Articles Posted in Insurance Dispute

oil_rig_technology_sea-768x1024Personal injury cases can be costly for all parties involved. Paying those costs can get confusing, especially when there is indemnification. Indemnification arises when a party is contractually obligated to foot the bill for attorney fees and defense costs. The question then arises, can you seek indemnification if fault was never established? This type of contractual clause and legal questions are the core issue in a recent appeal discussed below. 

In 2002, Murphy Exploration and Production Company contracted with McDermott, Inc. to design and construct an offshore oil rig facility fixed to the seafloor adjacent to the State of Louisiana. Part of that contract provided that Murphy agreed to indemnify McDermott against claims, losses, and expenses. 

James Hefren, a Murphy employee, filed a lawsuit against Murphy and McDermott, alleging an injury that occurred due to a defect on the facility. Eventually, McDermott filed a cross-claim against Murphy asserting that McDermott was entitled to indemnification, based on the 2002 contract between the two parties, for all costs related to its defense against Hefren’s lawsuit. The district court found that Hefren’s claims were barred and dismissed the claims with prejudice. Following that dismissal, McDermott sought indemnification for the expenses incurred in defending itself from Hefren’s suit. The district court entered a judgment for McDermott and awarded attorney costs. Murphy appealed the judgment.

coins_currency_investment_insurance_0-1024x683Auto insurance can be beneficial when you are in a car accident. However, it isn’t uncommon to have specific provisions in your insurance policy that can limit your coverage. A recent case out of Kenner, Louisiana, interpreted whether certain caveats in an insurance policy can limit a client’s uninsured motorist coverage (UM/UIM).

Denise Breaux was driving on Interstate 10 behind a truck driven by Jonathan Blum. When a ladder fell off the back of Blum’s truck, Breaux tried to dodge the ladder that fell right into her path. Unfortunately, Breaux’s vehicle collided with Danny Castille’s tractor/trailer while attempting to avoid the ladder. Castille and his wife filed a lawsuit against Breaux, her insurer, and Blum, and then later added Lloyds at Lloyd’s, London (Lloyds) as a defendant. The Castilles were seeking UM/UIM coverage from Lloyds under a surplus lines insurance policy that was issued to Mr. Castille.  

Lloyds asserted that the Castilles were not entitled to UM/UIM coverage because they specifically issued an insurance policy that applied when the tractor did not have the trailer attached, known as Bobtail Liability insurance. Further, they argued that liability insurance was only available when the tractor was bobtailing; therefore, UM/UIM coverage only applied in the same scenario. Since, at the time of the accident, the Castilles’ tractor had a trailer attached and was not bobtailing, Lloyds sought summary judgment. 

law_justice_court_judge-1024x768Most lawsuits begin with a petition that lays out the facts and basis for a claim. These facts are pertinent to the survival of each claim and defense. Many pretrial hearings and motions are based on what is pleaded in the petition. The face of each pleading can determine the case’s outcome from the beginning. 

To attack the petition to have a lawsuit thrown out of court, attorneys will file motions alleging various exceptions. These exceptions can be based on different issues surrounding the case, such as a prescription or peremption exception. When arguing those exceptions, the attorney must be conscientious to “admit” all the evidence into the record that bolsters their position. The following lawsuit out of Ascension Parish, Louisiana, shows how important it is to properly admit evidence into the record when arguing in Court and what can happen when an attorney forgets to “offer and introduce” evidence filed with a motion.

William and Rosa Cambre owned a building they leased to Premier Performance Marine, L.L.C (Premier). Premier had the building insured by an Atain Specialty Insurance Company (Atain) policy. Therefore, when a storm severely damaged the building, Attain paid Premier under the insurance policy.

thirty_30_shield_mark-683x1024Once a case has been fully litigated, it has been established that the plaintiff cannot bring additional lawsuits against the same parties for the same cause of action. This principle, res judicata, promotes stability, efficiency, and fairness within our court systems. The following Ascension Parish case is decided based on this concept.   

Arthur Deal was involved in a motor vehicle accident with Billie Fortenberry on April 27, 2012. Following this accident, Deal filed a lawsuit against Mr. Fortenberry, Mr. Fortenberry’s insurer, Farm Bureau, and his uninsured/underinsured motorist insurer, State Farm Mutual Automobile Insurance Company. Deal then settled his claims with Farm Bureau and State Farm and agreed to dismiss the lawsuit on October 14, 2015. 

