Insurance Deadline Documents

LOUISIANA INSURANCE CLAIM
PROTECTION INFORMATION
JULY 2007
PROVIDED BY: The Pro Bono Project, Common Ground Legal

Collective, and the Loyola University College of Law Katrina
Clinic, Southeast Louisiana Legal Services
PLEASE NOTE: The information provided in this packet is intended to provide persons
with information and does not constitute legal advice. You are encouraged to contact an
attorney to help you make legal decisions that are best for your particular case.
INSURANCE INFORMATION
PRESERVE YOUR RIGHTS PACKET
Under most property and homeowner’s insurance contracts, people with open claims
relating to Hurricanes Katrina and Rita are not allowed to file suit against their insurance
company more than TWO YEARS after their damages occurred. For victims of
Hurricane Katrina, this date is August 30, 2007, and for victims of Hurricane Rita, this
date is October 1, 2007. IF YOU DO NOT FILE BY THESE DATES YOU WILL
NEVER BE ABLE TO DO SO. THIS MEANS YOUR INSURANCE COMPANY
WILL NOT HAVE TO NEGOTIATE WITH YOU ANY FURTHER. (The National
Flood Insurance Program generally has different terms, and this packet may not apply to
the time line for flood insurance claims.)
We suggest you file suit by August 30, 2007 at the latest. Without the possibility of a
lawsuit, your insurance company may have less motivation to deal with you fairly. In
order to protect your rights, we strongly urge you to find an attorney to help you file a
claim. If you need help finding an attorney, see the contact information given at the end
of this packet.
Protect yourself by doing these things:
Hurricane Katrina Victims, you must: (1) settle or

(2) file suit by August 30, 2007.
Hurricane Rita Victims, you must: (1) settle or

(2) file suit by October 1, 2007.
“PART A” of this packet will provide you with information on how to settle your claim,
primarily through the Louisiana State Hurricane Mediation Program. “PART B” of this
packet is an instruction sheet and pro se petition you can file in court, on your own,
without an attorney.
Part A
HOW TO SETTLE
If you have not already signed up for the free Louisiana State Hurricane
Mediation Program, you should do so. Included are materials about the
program and how to register and prepare for it. Read The Attached
Mediation Materials Carefully.
1. When registering, ask for a mediation date before August 30, 2007.
2. If you get a date before August 30, 2007 (or October 1, 2007 for
Hurricane Rita victims):
2a. Contact an attorney to prepare for filing a claim if mediation

fails to result in settlement.
2b. Go to the mediation and use the advice given

to you in this packet.
2c. If you do not settle at the mediation, you should file suit using
the the advice of an attorney by August 30, 2007 (or October
1, 2007 for Hurricane Rita victims):
.
3. If you get a date after August 31, 2007 (or October 1, 2007 for
Hurricane Rita victims):
3a. File suit using the instructions of an attorney by August 30,

2007 (or October 1, 2007 for Hurricane Rita victims):
3b. Go to the mediation and use the advice given

to you in this packet.
Whenever you are dealing with an insurance company, always keep a copy of the
information you are providing them for your records
How to Prepare for Mediation with
Your Insurance Company
Mediation is an optional step after you receive a denial or a settlement offer that you are
unsatisfied with. Only after you have sent your complete case in a detailed letter to your
insurance company, and reviewed your claim with an attorney, should you request
mediation.
How to Request Mediation through the Louisiana Hurricane Mediation Program
W Contact the Louisiana Department of Insurance at 1-800-259-5300 or 1-800-259-

5301
W Contact the American Arbitration Association at 1-800-426-8792 or
http://www.adr.org;
W Print out a copy of the mediation request form, available at
http://www.ldi.state.la.us/whats_new/Mediation%20Request%20Form.pdf and mail it
certified to: American Arbitration Association, Center for Mediation, 1100 Poydras
Street, Suite 2725, New Orleans, LA 70163 or Fax it to: 504-561-8041. It is
recommended that you call first or fax the form.
You should receive notice at least ten days prior to the date your mediation is scheduled.
If you absolutely cannot attend, call the administrator listed on your notice right away
and change your appointment. If the date for mediation falls after your deadline for filing
suit, make sure to send you insurance company the enclosed letter asking them to put in
writing that they will extend your time to file suit 30 days after the mediation.
YOU MUST BE ON TIME AND PRESENT FOR YOUR MEDIATION! IF NOT

