General Insurance Dispute Information

Subrogation Rights Upheld: Insurer’s Claim Prevails Despite Settlement

Published on: September 26, 2024 | By Berniard Law Firm

pexels-kindelmedia-7688374-1-scaled In the realm of insurance claims and legal disputes, the concept of subrogation often plays a crucial role. Subrogation allows an insurer, after paying a claim to its insured, to step into the insured’s shoes and seek reimbursement from the party responsible for the loss. But what happens when the insured settles their claim directly with the at-fault party? Does the insurer lose its right to subrogation? A recent Louisiana Court of Appeals case, Louisiana Farm Bureau Casualty Insurance Company v. David Scott Burkett, et al., sheds light on this issue.

The Accident and the Claim:

The case stemmed from a car accident where Katherine Burkett, insured by Shelter Mutual Insurance Company, collided with Jessica Hall, insured by Louisiana Farm Bureau Casualty Insurance Company. Farm Bureau paid Hall $5,000 for medical expenses under her policy and became subrogated to her claim for that amount.

Louisiana Court Upholds Insurer’s Position in Uninsured Motorist Claim Dispute

Published on: September 14, 2024 | By Berniard Law Firm

pexels-kindelmedia-7688374-scaled In a recent ruling, the Louisiana Court of Appeal, Third Circuit, affirmed a trial court’s decision denying Amanda Bertrand’s claim for penalties and attorney fees against her underinsured/uninsured motorist (UM) insurer, Progressive Security Insurance Company. The case stemmed from a dispute over the timeliness of Progressive’s payment following Ms. Bertrand’s demand for the limits of her UM coverage.

Ms. Bertrand was injured in a car accident in 2012. The at-fault driver’s insurance company, Farm Bureau, tendered its policy limits of $15,000 in early 2013. Subsequently, Ms. Bertrand notified Progressive, her UM insurer, of the accident and demanded payment of her $15,000 UM policy limits.

Progressive received Ms. Bertrand’s demand letter but requested an additional medical record from her treating physician. Upon receiving this record, Progressive promptly issued payment. However, due to a communication issue, Ms. Bertrand’s attorney indicated that the payment had not been received, leading Progressive to stop the initial payment and reissue it.

Unexpected Acceleration or Failure to Yield? Louisiana Court Reverses Summary Judgment in Car Accident Case

Published on: September 7, 2024 | By Berniard Law Firm

girl-with-red-hat-oaKGY3tYVvw-unsplash-scaled In personal injury law, car accidents at intersections are all too common. However, the case of Trapp v. Allstate Property and Casualty Insurance Company brings a unique twist: the claim of a sudden, unexpected vehicle malfunction. This Louisiana Court of Appeal decision underscores the importance of thoroughly investigating all aspects of an accident before assigning fault, especially when a vehicle defect may have contributed.

The case arose from an accident at an intersection in Louisiana. Mr. Trapp was entering the highway from a gas station parking lot when his truck collided with Mr. Martin’s truck. While Mr. Trapp was cited for failure to yield, Mr. Martin claimed his truck suddenly accelerated out of control, preventing him from avoiding the collision.

The trial court initially granted summary judgment, finding Mr. Martin 100% at fault. However, the Court of Appeal reversed this decision, stating that genuine issues of material fact existed regarding comparative fault and the potential for a third party (the vehicle manufacturer) to be at fault.

When Does an Insurance Contract End? Louisiana Court Reverses Summary Judgment in Dispute Over Coverage Extension

Published on: August 30, 2024 | By Berniard Law Firm

pexels-albinberlin-906982-scaled In the complex world of insurance coverage disputes, a recent Louisiana Court of Appeal decision underscores the importance of thoroughly examining factual issues before granting summary judgment. The case involved a personal injury lawsuit and a subsequent dispute over insurance coverage. The appellate court’s ruling is a stark reminder that seemingly straightforward cases can hinge on nuanced contractual interpretations and disputed facts.

The case originated from a 1998 accident where Bobbie Sanders, an employee of Mark A. Robicheaux, Inc., was injured while working on a vessel constructed by Swiftships, Inc. Sanders sued Swiftships, which, in turn, filed a third-party demand against its insurer, United Fire & Casualty Company, claiming coverage under a policy issued to Robicheaux.

