Louisiana R.S. 22:1023: The Genetic Information Insurance Law, Its $50,000 Floor and the Doe Decision

What La. R.S. 22:1023 Covers

Section 1023 carries the title "Prohibited discrimination; genetic information; disclosure requirements; definitions." Its history note begins with Acts 1997, No. 1418 and records redesignation from R.S. 22:213.7 by Acts 2008, No. 415, effective January 1, 2009, with amendments through 2016. Courts call it the Louisiana Genetic Information Non-Discrimination Act, though the section gives itself no short title.

"Insurer" under subsection A(13) is wider than the word suggests. It takes in hospital, health and medical expense policies, service contracts, an "employee welfare benefit plan," group and association coverage, "a self-insurance plan," health maintenance and preferred provider organizations, and "insurance agents and third-party administrators," which deliver or issue a policy or plan in Louisiana. Subsection F, by contrast, attaches liability to "Any person," and subsection A(14) defines person as everyone other than the source of the tissue, including a family, a corporation, or a government. The section's breadth therefore depends on which subsection is at work.

"Genetic information" under A(8)(a) is "all information about genes, gene products, inherited characteristics, or family history/pedigree that is expressed in common language," and it expressly includes individual and family genetic tests, disease manifestation in family members, and fetus or embryo information. Sex and age are out.

Subsection G removes a large category: the section does not apply to "any actions of an insurer or third parties dealing with an insurer taken in the ordinary course of business in connection with the sale, issuance, or administration of a life, disability income, long-term care, or critical illness insurance policy."

Use of Genetic Information in Underwriting

Subsection B(1) bars an insurer, on the basis of genetic information or a request for or receipt of genetic services, or "the refusal to submit to a genetic test or make available the results," from terminating, restricting, cancelling, refusing to renew, denying or excluding coverage, imposing a rider, setting premium or cost-sharing differentials, or "otherwise" discriminating. Later paragraphs add specific bars: B(2) on requiring a test or questions about genetic information, B(4) on requesting, requiring or purchasing genetic information for underwriting or before enrollment, B(5) on requesting or requiring a test, B(6) on eligibility rules, B(7) on preexisting condition exclusions, and B(8) on premium adjustments.

Louisiana separates genetic information from manifested disease. Paragraphs B(6)(b), (7)(b) and (8)(b) preserve individual-market rules based on "the manifestation of a disease or disorder" in the individual or, for the premium and eligibility clauses, a covered family member. In the group market, B(8)(c) allows a premium increase for the employer based on manifestation in an enrolled person, but the manifestation "cannot also be used as genetic information about other group members."

Two narrow permissions complete the picture. B(9) lets an insurer obtain and use a test result for a payment determination, limited to the minimum information necessary. B(10) permits a request, never a requirement, for a test in research that complies with 45 CFR Part 46, provided participation is clearly voluntary, no information is used for underwriting, and the federal secretary is notified. B(3) adds a notice duty: every application or enrollment packet must include a written statement of rights "noticeable to and understandable by an average applicant or enrollee."

Disclosure, Consent and Ownership

Subsection C(1) forbids obtaining genetic information from an insured or enrollee, or their DNA sample, without first obtaining written informed consent. Paragraph C(2) lists what a valid authorization for disclosure contains:

• Writing, a signature, and a date matching the signature
• The person permitted to disclose and the recipient
• The specific genetic information, and the purpose described with specificity
• An expiration date, "which in no event shall be more than sixty days after the date of the authorization"
• A statement that it can be revoked before the disclosure and is invalid for any other purpose

A general release for medical records "shall not be construed as an authorization for disclosure of genetic information," under C(5), and the individual may revoke or amend at any time. Subsection D lists material the section does not apply to, including law enforcement identification, paternity, newborn screening and anonymous research. Acts 2016, No. 58 added two insurer-specific items: information obtained "For treatment, payment, and healthcare operations" consistent with HIPAA, and for record retention.

Subsection E is the unusual one. "An insured's or enrollee's genetic information is the property of the insured or enrollee," and no person may retain it without authorization, unless retention is for a criminal or death investigation or criminal or juvenile proceeding, or to determine paternity.

Remedies

Liability runs "to the individual," and both fee clauses speak of a successful action to enforce it. The treble clause appears only in the negligence paragraph, and the fifty-thousand-dollar figure there is the amount the trial court awarded in Doe.

A Diagnostic Code Counted as Genetic Information

The leading reported application is Doe v. Louisiana Health Service & Indemnity Co., No. 2014-CA-0789, decided by Louisiana's Fourth Circuit on May 20, 2015. Blue Cross denied individual coverage after its underwriters reviewed the plaintiff's claims history under her father's policy and found repeated ICD-9 codes for Marfan syndrome. The parties stipulated that she never developed the syndrome, and the opinion records that no DNA testing was ever performed on her.

The trial court found negligent disclosure and awarded the statutory $50,000 with interest, costs and fees. The court of appeal affirmed. It reasoned that a diagnostic code linked directly to a genetic disorder and submitted for claims "is unequivocally based upon genetic information, even if the only basis is the patient's physical or inherited characteristics," and it endorsed the trial court's statement that information about a genetic predisposition, without any manifestation of the disease itself, is genetic information.

It also rejected Blue Cross's argument that information kept inside the company was never disclosed. The Act defines disclosure as conveying or providing access to a person other than the individual, and access was provided to the insurer's underwriting department. The panel found no manifest error in the finding that the access was not willful, which kept the award at the negligence level. One judge dissented, reasoning that the 1994 fibrillin test did not characterize genetic information under the statute or under the Department of Insurance regulations the parties had stipulated at LAC 37:XIII.4501 to 4515; another concurred.

The opinion predates the 2016 additions in subsection D, and its subsection numbering differs from the current text. No later decision addressing how those additions interact with Doe was found for this post.

Beside HIPAA and GINA Title I

Paragraph C(6) preserves HIPAA expressly, stating that nothing in the section exempts a covered entity from its requirements on the collection, use or disclosure of genetic information. Our post on HIPAA and genetic information in underwriting covers that federal rule. The group market counterpart in Title I of the Genetic Information Nondiscrimination Act, 42 U.S.C. 300gg-4, tracks much of Louisiana's language: subsection (c) bars requesting or requiring a test, with the same treating-professional and payment clauses, and subsection (d) bars requesting, requiring or purchasing genetic information for underwriting or before enrollment.

Louisiana's text adds items that the federal section read here does not contain: the sixty-day written authorization, the property declaration, and the fixed damage floors. Its genetic information definition also names "family history/pedigree" in terms.

Louisiana's Other Genetic Statutes

Two adjacent provisions are easily missed. R.S. 22:1022 imposes a parallel rule for prenatal test results. R.S. 22:918, enacted by Acts 2021, No. 242 and amended in 2024 and 2025, covers insurers writing life, long-term care or annuity contracts, the lines 22:1023 excepts. It bars them from considering participation in genetic research or testing, unless the results are provided by the individual for consideration, and from requiring or requesting a test, and D(5) preserves consideration of genetic information already in a medical record on actuarial grounds.

A third is not an insurance statute at all. The Louisiana Human Genomic Security Act of 2025, R.S. 51:3181 to 3185, restricts sequencers and storage tied to the foreign adversary countries it lists, with a $10,000 fine per violation and sole attorney general authority under R.S. 51:3185.

Enforcement by the Louisiana Department of Insurance could not be assessed for this post: the department's website refused the request when it was attempted on November 9, 2026, and the regulations at LAC 37:XIII could not be retrieved from a public host, so no agency order or bulletin is recorded here.

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