YOU LOSE YOUR RIGHT TO A FREE MEDIATION, AND WILL HAVE TO
PAY!
W Mediations are scheduled for two hours, but may go longer if both parties agree
W Either party can request that the mediator be replaced if there is good cause.
W Mediation is paid for by the insurance company unless you fail to appear or cancel
without cause. Failure to arrive within 30 minutes of the starting time will be
considered failure to appear.
How to Prepare for Your Mediation
Many insurance companies are attempting to deny claims they classify as “flood”
damage. However, your damage may be the result of wind and wind-driven rain, which
is covered under homeowners policies. Rain entering the structure due to wind damage
can cause interior and structural water damage. Roof, window and exterior wall damage
are likely wind damage.
Collect statements about wind damage from neighbors who stayed during the hurricane.
Be sure to include a time-line (when the wind and rain occurred, when the flooding
occurred) and note if the water rose slowly or gently.
W It’s best if they have witnessed the pre-flooding wind damage to your home, but
statements witnessing similar wind damage to their own homes are helpful too. If
your homes are nearby, include the distance.
W Have them sign and date a written statement saying what they saw. If possible, have
this statement signed in front of a notary. Free notary services are available at Loyola
Law Clinic, 526 Pine Street, New Orleans, Louisiana. Phone: 861-5590, and usually
available Saturday, 12-3 at 1417 Franklin Ave, Common Ground Legal Clinic.
W Ask your neighbors, who have similar damages and the same insurance carrier, how
their company treated them. If they got more money than you did, you should bring
evidence of that into the mediation with you.
W Collect weather data about wind speeds and rainfall to support your claim.
W If you can get an architect, public adjuster, engineer or contractor to justify your
claim, ask them to attend or provide you with written information to use.
Proving Your Damage and Costs

Gather as much evidence of the damage and costs as possible. Make copies of
everything. Also, write a detailed estimate of damages above the flood line.
W Take photos of all the damage you think should be covered by your policy.
W Get a detailed estimate for permanent repairs to your home from a reliable contractor.
The estimate should contain the proposed repairs, repair costs and replacement prices
(and/or records of completed repair costs).
W Get estimates for exterior damage, such as trees, fences or sheds (and their contents).
W Prepare a detailed inventory of all damaged or destroyed personal property. Your list
should be as complete as possible including a description of the items, dates of
purchase or approximate age, cost at time of purchase and estimated replacement
cost. (Collect canceled checks, invoices, or receipts to help to determine the value.)
W Your living expenses due to displacement may be covered. Collect canceled checks,
invoices, receipts or credit card statements for evidence.
W Whenever you are dealing with an insurance company, always keep a copy of the
information you are providing them for your records!!!!
The Mediation
W Review your policy carefully and make certain the ‘named insured.’ can attend. If
not, someone with ‘power of attorney’ to act on behalf of the ‘named insured' must
attend.
W Insurance companies will have skilled adjusters to argue their case: you may want an
attorney with you. If so, you must provide the name of the attorney to your
administrator at least 6 days before the date of the mediation.
W Make a complete Claim File, including all the evidence you collected to support your
claim. Keep things orderly and easy to follow.
W Bring two copies of your Claim File to the mediation, one for you and one for the
insurance representative. Bring a summary letter of your dispute for the mediator.
After Your Mediation

W You are not legally obligated to accept the outcome.
W You can accept a partial settlement. If your insurance company agrees to pay you for
some claims, but not all, you can ask the insurance company to agree in writing to
pay you that amount as a partial settlement. Include in writing, in the agreement that
it’s only a partial settlement and other claims remain open. Then find an attorney to
file suit for you on the other claims.
W If you attend mediation without an attorney, you have a 3-day grace period to change
your mind about accepting the mediation decision. Inform your insurance company if
you change your mind.
W Nothing you say in mediation can be used against you in any other proceedings.
W If you are not satisfied you can still sue your insurance company.
W IF YOU CASH A CHECK GIVEN AT MEDIATION, YOU ARE ACCEPTING
FINAL PAYMENT, AND CANNOT DISPUTE THOSE CLAIMS FURTHER.
Additional Information.
- American Arbitration Association
1-800-426-8792
- Louisiana Department of Insurance
1-800-259-5300 or 1-800-259-5301
- Want the state brochure on Mediation?

http://www.ldi.state.la.us/whats_new/Hurricane_Mediation_Program_brochure_Revised.
pdf
- Want to hire a public adjuster?
http://www.napia.com/docs/PA_firms_hurricane_claims_gulf_states.pdf
- Need more tips for mediation?

http://www.adr.org/si.asp?id=2090
- Need free legal advice?

