Articles Posted in Accidents

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motorcyle_bicyle_old_fazl_0-scaledSometimes words that we think have clear meanings become less than clear when used in the law. For instance, if a state statute prohibits cars from driving on park grounds, we would naturally conclude that a regular passenger vehicle is forbidden from entering the park. However, what about a toy car? Would a toy car be banned as well? It would be ridiculous to think that the legislature intended to forbid toy cars and passenger vehicles from park property. In some cases, courts are called upon to apply statutes to situations that, based on the plain language of the law, are not entirely clear. On the other hand, in cases where the rule is clearly written, Louisiana courts favor a direct application of the law. 

William Foster, Jr. was riding his bicycle westbound on Pine Street in Ponchatoula, Louisiana, when he was struck by a Toyota Sequoia driven by Carol Kinchen. At the hospital, Foster was treated for the injuries he sustained in the collision. The hospital staff also did blood work and found that Foster had a blood alcohol content of 0.084% at the time of the accident. Foster filed a lawsuit seeking to recover for personal injuries against Kinchen, arguing that the accident was caused by Kinchen’s negligence.

Kinchen filed a motion for summary judgment, arguing that, according to Louisiana Revised Statutes 9:2798.4, she was free from liability because Foster was intoxicated when the accident occurred. The trial court dismissed the lawsuit, and Foster appealed to Louisiana’s First Circuit Court of Appeal. He argued that the trial court’s decision was improper because the statute relied upon by Kinchen concerned the operation of “motor vehicles” while under the influence of alcohol, yet, Foster was riding a bicycle at the time of the accident.  

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bike_abandonment_urban_exploration-scaledAnyone involved in a lawsuit knows that litigation can take months or even years to resolve. Though courts try to expedite the process, the parties involved are also responsible for moving the case forward expediently. If the plaintiff in a lawsuit files a complaint and fails to take further action for a certain amount of time, the defendant may file a motion to dismiss on the grounds of abandonment. The case below is an example of how the abandonment of a lawsuit by the plaintiff resulted in the dismissal of the action. 

Deborah Allen was an employee of the Louisiana Department of Social Services (“LADSS”). On February 2, 2007, she was riding as a passenger in a LADSS vehicle struck from behind by a car driven by Matthew Humphrey. Allen filed a lawsuit against Humprey and his automobile insurer, Imperial Fire and Casualty Insurance Company, seeking compensation for the injuries she received in the crash. Shortly after that, Louisiana’s Division of Administration, Office of Risk Management (“ORM”) filed a petition of intervention, seeking reimbursement from the defendants for workers’ compensation payments made to Allen. You can think of an intervenor as being a replacement or substitute plaintiff in an action who has a related claim against the defendants. 

Because Humphrey was underinsured, Allen filed a lawsuit against LADSS. However, LADSS claimed that it had no underinsured motorist coverage and that Allen was only entitled to workers’ compensation from LADSS. LADSS was successful in securing a dismissal of Allen’s lawsuit. In early 2013, Allen and LADSS settled Allen’s workers’ compensation claims. On February 8, 2013, Humphrey and Imperial Fire filed a motion to reduce the jury bond, which is money to procure a jury. In 2014, Humphrey and Imperial Fire sent a settlement letter to Allen, but neither Allen nor the ORM responded to the letter. In 2016, Humphrey and Imperial Fire filed a motion to dismiss Allen’s lawsuit on the grounds of abandonment. After the trial court granted the defendants’ motion, ORM appealed. 

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car_damage_auto_exterior-scaledCar accident cases often involve conflicting stories from each person involved, as no one generally wants to admit fault. When these cases get brought to court, the court must decide which party is telling the truth. The following case examines how a court determines the credibility of two individuals involved in a motor vehicle accident in Caddo Parish.  

Larry Fuller alleged that he sustained multiple injuries and property damage when Leman Bissell’s Chevy hit his Ford truck. Fuller contended that he exited the parking lot of the Country Market store on Hearne Avenue and pulled into the right-hand lane, where his truck unexpectedly stalled, leaving him stranded. Fuller also claimed that he gestured to other drivers who were able to swerve around him. However, Bissell’s vehicle pulled up quickly and ran into the driver’s door of Fuller’s truck. Fuller further alleged that the accident injured his lower back and caused radiating pain down one leg, forcing him to undergo two months of treatment with a neurologist and several sessions with a physical therapist. Bissell’s insurer, State Farm, asserted that Bissell did not have time to avoid hitting Fuller and was faced with a sudden emergency as Fuller’s vehicle lurched into traffic. The following case was on appeal from the Louisiana First Judicial District Court for the Parish of Caddo and was heard by the Louisiana Second Circuit Court of Appeal. 

