Justia Insurance Law Opinion Summaries

Ron Warren, individually and on behalf of the Estate of Derek Hebert, filed a petition for damages seeking to recover for the wrongful death of his son in a recreational boating accident under general maritime law and products liability. A jury found the defendant, Teleflex, Inc. liable under the plaintiff’s failure to warn theory of the case and awarded compensatory damages of $125,000 and punitive damages of $23,000,000. The court of appeal affirmed. The Louisiana Supreme Court granted certiorari mainly to review whether the trial court properly granted the plaintiff a new trial and whether the award of punitive damages was excessive and resulted in a violation of the defendant’s right to constitutional due process. After reviewing the record and the applicable law in this case, the Supreme Court found no reversible error in the trial court’s rulings; however, the Court did find the award of punitive damages was excessive and resulted in a violation of the defendant’s right to constitutional due process. View "Warren v. Shelter Mutual Ins. Co." on Justia Law

The Louisiana Supreme Court granted review to determine the applicability of La. R.S. 9:2795.3, the Equine Immunity Statute. The trial court granted a motion for summary judgment filed by Equest Farm, LLC, finding that the immunity statute applied because plaintiff Danielle Larson was a participant engaged in equine activity at the time an Equest Farm pony bit her. The court of appeal reversed, holding that Larson was not a “participant” under the immunity statute, and that summary judgment was inappropriate because there were genuine issues of material fact as to whether another provision in the immunity statute might apply. The Supreme Court held that there were indeed genuine issues of material fact on the issue of whether the immunity statute applied. Accordingly, the Court affirmed the court of appeal and remanded to the trial court. View "Larson v. XYZ Ins. Co." on Justia Law

The issue this case presented for the Louisiana Supreme Court's review was whether the duty to defend in long latency disease cases could be prorated between an insurer and its insured when occurrence-based policies provide coverage for only a portion of the time during which exposure occurred. In the underlying Arceneaux suit, plaintiffs alleged that they suffered hearing loss from exposure to unreasonably loud noise in the course of their work at American Sugar’s refinery in Arabi, Louisiana. Two sets of plaintiffs, the Barbe plaintiffs and the Waguespack plaintiffs, filed suit against American Sugar in 2006. These suits were consolidated with the Arceneaux action, which was filed in 1999 against American Sugar’s predecessor, Tate & Lyle North American Sugars, Inc. This opinion concerned only the Barbe and Waguespack plaintiffs, and not the Arceneaux plaintiffs whose claims had been litigated extensively in the trial court, the court of appeal, and the Louisiana Supreme Court. Continental Casualty Company argued that defense costs should have been prorated among insurers and the insured if there were periods of non-coverage. American Sugar Refining, Inc. claimed that the duty to defend as agreed upon in the policy provided for a complete defense so long as the duty to defend attached, even if some claims fell outside of coverage. The Supreme Court held that the duty to defend should have been prorated in this case based upon policy language. View "Arceneaux v Amstar Corp." on Justia Law

Both of the injured employees in these cases, Charles Morris and Charles Poole, were treated at the Lafayette Bone & Joint Clinic (“LB&J”); Morris was treated by Dr. Louis Blanda and Poole by Dr. John Cobb. Louisiana United Business SIF (“LUBA”), sent letters to LB&J and its doctors stating that LUBA would no longer pay for prescription medications directly dispensed by LB&J and directing LB&J doctors to issue future prescriptions for the instant injured employees that could be filled at local retail pharmacies. Despite these notices and subsequent denials of requests for reimbursement of dispensed prescription medications, LB&J doctors continued to dispense prescription medications to these injured employee patients throughout 2008 and to submit requests for reimbursement to LUBA. LUBA declined payment for these requests, citing its prior notice. LB&J and the treating physicians thereafter filed disputed claim forms with the Office of Workers’ Compensation (OWC), seeking to recover the cost of the medications dispensed, along with penalties and attorney fees. Following a joint trial in these two cases, the OWC judge ruled that the plaintiff/health care providers’ recovery for medications dispensed after the 2008 notice were nonemergency treatment dispensed without consent of the payor. Further, the OWC judge found that no penalties or attorney fees were warranted because LUBA had clearly advised the plaintiff/health care providers that no further reimbursement would be made for prescription medications dispensed by LB&J doctors after the date of the notice. The plaintiff/health care providers appealed, seeking an increase in the amount awarded and an award of penalties and attorney fees. The Louisiana Supreme Court granted writs to review the appellate court decisions, which awarded unreimbursed prescription medication costs beyond the $750 limitation set forth in LSA-R.S. 23:1142(B) and awarded penalties and attorney fees. The Court reversed the appellate court's modification of the amount awarded by the OWC, and affirmed in part, the decision to award penalties and attorney fees. View "LaFayette Bone & Joint Clinic v. Louisiana United Business SIF" on Justia Law