NOLAC 504-529-1000
Loyola Law Clinic 504 861-5590
SE LA Legal Service 1-800-521-6242
Fair Housing Center 877-445-2100
Common Ground Free Legal Clinic, 504-717-7324
- Need help finding an attorney?
LA Bar Referral and Information Service can help. Call 1-888-503-5747 or at
www.lsba.org (click on Public Services).
PART B
Instructions for Filing Pro Se Complaint Form
PLEASE NOTE:
IN ORDER TO PRESERVE YOUR CLAIM, YOU MUST DO THE
FOLLOWING!
1) FILE IN THE CORRECT COURT
2) PAY COURT FEES ( or are able to get “In Forma Pauperis” status)
3) PAY FOR SERVICE OF PROCESS
4) GIVE THE CORRECT ADDRESS FOR SERVICE
5) FILL YOUR FORMS OUT COMPLETELY
If, after reading the instructions you have questions about the requirements above, please
contact one of the four organizations listed in the back of your packet.
The following instructions will help you complete the attached Pro Se Complaint form if
your homeowner or automobile insurance provider has wrongfully refused to pay the
amount due under your insurance policy (“Pro Se” translated from Latin literally meaning “for
yourself” - Lawyers like to use Latin words to make themselves feel important). We strongly
recommend that you engage an attorney to represent you before commencing an action
and that you file your lawsuit before August 28, 2007. If you need to file suit, do not
wait until the last minute to file.
Complete the template in blue or black ink. Do not use pencil. Write clearly. If you are
filing a claim under a flood insurance policy, you must file your complaint in federal
court. You should revise the form accordingly if filing a flood insurance lawsuit. When
filing your claim, you must include the requisite filing fee, which varies from parish to
parish and depends upon whether you request a jury trial. (More about jury trials is
discussed below)
You may ask the court to waive the filing fees by filing an “In Forma Pauperis” form,
which can be obtained from the clerk of court. The court may not make you pay the fees
if you file this form showing that you cannot afford the fees. You should go the court
where you will be filing your petition and ask for a copy of the “In Forma Pauperis”
form at least one week before you will be filing your suit. (The form is different for each
court, so be sure you are at the correct one)! The form will tell you what information you
need to try and prove your eligibility for “In forma Pauperis” standing. File the “In
Forma Pauperis” form with the attached materials at the same time you file the suit and
DO THIS BEFORE AUGUST 28, 2007. (Note that filing the form does not automatically
mean you will not have to pay the fees. The court has to look at your paper-work you
turn in to determine if you are qualified).
To fill out the attached pro se petition:
Step 1: Clearly print the name of the proper court where you are filing your claim
(for example: CIVIL DISTRICT COURT FOR ORLEANS PARISH) in
the blank space at the top of the first page, just above “State of Louisiana.”
Just below, clearly print your full legal name in the blank space over the
word "Plaintiff". Similarly, find the full legal name of your insurance
company, and print this clearly in the blank space over the word
"Defendant".
Step 2: Complete the sentence "NOW INTO COURT comes Plaintiff ..." by
printing your full legal name in the blank space provided.
Step 3: Complete Paragraph 1 by again printing your full legal name in the first
space provided. Clearly print the name of the Parish in which you reside
in the second blank.
Step 4: Complete Paragraph 2 by clearly printing the full legal name of your
insurance carrier in the blank.
Step 5: To complete Paragraph 4, you will need your insurance policy
information. Your policy is numbered; locate this number and print it in
the first blank space provided. Finally, if your automobile is the property
that sustained damages, clearly print the word "automobile" in the final
blank space and include a description. The description should include the
year, maker, model, and license plate number. For example: Automobile,
1998 Ford Taurus LA Lic. LAM 000. If instead your house or business
was damaged, print the word "residence" or “business,” followed by the
address in the final blank space.
Step 6: In Paragraph 5, circle the appropriate name of the hurricane that affected
you, then the appropriate date of the hurricane that affected you.
Step 7: Clearly print the date that you first notified your insurer of the damages
suffered by the insured property in the first blank space in Paragraph 6.
An exact date is NOT necessary; an estimate of the month and year, such
as “In November 2005” or “Before June 2006” would be acceptable
responses.
Step 8: Circle “does” or “does not” request a jury trial. Realize that by requesting
a jury trial, you will be required to pay additional filing fees, and may
have to post a bond, which can be up to $2,500. By filing the “In Forma
Pauperis” form with your pleading, you may be able to avoid these
charges.
Requesting a jury trial will not necessarily get you a better judgment. It is
always best to consult with an attorney. If you do not ask for a jury trial,
you have ten days after your filing, or the defendant’s answer to ask for
one.
Step 9: Turn to the final page of the Pro Se Complaint. Write the date on the
blank space provided, and sign the document on the space below.
Step 10: In the blank space on that last page, under the words "Please serve",
clearly print the full legal name of your insurance company. Then, give
the proper address of your insurance company on the next line. You must
give the court the proper address for service of process. The proper
address of the most common carriers is included in this packet, following
the form. If your insurance company is not listed, contact the Louisiana
Secretary of state at (225) 925-4704 or the Louisiana Department of
Insurance at 1-800-259-5300 for the correct address of your insurance
company for purposes of service of process.
Step 11: Attach a copy of your insurance policy to the Pro Se Complaint.
Step 12: File this complaint with a copy of your insurance policy with the Clerk of
Court for the appropriate court in your parish. THE APPROPRIATE
COURT IS THE CIVIL COURT IN THE PARISH WHERE YOUR
PROPERTY IS LOCATED. (If it is a filing against flood insurance, file in
the appropriate Federal court). Here is a listing of courts and addresses:
Orleans Parish Civil District Court: 421 Loyola Ave, New Orleans, LA
70112 – (504) 592-9100- file at the clerk’s office on the 4th floor!
St. Bernard Parish Courthouse: 1101 W. St. Bernard Hwy., Chalmette,
LA 70043 (504) 278-4420
Jefferson Parish Courthouse: 200 Derbigny St., Gretna, LA 70053
(504) 731-4688
St. Tammany Parish Courthouse: 701 N. Columbia St., Covington, LA
70434 – (985) 809-8700
Washington Parish Courthouse: 908 Washington St, Franklin, LA 70438
(985) 839-4663
U.S. District Court, Eastern District of Louisiana (Federal Court): 500
Poydras St., New Orleans, LA 7013 (504) 589-7650
PLEASE NOTE:
IN ORDER TO PRESERVE YOUR CLAIM, YOU MUST DO THE
FOLLOWING!
1) FILE IN THE CORRECT COURT
2) PAY COURT FEES ( or are able to get “In Forma Pauperis” status)
3) PAY FOR SERVICE OF PROCESS
4) GIVE THE CORRECT ADDRESS FOR SERVICE
5) FILL YOUR FORMS OUT COMPLETELY
The pro se form is designed to be a minimal protection of your rights. It is