The crux of the dispute was whether Swiftships qualified as an additional insured under Robicheaux’s policy, even though the initial contract between the two companies had expired. Swiftships argued that the business relationship continued under the original contract’s terms, while United Fire contended there was no agreement to extend the contract.

How Is Coverage Divided When Multiple Insurance Policies Are Involved?

Published on: October 29, 2023 | By Berniard Law Firm

coins_currency_investment_insurance_0-scaled If you are involved in an automobile accident, it can be difficult to navigate insurance claims and coverage. The situation becomes even more complicated when there are multiple insurance policies involved. How is coverage allocated between multiple relevant insurance policies?

Sonya Theriot was unfortunately in an automobile accident in Lafayette, Louisiana. The other driver involved in the accident, Todd Sparks, was working for Thermal Technologies at the time of the accident. He was driving a rental car Thermal Technologies had paid for when he rear-ended Theriot while she was making a right-hand turn.

Thermal Technologies had a business automobile insurance policy with State Farm, a commercial general liability policy, and an umbrella insurance policy with Owners Insurance. Sparks had a personal automobile insurance policy with Travels Home Insurance Company. Theriot filed a lawsuit against State Farm, Sparks, and Thermal Technologies. She later added Travelers and Owners to the lawsuit.

Insurance Coverage Turns On Distinction Between Flood Damage And Mechanical Issue

Published on: September 6, 2023 | By Berniard Law Firm

dsc05934_0-scaled Dealing with the aftermath of a flood is never fun. This is especially true when the flood damages one of your vehicles. This is the situation Michael Jacobs found himself in after one of his cars was damaged in a flood. After a long fight with his insurance company, he eventually prevailed and was awarded damages.

Jacobs owned multiple vehicles that GEICO insured. His parish in North Louisiana was affected by heavy flooding. When the flooding started, Jacobs and his brother tried to move the vehicles from his house to higher ground but were unable to remove them before the floodwaters rose, so they could not drive up to the house. Jacobs waded through the floodwater to retrieve one of the vehicles, a 2001 Honda Accord. In the days following the flood, the Honda kept overheating. Jacobs claimed this had only occurred after the flood.

Jacobs submitted a claim to GEICO for the damage to the vehicle. The insurance inspector did not identify any flood-related problems and determined the upper radiator hose had blown out. Another mechanic gave Jacobs an opinion and concluded there were issues with his spark plugs. GEICO ultimately denied Jacobs’ claim because it had suffered a mechanical failure that was not flood-related. Jacobs filed a lawsuit against GEICO, alleging his Honda had been damaged from the flooding. At trial, the court ruled the Honda had suffered water damage and awarded vehicle property damages and attorney fees. GEICO filed an appeal.

Management Company Not Qualified As Additional Insured In Cleaning Company’s Insurance Policy

Published on: September 1, 2023 | By Berniard Law Firm

ladder_art_red_garden-scaled It can be challenging to interpret insurance policies, especially when they involve complex provisions such as coverage for an additional insured. Before signing an insurance policy, it is imperative to understand its language and what it does and does not cover. Here, the plain language of the insurance policy proved instrumental in the appellate court’s ruling.

Pamela Sloane was injured while working for Integrity Cleaning Services (“Integrity”) at Forestwood Apartments. She was cleaning a ceiling fan while standing on a ladder. She inadvertently touched an exposed wire, which electrocuted her, and she fell from the ladder. Sloane filed a lawsuit against CLK Multifamily Management (“CLK”) and others. Sloane claimed CLK had not adequately maintained the premises or warned of the dangerous condition of the exposed wire. CLK filed its answer to the lawsuit, denying the allegations, and added Travelers Indemnity (“Travelers”) to the lawsuit. CLK claimed Integrity was contractually required to have a general liability insurance policy that covered CLK as additional insureds.

Travelers filed a summary judgment motion, claiming CLK was not an additional insured under the policy. Travelers attached a copy of the relevant insurance policy to its summary judgment motion. CLK disagreed and claimed it was indeed an additional insured. The trial court concluded CLK was not qualified as an additional insured and granted Travelers’ summary judgment motion.