This matter stemmed from a public works project for the construction of a gymnasium in Terrytown. JaRoy Construction Inc. served as the general contractor, and pursuant to statute, furnished a surety bond to Jefferson Parish. Ohio Casualty Insurance Company was the surety. JaRoy entered into a written subcontract with Pierce Foundations, Inc. to provide and install pilings for the project. Once finished, Pierce alleged JaRoy failed to pay certain funds due under the subcontract. Pierce sued both JaRoy and Ohio Casualty Insurance, alleging they were jointly and severally liable to Pierce. JaRoy filed for bankruptcy, leaving only Ohio Casualty Insurance as party to the suit. When the project was substantially completed, the Jefferson Parish government filed a notice of acceptance of work with the Jefferson Parish mortgage records office. This occurred over a year after Pierce amended its lawsuit to add Ohio Casualty as a defendant. Pierce never filed a sworn statement of claim in the mortgage records. Ohio Casualty filed a motion for summary judgment, contending that Pierce was required to comply with statutory notice and recordation, and because it failed to do so within 45 days of Jefferson Parish’s acceptance of the project, Pierce could not recover from Ohio Casualty. Pierce argued that the statute did not affect its right to proceed in contract. After a bench trial, the trial court rendered judgment in favor of Pierce for sums owed under the contract plus judicial interest from the date of the original judgment. Ohio Casualty appealed, arguing that the trial court erred in not dismissing Pierce's claims. The court of appeal reversed and ruled in Ohio Casualty's favor. The Supreme Court, however, disagreed and affirmed the trial court judgment. View "Pierce Foundations, Inc. v. JaRoy Construction, Inc." on Justia Law

Plaintiffs, alleging to be putative class members of multiple class actions, have filed their own individual suits against the defendant, Louisiana Citizens Property Insurance Corporation (Citizens). Plaintiffs were residents of, and owned homes in, St. Bernard Parish at the time Hurricane Katrina. Their properties were insured under policies of all-risk or homeowners insurance by defendant. Plaintiffs originally filed suit against Citizens on December 3, 2009, seeking contractual and bad faith damages arising out of Citizens’ handling of their property damage claims related to Hurricane Katrina. Citizens excepted on grounds of prescription and lis pendens. At issue is whether the doctrine of lis pendens barred plaintiffs’ suits where the plaintiffs were not named parties in the first-filed class actions. The Supreme Court found the trial court erred in overruling the defendant’s exception of lis pendens. View "Aisola v. Louisiana Citizens Property Insurance Corp." on Justia Law

The question before the Supreme Court was whether La. R.S. 23:1203.1 applied to requests for medical treatment and/or disputes arising out of requests for medical treatment in cases in which the compensable accident or injury occurred prior to the effective date of the medical treatment schedule. The Office of Workers’ Compensation (OWC) ruled that the medical treatment schedule applied to all requests for medical treatment submitted after its effective date, regardless of the date of injury or accident. The court of appeal reversed, holding that La. R.S. 23:1203.1 was substantive in nature and could not be applied retroactively to rights acquired by a claimant whose work-related accident antedated the promulgation of the medical treatment schedule. The Supreme Court disagreed with the conclusion of the court of appeal and found that La. R.S. 23:1203.1 was a procedural statute and, thus, did not operate retroactively to divest a claimant of vested rights. As a result, the statute applied to all requests for medical treatment and/or all disputes emanating from requests for medical treatment after the effective date of the medical treatment schedule, regardless of the date of the work-related injury or accident. View "Church Mutual Insurance Co. v. Dardar" on Justia Law

The Supreme Court granted certiorari in this case to consider whether La. R.S. 23:1203.1 applied to a dispute arising out of a request for medical treatment where the request for treatment was submitted after the effective date of the statute and the medical treatment schedule, but the compensable accident and injury that necessitated the request occurred prior to that date. Both the Office of Workers’ Compensation (OWC) and the court of appeal ruled that La. R.S. 23:1203.1 applied to all requests for medical treatment submitted after the statute’s effective date, regardless of the date of accident and injury. Finding no reversible error, the Supreme Court affirmed. View "Cook v. Family Care Services, Inc." on Justia Law

The issue this case presented to the Supreme Court centered on whether the Patient’s Compensation Fund (PCF) could be bound by summary judgment rendered solely against a defendant physician in the underlying malpractice proceeding on the issue of causation. Plaintiffs, Majdi Khammash and his wife and children, filed suit against various defendants, including Dr. Gray Barrow. After approving plaintiff’s settlement with Dr. Barrow for the $100,000 Medical Malpractice Act (MMA) cap, the District Court granted partial summary judgment, finding plaintiff’s injuries were caused by the fault of Dr. Barrow. The case then proceeded to jury trial against the PCF for the remaining $400,000 MMA cap. The jury returned a verdict in the PCF’s favor, finding Dr. Barrow’s malpractice did not cause plaintiff damage. The Court of Appeal reversed, finding as a result of the partial summary judgment, the issue of causation was not properly before the jury, and remanded for a new trial on damages only. The Supreme Court granted certiorari to address the extent, if any, the PCF was bound by the partial summary judgment on causation. The Court found, in accordance with La. Rev. Stat. 40:1299.44(C)(5)(a) and its holding in "Graham v. Willis-Knighton Med. Ctr.," (699 So.2d 365), the partial summary judgment against Dr. Barrow on the issue of causation was not binding on the PCF in plaintiff’s claim for damages exceeding the $100,000 MMA cap. Furthermore, the Court found no manifest error in the jury’s factual findings on causation. The Court therefore reversed the judgment of the Court of Appeal and reinstated the District Court’s judgment in its entirety. View "Khammash v. Clark" on Justia Law

Plaintiff Ashley Hoffman was insured under an automobile insurance policy issued by defendant Travelers Indemnity Company of America. Following an automobile accident, plaintiff received medical treatment at Baton Rouge General Medical Center and sought reimbursement for the hospital bill under her Travelers' medical payments coverage. The Supreme Court granted certiorari to determine whether the Travelers’ policy, which provided for payment of medical expenses "incurred," allowed plaintiff to be reimbursed for the full, nondiscounted amount of the hospital bill when the charges were contractually reduced pursuant to the hospital’s agreement with plaintiff's health insurer, AETNA Insurance Company. The Court answered that question in the negative and reversed the rulings of the lower courts. View "Hoffman v. Travelers Indemnity Company of America" on Justia Law