Articles Posted in Insurance Dispute

valves_sprinkler_water_pipe-scaledMardi Gras, a time of joyous celebration, took an unexpected turn for a store near a French Quarter hotel when a sprinkler head malfunctioned, resulting in significant water damage. Despite the storeowner’s insurance covering the damages, a lawsuit ensued to determine the hotel’s liability for the losses incurred. This case highlights the complexities of determining responsibility and legal remedies in property damage cases, emphasizing the importance of seeking legal counsel to navigate such situations effectively.

Hotel Management of New Orleans (“HMNO”) owned and operated the French Market Inn. A sprinkler head located in the hotel was triggered during Mardi Gras, which caused a water leak and flooding in the store two floors below. The storeowner claimed water leaked into its store for approximately two hours. During that time, HMNO did not try to turn off the sprinkler but instead waited for the fire department to turn off the sprinkler. This caused damage to the store.

State Farm insured the storeowner and paid the storeowner approximately $41k under its policy. State Farm then filed a lawsuit against HMNO and its insurer, Companion Property, and Casualty Insurance Company, seeking repayment of the $41k it paid to the storeowner under its policy. The trial court found in favor of State Farm and ordered HMNO and Companion to pay the stipulated damages of $41k. HMNO and Companion appealed, arguing that the trial court erred in finding that HMNO knew or should have known the sprinkler was defective, HMNO employees were negligent, and denying HMNO’s motion for involuntary dismissal. 

news_stock_newspaper_glasses-scaledInsurance claims can be tricky, especially when multiple parties and contracts are involved. What happens, for example, when one insurance company claims they are not responsible for payment after a catastrophic event resulting in lost lives? The following Terrebonne Parish case follows this exact scenario. 

 An explosion at the Transco facility in Gibson, Louisiana, resulted in the death of four individuals, including two employees of Danos and Curole Marine Contractors, LLC (hereinafter referred to as  “Danos”) and two employees of Furmanite America, Inc. (hereinafter referred to as “Furmanite”). The Danos employees were working under a request-for-service order issued by Transco under a General Service Agreement, and the Furmanite employees were working as a subcontractor to Danos under a request-for-service order under a Master Service Contract. Following the explosion, many lawsuits, including this one, were filed against Transco, Danos, and Furmanite.

Transco then filed a third-party demand against The Gray Insurance Company (hereinafter referred to as “Gray”), maintaining that Gray must defend and indemnify Transco under a provision in an insurance contract issued to Danos for which Transco was named additionally insured under the General Service Agreement. Gray then filed multiple objections to Transco’s claim based on prematurity. The 32nd Judicial District Court for the Parish of Terrebonne then dismissed Transco’s claims. An appeal to the Louisiana First Circuit Court of Appeal by Transco followed.

wheelchair_pattern_black_background_23-scaledMost adults fear the day that they will need to rely on the care of another to function. Unfortunately, the rampant negligence and mistreatment only exasperate this fear throughout the nursing home and hospice industry. Small mistakes by caregivers are normal and almost expected, yet, Shirley Marzell faced severe injuries after her caregivers improperly secured her to a wheelchair lift.

Marzell was a resident at Charlyn Rehabilitation Center in Tallulah, Louisiana, at the time of her accident. In 2010, Marzell was loaded onto a wheelchair lift for the lift van operated by Charlyn. During this process, Marzell and her wheelchair rolled off the platform. This mistake caused Marzell to strike her head on the pavement, causing severe injuries. This case reached the Second Circuit Court of Appeals after Marzell and her daughters appealed the summary judgment ruling of the trial court. 

During the trial, the Marzells argued that Charlyn’s insurance carrier should pay for Shirley’s injuries. The insurance policy held by Charlyn, however, included an automobile exclusion. This provision shielded the insurance company from liability whenever Charlyn owned or operated an automobile. Operation was defined to include “loading and unloading”. The summary judgment ruling made by the trial court hinged on whether or not “loading or unloading” encompassed the loading of human cargo. The trial court held that it did, dismissing the case in favor of Charlyn and their insurance company.

accident_car_accident_car-scaledComplex insurance issues can add more hassle to the damage from a car accident. What happens if you’re in an automobile accident after failing to pay your insurance premium? Can you still get coverage for your claims? The following case out of Baton Rouge shows why insurance companies must follow proper procedure and offer evidence of cancellation or suffer consequences.

