2009 Louisiana Laws TITLE 46 Public welfare and assistance :: RS 46:1806 Application; requirements; confidentiality

§1806.  Application; requirements; confidentiality

A.  An application for reparations shall be filed in writing with the board within one year after the date of the personal injury, death, or catastrophic property loss or within such longer period as the board determines is justified by the circumstances.  The application shall be valid only if the act resulting in the personal injury, death, or catastrophic property loss was reported to the appropriate law enforcement officers within seventy-two hours after the date of the personal injury, death, or catastrophic property loss, or within such longer period as the board determines is justified by the circumstances.

B.  Application shall be made on a form prescribed and provided by the board, which shall contain at least the following:

(1)  A description of the date, nature, and circumstances of the act or acts resulting in the physical injury, death, or catastrophic property loss, and of the crime, if known.

(2)  A complete financial statement, including the cost of medical care or funeral, burial, or cremation expenses, the loss of wages or support, and the extent of the property loss, if any, which the claimant has incurred or will incur and the extent to which the claimant has been indemnified for these expenses from any collateral source.

(3)  Where appropriate, a statement indicating the extent of any disability resulting from the injury incurred.

(4)  An authorization permitting the board or its representatives to verify the contents of the application.

(5)  Such other information as the board may require.

C.  The following information, when submitted to the board as part of an application, shall be confidential:

(1)  Documents submitted by a claimant which relate to medical treatment.

(2)  Law enforcement investigative reports.

Added by Acts 1982, No. 250, §1, eff. July 17, 1982.  Acts 1986, No. 121, §1; Acts 1995, No. 421, §1.