Vs. Melissa Willis, As Parent/guardian Of Macy Lee Willis, Et Al. C/w Berkley

NEWS RELEASE #053
BERKLEY ASSURANCE COMPANY
FOR IMMEDIATE NEWS RELEASE
FROM: CLERK OF SUPREME COURT OF LOUISIANA
The Opinions handed down on the 9th day of December, 2022 are as follows:
BY Griffin, J.:
2021-C-01554 VS. MELISSA WILLIS, AS
PARENT/GUARDIAN OF MACY LEE WILLIS, ET AL. C/W BERKLEY
ASSURANCE COMPANY VS. MELISSA WILLIS, AS PARENT/GUARDIAN OF
Orleans Civil) MACY LEE WILLIS, ET AL. (Parish of
AFFIRMED. SEE OPINION.
Weimer, C.J., dissents and assigns reasons.
Crichton, J., additionally concurs and assigns reasons.
Crain, J., dissents and assigns reasons.
McCallum, J., dissents.

SUPREME COURT OF LOUISIANA
No. 2021-C-01554
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF MACY LEE WILLIS, ET
AL.
C/W
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF MACY LEE WILLIS, ET
AL.
On Writ of Certiorari to the Court of Appeal, Fourth Circuit,
Parish of Orleans Civil
GRIFFIN, J.
We granted this writ to determine whether the failure to include the insurer’s
name on an uninsured/underinsured motorist (“UM”) coverage selection form
renders it invalid. Because inclusion of the insurer’s name is an express requirement
on the face of the UM form itself, we agree with the court of appeal that the failure
to include such information results in an invalid waiver of coverage.
FACTS AND PROCEDURAL HISTORY
This dispute over UM coverage arises from a motor vehicle accident wherein
an uninsured motorist struck and killed Macy Lee Alvey, III, who was in the course
and scope of his employment with Rony’s Towing & Recovery, LLC (“Rony’s
Towing”). A commercial auto insurance policy issued by Berkley Assurance
Company (“Berkley”) provided liability limits of $1,000,000.00 per accident. The
policy contained a UM form selecting UM coverage for bodily injury in the amount
of $30,000.00 per acciden t. The UM form was electronically signed and dated by

2

the legal representative for Rony’s Towing. It is undisputed that the UM form did
not contain Berkley’s name as the insurer.
Berkley filed a petition for concursus, declaratory judgment, and injunctive
relief impleading the decedent’s minor child through his mother, Melissa Willis, and
decedent’s mother . Decedent’s alleged daughter, Sarah Viviano , intervened
(collectively “defendants”). Berkley filed a motion for summary judgment seeking
a final judgment declaring that the total amount of UM coverage under the policy
was $30,000.00. Defendants filed a cross -motion for summary judgment arguing
the UM form was invalid for failure to include the insurance company name, group
name, or logo. The trial court granted Berkley’s motion for summary judgment and
denied defendant’s cross-motion for summary judgment. Defendants appealed.
Reversing, the court of appeal distinguished the requirements for a valid
waiver of UM coverage articulated in Duncan v. U.S.A.A. Ins., Co. , 06-0363 (La.
11/29/06), 950 So.2d 544 and Gingles v. Dardenne, 08-2995 (La. 3/13/09), 4 So.3d
799, as the commissioner of i nsurance had since promulgated Bulletin 08 -02
together with a revised UM form that provided a designated box for the insurer’s
name, group name, or logo . Berkley Assurance Co. v. Willis , 20-0354, pp. 14 -15
(La.App. 4 Cir. 9/29/21), 328 So.3d 567, 575-76. The court of appeal thus held that
Bulletin 08 -02 superseded Duncan and Gingles such that , in the absence of the
insurer’s name, the UM form at issue was not properly completed thereby
invalidating the selection of lower limits of coverage. Id., 20-0354, pp. 16-17, 328
So.3d at 577.
Berkley’s writ application to this Court followed, which we granted. Berkley
Assurance Co. v. Willis, 21-1554 (La. 3/22/22), 334 So.3d 390.
DISCUSSION
The issue before this Court is whether the absence of Berkley’s name on the
UM form renders it invalid . “UM Coverage is determined not only by contractual