At the first trial, the District Court found several inconsistencies in Fuller’s testimony, including the number of accidents he had been involved in before the accident with Bissell, his history of drawing disability, and the number of times his Ford engine had stalled. However, the District Court also found no inconsistencies in Bissell’s testimony. Therefore, the District Court rejected Fuller’s claims and granted State Farm’s motion for involuntary dismissal. Fuller subsequently appealed this decision to the Court of Appeal. 

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padlock_grating_insurance_security-scaledBefore purchasing motor vehicle insurance, it is vital to fully understand what the policies will cover. For instance, some policies may not cover your medical bills if you were involved in a single-vehicle accident. Understanding what is covered and what is not may help you avoid legal action in the future.

Randy and Brenda Mills, husband, and wife, purchased separate uninsured/underinsured motorist (“UM”) coverage from State Farm on three of their vehicles: a Kawasaki motorcycle, a GMC Envoy, and a Chevy pickup. The policies on each of the three vehicles also included liability coverage. However, the UM and liability insurance policies for the motorcycle were in Randy’s name only, while the UM and liability insurance policies for the other two vehicles included Randy’s and Brenda’s names. 

One morning, Randy was driving the motorcycle with Brenda as a passenger when he lost control, went off the road, and entered a ditch. Brenda alleged that she suffered severe injuries and was hospitalized for three days. She claimed that, as a result of these injuries, her medical bills exceed $42,545. She also claimed lost wages, loss of employment benefits, emotional damages, and loss of enjoyment of life. State Farm then paid Brenda the $50,000 policy limit owed under the liability policy purchased by Randy on the motorcycle. However, State Farm declined to pay her for any of the UM benefits under the three separate policies. 

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car_crash_wreck_accident-scaledAlthough car accidents are common, they are still stressful. When you suffer a medical injury from an accident, you must have evidence to prove your injuries. One way to do so in Louisiana is using the “Housley” causation presumption. The following case helps answer the question, what exactly is the “Housley” presumption?

Burleigh Ruiz was driving a car that backed out of a parking space and hit a car occupied by Eurie Marie. Ruiz and Marie disputed what had happened. Although Ruiz claimed he was going slowly, Marie estimated Ruiz was driving about twenty to thirty miles per hour at the time of the accident. Marie told Ruiz he was not hurt but may need medical treatment in two or three weeks because his health was not that good. Marie had an extensive medical history, including multiple surgeries, severe diabetes with complications, and back pain. He had been disabled for eight years and sought treatment for neck pain approximately five months before the car accident. 

Marie went to the emergency room at Terrebonne General Hospital three weeks after the car accident. He complained of pain from his neck to his knee and mentioned the automobile accident. He also went to a chiropractor and was examined by an orthopedic surgeon. After more conservative treatments failed, the doctor recommended surgery. 

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lose_decay_old_factory_0-scaledIt is always difficult when you lose a job. But it can be even more difficult if you feel you were unfairly fired. If you find yourself in this situation, consider what legal options are available. This is the situation Christine Simpson found herself in after being fired from her job as a production technician in Canton, Mississippi.

Before she was terminated, Simpson allegedly injured her ankle on the job and pursued a claim under Mississippi’s workers’ compensation laws. Her employee, Kelly Services Inc., claimed she was fired for not calling in and for missing work after her doctor released her to return to work. Simpson, however, claimed that her absences were all excused due to her injury. She claimed that the real reason Kelly fired her was disability discrimination. 

Approximately two weeks after being terminated, Simpson filed a Petition for Chapter 13 Bankruptcy in the United States Bankruptcy Court for the Southern District of Mississippi. As part of the bankruptcy proceeding, Simpson was required to submit a Statement of Financial Affairs. One of the questions on the form asked her to list all lawsuits to which she was a party within one year immediately before filing for bankruptcy. Simpson checked the box labeled “none” next to that question. 

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louisiana_arrows_art_students-scaledImagine going shopping at your local Wal-Mart or other store and slipping and falling because there is standing water. You might think you can recover from the store for your injuries. However, simply showing that you slipped and fell is not enough to win in court. Rather, you must present sufficient evidence about the store’s involvement and knowledge of the unsafe conditions. 

