Articles Posted in Insurance Dispute

pexels-kampus-8441811-1024x684A recent Louisiana Court of Appeal decision underscores the importance of insurance agents fulfilling their duties with reasonable diligence and care. In Upscale Fashions, Inc. v. Botsay Insurance Network, Inc., an insurance agent’s failure to properly procure and communicate coverage details led to a significant financial loss for the insured and a hefty judgment against the agency.

Case Summary

Upscale Fashions, Inc., a retail clothing company, purchased a property insurance policy through Botsay Insurance Network, Inc. The policy initially included wind and hail coverage. However, this crucial coverage was excluded when the policy was renewed, allegedly without Upscale’s knowledge.

pexels-bruno-makori-774974101-25961335-683x1024When an employee suffers a work injury, it may result in negative consequences for the employee’s health. While Louisiana’s workers’ compensation laws allow the employee to recover damages for these future health complications, this has its limits. The employee must prove that this future negative consequence was related to the initial injury at work. This ensures that employees who are rightfully harmed are compensated while also protecting businesses from having to pay for every future medical problem the employee has.

Kym Hurst was a physical therapy assistant for Cirrus Allied in Lafayette, Louisiana. Ms. Hurst had a history of back problems, which she had previously sought treatment for. On January 6, 2010, Ms. Hurst injured her back while helping one of her patients.

Ms. Hurst sought workers’ compensation benefits from her employer and its insurer, Ullico Insurance Company. She was eventually awarded a lump sum of over $46,000 and weekly indemnity benefits. By February 2013, Ullico had stopped paying benefits and had ultimately been declared insolvent. Kentucky Insurance Guaranty Association (“KIGA”) took over for Ullico after the insolvency.

car_accident_accident_dig-1024x775After being involved in a motor vehicle accident, you will likely be left with various damages, including medical injuries. Although you may assume insurance will cover all of your injuries and related damages, this is not always the case. The following Ouachita Parish case demonstrates the importance of understanding your policies and legal rights when it comes to motor vehicle insurance claims and of hiring an experienced attorney if you are left unsure of these rights.  

Alcender Williams, Jr. was injured while crossing an intersection and being hit by a motor vehicle. Williams subsequently filed a claim to the insurance company of the vehicle’s owner, Sharon Davis, where he and the company, Progressive Security Insurance (hereinafter referred to as Progressive), agreed to a settlement amount; Williams, however, resided with his mother, Bernadene Hubbard, at the time of the motor vehicle accident, and reserved his rights under her uninsured/underinsured motorist insurer Affirmative Casualty Insurance Company (hereinafter referred to as Affirmative). He then filed a claim asserting the limits of the Progressive policy was not enough to compensate him for his various damages. Williams’ claim was then rejected by Affirmative, who argued he was not included as a driver under the policy.  

Williams then filed a lawsuit against Affirmative, where the trial and appeal courts found in favor of his claims for coverage. Affirmative was subsequently declared insolvent and, as a result, Louisiana Insurance Guaranty Association (hereinafter referred to as LIGA) took over the discharge of its obligation with regard to claims as provided by law. 

driving_school_driving_car-1024x685If you want to decline uninsured/underinsured (“UM”) coverage, you might think it is sufficient to merely tell your insurer you do not want UM coverage. However, under Louisiana law, there are strict requirements with which you must comply in order to validly waive UM coverage. What happens if the insured does not follow those formal requirements?  

Joey Higginbotham worked as a truck driver for Dupre Logistics. He was involved in a car accident while on the job. He filed a lawsuit against the other driver and his insurer, USAgencies. He also added Dupre’s liability insurer, Zurich, and sought UM coverage under its policy. 

Zurich claimed Dupre had waived its UM coverage and moved for summary judgment. Higginbotham also filed a summary judgment motion, arguing Dupre’s supposed waiver was not valid under Louisiana law. 

accident_auto_crash_car-1-1024x768Car accidents can often give rise to lawsuits with complicated issues of causation and damages. Often, one or both sides will have expert witnesses to help explain complicated issues to the jury. What happens if one side argues the other side’s expert witness should not be allowed to testify as an expert witness?

Sherman Turner was driving an 18-wheeler owned by AAA Cooper, his employer. While on the job and making a delivery in Alexandria, Louisiana, he accidentally missed where he was supposed to turn. Turner turned into another street to turn around the 18-wheeler. Chelsea Mace claimed she turned on to the same street as Turner, saw the 18-wheeler, and stopped her car five feet behind it. She claimed while her car was stopped, Turner started to reverse the 18-wheeler and ran into her car. Mace claimed as a result of the accident, she injured her back and her doctor recommended she undergo a lumbar fusion. A jury found Turner was not at fault for the accident. Mace appealed.

On appeal, Mace argued the trial court erred in allow defendant’s expert, Joseph Peles to testify as an expert in accident reconstruction and biomechanical engineering. Article 702 of the Louisiana Code of Evidence governs whether given expert testimony is admissible. At trial, Mace filed a Daubert challenge, arguing Peles should not be allowed to testify as an expert. Prior to being qualified as an expert, Peles explained his education and professional background involving biomechanical engineering and reconstruction. 

calculator_calculation_insurance_1680905-1024x683Although money can never replace a loved one, if you find yourself in the tragic aftermath of a loved one’s death, you might be looking to recover damages from the responsible parties. However, the process of recovering damages can be difficult and emotionally charged. This is especially true if an insurance policy is involved and the insurer argues it is not required to provide coverage. 