3

provisions, but also by applicab le statutes.” Duncan, 06-0363, p. 4, 950 So.2d at
547. Thus, whether coverage exists turns on the interpretation of the policy and UM
statute. Both are questions of law subject to de novo review. Baack v. McIntosh,
20-1054, p. 4 (La. 6/30/21), 333 So.3d 1206, 1211 (internal c itations omitted).
Similarly, appellate courts review the grant or denial of a motion for summary
judgment de novo using the same criteria as trial courts. Bernard v. Ellis, 11-2377,
p. 10 (La. 7/2/12), 111 So.3d 995, 1002.
“No automobile liability insurance [policy] ... shall be delivered or issued in
... [Louisiana] unless [UM] coverage is provide d.” La. R.S. 22:1295(1)(a)(i).
However, UM coverage is not required “if any insured named in the policy either
rejects coverage, selects lower limits, or selects economic -only coverage, in the
manner provided in [La. R.S. 22:1295(1)(a)(ii) ].” Id. “Such rejection ... shall be
made on a form prescribed by the commissioner of insurance” that is “provided by
the insurer and signed by the named insured or his legal representativ e.” La. R.S.
22:1295(1)(a)(ii). “The form signed by the named insured or his legal representative
which initially rejects such coverage … shall be conclusively presumed to become
a part of the policy” and a “properly completed and signed form creates a rebuttable
presumption that the insured knowingly rejected coverage, selected a lower limit, or
selected economic-only coverage.” Id. As “[t]he requirement of UM coverage is an
implied amendment to any automobile liability policy , “UM coverage will be read
into the policy unless validly rejected.” Duncan, 06-0363, p. 4, 950 So.2d at 547. It
is well-settled that the UM statute is liberally construed and exceptions to coverage
are interpreted strictly. Id.
Berkley argues the UM statute requires only that a waiver of coverage be
made on a form prescribed by the c ommissioner, signed by the insured or its legal
representative, and indicate whether coverage is being rejected or lower limits
selected for such waiver to be conclusively presumed to become part of the policy .

4

See La. R.S. 22:1295(1)(a)(ii). Berkley further argues that Gingles establishes the
failure to include the insurer’s name is not fatal to the enforcement of a UM waiver
regardless of language present in the accompanying Bulletin .1 08-2995, pp. 1-2, 4
So.3d at 799-800; Lynch v. Kennard, 09-0282, p. 2 (La. 5/15/09), 12 So.3d 944, 945
n. 4; Doerr v. Mobil Oil Corp., 00-0947, pp. 23-24 (La. 12/19/00), 774 So.2d 119,
134 (although the opinion of the commissioner of insurance regarding matters in his
province is persuasive, the judiciary is charged with interpreting statutes and
resolving disputes ove r insurance coverage). Berkley contends there is no
substantive difference between the UM form prescribed under Bulletin 98-01 and
the UM form prescribed under 08-02 – both have “space” for the insurer’s name and
the current version simply moved that space from the bottom left to the bottom right.
Berkley thus avers that under the statute and jurisprudence, the failure to include the
name of the insure r is a hyper -technical omission that does not invalidate a UM
waiver. Alternatively, Berkley argues the failure to properly complete the UM form
should only result in a loss of the rebuttable presumption that the insured knowingly
waived coverage.
Defendants counter that both Duncan and Gingles stand for the proposition
that the UM form, in effect at the time of the issuance of the policy, controls the
requirements for a valid rejection or selection of lower limits of coverage. Thus,
such requirements change if the commissioner of insurance rev ises the UM form
under his grant of legislative authority. See Duncan, 06-0363, p. 14, 950 So.2d at
553. Defendants further argue that the failure to reject or select lower limits of
coverage in the manner provided in La. R.S. 22:1295(1)(a)(ii) results i n UM
coverage up to the liability limits of the policy as required under La. R.S.
22:1295(1)(a)(i). That La. R.S. 22:1295(1)(a)(ii) does not set forth a penalty is

1 Specifically, Berkley avers the language of Bulletin 08-02 mandating inclusion of the insurer’s
name is nearly identical to the language in Bulletin 98-01 at issue in Gingles.