For the claim against Farm Bureau, Deal settled for the insured policy limit of $25,000, which Farm Bureau issued to Deal and his attorney in the form of a check on October 24, 2013. This amount, however, was not negotiated by Deal or his attorney. Following this, Deal retained new legal counsel. On September 23, 2015, almost two years after Farm Bureau issued the settlement check, Deal’s new attorney wrote the company a letter stating, in part, that the old check was not cashed and asked how long it would take Farm Bureau to issue a new one. Farm Bureau responded that, upon receipt of the old check, it would issue a new check to Deal and his attorney. Deal forwarded the old check to Farm Bureau on October 15, 2015. The company received it on October 16, 2015, and issued a new check on October 26, 2015. Deal and his attorney negotiated this check. 

headlights_roads_night_highways-1024x683Insurance claims can be complex, even for the courts. Lawsuits involving multiple plaintiffs and defendants are just as complicated. Claims, cross-claims, and counterclaims can arise from a single accident. Questions can arise during litigation, such as; can you appeal a partial summary judgment in Louisiana? A recent motorcycle accident in Arnaudville, Louisiana, demonstrates how convoluted insurance claims can become, as shown in the court’s opinion below. 

 The Colomb Foundation, Inc. (“Colomb”) was a property owner with a building erected along Louisiana Highway 93. As Erik Moran (hereafter “Moran”) drove by Colomb’s property at night, a flood light came on that Moran mistook for the headlight of an oncoming car. Moran alleged he was blinded by the light, which caused him to wreck his motorcycle into a gate located on Colomb’s property. 

After the accident, Moran filed a lawsuit against Colomb and its alleged liability insurer, United Specialty Insurance Company (“USI”). Shortly after, USI contacted Colomb to explain that they would not cover Moran’s claims under their insurance because Colomb’s insurance policy had been canceled six months earlier. The cancellation occurred due to a failure to pay the insurance premium. Colomb challenged this cancellation by filing a cross-claim against USI. Then, to make matters even more complicated, Colomb filed third-party demands against four additional parties, including Standard Lines Brokerage, Inc. (“SLB”), which is the entity in charge of the collection and cancelation of insurance policies for USI. 

court_hammer_auction_law-1-1024x768Most consumers in the U.S. are aware of increasingly high medical costs. For most people, those high costs are not directly paid; instead, they appear on a bill along with what one’s insurance company will pay as part of an agreement with the medical provider. Many insured consumers will look for “in-plan” medical providers to ensure that most costs are covered. Those “in-plan” providers are part of a preferred provider organization (PPO), which is a subscription-based medical arrangement that allows a substantial discount on rates to be charged. 

PPOs are organized by separate companies that generate revenue by charging an access fee. This type of PPO arrangement sets the backdrop for Best Comp, a recent case by the Louisiana Court of Appeals where plaintiffs sought class certification and defendants, the PPO, challenged it. The central evidence that plaintiffs presented for class certification was a data disc containing a Microsoft Excel spreadsheet showing the recommended discounts for each provider.  

The plaintiffs were Opelousas-based healthcare entities representing healthcare providers who treated employees under the Louisiana Workers’ Compensation Act. The providers subscribed to PPO agreements with defendant Bestcomp, Inc., and alleged that Bestcomp discounted their billing without the notice required by statute La.R.S. 40:2203.1

tax_forms_income_business-1024x683If you’re in a car wreck, you expect, or hope, to be covered for UM Bodily injury (UMBI) up to certain policy limits. However, when signing up for insurance, you must carefully review the coverages. The law in Louisiana has strict requirements when it comes to selecting or rejecting Uninsured motorist coverage. If you aren’t careful, you may unknowingly reject or limit the coverage you thought you had. New Orleans citizen Zachary Addison learned this lesson the hard way after being involved in a car incident in 2013. 

