Articles Posted in Insurance Dispute

car_accident_accident_dig-1024x775After being involved in a motor vehicle accident, you will likely be left with various damages, including medical injuries. Although you may assume insurance will cover all of your injuries and related damages, this is not always the case. The following Ouachita Parish case demonstrates the importance of understanding your policies and legal rights when it comes to motor vehicle insurance claims and of hiring an experienced attorney if you are left unsure of these rights.  

Alcender Williams, Jr. was injured while crossing an intersection and being hit by a motor vehicle. Williams subsequently filed a claim to the insurance company of the vehicle’s owner, Sharon Davis, where he and the company, Progressive Security Insurance (hereinafter referred to as Progressive), agreed to a settlement amount; Williams, however, resided with his mother, Bernadene Hubbard, at the time of the motor vehicle accident, and reserved his rights under her uninsured/underinsured motorist insurer Affirmative Casualty Insurance Company (hereinafter referred to as Affirmative). He then filed a claim asserting the limits of the Progressive policy was not enough to compensate him for his various damages. Williams’ claim was then rejected by Affirmative, who argued he was not included as a driver under the policy.  

Williams then filed a lawsuit against Affirmative, where the trial and appeal courts found in favor of his claims for coverage. Affirmative was subsequently declared insolvent and, as a result, Louisiana Insurance Guaranty Association (hereinafter referred to as LIGA) took over the discharge of its obligation with regard to claims as provided by law. 

driving_school_driving_car-1024x685If you want to decline uninsured/underinsured (“UM”) coverage, you might think it is sufficient to merely tell your insurer you do not want UM coverage. However, under Louisiana law, there are strict requirements with which you must comply in order to validly waive UM coverage. What happens if the insured does not follow those formal requirements?  

Joey Higginbotham worked as a truck driver for Dupre Logistics. He was involved in a car accident while on the job. He filed a lawsuit against the other driver and his insurer, USAgencies. He also added Dupre’s liability insurer, Zurich, and sought UM coverage under its policy. 

Zurich claimed Dupre had waived its UM coverage and moved for summary judgment. Higginbotham also filed a summary judgment motion, arguing Dupre’s supposed waiver was not valid under Louisiana law. 

accident_auto_crash_car-1-1024x768Car accidents can often give rise to lawsuits with complicated issues of causation and damages. Often, one or both sides will have expert witnesses to help explain complicated issues to the jury. What happens if one side argues the other side’s expert witness should not be allowed to testify as an expert witness?

Sherman Turner was driving an 18-wheeler owned by AAA Cooper, his employer. While on the job and making a delivery in Alexandria, Louisiana, he accidentally missed where he was supposed to turn. Turner turned into another street to turn around the 18-wheeler. Chelsea Mace claimed she turned on to the same street as Turner, saw the 18-wheeler, and stopped her car five feet behind it. She claimed while her car was stopped, Turner started to reverse the 18-wheeler and ran into her car. Mace claimed as a result of the accident, she injured her back and her doctor recommended she undergo a lumbar fusion. A jury found Turner was not at fault for the accident. Mace appealed.

On appeal, Mace argued the trial court erred in allow defendant’s expert, Joseph Peles to testify as an expert in accident reconstruction and biomechanical engineering. Article 702 of the Louisiana Code of Evidence governs whether given expert testimony is admissible. At trial, Mace filed a Daubert challenge, arguing Peles should not be allowed to testify as an expert. Prior to being qualified as an expert, Peles explained his education and professional background involving biomechanical engineering and reconstruction. 

calculator_calculation_insurance_1680905-1024x683Although money can never replace a loved one, if you find yourself in the tragic aftermath of a loved one’s death, you might be looking to recover damages from the responsible parties. However, the process of recovering damages can be difficult and emotionally charged. This is especially true if an insurance policy is involved and the insurer argues it is not required to provide coverage. 

Austin Trombley died while working at Rowdy Adventures, a zipline park owned by Howard Prince Jr. and located in Arkansas. While working during the summer at Rowdy Adventures, Trombley was living at a nearby camp, which Prince also owned. On the night he died, Trombley got drunk and was killed in a one-car accident while driving in a car owned by Abigale Williams. Williams was also in the car at the time of the accident, but she survived. 