5

immaterial as it is intended to provide the exclusive manner for an insured to waive
the default UM coverage established in La. R.S. 22:1295(1)(a)(i). We agree.
The UM form dictates the requi rements for a valid rejection or selection of
lower limits of coverage. See Duncan , 06 -0363, pp. 11 -12, 950 So.2d at 551
(deriving the tasks required for rejecting coverage based on what the UM form
entails); Gingles, 08 -2995, p. 1, 4 So.3d at 799 (observing “the pertinent UM
rejection form did not expressly provide for the insurer’s na me”). Waiver of UM
coverage “shall be made on a form prescribed by the commissioner of insurance”
and only a “ properly completed and signed form creates a rebuttable presumption
that the insured knowingly rejected coverage.” La. R.S. 22:1295(1)(a)(ii) (emphasis
added). “In directing the commissioner of insurance to prescribe a form , the
legislature gave the commissioner the authority to determine what the form would
require.”2 Duncan, 06 -0363, pp. 12 -13, 950 So.2d at 552 . “Pursuant to that
mandate, compliance with the form prescribed by the commissioner of insurance is
necessary for the UM waiver to be valid.” Id., 06-0363, p. 14, 950 So.2d at 553.
The current UM form, prescribed under Bulletin 08-02, mandates the insurer’s
name, group name, or logo is necessary for a valid waiver of coverage. In relevant
part, the form states: “If you wish to reject UMBI Coverage, select lower limits of
UMBI Coverage, or select Economic-Only UMBI Coverage, you must complete the
form and return it to your insurance a gent or insurance company.” Completion
requires filling out the UM form in its entirety except where otherwise indicated on
the face of the form. See La. C.C. art. 2047 (“words of a contract must be given their
generally prevailing meaning”). Unlike the prior iteration of the UM form at issue

2 Berkley’s argument largely tracks that of the insurer in Duncan that “the only requirements for a
valid rejection of UM coverage are those explicitly imposed by the statute.” Duncan, 06-0363, p.
11, 950 So.2d at 551. T his Court rejected the argument observing that if only the bare statutory
essentials were required, it would be unnecessary for it to direct the commissioner of insurance to
prescribe a form. Id., 06-0363, p. 12, 950 So.2d at 552.

6

in Gingles, a designated box in the current version of the form expressly provides
for the entry of the insurer’s name. 3 See Gingles, 08-2995, p. 1, 4 So.3d at 799 .
Thus, Bulletin 08 -02 made specific changes to the UM form by mandating the
inclusion of the two boxes on the lower right corner of the form. As correctly noted
by the court of appeal, while the descriptive “Optional” appears in the box provided
for “Information for Policy Identification Purposes Only,” no such language appears
in the box provided for the insurer’s name. Willis, 20-0354, pp. 14-15, 328 So.3d at
576. What is not optional is mandatory. Berkley had the authority, opportunity, and
responsibility to assure the UM form was properly comple ted. Gray v. American
Nat. Property & Cas. Co. , 07-1670, pp. 14-15 (La. 2/26/08), 977 So.2d 839, 849 -
50; see also Stone v. Allstate Property and Casualty Ins. Co. , 18-0547 (La.App. 3
Cir. 3/7/19), 269 So.3d 961 (UM form valid where insured initially rejected coverage
with a check mark but supplemented with initials upon request of insurer) . It was
not. A requirement mandated on the face of the UM form itself can never be hyper-
technical nor its absence considered a minor deviation.
The tasks mandated by the current UM form , prescribed under Bulletin 08 -
02, are as follows: 1) initialing the selection or rejection of coverage chosen; 2) if
limits lower than the policy limits are chosen, then filling in the amount of coverage
selected for each person an d each accident; 3) printing the name of the named
insured or legal representative; 4) signing the name of the named insured or legal
representative; 5) filling in the insurer’s name, the group name, or the insurer’s logo;
and 6) filling in the date. Failure to properly complete the UM form results in an
invalid rejection or selection of lower limits of UM coverage. Duncan, 06-0363, pp.
14-15, 950 So.2d at 553. Consequently, by operation of statute, UM coverage is

3 We find no merit to Berkley’s assertion that there is no substantive difference between the UM
forms prescribed under Bulletins 98-01 and 08-02. Notably, this Court observed in Gingles that
“the pertinent designated spaces on the form were filled out.” 08 -2995, p. 2, 4 So.3d at 800
(emphasis added).