On July 27, 2010, Beverly Smith and Darlene Shelmire were involved in a vehicle collision in Baton Rouge when Shelmire entered an intersection without yielding. Smith sustained injuries due to the accident and filed a claim against Shelmire and her insurer, Gramercy Insurance Company. The insurance company asked the court for summary judgment, claiming that Shelmire did not have insurance coverage at the time of the accident due to the cancellation of her policy for nonpayment. The court held a hearing on the motion and denied it.

The legal entity representing Gramercy Insurance Company, GoAuto, filed a new motion for summary judgment, asserting the same claim that Shelmire’s policy had been canceled before the accident. The trial court again denied this motion. In a bench trial, GoAuto filed a motion for involuntary dismissal, which the court denied. During the trial, the court heard evidence that Shelmire had paid her insurance premium on the afternoon of the accident and reported the accident a few hours later. GoAuto paid Shelmire for the damage to her vehicle the next day, despite their claim at trial that her insurance policy had been canceled by that point. Therefore, the trial ordered GoAuto to pay $15,000 in damages to Smith. GoAuto appealed this judgment. 

medical_consultation_treatment_room-scaledCourts often rely on motions for summary judgments to avoid the costly and time-consuming reality of going to trial and presenting a case in front of a jury. Motions for summary judgment are when one party asks the court to decide the case based on the current facts alleged in their favor. Courts should grant these motions when there are no facts in dispute for the jury to resolve. But how much evidence does a party have to present to survive one of these motions? A case out of New Orleans shows that, in some cases, just having medical records could be enough to deny a motion for summary judgment. 

Emmanuel Bridgewater was lounging on a median at the intersection of Washington Avenue and South Dorgenois Street when a Regional Transit Authority (RTA) bus made a left-hand turn off of Toledano street and an immediate right turn onto Washington Avenue. The bus cut the corner too closely and drove onto the median, hitting Bridgewater. As a result of the accident, Bridgewater’s right arm broke, his right leg was injured, and he said that the accident left him permanently disabled. Bridgewater alleged that the bus did not stop after he was hit and instead fled the scene. A bystander who did not witness the accident heard Bridgewater calling for help and called 911 emergency services. An ambulance and New Orleans Police Officer Roger Smith arrived at the scene. Bridgewater alleged that Smith did not question him about the accident before he was taken to the hospital.

Bridgewater filed a lawsuit against the RTA and the City of New Orleans and added the Transit Management of Southeast Louisiana, Inc. (TMSL) as a defendant. Bridgewater accused the defendants of being jointly liable for his injuries and argued that the NOPD officer assigned to the RTA acted to protect the RTA from liability. Bridgewater also asserted that the City was at fault because it failed to place signs in the accident area to warn pedestrians that buses may run onto the median and hit them. The City filed for summary judgment, and the court granted the City’s motion. Next, Bridgewater filed a motion for rehearing, contesting the court’s decision. Then, RTA also filed a motion for summary judgment, and the judge denied Bridgewater’s rehearing and granted RTA’s motion. Bridgewater eventually appealed, and RTA responded, seeking attorney fees and costs against Bridgewater for filing a frivolous claim, which means that the lawsuit lacked any basis. 

bridge_mississippi_river_baton-scaledNothing is more tragic than the loss of life. However, that loss can be tempered somewhat if insurance is in place that provides some financial compensation. While money cannot substitute for the loss of love and companionship that a spouse gives, it can at least provide some help with the bills and, therefore, one less thing to worry about when grieving. But what happens when the insurance company refuses to pay your claim? The following lawsuit in Tangipahoa, Louisiana, discusses these issues in the context of a car accident, uninsured motorist coverage, and the refusal of State Farm to pay the claim. 

As Jerry and his wife Lois Draayer drove down Interstate 55 in Pike County, Mississippi, a motorist struck the couple. Unfortunately, that driver had both crossed the median and lacked sufficient insurance. The underinsured motorist was Russel Allen, and Lois Draayer tragically died from the collision. 

Lois’s family brought a lawsuit against Allen, his automobile liability insurer (Progressive Insurance Company), and named their insurer, State Farm, which they claimed provided Lois with UM coverage. The Draayers added State Farm to the suit to ensure financial recovery for Lois’s death. 

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