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source_grass_lawn_water-1024x683The Collateral Source Rule in Louisiana law prevents a tortfeasor (a person who harmed another) from benefiting from the victim’s receipt of funds from an independent source.  So what does that mean?

Let’s say you were injured in a car wreck. As a result of your injuries, you have back surgery before the lawsuit settles. If you have health insurance, that surgery may be paid for by your health insurer. However, your health insurance company pays only part of the bill; they pay some agreed-upon amount with the medical provider. The collateral source rule allows the injured person to argue for the amount paid for the surgery plus 40% of the difference of the billed amount. An example is shown below:

  1. Joe is injured in a car wreck, has health insurance, and undergoes a $100,000 back surgery by ABC Back Drs.
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courthouse_court_law_justice-1024x683Lawsuits and appeals can bring up complicated legal issues such as jurisdiction. Jurisdiction is a legal principle that determines the extent and authority of a court to hear and decide cases. There are two primary types of jurisdiction: personal jurisdiction and subject matter jurisdiction.

The first type, personal jurisdiction, is a court’s power to have jurisdiction over the person or parties in the lawsuit. For example, a court in Ohio would most likely have jurisdiction over a resident of Ohio because that person lives and resides there. However, a Florida court would be less likely to have personal jurisdiction over that same Ohio resident unless some exceptions or circumstances occurred.

The other type of jurisdiction is called subject matter jurisdiction, which is a court’s power to have jurisdiction over the subject matter of a lawsuit. The Louisiana Fourth Circuit in Joseph stated that regardless of whether the parties address or challenge subject matter jurisdiction, courts have a duty to determine whether this type of jurisdiction exists before hearing a case. To do this, appellate courts, therefore, must first determine whether the ruling from the trial court that the appellant, the person appealing the decision of the lower court to the higher court, is an appealable judgment.

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headlights_roads_night_highways-1024x683Insurance claims can be complex, even for the courts. Lawsuits involving multiple plaintiffs and defendants are just as complicated. Claims, cross-claims, and counterclaims can arise from a single accident. Questions can arise during litigation, such as; can you appeal a partial summary judgment in Louisiana? A recent motorcycle accident in Arnaudville, Louisiana, demonstrates how convoluted insurance claims can become, as shown in the court’s opinion below. 

 The Colomb Foundation, Inc. (“Colomb”) was a property owner with a building erected along Louisiana Highway 93. As Erik Moran (hereafter “Moran”) drove by Colomb’s property at night, a flood light came on that Moran mistook for the headlight of an oncoming car. Moran alleged he was blinded by the light, which caused him to wreck his motorcycle into a gate located on Colomb’s property. 

After the accident, Moran filed a lawsuit against Colomb and its alleged liability insurer, United Specialty Insurance Company (“USI”). Shortly after, USI contacted Colomb to explain that they would not cover Moran’s claims under their insurance because Colomb’s insurance policy had been canceled six months earlier. The cancellation occurred due to a failure to pay the insurance premium. Colomb challenged this cancellation by filing a cross-claim against USI. Then, to make matters even more complicated, Colomb filed third-party demands against four additional parties, including Standard Lines Brokerage, Inc. (“SLB”), which is the entity in charge of the collection and cancelation of insurance policies for USI. 

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court_hammer_auction_law-1-1024x768Most consumers in the U.S. are aware of increasingly high medical costs. For most people, those high costs are not directly paid; instead, they appear on a bill along with what one’s insurance company will pay as part of an agreement with the medical provider. Many insured consumers will look for “in-plan” medical providers to ensure that most costs are covered. Those “in-plan” providers are part of a preferred provider organization (PPO), which is a subscription-based medical arrangement that allows a substantial discount on rates to be charged. 

PPOs are organized by separate companies that generate revenue by charging an access fee. This type of PPO arrangement sets the backdrop for Best Comp, a recent case by the Louisiana Court of Appeals where plaintiffs sought class certification and defendants, the PPO, challenged it. The central evidence that plaintiffs presented for class certification was a data disc containing a Microsoft Excel spreadsheet showing the recommended discounts for each provider.  