7

equal to the liability limits of the policy. Id., 06-0363, p. 16, 950 So.2d at 554; La.
R.S. 22:1295(1)(a)(i).
It is doubtless the role of the judiciary is to interpret statutes. However, under
our well-settled rules of statutory construction, we presume the legislature is aware
of the interpretation given to a statute by the jurisprudence. Borel v. Young , 07-
0419, pp. 9-10 (La. 11/27/07), 989 So.2d 42, 58 (on rehearing); Fontenot v. Reddell
Vidrine Water Dist. , 02-0439, pp. 13 -14 (La. 1/14/03), 836 So.2d 14, 24. In the
sixteen years since Duncan was decided , the legislature has amended La. R.S.
22:1295 three times.4 See Acts 2008, No. 194, § 1; Acts 2010, No. 210, § 1; Acts
2010, No. 703, § 1. Yet, despite ample opportunity, the legislature has not altered
any of the releva nt statutory language at issue . This Court has interpreted the
language of La. R.S. 22:1295(1)(a)(ii) enacted by the legislature. It is now up to the
legislature to evaluate that language in light of our interpretation, evaluate the policy
ramifications, and consider whether the language of the statute needs to be changed.
See State ex rel. Tureau v. BEPCO, L.P. , 21-0856 (La. 10/1/22), ___ So.3d ___,
2022 WL 12338524 at *15 (Weimer, C.J., additionally concurring).
DECREE
For the foregoing reasons, the ruling of the court of appeal is affirmed.

AFFIRMED

4 The statute was renumbered by Acts 2008, No. 415, § 1.

SUPREME COURT OF LOUISIANA
No. 2021-C-01554
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF
MACY LEE WILLIS, ET AL.
C/W
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF
MACY LEE WILL, ET AL.
On Writ of Certiorari to the Court of Appeal,
Fourth Circuit, Parish of Orleans Civil
WEIMER, C.J., dissenting.
The validity of UM waiver forms has been litigated for decades. The rule
formulated by the majority in Duncan v. U.S.A.A. Ins. Co., 06-363 (La. 11/29/06),
950 So.2d 544, which was intended to streamline the process and curtail these
disputes, has not succeeded. In my view, the failure to follow the relevant statutory
language as written is a significant part of the problem.
Louisiana R.S. 22:1295 generally mandates UM coverage equal to the liability
limits in all automobile liability policies, unless the insured “rejects [the] coverage,
selects lower limits, or selects economic only coverage, in the manner provided in
Item (1)(a)(ii)” of the statute. La. R.S. 22:1295(1)(a)(i). That subsection provides in
relevant part:
Such rejection, selection of lower limits, or selection of economic-only
coverage shall be made only on a form prescribed by the commissioner
of insurance. The prescribed form shall be provided by the insurer and
signed by the named insured or his legal representative. ... A properly
completed and signed form creates a rebuttable presumption that

the insured knowingly rejected coverage, selected a lower limit, or
selected economic-only coverage. (Emphasis added.)
Thus, by statute, a UM form is valid if (1) the insured rejects UM coverage, (2) on a
form prescribed by the commissioner of insurance, and (3) the form is signed by the
insured or his legal representative.1 Additionally, vital to this case is the fact that the
failure to properly complete a UM waiver form does not necessarily mean the form
is invalid. Rather, as I have consistently pointed out in dissenting opinions, the
consequence for failure to properly complete a UM waiver form is statutorily
prescribed–the insurer does not receive the benefit of a rebuttable presumption that the
insured knowingly rejected coverage. See La. R.S. 22:1295(1)(a)(ii); Duncan, 06-363
at 2 (Weimer, J., dissenting); Havard v. Jeanlouis, 21-00810, p. 1 (La. 6/29/22), 345
So.3d 1005, 1009 (Weimer, C.J., dissenting). The form can still be defended at a
hearing or trial. There is, simply stated, no other penalty prescribed in the statute and
imposing coverage for the failure to dot an “i” or cross a “t” is not statutorily
authorized. Further, such a penalty of imposing coverage is grossly unfair when the
insured did not want the coverage and did not pay for the coverage.
In this case, the basic statutory form requirements are satisfied: the
Commissioner’s form was used; a selection of lower UM limits was made; and the
signature of the legal representative for Rony’s Towing appears on the form. Thus,
the form is considered valid pursuant to the statute. See La. R.S. 22:1295(1)(a)(ii).
The omission of any remaining information concerns whether the form was “properly
completed,” which determines the applicability of the rebuttable presumption. The
dispute here arises because Berkley’s name as insurer was omitted on the UM form.
1 Importantly, the UM statute only references the “form” and does not require that the form include
the insurance company’s name or logo. Rather, this requirement only appears in the
“Commissioner’s bulletin.” The statute makes no mention of such bulletin, nor does it direct that
omission of the insurance company’s name renders the waiver invalid. (See Berkley Assurance
Co. v. Willis, 21-01554, slip. op. at __ (La. 12/__/22) (Crain, J. dissenting).
2