strongly recommended that you make every effort to hire a private attorney.
_______________________________
STATE OF LOUISIANA
Case No. Division
____________________________________,
Plaintiff,
versus
_____________________________________,
Defendant,
PRO SE COMPLAINT
NOW INTO COURT comes Plaintiff, _________________________,
who with respect avers as follows:
1.
Plaintiff _________________________ now is, and at all times relevant
to this action was, a resident of the Parish of _________________, State of
Louisiana.
2.
Defendant ____________________________ now is, and at all times
relevant to this action was, conducting business in Louisiana and may be
served though the Louisiana Secretary of State.
3.
Defendant is and was engaged in the business of writing and selling
insurance throughout the United States and the State of Louisiana.
4.
Sometime prior to August 29, 2005, Defendant issued to Plaintiff an
insurance policy, No. _________________ ("the policy"), by which
Defendant agreed to insure Plaintiff against loss arising from damages
sustained to Plaintiff’s __________________________________________
_______________________________________________________.
5.
Hurricane Katrina / Rita [circle one or both] made landfall in
southeast Louisiana on August 29 / September 24th, 2005 [circle one or
both], causing extensive damage to property insured under the policy.
6.
______________________, Plaintiff submitted a claim and demand
under the policy to recover for losses sustained to insured property as a
result of Hurricane Katrina / Rita. Plaintiff further satisfied all other terms
and conditions of the policy.
7.
Plaintiff's proof of loss fully advised Defendants of the facts of the
claim and was more than sufficient to enable the insurer to act on the claim.
8.
Defendant has wrongfully failed to act on the claim submitted by
Plaintiff, or, alternatively, has wrongfully denied the claim within the time
provisions established by La. R.S. 22:658 and La. R.S. 22:1220. In so
doing, Defendant has breached the express terms and conditions of the
policy and has otherwise denied Plaintiff the insurance coverage promised
by the Defendant in a manner that has been arbitrary, capricious, and
without probable cause.
9.
Further, the Defendant has acted without reasonable basis or
justification and in contravention of its duty of good faith and fair dealing in
handling the Plaintiff's claim, namely:
(a) the Defendant has unreasonably and intentionally refused to
pay benefits to which the Plaintiff is entitled under the
terms of the insurance policy;
(b) the Defendant has unreasonably and intentionally delayed
payments to which the Plaintiff is entitled under the terms
of the insurance policy;
(c) the Defendant has intentionally failed to conduct a
reasonable investigation into the claim reasonably based on
all available information, to reasonably evaluate and review
the information, and to make reasonable and timely efforts
to settle the claim; and
(d) the Defendant has no reliable knowledge or information
upon which to substantiate the denial of Plaintiff’s claim.
10.
The Defendant has acted with actual knowledge or with reckless
disregard of the lack of a reasonable basis in denying the claim, delaying
payment of the claim, failing to make reasonable attempts to settle the
claim, and failing to conduct a reasonable investigation into the claim and
failing to reasonably evaluate the available information.
11.
As a direct result of the Defendant's bad faith conduct, the Plaintiff
has suffered compensatory damages in an amount not yet ascertained, and
has and will continue to suffer damages, including, but not limited to stress,
mental anguish, extended loss of use of the insured property and the costs
and attorney's fees that may be incurred in maintaining this action, any costs
and attorney's fees that may be incurred in maintaining this action.
12.
Plaintiff is entitled to recover from the Defendant all losses,
including damages costs and attorney's fees, caused by the Defendant's
breach of contract and state law, in accordance with La. R.S. 22:658 as
amended by Louisiana Act no. 813, effective August 15, 2006.
13.
Defendant's intentional breach of its duty of good faith towards the
Plaintiff has been accompanied by oppression, fraud, or malice.
14.
Pursuant to La. R.S. 22:658, Defendant is obligated to pay Plaintiff