The plaintiffs were Opelousas-based healthcare entities representing healthcare providers who treated employees under the Louisiana Workers’ Compensation Act. The providers subscribed to PPO agreements with defendant Bestcomp, Inc., and alleged that Bestcomp discounted their billing without the notice required by statute La.R.S. 40:2203.1. 

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tax_forms_income_business-1024x683If you’re in a car wreck, you expect, or hope, to be covered for UM Bodily injury (UMBI) up to certain policy limits. However, when signing up for insurance, you must carefully review the coverages. The law in Louisiana has strict requirements when it comes to selecting or rejecting Uninsured motorist coverage. If you aren’t careful, you may unknowingly reject or limit the coverage you thought you had. New Orleans citizen Zachary Addison learned this lesson the hard way after being involved in a car incident in 2013. 

After his car accident, Mr. Addison filed a lawsuit against the other party involved and his insurance company LM General Insurance. Mr. Addison sued his insurance company to ensure they would provide adequate coverage for his injuries. In a motion for summary judgment, LM General Insurance argued to the trial court that Addison was not covered for uninsured/underinsured motorist coverage and bodily injury coverage and that he only selected UMBI coverage for his economic damages. LM General filed the motion based on the fact that Mr. Addison electronically selected economic-only UMBI coverage. 

When obtaining insurance, Addison received a quote via telephone and was given the option to send documents by mail, fax, or electronically. He chose to submit the documents electronically; the electronic documents had selections of coverage pre-made based on the quote he received. The pre-selected information could not be changed. Mr. Addison electronically signed the documents. 

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chalmette1972stbernardhwy-1024x664Car accidents are common and complicated. Wrecks can involve company cars, ride shares, and large commercial vehicles, all with different types of insurance. Impacts can occur while driving on a work errand. All these different types of accidents invoke numerous insurance questions. Questions such as; If you are out driving on a work errand, will your business’s uninsured motorist insurance provide coverage? The Louisiana Court of Appeals grappled with these issues in a recent appeal. 

Dr. Kenneth Allan, a Chalmette based veterinarian, is the sole member of Chalmette Pet Wellness Clinic and Hospital. Dr. Allan was transporting a dog to his clinic when he was rear-ended. Dr. Allan was driving a vehicle in his wife’s name and sustained injuries from the car accident. Dr. Allan sued his uninsured motorist insurance carrier, Bankers, which provided coverage for his work vehicle to recover compensation for his injuries. 

Bankers balked at paying his claim. Bankers and Dr. Allan asked the court to settle the coverage issue by filing summary judgment motions. They asked the court to determine if the Bankers policy provided uninsured/underinsured motorist insurance coverage for vehicles not owned by the pet clinic. The trial court ruled in favor of Dr. Allan, stating that Bankers should cover his claim. An appeal of the decision followed.

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workers_construction_worker_work-1024x576It can be a long road to recovery from a work-related injury. If you or a loved one suffered an injury on the job, it is crucial to understand the workers’ compensation system to comply with all the requirements to receive any compensation to which you are entitled. 

Carl Gabriel worked as a “Ready Reserve” employee at Delta. Less than two months after he started working, he was injured when a tow bar fell onto his foot. After a dispute with his employer over indemnity payments, Gabriel filed a Disputed Claim for Compensation, Form 1008, with the Office of Workers’ Compensation (“OWC”). He asserted that Delta failed to pay indemnity benefits and timely pay and authorize medical benefits. There was a trial where Gabriel won, with the court finding that Gabriel was entitled to benefits from Delta. 

Gabriel then filed a second Disputed Claim for Compensation, alleging that Delta had failed to pay the amounts owed to him under the prior judgment. He also sought penalties under La. R.S. 23:1201(F) and (G) for Delta’s failure to pay correctly. He also alleged that he was temporarily totally disabled again because of a worsening of his medical condition. Gabriel went to two physicians in Atlanta, Georgia, to deal with his worsening condition. Delta argued that neither Gabriel nor his physicians ever properly requested approval for the recommended treatment through Form 1010, submitted to Gabriel’s adjuster. Instead, Gabriel sought approval informally via fax. 