Even assuming the omission of the insurer’s name means the form was not properly
completed, this omission does not invalidate the UM waiver. There is no question
Berkley defended the validity of the UM form with evidence, despite not having the
benefit of a rebuttable presumption. Berkley introduced certified copies of its policy
and the UM form, accompanied by the affidavit of the senior claims adjuster attesting
to the authenticity of the UM form and that the Berkley policy was the only policy in
effect on the date of the accident. There is no evidence that Rony’s Towing disputes
that it selected lower UM limits. As noted by the district court, the representative for
Rony’s Towing paid the premium, indicated his desired coverage, and paid for what
he asked for–$30,000 in UM coverage. Moreover, because the Berkley policy was the
sole policy for Rony’s Towing, there is no evidence of confusion or mistake regarding
what company issued the policy or whether lower UM limits had been selected.2
There is no evidence of collusion between the insured and the insurance company to
engage in a post-accident effort to deny coverage or alter the limits of the policy.
Considering the undisputed facts of this case, invalidating the selection of lower limits
of UM coverage is at odds with the language and intent of the UM statute.
As I noted in my dissent in Duncan, “[i]n the majority opinion, form is being
substantially elevated over substance where one is provided coverage that was
apparently specifically rejected and neither bought nor paid for simply because a
potentially unnecessary number is not listed on the rejection form.” Duncan, 06-363
at 2, 950 So.2d at 555 (Weimer, J.,dissenting). The same is true here, where the
majority holds that UM coverage is mandated simply because the Berkley policy
number was not written on the form. Based on the facts of this case, I find it unjust
2 Pursuant to the UM statute, the UM form signed by the named insured or his legal representative
selecting lower limits “shall be conclusively presumed to become a part of the policy or contract
when issued and delivered, irrespective of whether physically attached thereto.” La. R.S.
22:1295(1)(a)(ii).
3

to force the insurance company to provide greater coverage for which it received no
premium. No one should get something for nothing in this circumstance–especially
when it was something not wanted, not paid for, and specifically rejected. Therefore,
I respectfully dissent.
4

1
S
UPREME COURT OF LOUISIANA
No
. 2021-C-01554
B
ERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF MACY LEE WILLIS, ET
AL.
C/W
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF MACY LEE WILLIS, ET
AL.
O
n Writ of Certiorari to the Court of Appeal, Fourth Circuit, Parish of Orleans
Civil
C
richton, J., additionally concurs and assigns reasons:
Ju
dicial restraint obligates me to adopt the majority’s interpretation of the
plain text set forth in La. R.S. 22:1295(1)(a)(ii), which notably mandates that a
rejection or limitation of UM coverage “ shall be made only on a form prescribed
by the commissioner of insurance.” The statute further provides that the “prescribed
form” shall be provided by the insurer and signed by the insured and that “[t]he form
. . . shall be conclusively presumed to become a part of the policy or contract when
issued and delivered, irrespective of whether physically attached thereto.” Id. In my
view, the delegation of authority present in La. R.S. 22:1295(1)(a)(ii) is
questionable, at best, but I cannot ignore that it exists. See also Duncan v. U.S.A.A.
Insurance Co. , 2006-363 (La. 11/29/06), 96 0 So. 2d 544, 552 (“In directing the
commissioner of insurance to prescribe a form, the legislature gave the
commissioner the authority to determine what the form would require.”).

2

In this case, it wa s incumbent on the insurer to ensure that its name was
included on the form, as prescribed. Baack v. McIntosh, 2020-01054 (La. 6/30/21),
333 So. 3d 1206, 1213 (the insured “should have known that signing and submitting
these forms could have specific legal consequences” and “it was incumbent on [the
insurer] to follow up with [the insured] to make any necessary corrections ” to the
form if it believed the insured made a mistake) ; see also Gray v. Am. Nat. Prop. &
Cas. Co., 2007-1670 (La. 2/26/08), 977 So. 2d 839, 849 (“Any perceived unfairness
to the insurer resulting from this decision is . . . offset by the fact that the insurer had
both the authority and the opportunity to assure that the UM selection form in this
case was completed properly.”). Despite our repeated pronouncements that the onus
of compliance with La. R.S. 22:1295(1)(a)(ii) is on the insurer, the insurer in this
case apparently failed to seek any necessary corrections to render the form valid.
While I have reluctance as to the conclusion of the well -reasoned opinion of
the Court, I write separately to highlight the need for the legislature to direct its
attention to this statute’s text, as its application creates a windfall to the insured. The
difficulties inherent in applying La. R.S. 22:1295(1)(a)(ii) have inundated the court
system for years . See, e.g., Duncan v. U.S.A.A. Insurance Co. , 2006-363 (La.
11/29/06), 960 So. 2d 544; Gingles v. Dardenne, 2008-2995 (La. 3/13/09), 4 So. 3d
799; Lynch v. Kennard, 2009-282, p. 2 (La. 5/15/09), 12 So. 3d 944; Elwakil v.
Burlington Ins. Co., 22-401 (La. App. 5 Cir. 11/17/22), 2022 WL 16985700; Dotson
v. Price, 399 F.Supp.3d 617, 622 (E.D. La. 2019) ; Guillory v. Commonwealth Ins.
Co. of Am., 2022 WL 1146425 (W.D. La. Apr. 18, 2022), 2022 WL 1146425. But if
there are parameters to the Commissioner’s authority to dictate the policy form
requirements for rejection or limitation of UM coverage, it is not the purview of the
judiciary to create such confines absent a challenge to the constitutionality of the
legislation. See La. C.C. art. 9.