Bethany Dubroc entered a Walmart in Pineville, Louisiana, while it was raining. While reaching for a prescription in her wallet, Dubroc slipped and fell. After she fell, Dubroc noticed that there was water on the floor. Dubroc sued Wal-Mart in the District Court for the Western District of Louisiana. 

Walmart moved for summary judgment, arguing Dubroc’s case should be dismissed because Dubroc did not provide evidence that Walmart either created or had actual or constructive knowledge of the water that allegedly caused Dubroc to slip and fall. In response, Dubroc argued that employees at Walmart did not follow Walmart’s Inclement Weather Policy. This Inclement Weather Policy required that Wal-Mart employees every fifteen minutes and wipe down wet shopping carts every fifteen minutes. However, for the hour before the time Dubroc fell, no Wal-Mart associate mopped the area where she fell or wiped down the shopping carts. Dubroc presented evidence, including surveillance video, deposition testimony, and witness statements. However, none of this evidence provided insight into how long the water had been on the floor at Wal-Mart prior to Dubroc’s fall. 

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It is extremely important to review your home insurance policy to determine what types of damages the policy will actually cover, especially in areas prone to suffer from hurricane damages. Under Louisiana law, the insured individual is required to first prove that the insurance policy covers the cause of the claim. For example, if the policy only covers certain types of causes of damage, such as wind and hail, then the insured must prove that the damage was in fact caused by either wind or hail. Once the insured has done this, then the insurance company can argue that the incident is not covered by the policy. Therefore, it is extremely important that the insured take the time to determine the cause of the damage in order to prove that the policy covers their claim.

 

A case arising from Lake Charles, Louisiana illustrates this point. In this case, a homeowner suffered roof damage that they believed was caused by Hurricane Ike around September 13, 2008. Four shingles were missing and the insured claimed that this resulted in leakage in several rooms of the home. However, State Farm, the homeowner’s insurance company, determined that the leakage was not caused by Hurricane Ike and reclassified the claim as a “non-hurricane” claim.

 

State Farm, using several experts, determined that the leakage resulted from normal wear and tear on the roof, and therefore the homeowner’s insurance policy did not cover the leakage damage. Instead, State Farm concluded that only the four missing shingles were the result of wind and that they were the only damages that State Farm should reimburse to the insured; State Farm did not reimburse the insured for the damages caused by the leakage, but just the replacement value of the four damaged or missing shingles. The total damages that State Farm paid were under $500.00.

 

The insured had damages that were estimated at $9,385.00 by one expert and $204,717.78 by another expert. However, while these experts estimated what the cost of the leakage damage and repairing the roof would be, neither expert determined the actual cause of the damages. One of the insured’s experts thought that the wind had lifted the house’s flat roofing, which allowed water to enter the home. However, the expert could not explain why the nails on the flat roofing were still in place if the wind had lifted it. The State Farm expert, on the other hand, determined that the wind damage only included those four damaged or missing shingles and the leakage was actually caused by normal wear and tear. The State Farm expert concluded that there was “no evidence of roof damage that would be caused by severe weather . . . . The roofs, both asbestos shingle and built up roofs and all associated flashings are past their life cycle and are in need of replacement.”

 

The insured’s policy did not cover “poor workmanship; wear, tear, deterioration, or latent defect; settling, cracking, or expansion of walls, roofs, or ceilings; or leakage of water from air conditioning systems, household appliances, or plumbing.” Since the State Farm expert determined that the cause of the damage was from normal wear and tear, there was no way that the insured could satisfy the requirement to prove that the policy covered his claim. As such, the court granted State Farm summary judgment.

 

The court will grant summary judgment where one party cannot meet their required burden as a matter of law at trial. Summary judgment allows the court to avoid costly trials where there is one clear winner before the trial even begins. In this case, where the insured had no evidence that all of the damage he was claiming was caused by an occurrence included in the insurance policy, the court determined that summary judgment was appropriate. If the insured had employed experts that specifically testified as to the cause of the leakage damage, then the court may have allowed the case to proceed to trial. Further, the insured could have made a more diligent effort to report leakage as it occurred, which would help prevent the damage from spreading in the long run.