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court_civil_ceremony_legal-1024x683Default judgments usually occur when one side fails to Answer a lawsuit after being served. You must collect and produce sufficient evidence to establish your claims to succeed with a default judgment. This is the same as if you were going to trial. Evidence is the key to all lawsuits; lawsuits live and die by what can and cannot be proven in court. Therefore, the party pursuing a default judgment must present competent evidence proving their claims following the standards for default judgment in Louisiana, as demonstrated by the case below.

Willie Evans was injured in a trip and fall accident while working for ADM Grain Elevator (“ADM”). As a result of the injury, ADM sent Evans to Dr. Jolly for treatment and pain management. Dr. Jolly alleged that Evans failed a drug test and tested positive for cocaine in his urine. Evans claimed that for the first drug test, there was no paperwork evidence of ordering a drug test that Evans had signed. For the second drug test, Evans alleged that Dr. Jolly sent falsified results of the test showing cocaine to ADM. This resulted in Evans being terminated from ADM.   

Evans sued Dr. Jolly for defamation, alleging that Dr. Jolly was liable to Evans for slander and defamation of his character for damaging his reputation and character and causing him to lose his job. When Dr. Jolly failed to file an answer to the lawsuit after he was served in the time required by law, Evans filed a motion for preliminary default. The trial court granted the motion for preliminary default. At the default confirmation hearing, the trial court ruled in favor of Evans for his defamation claims and against Dr. Jolly for mental anguish, pain, and suffering in the amount of $20,000, along with court costs and legal interests. 

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sparks_working_industry_metal-1024x711What happens if you are hurt on the job? Not only do you have to deal with the physical effects of your injury, but you also have to navigate when it is safe to return to work. The workers’ compensation system is designed to aid injured workers. It can provide compensation for lost wages and medical treatment. However, it can often be complex to navigate. 

This is the situation Eduardo Sanchez, an ironworker at MEMCO Inc., found himself in after he slipped from a metal beam while working. His safety harness caught him. Once safely on the ground, medical personnel at the worksite examined him, and he was sent home to rest. The next day, Sanchez reported to work and complained of a headache and pain in his back, neck, and testicle. He was sent home. Sanchez’s supervisor at MEMCO sent him to see a doctor. The doctor diagnosed Sanchez with a cervical and lumbar strain and released him to return to work “as tolerated.”

Two days later, Sanchez went to the emergency room complaining of chest, testicular, and lumbar pain. The emergency room doctor diagnosed him with lumbosacral strain, chest wall contusion, and a scrotal contusion. Sanchez returned to the doctor who first examined him. He released Sanchez to return to work on restricted duty “as tolerated.” About ten days later, Sanchez returned to the doctor, who discharged him to return to work “full duty.” 

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police_baltimore_police_officer-1024x648Despite stringent rules and regulations designed to keep unlicensed drivers off the road, minors often find their way behind the wheel. Police in Gonzales, Louisiana, were forced to reckon with the seriousness of such a driver when a high-speed police chase on Interstate 10 turned deadly in May of 2004. The outcome of this chase became the subject of a lawsuit left unsettled until 2017—a case which pondered: to what standard should police be held when engaged in an active car chase?

Just before eight o’clock in the evening, a Gonzales city police officer noticed an Oldsmobile without its headlights activated. The car, failing to stop or slow down, was pursued onto Interstate 10 by Louisiana State Police. The chase continued for nearly twenty minutes despite attempts to stop the vehicle with a spike strip. Then, the Oldsmobile’s fourteen-year-old driver lost control of the car and spun into a vehicle traveling in the opposite direction, driven by the Bristols. The Oldsmobile driver died on impact, while all seven passengers in the other car were severely injured, prompting a lawsuit against the Louisiana State Police. At trial, a jury found no liability for the Bristols’ injuries on the part of the department, and an appeal followed.

The Louisiana Highway Regulatory Act is excepted by La R.S. 32:24—which provides, under certain circumstances, statutory immunity to drivers of emergency vehicles. As such, police officers are allowed to exceed maximum speed limits and disregard other road rules so long as they maintain regard for the safety of others and have their audible or visual signals activated. However, this exception is not absolute: juries are allowed to determine, based on the circumstances and after being instructed on the law, whether a standard of ordinary negligence or a heightened reckless disregard standard should gauge the standard of care for an emergency vehicle driver. Lenard v. Dilley, 784 So.2d 706 (La. Ct. App. 2001).

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