3

I am troubled by the outcome of this case and am mystified by the lack of
further legislative guidance in the 16 years since Duncan , but I must follow the
written law. Legislative action is essential to remedy the inadequacies of La. R.S.
22:1295(1)(a)(ii) and to address the concerns set forth by Chief Justice Weimer and
Justice Crain, as well as my own.

SUPREME COURT OF LOUISIANA
No. 2021-C-01554
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF MACY LEE WILLIS,
ET AL.
C/W
BERKLEY ASSURANCE COMPANY
VS.
MELISSA WILLIS, AS PARENT/GUARDIAN OF MACY LEE WILLIS,
ET AL.
On Writ of Certiorari to the Court of Appeal, Fourth Circuit,
Parish of Orleans Civil
CRAIN, J., dissenting.
The rejection or selection of lower limits of uninsured-underinsured motorist
coverage is governed by Louisiana Revised Statute 22:1295(1)(a)(ii). I respectfully
submit the jurisprudential struggle with UM rejections is largely the result of
insufficient attention to this statutory language and an unwarranted deference to
administrative bulletins.
The first two sentences of Subsection 1295(1)(a)(ii) set forth the essential
form requirements for a rejection or selection of lower UM limits:
Such rejection, selection of lower limits, or selection of economic-only
coverage shall be made only on a form prescribed by the commissioner
of insuranc e. The prescribed form shall be provided by the insurer
and signed by the named insured or his legal representative.
Under this provision, the insured must (1) reject or select lower UM limits “on a
form prescribed by the commissioner of insurance,” and ( 2) the form must be
“signed by the named insured or his legal representative.” In the present case, there
is no dispute lower limits of UM coverage were selected using a form prescribed by

2

the commission er of insurance that was electronically signed and dated by the
insured’s legal representative. This complies with the statutory form requirements.
The majority nevertheless finds the form invalid because it does not identify
the insurance company. Th at information is not required by Louisiana Revised
Statute 22:1295. The majority instead relies on a bulletin issued by the commissioner
of insurance. However, t he commissioner is not authorized to add substantive
requirements to reject or select lower limits of UM not contained in Section 1295.
That statute vests the commissioner with discretion to develop “a form,” ostensibly
one that will apprise an insured of his statutory right to UM coverage and provide
the insured a means to reject that coverage or select lower limits. However, this
discretion does not include the ability to expand the statutory requirements for a
valid rejection or selection of lower UM limits. The legislature authorized the
commissioner to develop a form when insurers were making their own forms. The
authorization was not to enact substantive law. Because the UM statute does not
require the insurance company’s name on a rejection form, I find its omission from
the subject form is not fatal to the validity of the selection of lower limits.
Where a form contains the essential information required by Subsection
1295(1)(a)(ii), the failure to otherwise properly complete it does not invalidate the
waiver. The UM statute contains a single reference to the proper completion of the
commissioner’s form, Subsection 1295(1)(a)(ii)’s fourth sentence, which provides:
“A properly completed and signed form creates a rebuttable presumption that the
insured knowingly rejected coverage, selected a lower limit, or sele cted economic-
only coverage.” A properly completed form gives the insurer the benefit of this
evidentiary presumption. The failure to properly complete the form merely deprives
the insurer of this presumption. See La. R.S. 22:1295(1)(a)(ii); Duncan v. U.S.A.A.
Ins. Co., 06-363 (La. 11/29/06) , 950 So. 2d 544, 555 (Weimer, J., dissenting). I

3

would reverse the court of appeal judgment and reinstate the trial court judgment
declaring the total amount of UM coverage under the Berkley policy is $30,000.