Articles Posted in Insurance Dispute

Sometimes, a single witness can make the difference between winning and losing at trial. This is especially so when you are fighting for reasonable medical compensation. Since insurance companies generally try to give patients the least amount of money as possible, they look for all sorts of ways to do so. One way is to prevent a patient’s physician from testifying and giving an opinion of what he or she believes is causing the patient’s current pain. In the following case, the defendant attempted to do just this, but fortunately for the plaintiff, the Court of Appeal found error in the trial court’s decision to exclude the testimony of the plaintiff’s physician. 

Jasmine Jones and Keith Morgan were in opposite lanes of travel waiting for the traffic light to turn green. Morgan was driving a pickup truck while Jones was driving a compact car. When the light turned green, Jones headed straight, but Morgan made a turn and collided with Jones. Morgan struck Jones’s front tire, but Jones’s vehicle suffered only minor damage. However, Jones felt pain in her back and went to the Rapides Regional Hospital later that day. Dr. Gerald LaGlue, Jones’s initial physician, was unsuccessful in relieving Jones’s pain, and so he referred Jones to Dr. George Williams. Dr. Williams then referred Jones to Dr. Melanie Firmin who performed an epidural steroid spinal injection, which only increased Jones’s pain. 

After examining Jones further, Dr. Williams opined that the cause of her pain was radiculopathy, which likely originated from her car accident. However, Dr. Williams never actually performed a diagnostic test to determine if Jones’s pain was caused by radiculopathy. However, he was prevented from testifying about his opinion of Jones’s pain because the defendants succeeded in their Daubert motion, which essentially asks the court to exclude expert witness testimony because it is not reliable. As a result, Jones did not succeed in obtaining as much compensation as she desired because Dr. Williams was not able to testify. 

In today’s world, consumers are faced with increasingly complicated contracts and waiver forms for even the simplest transactions. These contracts not only have the potential to confuse consumers, but create an opportunity for corporate exploitation. The following case illustrates an example of the courts reaffirming protections for consumers over companies. 

Andrea Weddborn and Rene Martinez (“Plaintiffs”) had two car insurance policies that covered their 2007 Toyota Camry. They purchased these policies from Affirmative Insurance Company (“Affirmative”) and National Insurance Company (“National”) (collectively referred to as “Defendants”). In December 2012, Plaintiffs were involved in an automobile accident in Orleans Parish of Louisiana. The accident was caused by an unidentified driver of another vehicle who changed lanes, struck Plaintiffs’ vehicle, and then fled the scene. 

Both Affirmative and National refused to compensate Plaintiffs for the damages suffered in the accident, arguing that Plaintiffs’ insurance policies did not include Uninsured Motorist (“UM”) coverage. Plaintiffs subsequently filed suit against the insurance companies.

Comedian Chris Rock once famously opined that insurance should be renamed, “In-case-of.” You pay for insurance every month “in case of” some unfortunate circumstance occurring. Well, you better have access to an excellent attorney “in case of’ the other driver not having the insurance, or even the car, in his name. This is what happened to Wanda Kahl. When the insurance company disputed its obligation to pay for her injuries, Ms. Kahl was subject to a protracted legal battle in court.

Ms. Kahl was driving down Jane Ave in New Iberia one summer day in 2012 when she was rear-ended by a hit-and-run driver. She filed a lawsuit against the vehicle’s owner and his insurer. The registered owner, Tricky Chevalier, later testified in a deposition that the vehicle in question was ostensibly a “straw purchase.” That is to say, Chevalier had purchased, registered, and insured the vehicle in his name but all for the benefit of his cousin, one Joseph Pete. Mr. Pete operated the vehicle, and also paid the insurance premiums, while Chevalier remained owner in name only. After this deposition, Safeway Insurance moved for summary judgment. A summary judgment motion requests that the court rule for the movant without a trial because the evidence presented thus far shows “no genuine dispute of material fact.” La. C.C.P. art. 966. Safeway claimed Chevalier’s admission constituted a material misrepresentation of fact, without which he would not have received coverage. Since the coverage was procured by misrepresentation, Safeway argued that the contract for coverage was not valid, so they were not responsible for payment.

Ms. Kahl appealed Safeway’s summary judgment motion and countered with a summary judgment motion of her own, asserting that the law clearly states the accident must be covered. She relied on La. R.S.32:900(F)(1) to show that Safeway is obliged to pay. Safeway argued that the statute does not apply to the policy in question since this policy is an “automobile policy,” and not a “motor vehicle policy.” Safeway contended that to be a “motor vehicle policy,” the policy must be certified in accordance with La. R.S.32:898, and there no proof of this. Therefore, the policy in question is an automobile policy and not a motor vehicle policy. The trial court agreed, granting Safeway’s motion and denying Ms. Kahl’s.

Louisiana, like most states, requires drivers to maintain liability insurance (or less commonly, a liability bond or certificate of self-insurance) to legally operate a motor vehicle. In 1992, an amendment to this law explicitly allowing insurance companies to offer “named driver” exclusions in their policies, which allowed an insured the option of paying a lower premium in exchange for insurance that provides no coverage while the specifically named driver operates a covered vehicle. The law was upheld by Louisiana courts, though it did create some disagreements in its interpretation, both among the appellate courts and between the Louisiana Supreme Court and the legislature. One of these disagreements concerned whether the owner of a vehicle could purchase liability insurance and then, through the named driver exclusion, exclude himself from coverage under the policy. Although the Louisiana Supreme Court determined that to allow such a maneuver would be violative of public policy, their interpretation was overruled by subsequent legislation explicitly allowing it.

In Bourg v. Southall, a motor vehicle accident occurred in Marrero, Louisiana where there was no question of fault: Plaintiffs were stopped at the intersection of LA-45 and Lapalco when they were hit from behind by an intoxicated driver. Although Plaintiffs were able to recover damages at trial, that ruling was overturned by the Louisiana Fifth Circuit Court of Appeal on the basis that the driver of the vehicle was listed in a named driver exclusion of the policy, despite the fact that he was both the owner of the vehicle and the named insured (he purchased the policy).

La. R.S. 32:900(L) clearly allows the owner of a vehicle to purchase liability insurance on a vehicle and to exclude himself from coverage under the policy. Sensebe v. Canal Indemnity Co., 58 So.3d 441, 451 (La. 2011). Furthermore, this provision does not set forth any specific requirements with respect to the form to exclude a named person from coverage; the only requirement is a written agreement. See Gilbert v. Reynoso, 917 So.2d 503, 505–06 (La. Ct. App. 2005).