Insurance Dispute

June 4, 2013

Legal Concepts: Louisiana Code of Civil Procedure and Hearsay

The law has a wide variety of rules in place to force a clean route to evidence, especially from authorities on the topic, like people present or involved with the case’s topic. Hearsay is a statement, other than one made by the person themself while testifying at the present trial or hearing, offered in evidence to prove the truth of the matter asserted. Article 802 of the Louisiana Code of Evidence states “Hearsay is not admissible except as otherwise provided by this Code or other legislation.”

Understanding Legal Terms

Assertive Conduct:

June 3, 2013

Physical Rehabilitation Damage Leads to Difficult Ruling, Appeal of Facts

by Berniard Law Firm

Scott Ramocitti lost three fingers on his left hand in a work-related accident that occurred while he was using a saw blade in May of 2008. During his treatment Mr. Ramocitti was referred by his work insurance company to the defendant in this case, Helping Hand Physical, for physical therapy in order to learn how to adjust to his new situation. His physical therapy regiment included almost daily exercises with a Thera-Band exercise band to strengthen his hand and help Mr. Ramociotti learn to adjust to living with two fingers on his left hand.

A Thera-Band is a yellow latex band, used to help increase strength by providing resistance to muscles during rehabilitation. He was given his band by Chere Johnson, a Helping Hand physical therapist and instructed to do the exercises at home. After a month of using the Thera-Band, it broke during one of his exercises and re-injured Mr. Ramocitti’s left index finger.

This incident led to Mr. Ramocitti filing suit against Helping Hands claiming negligence for failure to properly instruct and warn him on how to use the Thera-Band. Helping Hands filed a motion for summary judgment, which was granted by the trial court judge in the initial proceeding. Upon receiving this judgment Mr. Ramocitti appealed.

May 31, 2013

Tractor Accident Leads to Question of Responsibility for Dead Tree Causing Incident

by Berniard Law Firm

In 2009, a Louisiana man was driving a tractor/trailer in Caddo Parish when he suddenly hit a large pine tree that had fallen across the road. Despite having already made this same trip on the same road several times that day, since the last time he had made the pass, the tree had fallen in the road. Unfortunately, the man did not have enough time to see the tree and stop his vehicle before driving into it. As a result of the accident, the man suffered serious neck injuries.

In light of this injury, who was to blame and what action could be taken? The man sued the owners of the property from which the tree fell, State Farm and the Parish. The claims against the owners and State Farm were settled, but the claim against the Parish went to court. Ultimately the trial court ruled against the man in favor of the Parish.

Taking the case further, the man appealed, arguing that the trial court had erred in three main regards. These errors had to do with admissibility of evidence, knowledge of the hazardous condition, and corrective action.

May 24, 2013

Slip at Large Retail Store Leads to Summary Judgment and Subsequent Appeal

by Berniard Law Firm

A summary judgment is strong medicine. When a trial court grants a motion for summary judgment, it precludes the non-moving party from having their case go to the jury and in some cases from presenting any evidence at all. Because this remedy is so potent, the granting of a motion for summary judgment is reviewed de novo on appeal. A summary judgment is a matter of law not a matter of fact so the trial court is not in any way in a better position to make this decision. The appellate court uses the same standard of review as the district court.

Wal-Mart Louisiana, L.L.C. was granted a summary judgment against Jean and Robert Gray. The trial court found that they had not presented any genuine disputes of material fact. The plaintiffs appeal was granted and a new trial ordered because the appellate court found that there were genuine issues of material fact. The appellate court reversed the trial court’s decision after commenting upon the meanings of the words “genuine” and “material.”

The appellate court found that a fact was “material” if when it is resolved in favor of one party or another it affects the outcome of the case under the governing law. A fact will only be found to be material if it could actually matter to the trial court’s decision. If a fact would not have any bearing on the case it cannot be deemed material. Facts that are presented that are immaterial do nothing to prevent a trial court from granting a motion for summary judgment.