Who’s At Fault if your car is stolen then involved in a wreck? The Thief, Victim, or Third Party Owner? (One Judges Dissenting Opinion)

Published on: August 28, 2023 | By Berniard Law Firm

car_burglary_thief_burglar-scaled In the legal system, dissenting opinions, i.e., opinions delivered by one or more judges who disagree with the decision, play a crucial role in shaping the interpretation and application of the law. They provide valuable insights into alternative viewpoints, often sparking discussion and debate and ultimately leading to the evolution of jurisprudence. One such notable dissenting opinion can be found in the case of Christopher Blanchard v. Demetrius J. Hicks et al., authored by Justice Cooks. In this blog post, we look at the case, the arguments made in the dissent, and the importance of dissent in the legal landscape.

The case of Christopher Blanchard v. Demetrius J. Hicks et al. arose from an incident in which Officer Blanchard’s patrol car was struck by a stolen truck. The plaintiff, Officer Blanchard, alleged that the defendant, Demetrius J. Hicks, was negligent in leaving his vehicle unattended with the keys in the ignition and the engine running, thereby facilitating the theft that led to the accident.

The majority of the court relied on the precedent set by the Supreme Court’s decision in Racine, which held that leaving keys in a vehicle does not create liability for the motorist if a thief steals the car and causes injury to a third party. However, Judge Cooks dissented from the majority’s opinion, arguing that Racine does not dispose of the factual matter at hand.

A Life-Altering Car Accident Ignites a Legal Feud

Published on: August 21, 2023 | By Berniard Law Firm

war_worlds_movie_car-scaled Imagine, for a moment, living a life of normalcy, the humdrum of day-to-day routines, a steady job, a peaceful existence. Suddenly, an unexpected accident shakes your world, thrusting you into the tumultuous tides of legal proceedings. This is the daunting reality Patricia and Calvin Henderson found themselves in, initiating a monumental case against Amy Lashouto and her insurer, State Farm Mutual Automobile Insurance Company (State Farm).

In a startling sequence of events, Patricia and Calvin Henderson found themselves in a legal confrontation against Lashouto. The case revolves around Patricia’s car accident, where a motor vehicle driven by Lashouto rear-ended her. Following the accident, the Hendersons filed a lawsuit against Lashouto, her insurer, and State Farm, contending that they were insured under a policy that could compensate them for their losses. State Farm, however, countered this claim, maintaining that the policy did not provide uninsured/underinsured motorist (UM) coverage for the accident.

After Lashouto and her insurer settled their case with the Hendersons, the couple found themselves embroiled in a legal dispute with State Farm. The latter moved for summary judgment, arguing that Calvin Henderson had validly rejected UM coverage on the policy. Despite the Hendersons’ absence from the hearing, the trial court sided with State Farm, dismissing the UM coverage claims.

How do Conditions on Payments in Louisiana Workers’ Compensation Work?

Published on: August 20, 2023 | By Berniard Law Firm

supreme_court_building_washington_3_5-scaled Louisiana’s Workers’ Compensation fund exists to pay employees injured at work. Payment can be used for medical care and lost wages. When parties sign a settlement agreement on payment terms, an employee may assume payment is imminent. In a recent case from Rapides Parish, an employee discovered some conditions in a settlement may delay payment.

Mary Ortega sustained an injury while employed by Cantu Services. Ortega filed a Disputed Claim for Compensation, and the parties entered a settlement agreement. The parties settled for $120,000. $56,049 of the total was allocated to a Medicare set-aside agreement (MSA) to cover future medical expenses related to the work injury. The MSA was filed with the Centers for Medicare and Medicaid Services (CMS) for approval. The parties agreed that if CMS did not approve the full amount in the MSA, the employer would adjust the amount paid in monetary benefits, so Ortega would still receive $120,000. Several months after signing the agreement, Ortega had not received any payments. She filed a motion to enforce the settlement agreement plus a request for fees and penalties before the Office of Workers’ Compensation.

The Workers’ Compensation Judge (WCJ) denied Ortega’s request because payment under the settlement agreement was conditioned on first getting approval from the MSA. Pending approval suspended the statutory requirement of payment within thirty days. Ortega appealed to the Louisiana Third Circuit Court of Appeal.