proper coverage under the policy, plus a penalty of 50% on the amount to
be due from the insured, or one thousand dollars, whichever is greater, or,
in the event a partial payment or tender has been made, 50% of the
difference between the amount paid or tendered and the amount found to be
due as well as reasonable attorney fees and costs of the amount due in
accordance with La. R.S. 22:658 as amended by Louisiana Act no. 813,
effective August 15, 2006.
15.
La. R.S. 22:1220 provides that an insurer “owes to his insured a duty of good faith
and fair dealing,” and provides that the insurer “has an affirmative duty to adjust claims
fairly and promptly, and to make a reasonable offer to settle claims with the insured.”
The statute further provides that “any insurer who breaches these duties shall be liable for
any damages sustained as a result of the breach.”
16.
La. R.S. 22:1220 specifically provides among the actions breaching
the insurer’s duties set forth above are:
a) “Misrepresenting pertinent facts or insurance policy
provisions relating to any coverages at issue,” or
b) “Failing to pay the amount of any claim due any person
insured by the contract within sixty days after receipt of
satisfactory proof of loss from the claimant when such
failure is arbitrary, capricious, or without probable
cause.”
La. R.S. 22:1220(B)(1) & (5)
17.
The statute further provides that an insurer who breaches this duty is
liable for, in addition to any general or special damages, a penalty equal to
the greater of two times the damages sustained or $5,000.00.
18.
Pursuant to La. R.S. 22:1220, Defendant is obligated to pay Plaintiff
the amount of actual damages sustained, plus a penalty of two times the
actual damages sustained by Plaintiff.
19.
Should an amendment to La.R.S. 22:1220 be enacted allowing for
attorneys fees and court costs to be collected in light of defendant’s actions,
defendant is obligated to pay the amount of those fees and costs to the
Plaintiff.
20.
Plaintiff is entitled to prejudgment and postjudgment interest on
Plaintiff's claims.
21.
The policy of insurance issue by Defendant to Plaintiff is a valued
policy as defined by Louisiana Law.
22.
In the event that it is determined that the insured property is a total
loss and that the insured property sustained some loss covered by the policy
of insurance, then, in that event, Defendant owes to Plaintiff the policy
limits of said policy of insurance, less and except any sums already
tendered to Plaintiff by Defendant.
23.
Plaintiff does / does not [circle one] request a trial by jury.
WHEREFORE, Plaintiff demands judgment against Defendant,
including payment for compensatory damages, statutory penalties, costs,
attorney's fees, and for such further relief as the Court deems just and
equitable.
Dated: ______________________
Please serve:
______________________________
(Name of Insurance Company)
______________________________
(Address of Insurance Company)
Insurance Company Addresses
Insurance Company Phone Number Registered Agent
LA Citizens Property LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
800-931-9548
Ins. Corp. 70809
LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
ACE USA 800-433-0385
70809
AIG Insurance LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
800-242-2418
Companies 70809
Allmerica 800-628-0250
70809
Allstate 800-547-8676
70809
America First 800-551-5100 LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
Insurance 877-263-7890 70809
800-321-2452 LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
American General
ext.2701 70809
American Reliable 800-245-1505
70809
Arch
archinsurance.com 70809
Armed Forces 800-664-9331 LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
Insurance Co. 913-727-5500 70809
Automobile Club
800-222-7623
Family Insurance
ext.5000
Co.
Autonmobile Club 800-222-7623 LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
Intl. Ins. Exchange ext.5000 70809
Balboa Insurance LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
888-768-2096
Group/Meritplan Ins. 70809
Non-Flood: 800-
765-9700 LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
Bankers Ins. Co.
Flood:866-397- 70809
6347
Bituminous 800-605-0311
70809
Chubb 800-252-4670
70809
CAN 877-262-2727
Farmers Ins. Group 800-435-7764
70809
Federated Mutual 800-237-8292
70809
FEMA 800-638-6620
FEMA Federal Aid 800-462-9029
PLEASE NOTE: The information provided in this packet is intended to provide