May 22, 2013

Statute of Limitations Key to Alleged Insurance Fraud Case

by Berniard Law Firm

Many laws or actions include a statute of limitation which provides for a certain length of time for claims to be brought. After that time runs out, the claim can no longer be brought in court. The case of Joseph v. Bach & Wasserman illustrates just how important the statute of limitations can be to a case.

The case arose out of an alleged insurance fraud regarding several retail food trailers in Jean Laffite. The Josephs alleged that Wasserman defrauded them by charging them rent from properties he had illegally possessed from them. They also allege that Wasserman was supposed to place them on the insurance policy for the properties in question, but never did despite charging them insurance premiums. Wasserman in turn claimed that the Josephs owed him $375,000 in back payments. In 2004, the Josephs state that they found out that they did not owe Wasserman any back payments and he had charged them exorbitant fees. They filed suit in Orleans Parish in December 2004. In January 2005, the state court found deficiencies in the Josephs’ claim and gave them fifteen days to correct the problems, but the Josephs failed to respond and their state claim was dismissed with prejudice.

In 2011, the Josephs filed a complaint in federal district court alleging violations of the Racketeer Influenced and Corrupt Organizations Act (RICO) and various state law claims. On February 8, 2012, the federal district court granted Wasserman’s motion to dismiss and declined to exercise jurisdiction over the state law claims. This case deals with the Joseph’s appeal of the district court’s decision.

May 17, 2013

Understanding Comparative Fault/Negligence and How it Impacts Judgments

by Berniard Law Firm

You have probably heard the phrase “accidents happen.” But if you are in an accident, the first thing that you want to ask is who is at fault. With all of the chaos that can be part of an accident, sometimes the answer to this question isn’t always clear. This is when comparative fault, also known as comparative negligence, comes into play. In general, negligence refers to conduct that falls below the standards of behavior established by law for the protection of others against unreasonable risk of harm. Comparative negligence is different from ordinary negligence in that ordinary negligence is a failure to exercise the care that a reasonable person would exercise in similar circumstances whereas comparative negligence describes conduct that creates an unreasonable risk to one’s self.

In 1979, Louisiana Civil Code Article 2323 was amended to provide for a pure comparative negligence regime where a plaintiff’s own contributing negligence did not bar the recovery of damages, but merely reduced it by his or her own portion of fault. The Louisiana Legislature, in 1996, further amended the Code, making Louisiana a “true” comparative fault jurisdiction and the language of that amendment provided:

In an action for damages where a person suffers injury … the degree or percentage of fault of all persons causing or contributing to the injury … shall be determined, regardless of whether the person is a party to the action, and regardless of such person’s insolvency, ability to pay, immunity by statute …

May 11, 2013

How Underinsured Motorist Coverage Applies to Passengers of an Accident

by Berniard Law Firm

Automobile accidents create questions of coverage and liability – the only problem is how to answer those questions. Who is liable? Are you covered? If you are covered, to what extent are you covered? If you are covered, are your passengers covered? The final point is a more complex question to which recent case law has provided guidance for us.

In February of 2009, an uninsured motorist crashed into a vehicle owned by Ann Bernard. Ann was the driver and she had two passengers with her, Andrea and Norell Bernard, both members of her family not living in her household. Ann filed suit against her insurance provider, Imperial Fire & Casualty Insurance Company in order to obtain uninsured/underinsured motorists coverage under Ann’s Imperial policy. This type of coverage was named “UM” coverage. Ann believed that herself, Andrea, and Norell were all “using” the vehicle and were, accordingly, all insured persons as defined under her policy; thus statutorily entitling them all to coverage under Louisiana law.

In her filing, Ann referenced La. R.S. 22:1295 which states, in relevant part:

May 7, 2013

Abandonment Examined by Appellate Court in Construction Lawsuit

by Berniard Law Firm

A Saint Martinville, Louisiana, construction company, Cole’s Construction Crews, Inc., recently had a judgment against it reversed and remanded back to the trial court. Back in 2007, Cole’s had filed a lawsuit against J-O-B Operating Company. A few months after filing suit, Cole’s requested production of documents and sent interrogatories (or a list of probing questions) to JOB. Almost two years later, in July of 2009, JOB finally answered the requests. Then, in June of 2011, JOB filed a motion to dismiss the suit, claiming that Cole’s had abandoned the lawsuit. Ultimately, the motion to dismiss was signed, and Cole’s then attempted to get the motion set aside. The trial court denied this attempt, and Cole’s appealed the case to the appellate court to get it reviewed.

