance Bad Faith for Louisiana on
Q: Can our policy be cancelled during litigation when all premiums have been paid?

Our church is being sued for a "trip and fall" and our policy has been cancelled for "failure to maintain our building". But no one has come to investigate the situation at all. it is as if the insurance company is taking the plaintiffs word on the matter. I am very frustrated.... Read more »

David Alan Wolf
David Alan Wolf answered on Aug 24, 2017

You should consult with an attorney. It is odd that the insurance company is cancelling the policy for failure to maintain the building. Typically, policies are challenged by the carrier if there is a misrepresentation or a failure to pay the premium. There may be a way to force the insurance... Read more »

1 Answer | Asked in Insurance Bad Faith, Personal Injury and Workers' Compensation for Louisiana on
Q: My insurance has denied a medical surgery procedure.

If I hire an attourney and it is proven that I do need this procedure, do I pay out of pocket or does my insurance cover my attourney costs.

Peter N. Munsing
Peter N. Munsing answered on Dec 13, 2016

Depends on your state's law regarding "bad faith" . Contact a member of the Louisiana Assn for Justice who handles insurance bad faith. In the meantime be sure they put the reason for their denial in writing.

1 Answer | Asked in Insurance Bad Faith and Car Accidents for Louisiana on
Q: In a wreck. Other driver t-boned my vehicle. My vehicle is a total loss. His insurance company paid the car off.

Can I file a claim against my own insurance company and use that money to purchase a new vehicle?

Peter N. Munsing
Peter N. Munsing answered on Jun 30, 2016

Assuming they paid for the damage to the car, you can't file a second claim for the same thing--look at your policy.You would have a claim for your injury so contact a member of the La. Trial Lawyers Assn--they give free consults.

1 Answer | Asked in Insurance Bad Faith and Car Accidents for Louisiana on
Q: Should I pursue legal action to have claim settled?

I was involved in an auto accident in December 2015 which totaled my vehicle. I was accused of staging the accident by the insurance company. A full investigation was done and is now completed. I didnt stage the accident. Here we are in April 2016 and as if this process hasn't been drug out... Read more »

Peter N. Munsing
Peter N. Munsing answered on Jun 29, 2016

Contact a member of the La. Trial Lawyers Assn who handles bad faith claims--they give free consultations.

1 Answer | Asked in Insurance Bad Faith, Insurance Defense and Car Accidents for Louisiana on
Q: What if I was in an auto accident in Louisiana and my final bill or notice of cancellation was within ten days of the

accident when I could not afford to pay my premium is that insurance company still liable if I was in a not at fault accident

Adam Studnicki
Adam Studnicki answered on Nov 14, 2015

Check the policy and local lawyer to see if there was a grace period. A local lawyer can review and advise.

Please Take Notice: I am not your lawyer unless we enter into an engagement agreement in writing. This is only general information. It is NOT legal advice, and it may not work for...
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