Articles Posted in Insurance Dispute

interview_paperwork_quill_law-1024x768When you sign a settlement agreement and release, it is easy to assume you waived all rights to sue over the incident that led to the agreement. However, there are certain circumstances where you should have been provided with relevant information at the time of signing. Therefore, it is crucial to understand your rights and the terms of any agreement. Consulting with a qualified attorney can ensure you are fully informed before signing.

Russell Charles was driving a vehicle while pulling a trailer on I-10 in Iberville Parish, Louisiana. A Dodge Ram truck driven by Mark Moore hit Charles from behind. Moore owned the Dodge Ram truck through his company, Moore Leasing, LLC, which State Farm insured. After the accident, Moore signed an affidavit stating that he was not working at the time of the accident and that only the State Farm insurance policy would provide coverage to Charles. In addition, Charles and his wife, Consandra, signed a release against all persons, firms, or corporations who were or might be liable for the accident in exchange for $50,000. 

Later, the Charleses filed a lawsuit against three companies owned by Moore and his wife, claiming that Moore had been working at the time of the accident, which would make the corporations vicariously liable. The company’s insurer was later added as a defendant. The defendants filed a motion for summary judgment, arguing that Moore had not been working at the time of the accident and that the previous release prevented this lawsuit. The trial court granted the motion and dismissed Charleses’ claims, but they appealed the decision.

business_signature_contract_962358-1024x768To avoid a lengthy trial, many lawsuits will be solved through settlements. Settlements may have their requirements, like signing a release. If presented with a release make sure you read it carefully and ensure it includes limiting language if other parties may be at fault. This is a lesson learned by Raymond Cressy when he signed a release form through his power attorney, severely hurting his claims. 

In 2010, Raymond Cressy was a passenger in a 2006 Dodge Durango driven by his brother and owned by his sister, Yolanda, in Natchitoches Parish, Louisiana. The driver swerved to avoid a tire in the roadway when control of the vehicle was lost. The vehicle consequently entered the median and rolled several times. The accident left Raymond a quadriplegic. 

Yolanda, later in 2010, was granted power of attorney over Raymond. In late 2011, acting as Raymond’s power of attorney, Yolanda signed a document titled “Release In Full of All Claims” on Raymond’s behalf with the understanding this was to settle claims against the GEICO insurance company.

padlock_grating_insurance_security-1024x768Protection from on-the-job injury is vital to any employee, especially those doing manual labor. But when so many types and subtypes of insurance coverage are involved in a single policy, how can you know when you’re covered? And what happens when you can’t tell if specific coverage applies to you? Can you still get protection and justice?

In August 2011, plaintiff William Weems was an employee of Cane River Construction LLC (Cane River). While on the job, Weems was driving a car owned by Cane River when another vehicle struck him from behind, and he suffered severe injuries. Defendant Houston Speciality was the automobile insurer for Cane River, and following the accident, Weems and his family sought uninsured/underinsured motorist (UM) coverage from Houston Speciality for his injuries. Houston Speciality denied that its policy extended UM coverage to Cane River and instead filed a third-party complaint against its insurance agent employed by Moreman Moore

Moreman Moore’s agent Mr. Dickerson was responsible for completing Houston Specialty’s insurance file. Mr. Dickerson is the agent with whom Cane River’s owner, Mr. Moran, secured the insurance agreement. The Louisiana Commissioner of Insurance requires insurance companies to employ UM waiver forms in their policies and allow their clients to accept or reject UM coverage. Dickerson delivered this waiver to Mr. Moran, and Mr. Moran denied UM coverage via the release. Therefore, Cane River’s insurance policy with Houston Speciality on the accident date thus did not include any UM coverage.

coins_currency_investment_insurance_0-1024x683One’s life is forever altered after an incapacitating injury. While the situation comes with enough issues, problems are enhanced when medical providers merge and change the disability benefits you have relied upon for a year. Unfortunately, this is precisely what happened to Michael Swinea after Humana Inc. bought Kanawha Insurance Company. 

Swinea required a total knee replacement after he was injured in March 2012. After this surgery, Swinea attempted to return to work. After working for about six months, Swinea’s physician instructed him to stop working again. Starting in April 2012, Swinea was given $2,700 per month in disability benefits through Kanawha. In November 2013, however, Humana bought Kanawha, and Swinea’s payments ceased. Humana informed Swinea that he would no longer be covered in a letter mailed to his home address.