 

This case illustrates several very important points for the average homeowner. First, you should carefully read your policy so that you know what type of damage is covered. Second, if necessary, you may need to acquire experts that can explain what caused the damage to your home. Lastly, report damages immediately so that you can avoid costly repairs later on.  Continue reading

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Louisiana has a Direct Action Statute that allows injured third parties to sue an insurance company directly when the insurance company’s insured causes an injury. For example, if you are involved an automobile accident where you are not at fault, you can sue the at-fault driver’s insurance company directly instead of suing the at-fault driver themselves. The Direct Action Statute is beneficial because it gives injured third parties access to the entity that will actually pay compensation for the injuries. It can be especially helpful where the insured fails to file a claim with their insurance company themselves. However, the injured third-party’s ability to sue the insurance company directly is limited by the insurance contract between the insurance company and the insured.

Despite the fact that the insurance contract is between the insurance company and the insured, an injured third party must still comply with most of the terms of the contract. This overarching rule applies specifically to whether the policy covers the insured and whether the policy covers a particular event. The insurance company will ask: Did this person have coverage when this accident happened? and Does this policy cover this type of event? For example, in insurance contracts limited to specific times, the insurance company will not cover a claim that occurred outside the time frame of the contract, regardless of who brings the claim. In a related example, automobile coverage that is limited to only certain vehicles will cover only those vehicles, regardless of who brings the claim. That is, the injured third party can have no greater rights than the insured would have had if he or she brought the complain themselves.

In a United States Fifth Circuit Court of Appeals case, the court determined that specific requirements of the contract also extend to injured third parties. That case involved a “claims-made-and-reported” policy. That type of policy not only requires that a claim arise within the policy period, but also that the insured (or another party under the Direct Action Statute) had to have reported the claim within the policy period. This type of notice requirement helps insurance companies avoid claims that are reported years after they happen; instead, this policy requires notice within a certain amount of time.

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When you signed up for automobile insurance, you might have noticed that many states now require automobile insurance agencies to include some sort of uninsured motorist (“UM”) clause in your insurance agreement. Oftentimes, the only way to get out of including this in your coverage, and therefore having to pay a higher premium, is by explicitly rejecting this additional coverage. How exactly do you reject this additional coverage, though? While this might seem like an easy question, most states, including the state of Louisiana, require very specific requirements to be met in order for rejection of UM coverage to be proper.

In the State of Louisiana, that is exactly the case: In order to get out of paying a higher premium for this uninsured motorist coverage, the insured has to explicitly reject that coverage. And the state of Louisiana has many rules with regard to how to properly complete this task.

In order for an uninsured motorist rejection to be considered proper, Louisiana courts have found six tasks that must be completed by the insured. In Duncan v. U.S.A.A Ins. Co., 06-0363 (La. 11/29/06), 950 So. 2d 544, the court outlines these six tasks as follows:

1) initialing the selection or rejection of coverage chosen;
2) if limits lower than the policy limits are chosen (available in options 2 and 4), then filling in the amount of coverage selected for each person and each accident;
3) printing the name of the named insured or legal representative;
4) signing the name of the named insured or legal representative;
5) filling in the policy number; and
6) filling in the date.

While the Court in Duncan did not explicitly deal with the timing of these tasks, a couple years later, the Court in Gray v. American National Propery & Cas. Co., 07-1670 (La. 2/26/08), 977 So. 2d 839, discussed the requisite timing in which the above tasks need to be completed. According to the Court in Gray, all six of these tasks have to be completed before the UM selection form is signed by the insured. The Court also went on to say that the completion of these tasks has to be done in a manner showing that the insured’s signature signifies that he or she agrees with all of the information that is contained in the insurance form. While the Court said that the tasks have to be completed before the UM selection form is signed by the insured, that was not the most important part of the Court’s findings. Rather, the most important part of the Court’s holding was that the insured’s signature needs to signify agreement with all that is contained in the form.

In the recent case decided by the Louisiana Supreme Court, Edward Morrison v. U.S.A.A Casualty Ins. Co., No. 2012-CC-2334, the Court really focused on the fact that the most important part of the timing of the UM selection form is that the insured’s signature is affirming agreement to all the clauses contained therein. This case primarily deals with task #1 listed above which requires that an individual properly initial the selection or rejection of coverage chosen in order for UM rejection to be considered proper.

In this case, the insured’s representative clearly meant to reject UM coverage but accidentally did not initial the line that stated such in the agreement form. When the insurer received the form, he or she noticed that the form was incomplete and sent it back to the insured’s representative. At that time, the representative initialed the proper line rejecting UM coverage and returned the form to the insurer. This clearly showed that the insured agreed with all of the clauses and various information contained in the form. Furthermore, all of this was completed before the relevant accident, so the court held the UM rejection valid.

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