After his car accident, Mr. Addison filed a lawsuit against the other party involved and his insurance company LM General Insurance. Mr. Addison sued his insurance company to ensure they would provide adequate coverage for his injuries. In a motion for summary judgment, LM General Insurance argued to the trial court that Addison was not covered for uninsured/underinsured motorist coverage and bodily injury coverage and that he only selected UMBI coverage for his economic damages. LM General filed the motion based on the fact that Mr. Addison electronically selected economic-only UMBI coverage. 

When obtaining insurance, Addison received a quote via telephone and was given the option to send documents by mail, fax, or electronically. He chose to submit the documents electronically; the electronic documents had selections of coverage pre-made based on the quote he received. The pre-selected information could not be changed. Mr. Addison electronically signed the documents. 

chalmette1972stbernardhwy-1024x664Car accidents are common and complicated. Wrecks can involve company cars, ride shares, and large commercial vehicles, all with different types of insurance. Impacts can occur while driving on a work errand. All these different types of accidents invoke numerous insurance questions. Questions such as; If you are out driving on a work errand, will your business’s uninsured motorist insurance provide coverage? The Louisiana Court of Appeals grappled with these issues in a recent appeal. 

Dr. Kenneth Allan, a Chalmette based veterinarian, is the sole member of Chalmette Pet Wellness Clinic and Hospital. Dr. Allan was transporting a dog to his clinic when he was rear-ended. Dr. Allan was driving a vehicle in his wife’s name and sustained injuries from the car accident. Dr. Allan sued his uninsured motorist insurance carrier, Bankers, which provided coverage for his work vehicle to recover compensation for his injuries. 

Bankers balked at paying his claim. Bankers and Dr. Allan asked the court to settle the coverage issue by filing summary judgment motions. They asked the court to determine if the Bankers policy provided uninsured/underinsured motorist insurance coverage for vehicles not owned by the pet clinic. The trial court ruled in favor of Dr. Allan, stating that Bankers should cover his claim. An appeal of the decision followed.

balconyKnowing what is in an insurance agreement can determine whether or not you are covered for different injuries. If a buyer signed a policy, did not ensure that certain aspects were covered, and then never bothered to check or revise the policy, this person will likely be held accountable for knowing precisely what is in that policy.

In April 2011, Ray Periso rented a house from Mr. Vu on Ashville Drive in Slidell, Louisiana. When he was on the balcony, its railing collapsed, causing Mr. Periso to fall fifteen feet and sustain injuries. Mr. Periso sued his landlord as part of a tort lawsuit in the Twenty-Second Judicial District Court for the Parish of St. Tammany, but Mr. Vu wanted his insurance company to pay for these damages. Unfortunately, his insurance plan did not cover personal liability; therefore, he filed a third-party demand against Southern Fidelity Insurance Company (SFIC) and his insurance agent, Mr. Frazier, alleging negligence in not covering personal liability. The District Court dismissed this third-party demand. A series of appeals by Mr. Vu in the Louisiana First Circuit Court of Appeal followed.

In Mr. Vu’s first appeal, the Court of Appeal affirmed dismissing SFIC because its insurance policy plainly did not provide for personal liability coverage. However, it left open the issue of Mr. Frazier’s negligence. Mr. Frazier then filed a peremptory exception, claiming that Mr. Vu’s negligence assertions were perempted or filed too late. The Court of Appeal agreed with Mr. Frazier and dismissed Mr. Vu’s claims.

crash_test_collision_60-1024x645One of the first things that occur after a car accident is the parties exchange insurance information. But, unfortunately, just because someone has an insurance card doesn’t always mean they are covered for the wreck they caused. A driver in Metairie learned that lesson the hard way, as shown by the case below.

In 2012 in the Parish of Jefferson, Miriam Blandino was driving her partner’s car with their children inside when she was rear-ended at a stop sign. She and her partner subsequently sued the driver (from now on “Ms. Doe”) and the driver’s insurance (from now on “USAgencies”) for damages. However, USAgencies was let out of the lawsuit because Ms. Doe never actually obtained insurance through them.

Earlier that year, in February, Ms. Doe had signed up for an automobile insurance plan covering her from February through August, but her initial payment was declined. USAgencies notified her of this failure to pay and allowed her to reinstate her policy: she would need to provide the proper amount and a fifteen-dollar fee within ten days of the notice. Unfortunately, USAgencies never received payment from Ms. Doe, and thus her policy never became effective, so she was never covered.

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