persons with information and does not constitute legal advice. You are encouraged to
contact an attorney to help you make legal decisions that are best for your particular
case.
Fireman's Fund 800-347-3428
70809
800-252-4633
First Floridian
800-238-6225
FM Global 877-639-5677
Foremost 800-527-3901
70809
Encompass 800-588-7400
70809
225-769-6829 John A. Sanchez, Jr. & Denver F. Gray, 2612 Severn Avenue
The Gray Ins. Co.
800-866-4061 Metairie, LA 70002
Great American
800-252-1363 70809
Hanover 800-628-0250
70809
Hartford Companies 800-243-5860
70809
Hartford Steam 800-472-5677
70809
Bob Warner, Jr., ann M. Metrailer and Wynne Jacobs, 9516
LA Farm Bureau 866-275-7322
Airline Highway, Baton Rouge, LA 70815
Liberty Mutual 800-225-2467
70809
Louisiana Medical John E. Lemoine, M.D. and Joan Winters Burmaster, One Galleria
225-295-4913
Mutual Ins. Co. Boulevard, Suite 700 Metairie, LA 70001
Metropolitan 800-854-6011
National Automotive Stephen C. Schrempp, 2121 Airline Highway - Suite 602 Metairie,
800-577-9471
Ins. Co. LA 70001
National Insurance
800-638-6620
Flood Program
One Beacon 877-248-4968
Progressive Ins. 800-274-4499
70809
Republic Ins. 800-451-0286
70809
Royal 800-847-6925
70809
SAFECO 800-332-3226
70809
Richard Emick Soileau, 200 West Congress Street, Suite 850
Safeway 800-252-3251
Lafayette, LA 70501
Selective 866-455-9969
70809
Shelter 800-743-5837
70809
Sompo Japan 800-444-6870
70809
case.
St. Paul
800-252-4633 70809
St. Paul Travelers 800-238-6225
State Farm Fire & LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
800-732-5246
Casualty 70809
State Farm General 800-732-5246
70809
Travelers
800-238-6225 70809
Trinity 888-252-2799
70809
Underwriters of 866-264-2533 LA Secretary of State, 8549 United Plaza Blvd., Baton Rouge, LA
Lloyds 212-382-4086 70809
United Fire Group 800-343-9131
70809
USAA 800-531-8222
70809
USAgencies 225-928-9000
70809
XL
800-688-1840 70809
Zurich 847-605-6000
70809