Trombley’s parents filed a lawsuit against Prince, Rowdy Adventures and the owner of the camp’s land, which was owned by Prince. His parents accused Prince of negligent supervision. ASI Lloyds was Prince’s homeowners’ insurance carrier. ASI claimed its policy did not cover Prince because of the business pursuit and motor vehicle exclusions in his insurance policy. 

coins_currency_investment_insurance-1024x683Automobile insurance policies can help compensate you if you are injured in a car accident. However, it is essential to be aware of potential policy exclusions that limit what you are entitled to recover. This is especially true with uninsured/underinsured motorist (“UM”) insurance because an insurer is allowed to have exclusions, such as the exclusion of vehicles covered by the insurance policy. 

Easter McGee was riding in a car her nephew was driving. A wheel flew off, causing her nephew to crash the car into a tree, injuring McGee. Her nephew had liability and UM insurance through Allstate. Allstate paid McGee the liability policy limits. McGee released claims against her nephew but reserved her rights to pursue coverage under his UM policy. 

McGee subsequently filed a lawsuit against Allstate, claiming she was entitled to recover under the UM coverage because her damages exceeded the policy’s liability coverage limits.  Allstate filed a summary judgment motion, claiming McGee was not entitled to recover under the UM provisions because she had been injured in a one-car accident where the driver was at fault, and his liability insurance covered McGee. Further, the UM coverage excluded vehicles with liability coverage under the insurance policy. The trial court granted Allstate’s summary judgment motion. McGee appealed.

laocoon_statue_greek_vatican-1024x609If you prevail in a lawsuit, you might be entitled to various damages. One type of damages available in Louisiana is Lejeune damages, under La. C.C. art. 2315.6. Lejeune damages allow an individual to recover damages from the mental anguish of witnessing the injury of a third party. 

Louise Theresa Doty and her husband, Homer Doty, were at Prien Lake Mall in Lake Charles, Louisiana. While on a crosswalk, Brittany Nicole Fontenot hit Mr. Doty. Ms. Doty heard him yell and saw him lying on the ground with severe injuries. Mrs. Doty filed a lawsuit against Fontenot, her insurer, GoAuto, and her under/uninsured motorist insurer, State Farm. Mrs. Doty claimed her Lejeune damages under her State Farm insurance policy was a separate “bodily injury.” As such, she claimed she was entitled to recover beyond the money State Farm had already paid her husband for his injuries. 

Mrs. Doty settled her claims against everyone besides State Farm. State Farm filed a summary judgment motion claiming it had exhausted its policy limits with his payment of $50,000 to Doty. Mrs. Doty claimed she was entitled to recover her Lejeune damages under a separate limit. After a trial, the court awarded Mrs. Doty $50,000 in general damages and a $25,000 penalty for State Farm’s failure to pay her claim within thirty days under La. R.S. 22:1892(B)(1), and her expenses. State Farm filed an appeal.

lying_promises_deception_dishonesty-1024x768What are the consequences of lying in a workers’ compensation claim? They can be harsh, as shown in the following lawsuit. Betty Reeder, a Certified Nursing Assistant (CNA) at Hardtner Medical Center, found herself embroiled in a legal battle after suffering an injury on the job. This article examines the details of the lawsuit, delves into the relevant Louisiana workers’ compensation law, and analyses the Appeals Court decision that shaped the outcome.

The chain of events leading to the lawsuit began in January 2013, when Betty Reeder tripped and fell on a wheelchair while performing her duties as a CNA. Following the accident, she received financial and medical support from the Louisiana Hospital Association Workers’ Compensation Interlocal Risk Management Agency through its agent, HSLI. She received weekly payments based on her average weekly wage for over a year, totaling approximately $23,000. 