Cole’s claims that granting the motion to dismiss was an error that should be reversed. First, JOB had just answered the interrogatories less than two years earlier, and second, JOB did not file the requisite affidavit with its motion to dismiss. Ultimately, the appellate court disagreed with the trial court’s ruling and decided that granting the motion to dismiss had been done in error. They came to this conclusion by considering the various aspects of the complex Louisiana abandonment law, which is discussed below.

In Louisiana, Article 561 of the Louisiana Code of Civil Procedure imposes three requirements on plaintiffs in order for their lawsuit to not be considered abandoned. The first requirement is that the plaintiff has to take some sort of formal action before the court with regard to the lawsuit. Next, this action needs to take place during a court proceeding and must be in the suit’s record, unless it is part of formal discovery. Finally, this action has to take place in the requisite amount of time. If three years have passed without an appropriate action as described above taken by either party, then the suit is automatically abandoned. Even though abandonment is self-executing, defendants are encouraged to get an ex part order of dismissal, just like JOB did in this case, to make sure that their right to assert abandonment is not waived.

April 23, 2013

Comparative Fault and Reduced Court Fees for Victims

by Berniard Law Firm

Louisiana, like many other jurisdictions, has adopted the doctrine of comparative fault. Prior to comparative fault, many plaintiffs were denied recovery from a negligent wrongdoer if they also were negligently at fault (according to the doctrine of contributory negligence). Comparative fault alleviated this harsh rule of contributory negligence and, for some time now, Louisiana Law has provided relief for an injured plaintiff, even if said plaintiff was negligent as well. For instance, if an injured plaintiff filed suit and the jury decided that the defendant was responsible for 15% of your injuries, that defendant would be liable for 15% of the damages. Such a rule promotes a fairness, but how does this rule comport with legal fees?

Trial itself isn’t free, and in many cases expert testimony is crucial. The general rule is that the percentage of fault assigned applies to court costs as well.

In a recent case, Davis v. State of Louisiana, there was an automobile accident where the jury found DOTD 25% at fault but the judge, rather than assigning DOTD 25% of the costs, assigned them 100% of expert fees and clerk’s costs.

April 13, 2013

The Threshold Issue in Negligence Lawsuits – Explanation of Duty

by Berniard Law Firm

A high percentage of personal injury lawsuits are based upon claims of negligence. Negligence and intentional torts are both similar in that they result in harm to others. However, negligence actions differ from intentional torts because they are the result of a non-intentional action. There are essentially four elements of a negligence claim that must be met in order to prevail in a lawsuit. There must be a duty of cared owed to another, a breach of this duty of care, actual harm as a result of this breach, and causation. An individual will be on the hook for any harm that arises due to his or her’s negligence actions. If one’s standard of care deviates from that of a reasonably prudent person under same or similar circumstances, then the individual’s actions may be considered negligent.

The concept of the first element of a negligence claim of a duty of care is highlighted in this recent case. Ms. Ponceti and her daughter, Katilynn, lived in an apartment complex located in Louisiana owned by First Lake Properties (“First Lake”). While Katilynn was playing in the courtyard of the apartment complex, a teenager lost control of his bicycle and injured her. Ms. Ponceti sued First Lake, claiming that it was negligent in allowing the teenager to ride bicycles on the sidewalks of the apartment complex.

This is a personal injury lawsuit based upon the previously discussed negligence tort theory. In claiming First Lake was negligent in allowing bikes on the sidewalks, Ms. Ponceti needed to show that First Lake owed her daughter a duty to take reasonable care by preventing people from riding bicycles on its sidewalks that may potentially cause injury. Here a critical issue comes into play: does First Lake owe her such a duty?