Justia Insurance Law Opinion Summaries

The issue central to this case arose from Plaintiff Ginger Durio's claims for property damage to her home following Hurricane Rita and for damages and penalties against her homeowner's insurer. The Court granted review of Plaintiff's case primarily to review the correctness of the rulings of the lower courts that applied the penalty provision of La. R.S. 22:1220 (C) to contractual damages, and awarding attorney fees pursuant to the amended La. R.S. 22:658. In September 2005, Plaintiff owned a home in Lake Charles, which was covered by a policy issued by Defendant Horace Mann Insurance Company (Horace Mann). The home was damaged by the hurricane. The extent of damage to the rest of the structure and to the interior of the home was disputed. Plaintiff filed suit against the insurer alleging her home and everything in it were destroyed, but Horace Mann "consistently arbitrarily and capriciously refused to classify [the] home as a total loss." Following a bench trial, the court ruled in Plaintiff's favor. The court ordered payment of policy limits on Plaintiff's homeowner policies. Horace Mann filed a motion for new trial. At the hearing on the motion for new trial, the court found it erred in awarding penalties under both La. R.S. 22:658 and La. R.S. 22:1220, and vacated those awards. Otherwise, the court denied Horace Mann’s motion for new trial. On its own motion, the court also granted a new trial relative to the attorney fees issue. Noting that newly discovered damages could trigger the amended version of La. R.S. 22:658, the court found there were newly discovered damages as established by the proofs of claim submitted, and those newly discovered damages were subsequent to the amendment. After review, the Supreme Court held that the lower courts erred in calculating 22:1220 penalties based on contractual amounts due under the insurance contract: "[s]uch penalties are properly calculated by doubling the amount of damages sustained as a result of the insurer’s breach of its duties under the statute." Applying the proper statutory interpretation to the facts of this case, the Court amended the trial court’s judgment to reflect the correct award of penalties. Furthermore, the Court held the lower courts erred in applying the amended version of La. R.S. 22:658 allowing attorney fees to be awarded. Thus, the Court reversed the lower courts’ rulings on this issue, and vacated the award of attorney fees. In all other respects, the rulings of the lower courts were affirmed.

This case involved a legal malpractice claim brought by Plaintiff MB Industries, LLC (MBI) against attorneys Steven Durio and John Weinstein. The attorneys represented MBI in an ultimately unsuccessful lawsuit against former MBI employees. Rather than appeal the unfavorable judgment, MBI chose to sue its former attorneys. The issues before the Supreme Court were: (1) whether a party's failure to appeal an underlying judgment waived any right to bring a legal malpractice claim based on that judgment; and (2) whether summary judgment was properly granted in light of MBI's failure to introduce expert testimony to establish the applicable standard of care which would have demonstrated the attorneys' actions fell below that standard. After careful review, the Court found that Louisiana law does not impose a "per se" rule requiring an appeal before a client can sue his former attorney. Furthermore, the Court found that a party alleging legal malpractice must introduce expert testimony to establish a standard of care "except in those rare cases involving malpractice so egregious that a lay jury could infer the defendant's actions fell below any reasonable standard." The Court found that under the particular facts of this case, there were no genuine issues of material fact, and that MBI failed to establish it could satisfy its evidentiary burden of proof at trial. The attorneys were entitled to judgment as a matter of law. Accordingly, the Court reversed the appellate court and reinstated the trial court's original judgment in favor of the attorneys.

In 1999, four employees of a Domino Sugar refinery sued parent company Tate & Lyle North America Sugars, Inc. (T&L) for damages from noise exposure during their employment with T&L between 1947 and 1994. Continental Casualty Insurance Company insured T&L with eight general liability policies. Each of the policies contained exclusions for bodily injury to employees arising out of the course and scope of their employees. In one of the eight policies, the exclusion was deleted by a special endorsement effective in 1975. After T&L notified Continental of the lawsuit, Continental retained defense counsel to defend T&L. In 2001, 125 new plaintiffs were added to the suit, and the complaint was amended to allege noise exposure from 1947 to 2001. At some point, trial was continued to allow for settlement. In 2003, without Continental's consent, T&L settled with 1 of 15 "flights" of plaintiffs for $35,000 per plaintiff. After that settlement, Continental was notified. One month later, Continental withdrew from the defense, disclaiming its liability based on a mistaken belief that all of its policies contained the exclusions for injuries to employees. In the subsequent years following the first settlement, additional plaintiffs were added. In 2004, the trial court granted partial summary judgment to T&L, finding that Continental had waived its right to rely on its policy exclusion defenses for "first flight" plaintiffs. The issue before the Supreme Court centered on Continental's exclusions and its disclaiming liability for subsequent plaintiffs. Upon careful consideration of the trial court record, the Court held that an insurer's breach of the duty to defend does not result in a waiver of all coverage defenses when the insured seeks indemnity under the policy. In this case, Continental had disclaimed coverage at the time more plaintiffs were added to the lawsuit, and did not provide a defense to those claims. Therefore, waiver principles did not apply. Continental was only liable to T&L in indemnity on a pro rata basis for the exposures that took place during the coverage period. The Court remanded the case for a determination of whether twelve remaining plaintiff-flights met the settlement criteria.

To provide relief in the aftermath of Hurricanes Katrina and Rita, Congress appropriated funds to Louisiana which distributed some of those funds through the "Road Home" program. The State required more than 150,000 Road Home grant recipients to execute a "Limited Subrogation/Assignment Agreement." The Road Home program created "perverse incentives" for insurance companies and their insured homeowners: some insurers inadequately adjusted and paid grant-eligible claims, and some grant-eligible homeowners had little motivation for file insurance claims. As a result, Road Home applications skyrocketed and created a $1 billion shortfall in the program. The State filed suit against more than 200 insurance companies, seeking to recover the funds spent and yet to be spent on claims under the Road Home program. The Insurance Companies successfully removed the case to the federal district court. The Insurance Companies then sought to dismiss the State's case, arguing that as a matter of law, anti-assignment clauses in the homeowners' policies invalidated the subrogation/assignment to the State. The federal district court denied the Companies' motion to dismiss. The Companies appealed to the Fifth Circuit. Because interpretation of the policy provisions at issue was a matter of State law, the Court certified interpretation to the Louisiana Supreme Court. The Supreme Court found that there is no public policy in Louisiana that precludes anti-assignment claims from applying to post-loss assignments. The Court commented that the language of the anti-assignment clause must clearly and unambiguously express that it applies to post-loss assignments, and as such must be evaluated on a policy-by-policy basis.