Austin Trombley died while working at Rowdy Adventures, a zipline park owned by Howard Prince Jr. and located in Arkansas. While working during the summer at Rowdy Adventures, Trombley was living at a nearby camp, which Prince also owned. On the night he died, Trombley got drunk and was killed in a one-car accident while driving in a car owned by Abigale Williams. Williams was also in the car at the time of the accident, but she survived. 

Trombley’s parents filed a lawsuit against Prince, Rowdy Adventures and the owner of the camp’s land, which was owned by Prince. His parents accused Prince of negligent supervision. ASI Lloyds was Prince’s homeowners’ insurance carrier. ASI claimed its policy did not cover Prince because of the business pursuit and motor vehicle exclusions in his insurance policy. 

coins_currency_investment_insurance-1024x683Automobile insurance policies can help compensate you if you are injured in a car accident. However, it is essential to be aware of potential policy exclusions that limit what you are entitled to recover. This is especially true with uninsured/underinsured motorist (“UM”) insurance because an insurer is allowed to have exclusions, such as the exclusion of vehicles covered by the insurance policy. 

Easter McGee was riding in a car her nephew was driving. A wheel flew off, causing her nephew to crash the car into a tree, injuring McGee. Her nephew had liability and UM insurance through Allstate. Allstate paid McGee the liability policy limits. McGee released claims against her nephew but reserved her rights to pursue coverage under his UM policy. 

McGee subsequently filed a lawsuit against Allstate, claiming she was entitled to recover under the UM coverage because her damages exceeded the policy’s liability coverage limits.  Allstate filed a summary judgment motion, claiming McGee was not entitled to recover under the UM provisions because she had been injured in a one-car accident where the driver was at fault, and his liability insurance covered McGee. Further, the UM coverage excluded vehicles with liability coverage under the insurance policy. The trial court granted Allstate’s summary judgment motion. McGee appealed.

laocoon_statue_greek_vatican-1024x609If you prevail in a lawsuit, you might be entitled to various damages. One type of damages available in Louisiana is Lejeune damages, under La. C.C. art. 2315.6. Lejeune damages allow an individual to recover damages from the mental anguish of witnessing the injury of a third party. 

Louise Theresa Doty and her husband, Homer Doty, were at Prien Lake Mall in Lake Charles, Louisiana. While on a crosswalk, Brittany Nicole Fontenot hit Mr. Doty. Ms. Doty heard him yell and saw him lying on the ground with severe injuries. Mrs. Doty filed a lawsuit against Fontenot, her insurer, GoAuto, and her under/uninsured motorist insurer, State Farm. Mrs. Doty claimed her Lejeune damages under her State Farm insurance policy was a separate “bodily injury.” As such, she claimed she was entitled to recover beyond the money State Farm had already paid her husband for his injuries. 

Mrs. Doty settled her claims against everyone besides State Farm. State Farm filed a summary judgment motion claiming it had exhausted its policy limits with his payment of $50,000 to Doty. Mrs. Doty claimed she was entitled to recover her Lejeune damages under a separate limit. After a trial, the court awarded Mrs. Doty $50,000 in general damages and a $25,000 penalty for State Farm’s failure to pay her claim within thirty days under La. R.S. 22:1892(B)(1), and her expenses. State Farm filed an appeal.

lying_promises_deception_dishonesty-1024x768What are the consequences of lying in a workers’ compensation claim? They can be harsh, as shown in the following lawsuit. Betty Reeder, a Certified Nursing Assistant (CNA) at Hardtner Medical Center, found herself embroiled in a legal battle after suffering an injury on the job. This article examines the details of the lawsuit, delves into the relevant Louisiana workers’ compensation law, and analyses the Appeals Court decision that shaped the outcome.

The chain of events leading to the lawsuit began in January 2013, when Betty Reeder tripped and fell on a wheelchair while performing her duties as a CNA. Following the accident, she received financial and medical support from the Louisiana Hospital Association Workers’ Compensation Interlocal Risk Management Agency through its agent, HSLI. She received weekly payments based on her average weekly wage for over a year, totaling approximately $23,000. 

However, the situation took a contentious turn when HSLI accused Reeder of making false statements to obtain compensation. The case went to trial, with Reeder having to forfeit her right to workers’ compensation benefits by violating La.R.S. 23:1208. Faced with the Workers Compensation Judge’s (WCJ) initial ruling against her, Reeder appealed the decision and sought a reconsideration of her case.

the_police_arrest_lego-1024x683In the world of litigation, there are often cases that raise questions about who should be held responsible for damages caused by certain events. Take the recent case of Christopher Blanchard, who claimed damages after his police car was hit by a stolen car. The trial court granted summary judgment in favor of the defendants, GoAuto Insurance Company and its insured, Demetrius J. Hicks, dismissing Blanchard’s claim for damages. The court ruled that Hicks, the vehicle’s owner, was not liable for the damages caused by an unknown thief who stole his truck and crashed it into Blanchard’s police car. To better understand how this came about, let us examine the facts and legal arguments of the case and explore the court’s reasoning for upholding the verdict.

The undisputed facts are as follows: Demetrius J. Hicks, a carpenter and subcontractor, parked his truck in front of a house he was inspecting, leaving the keys in the ignition and the engine running. Within minutes, an unknown thief stole the truck and drove off. Hicks tried to stop the thief but was unsuccessful. Eventually, the thief abandoned the truck behind Blanchard’s patrol car and fled on foot. The stolen truck collided with the police car, causing damage.

Blanchard filed a lawsuit against Hicks and GoAuto, the insurance company, seeking compensation for the accident. Hicks and GoAuto denied liability, claiming that Hicks’ truck had been stolen and the thief was responsible for the accident. The trial court granted summary judgment in favor of the defendants, dismissing Blanchard’s claims with prejudice.

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