After receiving the letter, Swinea contacted the appeals body specified in the letter. The Humana appeals body instructed Swinea to send any pertinent documents that he would like to be considered during the review. After complying, Swinea received a letter from a Humana Grievance and Appeals Specialist notifying him that his request for disability benefits was denied. 

car_old_car_car-1024x683Driving while on the job can be a common occurrence for many employees. Sometimes you may even use your personal vehicle on a workplace errand. If so, beware; Accidents happen, and your employer’s insurance may not cover you. 

Kim Simon was struck by an uninsured motorist when driving her personal vehicle while doing her job. Simon’s vehicle was damaged, but her employer’s insurance would not pay to fix the damages. So Simon sued her employer’s insurance to get coverage for her personal vehicle. 

Her company’s insurance provider argued that Simon’s personal vehicle was not covered under the policy because it was not a “covered auto” defined by the policy. Simon argued that because the auto policy did not list any “covered autos.” Further, she felt Louisiana revised statute 22:1295(1)(e) required the insurance policy to cover her unlisted car. 

housing_real_estate_estate-1024x681Generally, when you ask an insurance agent for a specific policy, you expect them to honor your request. But what happens when your insurance agent doesn’t procure the coverage you requested for? The following case is an example of a property owner who believed he maintained insurance when he did not. 

Ray Periso claimed he was an invitee to the property owned by Ban Vu when a balcony railing collapsed, causing Periso to fall fifteen feet. Periso also claimed that his subsequent injuries resulted from Vu’s negligence. Periso sued Vu, who then turned to his insurance company to provide coverage and representation for the claim. Vu was then told he didn’t have insurance coverage, which surprised him as he believed he told his insurance agent to “procure all necessary insurance on his properties for personal and property protection. “

To seek coverage, Vu filed a third-party demand against Frazier Insurance Agency, Inc. and Jamie Frazier (collectively referred to as “Frazier”), alleging negligence in not procuring a policy that provided personal liability coverage, as he requested. A hearing occurred in the 22nd Judicial District Court in and for the Parish of Tammany, Louisiana, wherein Frazier sought to exit the litigation by way of a peremption objection. The 22nd JDC ruled for Frazier, and an appeal to the Louisiana Court of Appeal First Circuit followed.  

texas_flag_texas_flag-1024x683Have you ever been involved in a car accident that potentially involved two states and wondered which state’s laws would govern your personal injury lawsuit? Say, you have an insurance policy issued in Texas, and you get into a car wreck in Louisiana. Which state’s laws will apply if you file a lawsuit related to the accident? The following case shows how Louisiana Courts use a choice of law analysis to determine what state laws should apply in these situations. 

Rafael Garces-Rodriguez and Julio Alonso (Rafels) were involved in a car accident when another motorist struck their car from behind. At the time of the accident, they were insured by Progressive County Mutual Insurance Company. Two years after the accident, Rafels filed a lawsuit against Progressive seeking compensation for their injuries and other damages sustained during the car accident. Progressive filed a motion with the court seeking dismissal of the case, asserting that Rafels rejected uninsured/underinsured motorist coverage (UM coverage). 

Progressive argued that Texas law should apply in the case because the policies were issued in Texas. Under Texas law, rejection for UM coverage is required to be in writing. However, there are no other special procedures or particular language that needs to be used for the writing. See: Ortiz v. State Farm Mut. Auto. Ins. Co., 955 S.W.2d 353 (Tex. App.-San Antonio 1997, pet. denied). A satisfactory rejection in Texas requires minimal effort by the insured. 

accident_auto_damage_vehicle_2-1024x768Automotive accidents can cause severe injuries to those involved. However, the testimony of accident reconstruction experts can help juries determine what happened and come to the correct conclusions about liability. The following lawsuit out of Baton Rouge shows how an accident reconstruction expert can help you win your automobile accident lawsuit.

In December 2012, Lisa Lirrochi was involved in a collision with a Peterbilt garbage truck driven by David Washington. At the time of the accident, Washington was in his capacity as an employee of Ace Waste Systems, Inc. Ms. Lirrochi was driving behind Washington’s truck around 4:30 A.M. when he moved the truck left into another lane in preparation to make a right-hand turn into a driveway. The two vehicles then collided. 

Lirrochi filed a lawsuit against Washington, Ace Waste, and the company’s insurer, alleging injuries and ongoing pain due to the accident. In return, Ace Waste filed a reconventional demand for the loss of its garbage truck. Lirrochi testified that she did not see Washington use his right turn signal and move into a clear open lane ahead. However, Washington testified that he did use his right-turn signal. 

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. 

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