case.
CONTACTS
Loyola University College of Law, Law Clinic

7214 St. Charles Ave., Campus Box 902
New Orleans, Louisiana 70118
Phone: (504) 861-5590
Fax: (504) 861-5660
New Orleans Legal Assistance Center

1010 Common, Suite 1400A
Phone: (504) 529-1000
The New Orleans Pro Bono Project

615 Baronne St., Suite 201
Phone: (504) 581-4043
Common Ground Legal Collective

1415 Franklin Ave.
Phone: (504) 717-7324
Southeast Louisiana Legal Services

case.

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LOUISIANA INSURANCE CLAIM

PROVIDED BY: The Pro Bono Project, Common Ground Legal

Protect yourself by doing these things:

Hurricane Katrina Victims, you must: (1) settle or

Hurricane Rita Victims, you must: (1) settle or

2a. Contact an attorney to prepare for filing a claim if mediation

2b. Go to the mediation and use the advice given

3a. File suit using the instructions of an attorney by August 30,

3b. Go to the mediation and use the advice given

How to Request Mediation through the Louisiana Hurricane Mediation Program

W Contact the Louisiana Department of Insurance at 1-800-259-5300 or 1-800-259-

YOU MUST BE ON TIME AND PRESENT FOR YOUR MEDIATION! IF NOT

How to Prepare for Your Mediation

Proving Your Damage and Costs

After Your Mediation

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3) PAY FOR SERVICE OF PROCESS

4) GIVE THE CORRECT ADDRESS FOR SERVICE

5) FILL YOUR FORMS OUT COMPLETELY

3) PAY FOR SERVICE OF PROCESS

4) GIVE THE CORRECT ADDRESS FOR SERVICE

The pro se form is designed to be a minimal protection of your rights. It is

NOW INTO COURT comes Plaintiff, _________________________,

who with respect avers as follows:

Plaintiff _________________________ now is, and at all times relevant

to this action was, a resident of the Parish of _________________, State of

Defendant ____________________________ now is, and at all times

relevant to this action was, conducting business in Louisiana and may be

served though the Louisiana Secretary of State.

Defendant is and was engaged in the business of writing and selling

insurance throughout the United States and the State of Louisiana.

Sometime prior to August 29, 2005, Defendant issued to Plaintiff an

insurance policy, No. _________________ ("the policy"), by which

sustained to Plaintiff’s __________________________________________

Hurricane Katrina / Rita [circle one or both] made landfall in

southeast Louisiana on August 29 / September 24th, 2005 [circle one or

both], causing extensive damage to property insured under the policy.

______________________, Plaintiff submitted a claim and demand

under the policy to recover for losses sustained to insured property as a

and conditions of the policy.

Plaintiff's proof of loss fully advised Defendants of the facts of the

Defendant has wrongfully failed to act on the claim submitted by

provisions established by La. R.S. 22:658 and La. R.S. 22:1220. In so

by the Defendant in a manner that has been arbitrary, capricious, and

without probable cause.

Further, the Defendant has acted without reasonable basis or

handling the Plaintiff's claim, namely:

(a) the Defendant has unreasonably and intentionally refused to

pay benefits to which the Plaintiff is entitled under the

terms of the insurance policy;

(b) the Defendant has unreasonably and intentionally delayed

payments to which the Plaintiff is entitled under the terms

of the insurance policy;

(c) the Defendant has intentionally failed to conduct a

reasonable investigation into the claim reasonably based on

all available information, to reasonably evaluate and review

the information, and to make reasonable and timely efforts

to settle the claim; and

(d) the Defendant has no reliable knowledge or information

upon which to substantiate the denial of Plaintiff’s claim.

The Defendant has acted with actual knowledge or with reckless

disregard of the lack of a reasonable basis in denying the claim, delaying