However, the situation took a contentious turn when HSLI accused Reeder of making false statements to obtain compensation. The case went to trial, with Reeder having to forfeit her right to workers’ compensation benefits by violating La.R.S. 23:1208. Faced with the Workers Compensation Judge’s (WCJ) initial ruling against her, Reeder appealed the decision and sought a reconsideration of her case.

the_police_arrest_lego-1024x683In the world of litigation, there are often cases that raise questions about who should be held responsible for damages caused by certain events. Take the recent case of Christopher Blanchard, who claimed damages after his police car was hit by a stolen car. The trial court granted summary judgment in favor of the defendants, GoAuto Insurance Company and its insured, Demetrius J. Hicks, dismissing Blanchard’s claim for damages. The court ruled that Hicks, the vehicle’s owner, was not liable for the damages caused by an unknown thief who stole his truck and crashed it into Blanchard’s police car. To better understand how this came about, let us examine the facts and legal arguments of the case and explore the court’s reasoning for upholding the verdict.

The undisputed facts are as follows: Demetrius J. Hicks, a carpenter and subcontractor, parked his truck in front of a house he was inspecting, leaving the keys in the ignition and the engine running. Within minutes, an unknown thief stole the truck and drove off. Hicks tried to stop the thief but was unsuccessful. Eventually, the thief abandoned the truck behind Blanchard’s patrol car and fled on foot. The stolen truck collided with the police car, causing damage.

Blanchard filed a lawsuit against Hicks and GoAuto, the insurance company, seeking compensation for the accident. Hicks and GoAuto denied liability, claiming that Hicks’ truck had been stolen and the thief was responsible for the accident. The trial court granted summary judgment in favor of the defendants, dismissing Blanchard’s claims with prejudice.

car_wrecked_accident_collision-1024x617To succeed in a lawsuit, it is not enough that your claim has merit. Rather, you must also comply with sometimes complex procedural requirements. These requirements include strict time limits in which you must file your claim. Otherwise, even if your claim has merit, it could be dismissed because of a peremptory exception of prescription. The following lawsuit involving bad faith insurance claims shows just how critical timely filing and proper crafting of a lawsuit are to preserve all of your claims. 

While Harold Fils was driving a vehicle owned by Bilfinger Salmis, his employer, he was hit by a vehicle driven by an uninsured motorist. Bilfinger’s uninsured motorist insurer was Starr Indemnity. Fils submitted a claim to Starr for his injuries and other damages. Starr paid Fils $45,000 but refused to make any additional payments due to Fils’s purported pre-existing conditions. 

Fils filed a lawsuit against Starr for additional payments. Fils claimed his medical expenses alone were over $45,000. He later amended his petition to claim Starr had acted in bad faith and sought penalties and attorney fees under La. R.S. 22:1973 and 22:1892. Starr filed a peremptory exception of prescription, claiming Fils’ bad faith claim was barred as it had been filed more than one year after he filed his lawsuit against them. The trial court ruled in favor of Starr and dismissed Fils’ bad faith claim. Fils appealed.

news_stock_newspaper_glasses-1-1024x732A homeowner’s insurance policy can help protect you if someone is injured on your property. However, like any insurance policy, a homeowner’s insurance policy can include many exclusions that limit what type of injuries your insurance policy will cover. If such an exclusion applies to your claim, your insurance company will likely try to claim it is not responsible for the pay the damages claimed. This can result in complex litigation, including complicated procedural devices such as the peremptory exception of no right of action at issue in the following case.

Terry Leone was a bail bondsman who was injured after falling out of the back door of a mobile home in Woodworth, Louisiana. The mobile home was owned by Don Ware and occupied by his son, Aaron, whom he was a guarantor for on a criminal surety bond. Don contacted Leone and told him he wanted to withdraw as Aaron’s guarantor. Leone went to the mobile home to assist with apprehending Aaron, so he could be turned in to the police. A physical altercation ensued, during which Leone fell out of the back door of the mobile home, injuring his knee. Leone filed a lawsuit against Don, Aaron, and Republic Fire and Casualty Insurance, who insured Don’s mobile home. Republic filed a peremptory exception of no right of action under La. C.C.P. art. 927, claiming the insured’s actions were intentional acts, so the insurance policy did not cover them. The trial court ruled in favor of Republic and granted its peremptory exception. Leone appealed. 

On appeal, Leone argued the trial court erred when it granted Republic’s peremptory exception of no right of action and found the allegations involved an intentional tort, so they were excluded from Republic’s policy. The purpose of an exception of no right of action is to determine whether the plaintiff (here, Leone) is part of the class of people with the right to bring the asserted claim. 

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